Associations between PTSD symptom clusters and multi-region pain in young adults with chronic pain.

Posttraumatic stress disorder (PTSD) symptoms are positively associated with multi-region pain, which is linked to greater disease burden than localized pain. Little is known about these relationships in young adults nor the role of specific PTSD symptom clusters. We examined whether pain symptoms differed by multi-region pain status and whether PTSD symptom clusters were associated with increased odds of multi-region (vs. more localized) pain among young adults with chronic pain. Young adults with chronic pain (N = 123; Mage = 19.0, 71.5% White, 70.7% female) completed baseline measures as part of a larger study. Multi-region pain (≥ five regions) was assessed using the Michigan Body Map. Mann-Whitney U and independent t-tests were used to compare pain severity and pain interference by multi-region pain status. Separate logistic regressions adjusting for gender examined whether PTSD symptoms (total and clusters) were associated with odds of multi-region pain. Participants with multi-region pain reported significantly greater pain severity (M = 5.6 vs. 4.8) and pain interference (Mdn = 57 vs. 32.5) than those with more localized pain (ps < .05). Total PTSD symptoms and all four symptom clusters were each significantly, positively associated with odds of experiencing multi-region pain. When all clusters were entered simultaneously with gender as a covariate, only hyperarousal symptoms were significantly associated with odds of multi-region pain, OR = 1.13, 95% CI [1.01, 1.27]. These results implicate hyperarousal as a potential intervention target for treatment of multi-region pain. Future longitudinal research is warranted to identify mechanisms and elucidate the directionality of these relationships.