American researchers have recently explore the relationships impacting upon pain and psychological outcomes in war veterans with chronic musculoskeletal pain and comorbid post-traumatic stress disorder (PTSD), comparing these subjects to people with pain alone to determine if veterans with comorbidity respond differently to a stepped-care intervention. 222 people veterans from the Iraq and Afghanistan conflicts were recruited to the study from six Veterans Health Affairs clinics.The subjects had chronic musculoskeletal pain. Pain severity, pain cognitions, and psychological outcomes in veterans with comorbid pain and PTSD were worse when compared with those with pain alone. Analysis of covariance (ANCOVA) modeling change scores from baseline to nine months indicated NO statistically significant differences, controlling for PTSD, for pain severity, pain centrality, or pain self-efficacy, BUT there were significant differences emerged for pain catastrophizing (t = 3.10, P < 0.01), depression (t = 3.39, P < 0.001), and anxiety (t = 3.80, P < 0.001). The interaction between PTSD and the stepped-care intervention was not significant. Veterans with the pain–PTSD comorbidity had worse pain and psychological outcomes than those with chronic pain alone. These findings suggest that those with PTSD experience pain more severely. It would be interesting to explore the implications for others with PTSD arising from other sources. Read more here.