Addressing Shared Vulnerability for Comorbid PTSD and Chronic Pain: A Cognitive-Behavioral Perspective

Posttraumatic stress disorder (PTSD) frequently co-occurs with other conditions and symptoms that can complicate assessment and treatment. Of these, chronic musculoskeletal pain and related avoidance behaviors are amongst the most common and, unfortunately, the most often overlooked. In this paper we discuss issues that warrant consideration in developing and implementing a treatment plan that may maximize chances of successful outcome for GH, a patient with PTSD and chronic pain. Assessment strategies used in arriving at a case formulation are presented and, based on the emerging state-of-the-art, a tentative cognitive-behavioral treatment program targeting shared vulnerability for PTSD and chronic musculoskeletal pain is presented. Issues pertinent to anticipated treatment outcome are also discussed.