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Coexistence of PTSD symptoms and pain : a network analysis in a trauma-exposed sample with mixed chronic pain complaints

Åkerblom, Sophia LU ; Nordin, Linda LU and Zhao, Xiang (2026) In Scandinavian Journal of Pain 26(1).
Abstract

OBJECTIVES: Improving treatment outcomes for comorbid chronic pain and posttraumatic stress disorder (PTSD) requires a better understanding of how these conditions interact.

METHODS: This study examined the co-occurrence and interrelations of PTSD symptoms and chronic pain in a trauma-exposed sample recruited from the Pain Rehabilitation Unit at Skåne University Hospital, Sweden. Using a network analysis approach, data from 136 adults with chronic pain and traumatic exposure were analyzed. All DSM-5 PTSD symptoms were assessed at both item and cluster levels, alongside a comprehensive evaluation of chronic pain-covering severity, interference, and extent-as well as common comorbidities, including depression and... (More)

OBJECTIVES: Improving treatment outcomes for comorbid chronic pain and posttraumatic stress disorder (PTSD) requires a better understanding of how these conditions interact.

METHODS: This study examined the co-occurrence and interrelations of PTSD symptoms and chronic pain in a trauma-exposed sample recruited from the Pain Rehabilitation Unit at Skåne University Hospital, Sweden. Using a network analysis approach, data from 136 adults with chronic pain and traumatic exposure were analyzed. All DSM-5 PTSD symptoms were assessed at both item and cluster levels, alongside a comprehensive evaluation of chronic pain-covering severity, interference, and extent-as well as common comorbidities, including depression and insomnia.

RESULTS: The findings revealed significant interconnections between specific PTSD symptoms, particularly those related to arousal and reactivity, and pain severity. Negative trauma-related emotions and detachment emerged as central nodes in the PTSD-pain network, suggesting that these symptoms may represent important targets for integrated treatment approaches. In contrast, pain extent showed weak or non-significant associations with PTSD symptoms and other pain-related variables.

CONCLUSIONS: Overall, these findings underscore the need to address both PTSD and chronic pain concurrently in clinical interventions to improve outcomes for individuals with these comorbid conditions. Targeting arousal and reactivity symptoms, identified as potential bridges between the two disorders, could be a promising strategy for enhancing treatment effectiveness. Further research is needed to clarify the mechanisms linking PTSD and chronic pain and to inform the development of integrated, tailored interventions for this patient population with complex symptoms.

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Please use this url to cite or link to this publication:
author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Humans, Stress Disorders, Post-Traumatic/epidemiology, Chronic Pain/epidemiology, Female, Male, Adult, Middle Aged, Sweden/epidemiology, Comorbidity, Aged, Pain Measurement
in
Scandinavian Journal of Pain
volume
26
issue
1
publisher
De Gruyter
external identifiers
  • pmid:42161364
  • scopus:105039566281
ISSN
1877-8860
DOI
10.1515/sjpain-2026-0003
language
English
LU publication?
yes
additional info
© 2026 the author(s), published by De Gruyter, Berlin/Boston.
id
a39290c8-ce69-41f3-bed5-6f8f4a502c51
date added to LUP
2026-08-14 16:58:19
date last changed
2026-09-12 05:47:01
@article{a39290c8-ce69-41f3-bed5-6f8f4a502c51,
  abstract     = {{<p>OBJECTIVES: Improving treatment outcomes for comorbid chronic pain and posttraumatic stress disorder (PTSD) requires a better understanding of how these conditions interact.</p><p>METHODS: This study examined the co-occurrence and interrelations of PTSD symptoms and chronic pain in a trauma-exposed sample recruited from the Pain Rehabilitation Unit at Skåne University Hospital, Sweden. Using a network analysis approach, data from 136 adults with chronic pain and traumatic exposure were analyzed. All DSM-5 PTSD symptoms were assessed at both item and cluster levels, alongside a comprehensive evaluation of chronic pain-covering severity, interference, and extent-as well as common comorbidities, including depression and insomnia.</p><p>RESULTS: The findings revealed significant interconnections between specific PTSD symptoms, particularly those related to arousal and reactivity, and pain severity. Negative trauma-related emotions and detachment emerged as central nodes in the PTSD-pain network, suggesting that these symptoms may represent important targets for integrated treatment approaches. In contrast, pain extent showed weak or non-significant associations with PTSD symptoms and other pain-related variables.</p><p>CONCLUSIONS: Overall, these findings underscore the need to address both PTSD and chronic pain concurrently in clinical interventions to improve outcomes for individuals with these comorbid conditions. Targeting arousal and reactivity symptoms, identified as potential bridges between the two disorders, could be a promising strategy for enhancing treatment effectiveness. Further research is needed to clarify the mechanisms linking PTSD and chronic pain and to inform the development of integrated, tailored interventions for this patient population with complex symptoms.</p>}},
  author       = {{Åkerblom, Sophia and Nordin, Linda and Zhao, Xiang}},
  issn         = {{1877-8860}},
  keywords     = {{Humans; Stress Disorders, Post-Traumatic/epidemiology; Chronic Pain/epidemiology; Female; Male; Adult; Middle Aged; Sweden/epidemiology; Comorbidity; Aged; Pain Measurement}},
  language     = {{eng}},
  month        = {{01}},
  number       = {{1}},
  publisher    = {{De Gruyter}},
  series       = {{Scandinavian Journal of Pain}},
  title        = {{Coexistence of PTSD symptoms and pain : a network analysis in a trauma-exposed sample with mixed chronic pain complaints}},
  url          = {{http://dx.doi.org/10.1515/sjpain-2026-0003}},
  doi          = {{10.1515/sjpain-2026-0003}},
  volume       = {{26}},
  year         = {{2026}},
}