The Journal of Pain Summary
Highlight from The Journal of Pain (Volume 19, No. 7, July 2018 Issue)
Chronic Pain, TBI and PTSD in Military Veterans: A Link to Suicide Ideation and Violent Impulses?
Shannon M. Blakey, H. Ryan Wagner, Jennifer Naylor, Mira Brancu, Ilana Lane, Meghann Sallee, Nathan A. Kimbrel, VA Mid-Atlantic MIRECC Workgroup, Eric B. Elbogen
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Veterans Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
- Durham VA Medical Center, Durham, NC
Half of U.S. military veterans experience chronic pain, and their symptoms often are comorbid with psychiatric conditions, such as depression, substance-abuse disorder and post-traumatic stress disorder (PTSD). Together, chronic pain, PTSD, and traumatic brain injury (TBI) form a polytrauma clinical triad. Previous research indicates that veterans suffering from these disorders in isolation have increased risk for suicide attempts or ideation. Researchers from University of North Carolina and Duke University examined whether the polytrauma triad increases the risk for suicide and violent behavior.
For the study, data from 667 veterans and active-duty personnel were evaluated. Eligible participants reported experiencing consistent pain for at least 7 months to be eligible. Study subjects also reported their lifetime TBI history, and interviews were conducted to diagnose current PTSD.
Results showed the primary hypothesis that the polytrauma triad would be a stronger predictor of suicide and violence risk was only partially supported, but the second hypothesis stating pain-related interference with daily functioning was associated with greater suicide and violence risk was strongly supported by study results.
The authors concluded that the growing prevalence of co-occurring chronic pain, PTSD, and TBI heightens the need for improved assessment and treatment planning in this vulnerable population.
