Abstract
PURPOSE/OBJECTIVE: Identifying individuals with high levels of pain catastrophizing (PC) may inform early psychological interventions to prevent the transition from acute to chronic post-injury pain. We examined whether pre-and post-injury posttraumatic stress symptoms (PTSS) predict post-injury PC among emergency department (ED) patients following acute motor vehicle crash (MVC). RESEARCH METHOD/DESIGN: This study represents secondary data analysis of a randomized clinical trial (NCT03247179) examining the efficacy of the PTSD Coach app on post-injury PTSS (PTSS(post)). Among 63 injured ED patients (63% female; 57% non-White; average age = 37) with moderate pain (≥4 of 10), we assessed recall of pre-injury PTSS (PTSS(recall): stemming from preexisting exposures) and baseline PC within 24 hr post-MVC; PTSS(post) stemming from the MVC was assessed 30-days later, and the outcome of PC was assessed at 90-days post-injury. We controlled for group assignment (intervention vs. control) in all analyses. RESULTS: Results revealed that at baseline and 90-days, PC was higher among non-White versus White participants. After adjusting for relevant covariates, PTSS(recall) uniquely predicted post-injury PC and each subscale of PC (helplessness, magnification, and rumination). Similarly, after controlling for PTSS(recall) and relevant covariates, PTSS(post) uniquely predicted total and subscale post-injury PC. Intervention group participants reported less rumination than control group participants. CONCLUSIONS/IMPLICATIONS: These novel findings highlight that injured Black patients may be vulnerable to post-injury PC, and that both PTSS(recall) and PTSS(post) significantly predict post-injury PC. Brief PTSS assessment in the ED can identify high-risk patients who may benefit from early intervention. (PsycInfo Database Record (c) 2023 APA, all rights reserved).