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Heightened risk of pain in young adult women with a history of childhood maltreatment

a prospective longitudinal study

Beal, Sarah J.a,b,*; Kashikar-Zuck, Susmitaa,b; King, Christophera,b; Black, Williamc; Barnes, Jaclynb; Noll, Jennie G.a,b,d

doi: 10.1097/j.pain.0000000000001706
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A child maltreatment history is reported more frequently among adults with chronic pain compared with the general population; unfortunately, studies have primarily relied upon retrospective maltreatment reports by adults with chronic pain. This prospective study assessed pain symptoms in a cohort of young adult women with a documented history of child maltreatment, compared with a matched cohort of women who did not experience childhood maltreatment. Young women (N = 477) were recruited between ages 14 to 17 years and followed annually to age 19. Of these women, 57% experienced maltreatment (ie, physical, sexual, or emotional abuse, neglect; n = 273) substantiated by child welfare record. Maltreated women were demographically matched to nonmaltreated women, also confirmed by child welfare record. In adolescence, post-traumatic stress was assessed. Women were contacted as young adults (Mage = 24.76; n = 383) and surveyed about their pain experiences, including the presence of pain in the past week, pain severity (0-10), and number of body areas with pain. Mediation path analyses examining the impact of maltreatment and adolescent post-traumatic stress on young adult pain were estimated through structural equation modeling. As adults, women who had experienced child maltreatment reported higher pain intensity, a greater number of pain locations, and were more likely to experience pain in the previous week than nonmaltreated women. Adolescent post-traumatic stress partially explained the effects of maltreatment on pain. Young adult women who experienced child maltreatment are at higher risk of pain, particularly when they also experienced post-traumatic stress as adolescents.

This study examined associations between childhood maltreatment and pain in young adult women; adolescent post-traumatic stress symptoms partially explained relations between maltreatment and subsequent pain.

aDepartment of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States

bDivision of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States

cDepartment of Pediatrics, University of Kansas Medical Center, Kansas City, KS, United States

dDepartment of Human Development and Family Studies, The Pennsylvania State University, State College, PA, United States

Corresponding author. Address: Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 7039, Cincinnati, OH 45229-3026, United States. Tel.:513-636-4614; fax 513-636-3677. E-mail address: Sarah.Beal@cchmc.org (S.J. Beal).

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.painjournalonline.com).

Received May 22, 2019

Received in revised form August 12, 2019

Accepted August 29, 2019

© 2019 International Association for the Study of Pain
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