Objective: Evidence supports high rates of co-occurrence of posttraumatic stress disorder (PTSD) and chronic pain disorders involving central sensitization, [perception of pain in the brain] . The nature of this relationship, however, remains relatively unexplored. In this study, we aimed to (1) assess how both trauma exposure and current PTSD symptoms are related to clinical manifestations of central sensitization, and (2) test whether PTSD symptoms explain the relationship between trauma exposure and central sensitization. Because experiential avoidance has been shown to impact the relationship between trauma and health outcomes, we (3) explored experiential avoidance as a possible mediator or moderator of the trauma–central sensitization relationship.
Methods: A sample of 202 adult patients (79% female) with chronic pain completed validated self-report measures of trauma exposure, current PTSD symptoms, experiential avoidance, and 3 manifestations of central sensitization: widespread pain, greater pain severity, and polysomatic symptom reporting. We used path analysis and multivariate regression to assess our study aims.
Results: Both trauma exposure and PTSD symptoms were significantly associated with all 3 clinical indicators of central sensitization. PTSD symptoms partially explained the relationship between trauma exposure and widespread pain, pain intensity, and polysomatic symptoms. Experiential avoidance did not mediate or moderate the trauma–central sensitization relationship.
Conclusions: Our findings suggest that trauma exposure is linked to elevated clinical markers of central sensitization but a critical factor in this relationship is the mediating effect of current PTSD symptoms.