Chronic pain acceptance incrementally predicts disability in polytrauma-exposed veterans at baseline and 1-year follow-up.

Journal Article (Journal Article)

War veterans are at increased risk for chronic pain and co-occurring neurobehavioral problems, including posttraumatic stress disorder (PTSD), depression, alcohol-related problems, and mild traumatic brain injury (mTBI). Each condition is associated with disability, particularly when co-occurring. Pain acceptance is a strong predictor of lower levels of disability in chronic pain. This study examined whether acceptance of pain predicted current and future disability beyond the effects of these co-occurring conditions in war veterans. Eighty trauma-exposed veterans with chronic pain completed a PTSD diagnostic interview, clinician-administered mTBI screening, and self-report measures of disability, pain acceptance, depression, and alcohol use. Hierarchical regression models showed pain acceptance to be incrementally associated with disability after accounting for symptoms of PTSD, depression, alcohol-related problems, and mTBI (total adjusted R(2) = .57, p < .001, ΔR(2) = .03, p = .02). At 1-year follow-up, the total variance in disability accounted for by the model decreased (total adjusted R(2) = .29, p < .001), whereas the unique contribution of pain acceptance increased (ΔR(2) = .07, p = .008). Pain acceptance remained significantly associated with 1-year disability when pain severity was included in the model. Future research should evaluate treatments that address chronic pain acceptance and co-occurring conditions to promote functional recovery in the context of polytrauma in war veterans.

Full Text

Duke Authors

Cited Authors

  • Cook, AJ; Meyer, EC; Evans, LD; Vowles, KE; Klocek, JW; Kimbrel, NA; Gulliver, SB; Morissette, SB

Published Date

  • October 2015

Published In

Volume / Issue

  • 73 /

Start / End Page

  • 25 - 32

PubMed ID

  • 26233854

Pubmed Central ID

  • PMC5032639

Electronic International Standard Serial Number (EISSN)

  • 1873-622X

Digital Object Identifier (DOI)

  • 10.1016/j.brat.2015.07.003


  • eng

Conference Location

  • England