Pain, PTSD, and General Mental Health During the Novel Coronavirus (2019) Pandemic Among those with Chronic Pain and/or PTSD: The Moderating Roles of Coronavirus Impact, Threat, and Experiences

Chronic pain and posttraumatic stress disorder (PTSD) are disorders that disrupt one’s potential life trajectory. Research indicates that among those with chronic pain, 18.9-26.3% have PTSD (Andersen, Andersen, & Andersen, 2014; Ravn, Vaegter, Cardel, & Andersen, 2018), and this comorbidity has been identified as a contributor to adverse outcomes (Andersen et al., 2014). The mutual maintenance model (Sharp & Harvey, 2001) proposes that anxiety sensitivity and negative affect contribute to the comorbidity. Moreover, recent research suggests that past traumatic experiences increases susceptibility to PTSD and depression (Fernandez et al., 2020). Amid a global pandemic, individuals with chronic pain and/or PTSD may be expected to show a decline in physical and mental health. However, this hypothesis has yet to be tested. On March 11, 2020, the World Health Organization (WHO) announced that novel Coronavirus-19 has resulted in a global pandemic. As of June 26, 2020, there have been nearly 10 million confirmed diagnoses worldwide, with 2,367,064 confirmed cases and 121,645 deaths in the U.S. alone (WHO, 2020). Along with the devastating human toll, CV-19 has upended the way Americans engage with their health providers (Smith et al., 2020), potentially impacting their ability to manage their symptoms. Distress associated with the sudden lack of external healthcare resources may be compounded by social isolation status post-quarantine that could significantly worsen coping, diminish self-esteem, disrupt one’s identity, and worsen both pain and trauma symptoms. Collective societal traumas, such as the CV-19 pandemic, force individuals to make meaning out of the events and incorporate novel information into pre-existing cognitive and emotional schemas (Hirschberger, 2018). Individuals with comorbid chronic pain and PTSD, due to their heightened anxiety and negative biases (Sharp & Harvey, 2001), may be particularly susceptible to wholescale changes in their lives. The present study attempts to examine this assertion by implementing a longitudinal cohort study design, whereby PTSD symptoms, pain-related disability, and general mental health were assessed prior to the novel coronavirus pandemic (January, 2019) and during its active phase (May, 2020). The aim of the present work is to determine how the pandemic has impacted general mood symptoms, pain-related disability, and PTSD symptoms during the active phase among individuals with chronic pain, PTSD, and comorbid chronic pain and PTSD. The moderating role of how individuals have been impacted by the coronavirus, how they have been threatened by the coronavirus, and how they have experienced the coronavirus is specifically examined.