{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T00:47:44Z","timestamp":1790988464833,"version":"4.1.0"},"reference-count":40,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,12,19]],"date-time":"2026-12-19T00:00:00Z","timestamp":1797638400000},"content-version":"am","delay-in-days":352,"URL":"http:\/\/www.elsevier.com\/open-access\/userlicense\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["3K23HD104934"],"award-info":[{"award-number":["3K23HD104934"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001230","name":"Macquarie University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001230","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jpain.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Pain"],"published-print":{"date-parts":[[2026,1]]},"DOI":"10.1016\/j.jpain.2025.105589","type":"journal-article","created":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T02:58:16Z","timestamp":1762570696000},"page":"105589","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":4,"special_numbering":"C","title":["PTSD and chronic pain: A systematic review and meta-analysis of mediation studies"],"prefix":"10.1016","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-0958-0802","authenticated-orcid":false,"given":"Scott G.","family":"Ravyts","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8413-6098","authenticated-orcid":false,"given":"Ryan","family":"Hall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1205-570X","authenticated-orcid":false,"given":"Drew","family":"Vandine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"Woods","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Harris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Dudeney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2182-8566","authenticated-orcid":false,"given":"Rachel V.","family":"Aaron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jpain.2025.105589_bib1","doi-asserted-by":"crossref","DOI":"10.3389\/fpsyt.2017.00164","article-title":"Prevalence of posttraumatic stress disorder in persons with chronic pain: a meta-analysis","volume":"8","author":"Siqveland","year":"2017","journal-title":"Front Psychiatry"},{"issue":"4","key":"10.1016\/j.jpain.2025.105589_bib2","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1093\/pm\/pnw065","article-title":"Chronic pain types differ in their reported prevalence of post-traumatic stress disorder (PTSD) and there is consistent evidence that chronic pain is associated with PTSD: an evidence-based structured systematic review","volume":"18","author":"Fishbain","year":"2017","journal-title":"Pain Med"},{"issue":"11-12","key":"10.1016\/j.jpain.2025.105589_bib3","doi-asserted-by":"crossref","first-page":"2303","DOI":"10.1093\/milmed\/usae313","article-title":"Comorbid chronic pain and post-traumatic stress disorder: current rates and psychiatric comorbidities among U.S. Military Veterans","volume":"189","author":"Hadlandsmyth","year":"2024","journal-title":"Mil Med"},{"issue":"5","key":"10.1016\/j.jpain.2025.105589_bib4","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1016\/j.jpain.2017.12.262","article-title":"Number and type of post-traumatic stress disorder symptom domains are associated with patient-reported outcomes in patients with chronic pain","volume":"19","author":"Langford","year":"2018","journal-title":"J Pain"},{"issue":"17","key":"10.1016\/j.jpain.2025.105589_bib5","doi-asserted-by":"crossref","first-page":"1220","DOI":"10.1097\/BRS.0000000000003053","article-title":"Post-traumatic stress disorder symptoms are associated with incident chronic back pain: a longitudinal twin study of older male veterans","volume":"44","author":"Suri","year":"2019","journal-title":"Spine"},{"issue":"5","key":"10.1016\/j.jpain.2025.105589_bib6","article-title":"Co-occurrence of posttraumatic stress symptoms, pain, and disability 12 months after traumatic injury","volume":"2","author":"Giummarra","year":"2017","journal-title":"PAIN Rep"},{"issue":"1","key":"10.1016\/j.jpain.2025.105589_bib7","doi-asserted-by":"crossref","first-page":"5652","DOI":"10.3402\/ejpt.v2i0.5652","article-title":"Predicting posttraumatic stress disorder symptoms and pain intensity following severe injury: the role of catastrophizing","volume":"2","author":"Carty","year":"2011","journal-title":"Eur J Psychotraumatol."},{"issue":"6","key":"10.1016\/j.jpain.2025.105589_bib8","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1016\/S0272-7358(00)00071-4","article-title":"Chronic pain and posttraumatic stress disorder: mutual maintenance?","volume":"21","author":"Sharp","year":"2001","journal-title":"Clin Psychol Rev"},{"issue":"1","key":"10.1016\/j.jpain.2025.105589_bib9","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.cbpra.2005.03.001","article-title":"Addressing shared vulnerability for comorbid PTSD and chronic pain: a cognitive-behavioral perspective","volume":"13","author":"Asmundson","year":"2006","journal-title":"Cogn Behav Pr"},{"issue":"7","key":"10.1016\/j.jpain.2025.105589_bib10","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1017\/S0033291709991310","article-title":"Support for the mutual maintenance of pain and post-traumatic stress disorder symptoms","volume":"40","author":"Liedl","year":"2010","journal-title":"Psychol