Pre-treatment pain predicts outcomes in multimodal treatment for tortured and traumatized refugees: A pilot investigation
Nordin, Linda LU and Perrin, Sean LU
(2019)
In European Journal of Psychotraumatology
10(1).
p.1-9
- Abstract
- Background: Chronic pain is a common comorbid complaint in traumatized refugees seeking treatment for posttraumatic stress disorder (PTSD) and depression. However, the effect of comorbid pain on treatment remains under investigated. Objective: To investigate whether pre-treatment pain (severity/interference) predicts outcomes in a multimodal treatment targeting PTSD, depression, anxiety, somatic complaints, and health-related disability in refugees exposed to torture and organized violence. Additional predictors were gender, age, and number of treatment sessions. Method: Participants were active cases at a specialist outpatient clinic for tortured refugees (n = 276; 170 men, 106 women) who were either on a treatment waitlist (mean length =... (More)
- Background: Chronic pain is a common comorbid complaint in traumatized refugees seeking treatment for posttraumatic stress disorder (PTSD) and depression. However, the effect of comorbid pain on treatment remains under investigated. Objective: To investigate whether pre-treatment pain (severity/interference) predicts outcomes in a multimodal treatment targeting PTSD, depression, anxiety, somatic complaints, and health-related disability in refugees exposed to torture and organized violence. Additional predictors were gender, age, and number of treatment sessions. Method: Participants were active cases at a specialist outpatient clinic for tortured refugees (n = 276; 170 men, 106 women) who were either on a treatment waitlist (mean length = 7.4 months, SD = 4.5), in treatment (mean length = 12.2 months, SD = 6.5), or who completed treatment and had (or were waiting for) a follow-up assessment. Participants completed symptom measures at referral, pre- and post-treatment, and 9-month follow-up. Multi-level mixed modelling was used to assess whether outcomes at post-treatment and 9-months were predicted by pain, gender, age, or the number of treatment sessions. Results: Treatment yielded significant pre-to-post-treatment reductions in PTSD, depression, anxiety, and number of pain locations, but no reductions in pain severity/interference, or health-related disability, except for societal participation. Gains for PTSD, depression, and societal participation were maintained at the 9-month follow-up. Higher levels of pain interference (but not severity) predicted poorer outcomes (PTSD, depression, and anxiety). Age, gender and number of treatment sessions did not predict outcomes, except for a small negative effect of (older) age on PTSD. Conclusions: A growing body of literature suggests that pain and PTSD symptoms interact in ways to increase the severity and impact of both disorders in refugee and non-refugee populations alike. The present study suggests interference from pain can lessen the effectiveness of standard multi-modal treatments for refugees. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/7d545359-bbba-4fab-bd7c-8443c13509d6
- author
- Nordin, Linda
LU
and Perrin, Sean
LU
- organization
- publishing date
- 2019-11-11
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Torture Survivors, PTSD, Pain, Treatment prediction
- in
- European Journal of Psychotraumatology
- volume
- 10
- issue
- 1
- pages
- 1 - 9
- publisher
- Taylor & Francis
- external identifiers
-
- scopus:85074998494
- pmid:31762955
- ISSN
- 2000-8066
- DOI
- 10.1080/20008198.2019.1686807
- language
- English
- LU publication?
- yes
- id
- 7d545359-bbba-4fab-bd7c-8443c13509d6
- date added to LUP
- 2019-10-20 21:06:49
- date last changed
- 2022-04-18 18:30:03
@article{7d545359-bbba-4fab-bd7c-8443c13509d6,
abstract = {{Background: Chronic pain is a common comorbid complaint in traumatized refugees seeking treatment for posttraumatic stress disorder (PTSD) and depression. However, the effect of comorbid pain on treatment remains under investigated. Objective: To investigate whether pre-treatment pain (severity/interference) predicts outcomes in a multimodal treatment targeting PTSD, depression, anxiety, somatic complaints, and health-related disability in refugees exposed to torture and organized violence. Additional predictors were gender, age, and number of treatment sessions. Method: Participants were active cases at a specialist outpatient clinic for tortured refugees (n = 276; 170 men, 106 women) who were either on a treatment waitlist (mean length = 7.4 months, SD = 4.5), in treatment (mean length = 12.2 months, SD = 6.5), or who completed treatment and had (or were waiting for) a follow-up assessment. Participants completed symptom measures at referral, pre- and post-treatment, and 9-month follow-up. Multi-level mixed modelling was used to assess whether outcomes at post-treatment and 9-months were predicted by pain, gender, age, or the number of treatment sessions. Results: Treatment yielded significant pre-to-post-treatment reductions in PTSD, depression, anxiety, and number of pain locations, but no reductions in pain severity/interference, or health-related disability, except for societal participation. Gains for PTSD, depression, and societal participation were maintained at the 9-month follow-up. Higher levels of pain interference (but not severity) predicted poorer outcomes (PTSD, depression, and anxiety). Age, gender and number of treatment sessions did not predict outcomes, except for a small negative effect of (older) age on PTSD. Conclusions: A growing body of literature suggests that pain and PTSD symptoms interact in ways to increase the severity and impact of both disorders in refugee and non-refugee populations alike. The present study suggests interference from pain can lessen the effectiveness of standard multi-modal treatments for refugees.}},
author = {{Nordin, Linda and Perrin, Sean}},
issn = {{2000-8066}},
keywords = {{Torture Survivors; PTSD; Pain; Treatment prediction}},
language = {{eng}},
month = {{11}},
number = {{1}},
pages = {{1--9}},
publisher = {{Taylor & Francis}},
series = {{European Journal of Psychotraumatology}},
title = {{Pre-treatment pain predicts outcomes in multimodal treatment for tortured and traumatized refugees: A pilot investigation}},
url = {{https://lup.lub.lu.se/search/files/71995531/Nordin_Perrin_2019_Pre_treatment_pain_predicts_outcomes_in_multimodal_treatment_for_tortured_traumatized_refugees.pdf}},
doi = {{10.1080/20008198.2019.1686807}},
volume = {{10}},
year = {{2019}},
}