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The Explanatory Role of Insomnia in the Relationship between Pain Intensity and Posttraumatic Stress Symptom Severity among Trauma-Exposed Latinos in a Federally Qualified Health Center

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Abstract

Latinos, one of the fastest growing populations in the United States, suffer from high rates of posttraumatic stress symptoms (PTS) and its clinical correlates (e.g., disability). Although research suggests the experience of pain is closely related to PTS among trauma-exposed groups, there has been little exploration of the processes that may link pain intensity to greater PTS among trauma-exposed Latinos. The current study explored insomnia, a common problem associated with both pain intensity and PTS, as a mechanism in the association between pain intensity and PTS among trauma-exposed Latinos (N = 208, Mage = 39.39 years, SD = 11.48) attending a Federally Qualified Health Center. Results indicated that insomnia partially explained the relationship between pain intensity and PTS total score (B = 0.25, 95% CI [0.12, 0.43]), as well as re-experiencing (B = 0.09, 95% CI [0.04, 0.17]), avoidance (B = 0.09, 95% CI [0.04, 0.17]), and arousal symptoms (B = 0.10, 95% CI [0.04, 0.17]). Future work is needed to explore the extent to which insomnia accounts for relations between pain and PTS using longitudinal designs to further clarify theoretical health disparity models involving these comorbid conditions.

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Notes

  1. Since PDS Arousal subscale includes item specific to insomnia symptoms, the analyses were run without the insomnia item included [25]. Comparing the model with the insomnia item and without the insomnia item yielded the same results. Therefore, the reported results include the validated PDS Arousal subscale.

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Authors and Affiliations

  1. Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX, 77204, USA

    Andrew H. Rogers, Jafar Bakhshaie, Andres G. Viana, Nubia A. Mayorga & Michael J. Zvolensky

  2. Legacy Community Health Center, Houston, TX, USA

    Chad Lemaire, Monica Garza & Melissa Ochoa-Perez

  3. Department of Psychology, Syracuse University, Syracuse, NY, USA

    Joseph W. Ditre

  4. Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Michael J. Zvolensky

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Rogers, A.H., Bakhshaie, J., Viana, A.G. et al. The Explanatory Role of Insomnia in the Relationship between Pain Intensity and Posttraumatic Stress Symptom Severity among Trauma-Exposed Latinos in a Federally Qualified Health Center. J. Racial and Ethnic Health Disparities 5, 1389–1396 (2018). https://doi.org/10.1007/s40615-018-0489-7

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