Med"},{"issue":"2","key":"10.1016\/j.jpain.2025.105589_bib11","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/j.pain.2008.01.001","article-title":"An examination of the synergy of pain and PTSD on quality of life: additive or multiplicative effects?","volume":"138","author":"Clapp","year":"2008","journal-title":"PAIN"},{"issue":"4","key":"10.1016\/j.jpain.2025.105589_bib12","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1080\/03637750903310360","article-title":"Beyond Baron and Kenny: statistical mediation analysis in the new millennium","volume":"76","author":"Hayes","year":"2009","journal-title":"Commun Monogr"},{"issue":"3","key":"10.1016\/j.jpain.2025.105589_bib13","first-page":"2009","article-title":"Posttraumatic stress disorder symptoms and chronic orofacial pain: an empirical examination of the mutual maintenance model","volume":"23","author":"Burris","year":"2025","journal-title":"J Orofac Pain"},{"issue":"6","key":"10.1016\/j.jpain.2025.105589_bib14","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1097\/AJP.0000000000000561","article-title":"The relationship between posttraumatic stress disorder and chronic pain in people seeking treatment for chronic pain: the mediating role of psychological flexibility","volume":"34","author":"\u00c5kerblom","year":"2018","journal-title":"Clin J Pain"},{"issue":"4","key":"10.1016\/j.jpain.2025.105589_bib15","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1097\/AJP.0000000000000543","article-title":"Increased pain sensitivity in accident-related chronic pain patients with comorbid posttraumatic stress","volume":"34","author":"Vaegter","year":"2018","journal-title":"Clin J Pain"},{"issue":"4","key":"10.1016\/j.jpain.2025.105589_bib16","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1016\/j.pain.2013.01.001","article-title":"The relationship between PTSD and chronic pain: mediating role of coping strategies and depression","volume":"154","author":"Morasco","year":"2013","journal-title":"Pain"},{"key":"10.1016\/j.jpain.2025.105589_bib17","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"issue":"5","key":"10.1016\/j.jpain.2025.105589_bib18","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1016\/j.berh.2013.10.001","article-title":"Why and how back pain interventions work: what can we do to find out?","volume":"27","author":"Mansell","year":"2013","journal-title":"Best Pr Res Clin Rheuma"},{"issue":"6","key":"10.1016\/j.jpain.2025.105589_bib19","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1097\/j.pain.0000000000000146","article-title":"How does pain lead to disability? A systematic review and meta-analysis of mediation studies in people with back and neck pain","volume":"156","author":"Lee","year":"2015","journal-title":"PAIN"},{"issue":"6","key":"10.1016\/j.jpain.2025.105589_bib20","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1097\/AJP.0000000000000697","article-title":"Sleep and pain: a systematic review of studies of mediation","volume":"35","author":"Whibley","year":"2019","journal-title":"Clin J Pain"},{"issue":"3","key":"10.1016\/j.jpain.2025.105589_bib21","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1002\/jrsm.1240","article-title":"Power analysis for random-effects meta-analysis","volume":"8","author":"Jackson","year":"2017","journal-title":"Res Synth Methods"},{"issue":"5","key":"10.1016\/j.jpain.2025.105589_bib22","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1097\/01.MLR.0000062554.74615.4C","article-title":"Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation","volume":"41","author":"Norman","year":"2003","journal-title":"Med Care"},{"key":"10.1016\/j.jpain.2025.105589_bib23","unstructured":"Higgins J.P. Cochrane handbook for systematic reviews of interventions. Version 5.1. 0 [updated March 2011]. The Cochrane Collaboration. Www Cochrane-Handb Org. Published online 2011."},{"issue":"7109","key":"10.1016\/j.jpain.2025.105589_bib24","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1136\/bmj.315.7109.629","article-title":"Bias in meta-analysis detected by a simple, graphical test","volume":"315","author":"Egger","year":"1997","journal-title":"bmj"},{"issue":"2","key":"10.1016\/j.jpain.2025.105589_bib25","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1111\/j.0006-341X.2000.00455.x","article-title":"Trim and fill: a simple funnel-plot\u2013based method of testing and adjusting for publication bias in meta-analysis","volume":"56","author":"Duval","year":"2000","journal-title":"Biometrics"},{"key":"10.1016\/j.jpain.2025.105589_bib26","article-title":"Comprehensive Meta-Analysis Version 4","author":"Bornstein","year":"2022","journal-title":"Biostat"},{"issue":"1","key":"10.1016\/j.jpain.2025.105589_bib27","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1177\/1359105320947819","article-title":"Association of fear-avoidance and self-efficacy on pain disability in individuals with co-morbid post-traumatic stress and chronic pain","volume":"27","author":"Devlin","year":"2022","journal-title":"J Health Psychol"},{"issue":"6","key":"10.1016\/j.jpain.2025.105589_bib28","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1002\/jts.22550","article-title":"Clinical manifestations of trauma exposure in fibromyalgia: the role of anxiety in the association between posttraumatic stress symptoms and fibromyalgia