This study suggests a 'two hit model' for the risk for pain syndromes: an initial stressor that predisposes to increased reactivity to later stress. The authors implicate both stress response and inflammation systems in the body in the link between stress and pain, potentially pointing to new treatment mechanisms."Chronic pain is a significant problem for people with PTSD. One reason for the co-occurrence of PTSD and pain is that the events that produce PTSD also may be associated with bodily harm. We have long known that childhood stress increases the vulnerability to PTSD. This new study also raises the possibility that early life stressors may increase the risk for pain syndromes," noted John H. Krystal, M.D., Editor of Biological Psychiatry. The article is "Stress in the Adult Rat Exacerbates Muscle Pain Induced by Early-Life Stress" by Pedro Alvarez, Paul G. Green, and Jon D. Levine (doi: 10.1016/j.biopsych.2013.04.006). The article appears in Biological Psychiatry, Volume 74, Issue 9 ( November 1, 2013), published by Elsevier. Notes for editors Full text of the article is available to credentialed journalists upon request; contact Rhiannon Bugno at +1-214-648-0880 or Biol.Psych@utsouthwestern.edu. Journalists wishing to interview the authors may contact Jon D. Levine at +1-415-476-5108 or Jon.Levine@ucsf.edu. The authors' affiliations, and disclosures of financial and conflicts of interests are available in the article. John H. Krystal, M.D., is Chairman of the Department of Psychiatry at the Yale University School of Medicine, Chief of Psychiatry at Yale-New Haven Hospital, and a research psychiatrist at the VA Connecticut Healthcare System. His disclosures of financial and conflicts of interests are available here. About Biological Psychiatry Biological Psychiatry is the official journal of the Society of Biological Psychiatry, whose purpose is to promote excellence in scientific research and education in fields that investigate the nature, causes, mechanisms and treatments of disorders of thought, emotion, or behavior. In accord with this mission, this peer-reviewed, rapid-publication, international journal publishes both basic and clinical contributions from all disciplines and research areas relevant to the pathophysiology and treatment of major psychiatric disorders. The journal publishes novel results of original research which represent an important new lead or significant impact on the field, particularly those addressing genetic and environmental risk factors, neural circuitry and neurochemistry, and important new therapeutic approaches. Reviews and commentaries that focus on topics of current research and interest are also encouraged.