1 - (SYM 112) Posttraumatic Stress and Dissociative Symptoms Are Differentially Associated with Pain Sensitivity

About 20% of individuals in the United States have chronic pain (Dahlhamer et al., 2018), which is linked to a history of trauma exposure (Afari et al., 2014).  Heightened sensitivity to pain stimuli may partly convey the association between trauma exposure and pain outcomes.  However, previous findings have been mixed on the association between traumatic exposure and pain sensitivity.  Previous research suggests that trauma sequelae (i.e., hyperreactivity and dissociation) may be differentially associated with heightened sensitivity to pain (Defrin et al., 2015; Tesarz et al., 2020).  The present study aimed to replicate and extend prior research by evaluating the association between posttraumatic stress symptoms (PTSS) and dissociation on pressure pain sensitivity and temporal summation in a mixed pain, mixed trauma sample.  Michigan Medicine patients between the ages of 18 and 65 completed measures of trauma exposure, trauma sequelae and an experimental session assessing pressure pain sensitivity and temporal summation.  Preliminary data from 94 participants (M_age=44.5, SD=13.0; 76.6% Women; 83.0% White) were analyzed.  About half (53.2%) reported chronic pain.  PTSS (M_PCL5=12.6, SD=13.1) and dissociative symptoms were low (M_MDI=38.4, SD=10.1).  Compared to those without chronic pain, individuals with chronic pain reported more PTSS (p=.005).  Group differences in overall dissociation scores were nonsignificant; however, individuals with chronic pain reported significantly higher depersonalization scores (p = .040) and marginally higher disengagement scores (p = .054).  Among individuals with chronic pain, temporal summation was positively associated with posttraumatic stress symptoms (r=.34, p =.018) and depersonalization (r=.29, p = .04). Overall dissociation scores were marginally negatively associated with pressure pain threshold (r=-.24, p=.091 [higher sensitivity]).  Among individuals without chronic pain, depersonalization (r=.25, p=.097) and emotional constriction (r=.25, p=.099) were positively associated with pressure pain threshold [lower sensitivity].   The findings suggest that among individuals with chronic pain, posttraumatic stress symptoms and dimensions of dissociation may be linked to dynamic, centralized alterations in pain processing as well as hypersensitivity to pain stimuli.  Among those without chronic pain, dissociative symptoms may be associated with hyporesponsivity to pain stimuli.  These findings have potentially important implications for trauma assessment and treatment.