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PTSD perpetuates pain in children with traumatic brain injury

Erin A Brown1, Justin A Kenardy2, Belinda L Dow2

  • 1Centre of National Research on Disability and Rehabilitation Medicine (CONROD), School of Medicine, The University of Queensland, Brisbane, Australia e.brown5@uq.edu.au.

Journal of Pediatric Psychology
|April 15, 2014
PubMed

Insights

In children with traumatic brain injury (TBI), posttraumatic stress disorder (PTSD) symptoms appear to cause physical pain, not the other way around. Addressing PTSD may help speed up recovery from pain.

Area of Science:

  • Neuroscience
  • Pediatric Psychology
  • Trauma Studies

Background:

  • Traumatic brain injury (TBI) in children can lead to complex physical and psychological challenges.
  • The interplay between pain and posttraumatic stress disorder (PTSD) in pediatric TBI populations requires further investigation.
  • Existing theoretical models do not fully explain the relationship between pain and PTSD in this vulnerable group.

Purpose of the Study:

  • To test theoretical models examining the relationship between pain and PTSD in children who have experienced TBI.
  • To determine the directionality of the association between pain and PTSD symptoms following pediatric TBI.
  • To propose a refined model based on empirical findings.

Main Methods:

  • A cohort of 195 children (aged 6-15 years) with mild-severe TBI were assessed at 3, 6, and 18 months post-injury.
  • PTSD symptoms were evaluated using the Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA) via clinical interviews.
  • Physical pain was assessed using the Child Health Questionnaire (CHQ-PF50) through self-report questionnaires.

Main Results:

  • Structural equation modeling supported the mutual maintenance model and the nested perpetual avoidance model.
  • These findings indicate a significant influence of PTSD on the experience of pain in children with TBI.
  • The data did not support a model where pain drives PTSD symptoms.

Conclusions:

  • The results suggest that PTSD is a primary driver of pain in children following TBI.
  • A novel fourth model was proposed, emphasizing the causal role of PTSD in pediatric TBI-related pain.
  • Targeting PTSD symptoms in treatment plans may be crucial for effectively managing and alleviating pain, thereby expediting recovery in pediatric TBI patients.
Abstract

Keywords:
PTSDTBIchildrenmutual maintenancepainperpetual avoidanceposttraumatic stresstraumatic brain injury

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