Researchers develop an integrated treatment for veterans with chronic pain and posttraumatic stress

Sep 30, 2009

The wars in Iraq and Afghanistan have resulted in a growing number of soldiers evacuated to the United States for comprehensive care for physical and psychological trauma. Given the number of physical injuries often experienced by soldiers, it is not surprising that chronic pain is a frequent problem among returning soldiers from Operation Iraqi Freedom and Operation Enduring Freedom (OIF/OEF).

Common sources of pain are in the head (traumatic-brain injury or post-concussion syndrome), legs (fractures, amputations, burns) and shoulders. Other physical injuries include spinal-cord and eye injuries as well as auditory trauma. In addition, veterans are reporting high rates of issues, including posttraumatic stress disorder (PTSD), depression and alcohol use disorders.

Boston University School of Medicine (BUSM) researchers have developed an integrated treatment program for veterans with comorbid chronic pain and PTSD. This study appeared in the October issue of Pain Medicine.

BUSM researchers found in this pilot study that soldiers have shown great benefit from receiving the integrated treatment for pain and PTSD. BUSM researchers used components of cognitive processing therapy (CPT) for PTSD and (CBT) for chronic pain management. A 12-session integrated treatment for veterans was developed including a therapist manual and patient workbook for weekly readings and homework assignments. Participants received pre and post-treatment evaluations using measures of pain, PTSD, physical disability and psychological distress.

The CBT approach has been shown to be highly effective in treating a range of disorders, from PTSD to chronic pain in children and adults. Using CBT for chronic pain involves challenging maladaptive beliefs and teaching patients' ways of safely reintroducing enjoyable activities into their lives. BUSM researchers used different methods for treating chronic pain and PTSD, including teaching veterans cognitive restructuring, relaxation training, time-based activity pacing so that veterans become more active without overdoing it, and lastly graded homework assignments designed to decrease patients' avoidance of activity and reintroduce a healthy active lifestyle.

"Several themes emerged over the course of implementing the treatment, including the importance of establishing participant trust, regular therapy attendance and addressing participant avoidance," explained lead researcher John D. Otis, PhD an assistant professor of psychiatry and psychology at Boston University School of Medicine and clinical psychologist in the Research Services at the VA Boston Healthcare System. "Participants reported that they liked the format of treatment, appreciated learning about the ways that chronic pain and PTSD share common symptoms and how the two disorders interact with one another," said Otis.

Upon completing the 12-week integrated treatment, several participants no longer met diagnostic criteria for PTSD and reported reductions in symptoms of , and disability.

Source: Boston University Medical Center

Explore further: Religious music brings benefit to seniors' mental health

add to favorites email to friend print save as pdf

Related Stories

PTSD associated with more, longer hospitalizations

Mar 27, 2008

Researchers from Boston University School of Medicine (BUSM) and Boston Medical Center (BMC) have found post-traumatic stress disorder (PTSD) is associated with more hospitalizations, longer hospitalizations and greater mental ...

CBT and BT: Some effect against chronic pain

Apr 15, 2009

Cognitive Behaviour Therapy (CBT) and Behaviour Therapy (BT) show some effect in helping the disability associated with chronic pain, according to a Cochrane Systematic Review. The researchers assessed the use of CBT and ...

Metabolic syndrome a risk for veterans with PTSD

Jan 08, 2009

Veterans with post-traumatic stress disorder (PTSD) are more likely to have metabolic syndrome than veterans without PTSD, according to a study led by Pia Heppner, Ph.D., psychologist with the University of California, San ...

Growing problem for veterans: Domestic violence

Nov 06, 2008

"The increasing number of veterans with posttraumatic stress disorder (PTSD) raises the risk of domestic violence and its consequences on families and children in communities across the United States," says Monica Matthieu, ...

Recommended for you

Religious music brings benefit to seniors' mental health

22 hours ago

A new article published online in The Gerontologist reports that among older Christians, listening to religious music is associated with a decrease in anxiety about death and increases in life satisfaction, self-e ...

User comments : 0

More news stories

Treating depression in Parkinson's patients

A group of scientists from the University of Kentucky College of Medicine and the Sanders-Brown Center on Aging has found interesting new information in a study on depression and neuropsychological function in Parkinson's ...

Airbnb rental site raises $450 mn

Online lodging listings website Airbnb inked a $450 million funding deal with investors led by TPG, a source close to the matter said Friday.

Health care site flagged in Heartbleed review

People with accounts on the enrollment website for President Barack Obama's signature health care law are being told to change their passwords following an administration-wide review of the government's vulnerability to the ...