Andrew Schrepf1, Bruce Naliboff2,3, David A Williams1, Alisa J Stephens-Shields4, J Richard Landis4, Arpana Gupta5, Emeran Mayer5, Larissa V Rodriguez6, Henry Lai7,8, Yi Luo9, Catherine Bradley9,10, Karl Kreder9, Susan K Lutgendorf11. 1. Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA. 2. Department of Medicine, University of California, Los Angeles, CA, USA. 3. Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA. 4. Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA. 5. Oppenheimer Center for Neurobiology of Stress, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA. 6. Department of Urology, University of Southern California, Los Angeles, CA, USA. 7. Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA. 8. Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA. 9. Department of Urology, University of Iowa, Iowa City, IA, USA. 10. Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA, USA. 11. Department of Psychological and Brain Sciences and Urology, University of Iowa, Iowa City, IA, USA.
Abstract
Background: Adverse Childhood Experiences (ACEs) such as sexual and physical violence, serious illness, and bereavement have been linked to number of chronic pain conditions in adulthood, and specifically to urologic chronic pelvic pain syndrome (UCPPS). Purpose: We sought to characterize the prevalence of ACEs in UCPPS using a large well-characterized cohort in comparison with a group of healthy controls. We also sought to determine the association of ACE severity with psychological factors known to impact pain and to determine whether ACEs are associated with patterns of improvement or worsening of symptom over a year of naturalistic observation. Methods: For longitudinal analyses we used functional clusters identifying broad classes of (a) improved, (b) worsened, and (c) stable groups for genitourinary pain and urinary symptoms. We employed a mediation/path analysis framework to determine whether ACEs influenced 1 year outcomes directly, or indirectly through worse perceptions of physical well-being. Results: ACE severity was elevated in UCPPS (n = 421) participants compared with healthy controls (n = 414; p < .001), and was most strongly associated with factors associated with complex chronic pain, including more diffuse pain, comorbid functional symptoms/syndromes, and worse perceived physical well-being (all p < .001). Finally, worse physical well-being mediated the relationship between ACE severity and less likelihood of painful symptom improvement (OR = .871, p = .007)) and a greater likelihood of painful symptom worsening (OR = 1.249, p = .003) at 1 year. Conclusions: These results confirm the association between ACEs and UCPPS symptoms, and suggest potential targets for therapeutic interventions in UCPPS. Clinical Trial registration: NCT01098279.
Background: Adverse Childhood Experiences (ACEs) such as sexual and physical violence, serious illness, and bereavement have been linked to number of chronic pain conditions in adulthood, and specifically to urologic chronic pelvic pain syndrome (UCPPS). Purpose: We sought to characterize the prevalence of ACEs in UCPPS using a large well-characterized cohort in comparison with a group of healthy controls. We also sought to determine the association of ACE severity with psychological factors known to impact pain and to determine whether ACEs are associated with patterns of improvement or worsening of symptom over a year of naturalistic observation. Methods: For longitudinal analyses we used functional clusters identifying broad classes of (a) improved, (b) worsened, and (c) stable groups for genitourinary pain and urinary symptoms. We employed a mediation/path analysis framework to determine whether ACEs influenced 1 year outcomes directly, or indirectly through worse perceptions of physical well-being. Results:ACE severity was elevated in UCPPS (n = 421) participants compared with healthy controls (n = 414; p < .001), and was most strongly associated with factors associated with complex chronic pain, including more diffuse pain, comorbid functional symptoms/syndromes, and worse perceived physical well-being (all p < .001). Finally, worse physical well-being mediated the relationship between ACE severity and less likelihood of painful symptom improvement (OR = .871, p = .007)) and a greater likelihood of painful symptom worsening (OR = 1.249, p = .003) at 1 year. Conclusions: These results confirm the association between ACEs and UCPPS symptoms, and suggest potential targets for therapeutic interventions in UCPPS. Clinical Trial registration: NCT01098279.
