Disaggregating the relationship between posttraumatic stress disorder symptom clusters and chronic orofacial pain: Implications for the prediction of health outcomes with PTSD symptom clusters

Background: Research has established a significant relationship between posttraumatic stress disorder (PTSD) symptoms and pain; however, very little research has examined the differential role of PTSD symptom clusters on pain outcomes. Purpose: (a) To confirm the most appropriate PTSD symptom factor structure for an orofacial pain population and (b) to test a model of prediction of pain outcomes with PTSD symptom clusters. Methods: The study was a cross-sectional, retrospective case series of 411 female patients with orofacial pain (mean 41.0 years, SD 13.1). A series of structural equation modeling analyses were conducted to examine five competing models of PTSD symptom clusters. Results: Two four-factor models of PTSD symptom clusters fit the data reasonably well, and differing PTSD symptom clusters predicted different components of pain. Conclusions: To increase predictive utility for pain and for a wide range of health disorders, researchers should examine the unique predictive power of PTSD symptom clusters rather than examining a one-factor model of PTSD symptoms.