{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:36:31Z","timestamp":1792787791223,"version":"4.5.0"},"reference-count":50,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"National Institute for Health and Care Research (NIHR) Biomedical Research Centre at the South London and Maudsley NHS Foundation Trust and King\u2019s College London","id":[{"id":"https:\/\/ror.org\/015803449","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["British Journal of Pain"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Experiences of trauma are common among people with chronic pain, although estimates of comorbid post-traumatic stress vary widely across contexts. Acceptance and commitment therapy (ACT), which targets psychological flexibility to improve pain-related functioning, is increasingly delivered for people with pain. To inform treatment delivery, understanding of the prevalence and correlates of post-traumatic stress among those attending ACT-based treatment for pain is needed. This study aimed to identify the prevalence of post-traumatic stress and its associations with key pain-related outcomes and other relevant psychosocial factors at the start of an ACT-based treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a cross-sectional study using data collected within routine clinical care at a speciality pain management service in the UK. Four hundred and fifty-one participants completed standardized self-report questionnaires of post-traumatic stress symptoms (PTSS), pain-related outcomes (pain intensity and interference, work and social adjustment, and depression symptoms), psychological flexibility\/inflexibility, and stigma at the start of an interdisciplinary ACT-based treatment for chronic pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty-seven percent of patients (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 213) reported a traumatic exposure and 30% of the sample reported clinically meaningful PTSS. Greater severity of PTSS and probable post-traumatic stress disorder (PTSD) were associated with significantly worse pain-related outcomes, psychological flexibility\/inflexibility, and stigma in bivariate analyses. PTSS severity and probable PTSD showed significant unique associations with poorer pain outcomes in regression models controlling for covariates and psychological flexibility\/inflexibility.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Post-traumatic stress is common among people engaging in ACT-based treatment for pain and associated with adverse pain outcomes. Trauma-informed practice is therefore important when providing ACT-based treatment for pain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20494637261497966","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T19:29:07Z","timestamp":1792178947000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["A cross-sectional study of the prevalence and correlates of post-traumatic stress among people attending acceptance and commitment therapy for chronic pain"],"prefix":"10.1177","author":[{"given":"Kezia","family":"Kadri","sequence":"first","affiliation":[{"name":"Guy\u2019s & St Thomas\u2019 NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cara","family":"Keating","sequence":"additional","affiliation":[{"name":"King\u2019s College London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeleine","family":"Anderson","sequence":"additional","affiliation":[{"name":"Guy\u2019s & St Thomas\u2019 NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Novelli","sequence":"additional","affiliation":[{"name":"Guy\u2019s & St Thomas\u2019 NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"McBride","sequence":"additional","affiliation":[{"name":"King\u2019s College London"},{"name":"Lewisham and Greenwich NHS Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2529-9083","authenticated-orcid":false,"given":"Whitney","family":"Scott","sequence":"additional","affiliation":[{"name":"Guy\u2019s & St Thomas\u2019 NHS Foundation Trust"},{"name":"King\u2019s College London"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,16]]},"reference":[{"key":"e_1_3_9_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000003056"},{"key":"e_1_3_9_3_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpain.2022.923866"},{"key":"e_1_3_9_4_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_3_9_5_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2017.00164"},{"key":"e_1_3_9_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.62.6.593"},{"key":"e_1_3_9_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-020-02642-y"},{"key":"e_1_3_9_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2018.07.014"},{"key":"e_1_3_9_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12529-017-9641-8"},{"key":"e_1_3_9_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/PR9.0000000000000622"},{"key":"e_1_3_9_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pny272"},{"key":"e_1_3_9_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000003243"},{"key":"e_1_3_9_13_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.20220397"},{"key":"e_1_3_9_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/PSY.0000000000001181"},{"key":"e_1_3_9_15_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2020.00749"},{"key":"e_1_3_9_16_2","first-page":"CD007407","article-title":"Psychological therapies for the management of chronic pain (excluding headache) in adults","volume":"8","author":"Williams ACC","year":"2020","unstructured":"Williams ACC, Fisher E, Hearn L, et al. 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