Randy A Sansone1, Daron A Watts1, Michael W Wiederman1. 1. Departments of Psychiatry (Drs Sansone and Watts) and Internal Medicine (Dr Sansone), Wright State University School of Medicine, Dayton, and Department of Psychiatry Education, Kettering Medical Center, Kettering (Dr Sansone), Ohio; and Department of Psychology, Columbia College, Columbia, South Carolina (Dr Wiederman).
Abstract
OBJECTIVE: Previous studies have indicated relationships between trauma in childhood and pain in adulthood, although some studies have reported no such relationships and challenge the methodologies of large-scale community samples. In this study involving a clinical sample, we examined relationships among (1) childhood trauma at ages 12 or younger, (2) rated pain for 3 time points in adulthood, and (3) pain catastrophizing (ie, catastrophic thoughts and feelings about pain). METHOD: Using a cross-sectional approach and a self-report survey methodology in a consecutive sample of adult internal medicine outpatients (n = 243), we examined relationships among 5 types of childhood trauma (witnessing violence, physical neglect, emotional abuse, physical abuse, and sexual abuse); ratings of pain now, over the past month, and over the past year; and scores on the Pain Catastrophizing Scale (PCS) and its subscales (rumination, magnification, and helplessness). Data were collected in November 2012. RESULTS: In univariate analyses, nearly all types of childhood trauma statistically significantly (P < .01) correlated with all self-ratings of pain, as well as the total PCS score and scores on the subscales of the PCS, with a few exceptions involving physical neglect, which demonstrated a weaker relationship. In multivariate analyses, emotional abuse (standardized β = 0.17, t = 2.37, P < .05) and sexual abuse (standardized β = 0.16, t = 2.26, P < .05) were uniquely predictive of the summed ratings of pain for each participant, and emotional abuse uniquely predicted catastrophic thoughts and feelings about pain (standardized β = 0.32, t = 4.58, P < .001). CONCLUSIONS: In this clinical sample of adult outpatients, there were clear relationships between childhood trauma and all forms of pain assessment and pain catastrophizing. We discuss possible explanations and implications of these findings.
OBJECTIVE: Previous studies have indicated relationships between trauma in childhood and pain in adulthood, although some studies have reported no such relationships and challenge the methodologies of large-scale community samples. In this study involving a clinical sample, we examined relationships among (1) childhood trauma at ages 12 or younger, (2) rated pain for 3 time points in adulthood, and (3) pain catastrophizing (ie, catastrophic thoughts and feelings about pain). METHOD: Using a cross-sectional approach and a self-report survey methodology in a consecutive sample of adult internal medicine outpatients (n = 243), we examined relationships among 5 types of childhood trauma (witnessing violence, physical neglect, emotional abuse, physical abuse, and sexual abuse); ratings of pain now, over the past month, and over the past year; and scores on the Pain Catastrophizing Scale (PCS) and its subscales (rumination, magnification, and helplessness). Data were collected in November 2012. RESULTS: In univariate analyses, nearly all types of childhood trauma statistically significantly (P < .01) correlated with all self-ratings of pain, as well as the total PCS score and scores on the subscales of the PCS, with a few exceptions involving physical neglect, which demonstrated a weaker relationship. In multivariate analyses, emotional abuse (standardized β = 0.17, t = 2.37, P < .05) and sexual abuse (standardized β = 0.16, t = 2.26, P < .05) were uniquely predictive of the summed ratings of pain for each participant, and emotional abuse uniquely predicted catastrophic thoughts and feelings about pain (standardized β = 0.32, t = 4.58, P < .001). CONCLUSIONS: In this clinical sample of adult outpatients, there were clear relationships between childhood trauma and all forms of pain assessment and pain catastrophizing. We discuss possible explanations and implications of these findings.
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