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. 2023 Jul 27:14:1221762.
doi: 10.3389/fpsyt.2023.1221762. eCollection 2023.

Time doesn't heal all: PTSD symptoms exacerbate the relationship between age and pain intensity

Victoria O'Connor  1   2   3 , Jared A Rowland  1   2   3 , Jennifer C Naylor  2   4   5 , Anna T Magnante  1   2   3 , Katherine M Craig  1   2 , Holly M Miskey  1   2   3 ; VA Mid-Atlantic MIRECC Workgroup; Sarah L Martindale  1   2   3
Collaborators, Affiliations

Time doesn't heal all: PTSD symptoms exacerbate the relationship between age and pain intensity

Victoria O'Connor et al. Front Psychiatry. .

Abstract

Objective: Posttraumatic stress disorder (PTSD) symptoms and pain interfere with daily functioning and quality of life for many combat Veterans. As individuals age, pain symptoms tend to increase whereas PTSD symptoms tend to decrease. PTSD symptoms exacerbate pain, but the nature of this relationship across the aging process is unclear. The purpose of this study was to determine how PTSD symptoms affect the association between age and pain intensity.

Methods: Participants in this cross-sectional study included 450 Veterans (80% male) who served after September 11, 2001. PTSD and pain intensity ratings were assessed by the PTSD Checklist for DSM-5 (PCL-5) and the Brief Pain Inventory (BPI), respectively. Hierarchical multiple linear regression evaluated main and interaction effects between age, PTSD symptoms, and pain intensity.

Results: Age (B = 0.04, p < 0.001) and PTSD symptoms (B = 0.05, p < 0.001) were positively associated with pain intensity. Age and PTSD symptoms were inversely correlated (r = -0.16, p < 0.001). PTSD symptoms exacerbated the relationship between age and pain intensity (ΔR2 = 0.01, p = 0.036). Specifically, when greater PTSD symptoms were reported at older ages, pain intensity was significantly higher.

Conclusion: Results of these analyses suggests that age is important when considering the effects of PTSD symptoms on pain intensity ratings. Specifically, pain intensity ratings are higher in older Veterans with PTSD symptoms. These findings underscore the importance for clinical providers to evaluate trauma history and PTSD symptoms in older Veterans reporting pain symptoms.

Keywords: aging; pain; pain intensity; posttraumatic stress disorder; veterans.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Johnson-Neyman graph illustrating the conditional effect of PTSD on the relationship between age and pain intensity. Johnson-Neyman analysis provides the point of the moderator at which the effect of the independent variable on the dependent variable is significant. In the present sample, the effect of age on pain is significant when PCL-5 scores were above 14.72. Blue shading reflects the region of significance.
Figure 2
Figure 2
Bar graph illustrating average pain intensity at different PTSD symptom severity scores by decade of life. This figure groups age by decade and PCL scores in 10-point increments for illustrative purposes only; continuous age and PCL-5 scores were utilized in analyses. Sample size for age groups: 30–39 (n = 74, 16.44%); 40–49 (n = 127, 28.22%); 50–59 (n = 164, 36.44%); 60–69 (n = 71, 15.78%); 70–79 (n = 14, 3.11%). BPI = Brief Pain Inventory. PCL-5 = PTSD Checklist.
See this image and copyright information in PMC

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