Trauma-related guilt and pain among veterans with PTSD

Despite the well-known co-occurrence of posttraumatic stress disorder (PTSD) and chronic pain, large gaps remain in understanding how these two conditions influence each other. The aim of the present study was to examine the association between trauma-related guilt and pain among veterans with PTSD. Participants were 140 veterans enrolling in treatment for PTSD and alcohol use disorder. Trauma-related guilt was assessed by the trauma-related guilt inventory, including the global guilt, distress, and guilt cognitions scales. Measures of pain included pain severity, pain disability, and fear of pain. Several significant bivariate associations were observed between trauma-related guilt scales and pain outcomes; however, in linear regression models, only the association between thoughts of trauma-related guilt and fear of pain remained statistically significant after controlling for confounding factors. Further, thoughts of trauma-related guilt, specifically thoughts of wrongdoing, partially mediated the association between PTSD severity and fear of pain. Our findings suggest that trauma-related guilt may play a role in the relationship between PTSD and chronic pain. Future research is encouraged to examine thoughts of trauma-related guilt as a potential therapeutic target in the treatment of persons with comorbid PTSD and chronic pain.