Chronic pain acceptance incrementally predicts disability in polytrauma-exposed veterans at baseline and 1-year follow-up

被引:23
作者
Cook, Andrew J. [1 ,2 ,3 ]
Meyer, Eric C. [1 ,2 ,3 ]
Evans, Lianna D. [1 ,2 ]
Vowles, Kevin E. [4 ]
Klocek, John W. [5 ]
Kimbrel, Nathan A. [6 ,7 ,8 ]
Gulliver, Suzy Bird [3 ,9 ]
Morissette, Sandra B. [1 ,2 ,3 ]
机构
[1] VISN 17 Ctr Excellence Res Returning War Vet, Dept Vet Affairs, Waco, TX USA
[2] Cent Texas Vet Hlth Care Syst, Temple, TX USA
[3] Texas A&M Hlth Sci Ctr, Coll Med, Temple, TX USA
[4] Univ New Mexico, Dept Psychol, Albuquerque, NM 87131 USA
[5] Baylor Univ, Dept Psychol & Neurosci, Waco, TX 76798 USA
[6] Durham VA Med Ctr, Durham, NC USA
[7] VA Midatlantic Mental Illness Res Educ & Clin Ctr, Durham, NC USA
[8] Duke Univ, Med Ctr, Dept Psychiat & Behav Sci, Durham, NC USA
[9] Baylor Scott & White Healthcare Syst, Warriors Res Inst, Waco, TX USA
关键词
Chronic pain; Acceptance; Functioning; Disability; Posttraumatic stress disorder; Veterans; POSTTRAUMATIC-STRESS-DISORDER; TRAUMATIC BRAIN-INJURY; COMORBID CHRONIC PAIN; VALUES-BASED ACTION; COMMITMENT THERAPY; OIF/OEF VETERANS; MENTAL-HEALTH; PRIMARY-CARE; PREVALENCE; PTSD;
D O I
10.1016/j.brat.2015.07.003
中图分类号
B849 [应用心理学];
学科分类号
040203 ;
摘要
War veterans are at increased risk for chronic pain and co-occurring neurobehavioral problems, including posttraumatic stress disorder (PTSD), depression, alcohol-related problems, and mild traumatic brain injury (mTBI). Each condition is associated with disability, particularly when co-occurring. Pain acceptance is a strong predictor of lower levels of disability in chronic pain. This study examined whether acceptance of pain predicted current and future disability beyond the effects of these co-occurring conditions in war veterans. Eighty trauma-exposed veterans with chronic pain completed a PTSD diagnostic interview, clinician-administered mTBI screening, and self-report measures of disability, pain acceptance, depression, and alcohol use. Hierarchical regression-models showed pain acceptance to be incrementally associated with disability after accounting for symptoms of PTSD, depression, alcohol-related problems, and mTBI (total adjusted R-2 =.57, p <.001, Delta R-2 =.03, p =.02). At 1-year follow-up, the total variance in disability accounted for by the model decreased (total adjusted R-2 =.29, p <.001), whereas the unique contribution of pain acceptance increased (Delta R-2 =.07, p =.008). Pain acceptance remained significantly associated with 1-year disability when pain severity was included in the model. Future research should evaluate treatments that address chronic pain acceptance and co-occurring conditions to promote functional recovery in the context of polytrauma in war veterans. Published by Elsevier Ltd.
引用
收藏
页码:25 / 32
页数:8
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