status","volume":"33","author":"Mir\u00f3","year":"2020","journal-title":"J Trauma Stress"},{"issue":"5","key":"10.1016\/j.jpain.2025.105589_bib29","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1097\/AJP.0000000000000689","article-title":"Posttraumatic stress symptoms mediate the effects of trauma exposure on clinical indicators of central sensitization in patients with chronic pain","volume":"35","author":"McKernan","year":"2019","journal-title":"Clin J Pain"},{"issue":"6","key":"10.1016\/j.jpain.2025.105589_bib30","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1002\/ejp.1203","article-title":"Catastrophizing, pain and traumatic stress symptoms following burns: a prospective study","volume":"22","author":"Van Loey","year":"2018","journal-title":"Eur J Pain"},{"issue":"8","key":"10.1016\/j.jpain.2025.105589_bib31","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1002\/ejp.848","article-title":"Pain-catastrophizing and fear-avoidance beliefs as mediators between post-traumatic stress symptoms and pain following whiplash injury \u2013 A prospective cohort study","volume":"20","author":"Andersen","year":"2016","journal-title":"Eur J Pain"},{"issue":"2","key":"10.1016\/j.jpain.2025.105589_bib32","doi-asserted-by":"crossref","DOI":"10.1002\/ejp.4721","article-title":"Increased behavioural inhibition and decreased behavioural activation in whiplash-associated disorders: associations with health outcomes","volume":"29","author":"Smith","year":"2025","journal-title":"Eur J Pain"},{"issue":"11","key":"10.1016\/j.jpain.2025.105589_bib33","doi-asserted-by":"crossref","first-page":"2159","DOI":"10.1097\/j.pain.0000000000001331","article-title":"Do post-traumatic pain and post-traumatic stress symptomatology mutually maintain each other? A systematic review of cross-lagged studies","volume":"159","author":"Ravn","year":"2018","journal-title":"PAIN"},{"issue":"4","key":"10.1016\/j.jpain.2025.105589_bib34","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1097\/j.pain.0000000000002425","article-title":"Trauma matters: psychological interventions for comorbid psychosocial trauma and chronic pain","volume":"163","author":"Lumley","year":"2022","journal-title":"Pain"},{"issue":"2","key":"10.1016\/j.jpain.2025.105589_bib35","first-page":"114","article-title":"Psychological therapy for centralized pain: an integrative assessment and treatment model","volume":"81","author":"Lumley","year":"2019","journal-title":"Biopsy Sci Med"},{"key":"10.1016\/j.jpain.2025.105589_bib36","article-title":"Comparative main effects, mediators, and moderators of cognitive behavioral therapy, acceptance and commitment therapy, and emotional awareness and expression therapy for chronic spinal pain: randomized controlled trial rationale and protocol","volume":"44","author":"Burns","year":"2025","journal-title":"Conte Clin Trials Commun"},{"issue":"4","key":"10.1016\/j.jpain.2025.105589_bib37","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1097\/j.pain.0000000000001769","article-title":"Sleep disturbance underlies the co-occurrence of trauma and pediatric chronic pain: a longitudinal examination","volume":"161","author":"Pavlova","year":"2020","journal-title":"PAIN"},{"issue":"1","key":"10.1016\/j.jpain.2025.105589_bib38","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1037\/a0038889","article-title":"A critique of the cross-lagged panel model","volume":"20","author":"Hamaker","year":"2015","journal-title":"Psychol Methods"},{"issue":"1","key":"10.1016\/j.jpain.2025.105589_bib39","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1017\/S0033291710000401","article-title":"Race\/ethnic differences in exposure to traumatic events, development of post-traumatic stress disorder, and treatment-seeking for post-traumatic stress disorder in the United States","volume":"41","author":"Roberts","year":"2011","journal-title":"Psychol Med"},{"issue":"11","key":"10.1016\/j.jpain.2025.105589_bib40","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1001\/jama.2021.14075","article-title":"A guideline for reporting mediation analyses of randomized trials and observational studies: the AGReMA statement","volume":"326","author":"Lee","year":"2021","journal-title":"Jama"}],"container-title":["The Journal of Pain"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1526590025008168?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1526590025008168?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T07:19:58Z","timestamp":1780816798000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1526590025008168"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":40,"alternative-id":["S1526590025008168"],"URL":"https:\/\/doi.org\/10.1016\/j.jpain.2025.105589","relation":{},"ISSN":["1526-5900"],"issn-type":[{"value":"1526-5900","type":"print"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"PTSD and chronic pain: A systematic review and meta-analysis of mediation studies","name":"articletitle","label":"Article Title"},{"value":"The Journal of Pain","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jpain.2025.105589","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 \u00a9 Published by Elsevier Inc. on behalf of United States Association for the Study of Pain, Inc All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"105589"}}