Abstract
Manualized treatments have become popular, despite concern about their use when comorbid diagnoses are present. In this report, the efficacy of manualized posttraumatic stress disorder (PTSD) treatment was examined in the presence of chronic pain. Additionally, the effect of PTSD treatment on chronic pain and additional psychiatric diagnoses was explored. Six female patients with both PTSD and chronic pain following motor vehicle accidents were treated for PTSD using a multiple baseline design. The results indicate that manualized treatment for PTSD was effective in reducing PTSD symptoms in these patients. Although there were no changes in subjective pain, there were pain-related functional improvements and reductions in other psychiatric diagnoses for the majority of patients.
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References
Blake, D. D., Weathers, F. W., Nagy, L. M., Kaloupek, D. G., Gusman, F. D., Charney, D. S., et al. (1990). A clinician rating scale for assessing current and lifetime PTSD: The CAPS-1. Behaviour Research and Therapy, 13, 187–188.
Blanchard, E. B., & Hickling, E. J. (1997). After the crash: Assessment and treatment of motor vehicle accident survivors. Washington, DC: American Psychological Association.
Blanchard, E. B., Hickling, E. J., Devineni, T., Veazey, C. H., Galovski, T. E., Mundy, E., Malta, L. S., & Buckley, T. C. (2003). A controlled evaluation of cognitive behavioral therapy for posttraumatic stress in motor vehicle accident survivors. Behaviour Research and Therapy, 41, 79–96.
Brady, K. T., Killeen, T. K., Brewerton, T., & Lucerini, S. (2000). Comorbidity of psychiatric disorders and Posttraumatic Stress Disorder. Journal of Clinical Psychiatry, 61(Suppl. 7), 22–32.
Bryant, R. A., Marosszeky, J. E., Crooks, J., Baguley, I. J., & Gurka, J. A. (1999). Interaction of posttraumatic stress disorder and chronic pain following traumatic brain injury. Journal of Head Trauma Rehabilitation, 14, 588–594
DiNardo, P., Brown, T., & Barlow, D. (1994). Anxiety disorders interview schedule for DSM-IV. Albany, NY: Greywind.
DiNardo, P., Moras, K., Barlow, D., Rapee, R., & Brown, T. (1993). Reliability of DSM-III-R anxiety disorder category. Archives of General Psychiatry, 50, 251–256.
Dworkin, R. H., Hartstein, G., Rosner, H. L., Walther, R. R., Sweeney, E. W., & Brand, L. (1992). A high-risk method for studying psychosocial antecedents of chronic pain: The prospective investigation of herpes zoster. Journal of Abnormal Psychology, 101, 200–205.
Fairbank, J. C. T., Couper, J., Davies, J., & O'Brien, J. (1980). The Oswestry Low Back Pain Disability Questionnaire. Physiotherapy, 66, 271–273.
Geisser, M. E., Roth, R. S., Bachman, J. E., & Eckert, T. A. (1996). The relationship between symptoms of post-traumatic stress disorder and pain, affective disturbance and disability among patients with accident and non-accident related pain. Pain, 66, 207–214.
Hayes, S. C., Barlow, D. H., & Nelson-Gray, R. O. (1999). The scientist practitioner: Research and accountability in clinical and educational settings. Needham Heights, MA: Allyn and Bacon.
Hickling, E. J., Blanchard, E. B., Silverman, D. J., & Schwartz, P. (1992). Motor vehicle accidents, headaches and post-traumatic stress disorder: Assessment findings in a consecutive series. Headache, 32, 147–151.
Horowitz, M., Wilner, N., & Alvarez, W. (1979). Impact of Event Scale: A measure of subjective stress. Psychosomatic Medicine, 41, 209–218.
International Association for the Study of Pain. (1986). Classification of chronic pain. Pain (suppl. 3), S1-S226.
Kerns, R. D., Turk, D. C., & Rudy, T. E. (1985). The West Haven Yale Multidimensional Pain Inventory (WHYMPI). Pain, 23, 345–356.
Kuch, K., Cox, B. J., & Evans, R. J. (1996). Posttraumatic stress disorder and motor vehicle accidents: A multidisciplinary overview. Canadian Journal of Psychiatry, 41, 429–434.
Mueser, K. T., Yarnold, P. R., & Foy, D. W. (1991). Statistical analysis for single-case designs: Evaluating outcome of imaginal exposure treatment of chronic PTSD. Behavior Modification, 15, 134–155.
Sharp, T. J., & Harvey, A. G. (2001). Chronic pain and posttraumatic stress disorder: Mutual maintenance? Clinical Psychology Review, 21, 857–877.
Shipherd, J. C., Beck, J. G., Hamblen, J. L., & Freeman, J. B. (2000). Assessment and treatment of PTSD in motor vehicle accident survivors. In L. VandeCreek & T. L. Jackson (Eds.), Innovations in clinical practice: A source book (Vol. 18, pp. 135–152). Sarasota, FL: Professional Resource Press.
Wallis, B. J., Lord, S. M., & Bogduk, N. (1997). Resolution of psychological distress of whiplash patients following treatment by radiofrequency neurotomy: A randomized, double-blind, placebo-controlled trial. Pain, 73, 15–22.
Weathers, F. W., Keane, T. M., & Davidson, J. R. T. (2001). Clinician-administered PTSD scale: A review of the first ten years of research. Depression and Anxiety, 13, 132–156.
Zilberg, N. J., Weiss, D. S., & Horowitz, M. J. (1982). Impact of event scale: A cross-validation study and some empirical evidence supporting a conceptual model of stress response syndromes. Journal of Consulting and Clinical Psychology%, 50, 407–414.
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Shipherd, J.C., Beck, J.G., Hamblen, J.L. et al. A Preliminary Examination of Treatment for Posttraumatic Stress Disorder in Chronic Pain Patients: A Case Study. J Trauma Stress 16, 451–457 (2003). https://doi.org/10.1023/A:1025754310462
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DOI: https://doi.org/10.1023/A:1025754310462