The Association between Pain Trajectories with PTSD, Depression, and Disability During the Acute Post Trauma Period.

Objective Exposure to a traumatic event is common among US adults, yet only a small fraction develops post-traumatic stress disorder (PTSD). Higher pain after a traumatic injury has been associated with higher PTSD symptomology and thus may be a risk factor. However, few studies have examined how pain during the period immediately after a trauma, referred to as the acute post trauma period, relates to later to PTSD outcomes. Methods A sample of (n = 87) individuals who had experienced a traumatic injury assessed their pain through daily mobile assessments for the first month after injury. PTSD, depression, and functional impairment were assessed at time of trauma and 1, and 3 months later. Results Using latent class growth analysis (LCGA), three trajectories of pain were identified: low pain (41.3%), decreasing pain (43.7%), and high pain (14.9%). At baseline, the high pain class reported higher levels of depression and functional impairment than the low pain group. From baseline to 3 months, the low pain class experienced a reduction in PTSD, depression, and functional impairment whereas the high pain class experienced an increase in PTSD symptoms, and persistent depression, and functional impairment. Conclusions These results demonstrate that there are distinct trajectories of pain after a traumatic injury. Persistent elevated pain is associated with more severe psychopathology in the period immediately following a traumatic injury.