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Studies on associations among pain and <jats:styled-content style=\"fixed-case\">PTSS<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">PTSD<\/jats:styled-content> in youth have largely been conducted in the context of acute injury or trauma. Less is known about the risk for co\u2010occurrence with paediatric chronic pain. In this review, we (1) propose a conceptual framework to outline factors salient during childhood that may be associated with symptom severity, co\u2010occurrence and mutual maintenance, (2) present relevant literature on <jats:styled-content style=\"fixed-case\">PTSS<\/jats:styled-content> in youth with acute and chronic pain and identify research gaps and (3) provide recommendations to guide paediatric research examining shared symptomatology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Databases and data treatment<\/jats:title><jats:p>Electronic databases (PubMed and Google Scholar) were used to identify relevant articles using the search terms \u2018child, adolescent, paediatric, chronic pain, acute pain, post\u2010traumatic stress symptoms and post\u2010traumatic stress disorder\u2019. Studies were retrieved and reviewed based on relevance to the topic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our findings revealed that existing biobehavioural and ecological models of paediatric chronic pain lack attention to traumatic events or the potential development of <jats:styled-content style=\"fixed-case\">PTSS<\/jats:styled-content>. Paediatric studies are also limited by lack of a conceptual framework for understanding the prevalence, risk and trajectories of <jats:styled-content style=\"fixed-case\">PTSS<\/jats:styled-content> in youth with chronic pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our new developmentally informed framework highlights individual symptoms and shared contextual factors that are important when examining potential associations among paediatric chronic pain and <jats:styled-content style=\"fixed-case\">PTSS<\/jats:styled-content>. Future studies should consider bidirectional and mutually maintaining associations, which will be aided by prospective, longitudinal designs.<\/jats:p><\/jats:sec><jats:sec><jats:title>What does this review add?<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n\n<jats:list-item><jats:p>This review presents relevant literature on pain and PTSS in youth and proposes a conceptual framework to examine factors salient during childhood that may be associated with symptom severity, comorbidity and mutual maintenance of chronic pain and PTSS in paediatric populations.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>We highlight dynamic factors that may change across children's development and provide recommendations to guide paediatric research examining potential associations among PTSS and chronic 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