Predictors of Posttraumatic Stress Disorder in Chronic Low Back Pain Patients

Abstract

The present study investigated the predictors of posttraumatic stress disorder (PTSD) symptom severity level in patients with chronic low back pain (CLBP). Research questions focused on whether or not patients with CLBP would evidence clinically-significant levels of PTSD, whether or not the intensity and duration of the trauma would predict PTSD symptoms, and whether or not the age of the patient and perceived uncontrollability would positively predict PTSD symptom severity level. Participants included 161 patients receiving treatment for their CLBP from several Southern California chronic pain clinics, as well as major Southern California chiropractic facilities. Data was gathered through selfreport measures for perceived pain severity, traumatic experiences, locus of control, and PTSD. Participants were placed into one of the following groups: (1) Pain Only, No Trauma, (2) Pain w/ Non-Back-Related Trauma, (3) Pain w/Back-Related Trauma, or (4) Pain w/ Combined Trauma. Results indicated that approximately 51 % of the patients in the CLBP sample evidenced clinically-significant levels of posttraumatic stress disorder symptoms. In the groups, between 25% and 77% of patients reported clinically-significant PTSD symptoms. Patients with pain and combined trauma exhibited the highest levels of PTSD symptoms in comparison to the other groups. These individuals also evidenced more: pain severity, severe diagnoses, back surgeries, treatments for their CLBP, perceived uncontrollability (external locus of control), and numerous other negative life events. Moreover, age and perceived uncontrollability positively predicted PTSD symptom severity level across all of the groups. Further, pain alone may be a sufficient trauma to predict PTSD symptoms in this population. The present study established links between a number of predictors, and a preliminary model was subsequently devised for predictors of PTSD symptom severity level in patients with CLBP. A paucity of research still remains for considering the relationship between CLBP and PTSD. The present study ascertained that both the nature of the trauma, as well as person characteristics must be considered in the assessment, diagnosis, and treatment of patients with CLBP. In addressing all possible predictors, clinicians may promote greater healing at all levels for patients with chronic low back pain