Authors: Michael Noll-Hussong; Alexander Otti; Leonhard Laeer; Afra Wohlschlaeger; Claus Zimmer; Claas Lahmann; Peter Henningsen; Thomas Toelle; Harald Guendel Journal: J Psychosom Res Date: 2010-03-16 Impact factor: 3.006
Authors: Stefan Kempke; Patrick Luyten; Stephan Claes; Peter Van Wambeke; Patrick Bekaert; Lutgarde Goossens; Boudewijn Van Houdenhove Journal: J Psychiatr Res Date: 2013-02-16 Impact factor: 4.791
Authors: J Quentin Clemens; Elizabeth A Calhoun; Mark S Litwin; Mary McNaughton-Collins; John W Kusek; Evelyn M Crowley; J Richard Landis Journal: Urology Date: 2009-10-02 Impact factor: 2.649
Authors: Eva Raphael; Stephen K Van Den Eeden; Carolyn J Gibson; Chris Tonner; David H Thom; Leslee Subak; Alison J Huang Journal: Am J Obstet Gynecol Date: 2021-09-20 Impact factor: 8.661
Authors: Giovanni Berardi; Laura Frey-Law; Kathleen A Sluka; Emine O Bayman; Christopher S Coffey; Dixie Ecklund; Carol G T Vance; Dana L Dailey; John Burns; Asokumar Buvanendran; Robert J McCarthy; Joshua Jacobs; Xiaohong Joe Zhou; Richard Wixson; Tessa Balach; Chad M Brummett; Daniel Clauw; Douglas Colquhoun; Steven E Harte; Richard E Harris; David A Williams; Andrew C Chang; Jennifer Waljee; Kathleen M Fisch; Kristen Jepsen; Louise C Laurent; Michael Olivier; Carl D Langefeld; Timothy D Howard; Oliver Fiehn; Jon M Jacobs; Panshak Dakup; Wei-Jun Qian; Adam C Swensen; Anna Lokshin; Martin Lindquist; Brian S Caffo; Ciprian Crainiceanu; Scott Zeger; Ari Kahn; Tor Wager; Margaret Taub; James Ford; Stephani P Sutherland; Laura D Wandner Journal: Front Med (Lausanne) Date: 2022-04-25
Authors: Pau Yen Wu; Blaise Menta; Alexander Visk; Janelle M Ryals; Julie A Christianson; Douglas E Wright; Andrea L Chadwick Journal: Burns Date: 2021-04-20 Impact factor: 2.744
Authors: Jennifer Pierce; Afton L Hassett; Chad M Brummett; Jenna McAfee; Christine Sieberg; Andrew Schrepf; Steven E Harte Journal: Ann Behav Med Date: 2021-08-23
Authors: Isabella M Fuentes; Brittni M Jones; Aaron D Brake; Angela N Pierce; Olivia C Eller; Rachel M Supple; Douglas E Wright; Julie A Christianson Journal: Pain Date: 2021-06-01 Impact factor: 7.926
Authors: André Bussières; Jan Hartvigsen; Manuela L Ferreira; Paulo H Ferreira; Mark J Hancock; Laura S Stone; Timothy H Wideman; Jill Boruff; Ask Elklit Journal: Syst Rev Date: 2020-09-17
Authors: Aaron D Brake; Xiaofang Yang; Chu-Yu Lee; Phil Lee; Paul Keselman; Olivia C Eller; In-Young Choi; Janna L Harris; Julie A Christianson Journal: Front Pain Res (Lausanne) Date: 2022-01-27
Authors: Steven E Harte; Andrew Schrepf; Robert Gallop; Grant H Kruger; Hing Hung Henry Lai; Siobhan Sutcliffe; Megan Halvorson; Eric Ichesco; Bruce D Naliboff; Niloofar Afari; Richard E Harris; John T Farrar; Frank Tu; John Richard Landis; Daniel J Clauw Journal: Pain Date: 2019-06 Impact factor: 7.926