Somatic burden and perceived cognitive problems in trauma-exposed adults with posttraumatic stress symptoms or pain

Objective: Posttraumatic stress disorder (PTSD) is associated with somatic and cognitive changes, which may be magnified when accompanied by persistent pain. The mechanisms of somatic sensation processing may extend to cognitive symptoms, revealing a potential generalization of impairment across cognitive and somatic domains in PTSD. We hypothesized that somatic burden would mediate relationships between PTSD, pain, and perceived cognitive impairment. Methods: Two samples-360 trauma-exposed college students and 268 mechanical Turk users-completed self-report measures. Results: Both samples revealed similar findings. There was a significant indirect effect of PTSD and pain on perceived cognitive problems through somatic burden. There remained a direct effect of PTSD symptoms. These findings indicate that in trauma-exposed samples with pain, somatic burden rather than pain severity accounts for perceived cognitive problems. Conclusion: High somatic burden may reflect an underlying appraisal about somatic cues, which extend in part to interpretation of cognitive cues.