Accelerated Resolution Therapy for treatment of pain secondary to symptoms of combat-related posttraumatic stress disorder

Kevin E Kip; Laney Rosenzweig; Diego F Hernandez; Amy Shuman; David M Diamond; Sue Ann Girling; Kelly L Sullivan; Trudy Wittenberg; Ann M Witt; Cecile A Lengacher; Brian Anderson; Susan C McMillan

doi:10.3402/ejpt.v5.24066

Accelerated Resolution Therapy for treatment of pain secondary to symptoms of combat-related posttraumatic stress disorder

Eur J Psychotraumatol. 2014 May 7:5. doi: 10.3402/ejpt.v5.24066. eCollection 2014.

Affiliations

¹ College of Nursing, University of South Florida, Tampa, FL, USA.
² Western New England University, Springfield, MA, USA.
³ Department of Psychology, University of South Florida, Tampa, FL, USA ; Department of Molecular Pharmacology and Physiology, Center for Preclinical/Clinical Research on PTSD, University of South Florida, Tampa, FL, USA.
⁴ Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
⁵ PieWiseLiving, LLC, Tampa, FL, USA.
⁶ Pasco County Veterans Service Office, Port Richey, FL, USA.

Abstract

Background: As many as 70% of veterans with chronic pain treated within the US Veterans Administration (VA) system may have posttraumatic stress disorder (PTSD), and conversely, up to 80% of those with PTSD may have pain. We describe pain experienced by US service members and veterans with symptoms of PTSD, and report on the effect of Accelerated Resolution Therapy (ART), a new, brief exposure-based therapy, on acute pain reduction secondary to treatment of symptoms of PTSD.

Methods: A randomized controlled trial of ART versus an attention control (AC) regimen was conducted among 45 US service members/veterans with symptoms of combat-related PTSD. Participants received a mean of 3.7 sessions of ART.

Results: Mean age was 41.0 + 12.4 years and 20% were female. Most veterans (93%) reported pain. The majority (78%) used descriptive terms indicative of neuropathic pain, with 29% reporting symptoms of a concussion or feeling dazed. Mean pre-/post-change on the Pain Outcomes Questionnaire (POQ) was -16.9±16.6 in the ART group versus -0.7±14.2 in the AC group (p=0.0006). Among POQ subscales, treatment effects with ART were reported for pain intensity (effect size = 1.81, p=0.006), pain-related impairment in mobility (effect size = 0.69, p=0.01), and negative affect (effect size = 1.01, p=0.001).

Conclusions: Veterans with symptoms of combat-related PTSD have a high prevalence of significant pain, including neuropathic pain. Brief treatment of symptoms of combat-related PTSD among veterans by use of ART appears to acutely reduce concomitant pain.

Keywords: PTSD; Psychological trauma; clinical trials; combat; exposure therapy; eye movements; imagery rescripting; pain; prevalence; psychotherapy.