Childhood Adversity Among Adults With Chronic Pain

Abstract

Objectives: Adverse childhood experiences (ACEs) have been linked to the development and impact of chronic pain in adulthood. The goal of this study was to investigate the prevalence of ACEs in a treatment-seeking sample of adults with chronic pain and the relationship between number and type(s) of ACEs and pain-related outcomes. Methods: Adults (N=1794) presenting for treatment at a multidisciplinary pain management center completed self-report measures of childhood adversity, pain, functioning, emotional distress, and adjustment to pain. Results: Participants endorsing ≥4 ACEs had significantly worse pain-related outcomes and lower quality of life compared with individuals reporting fewer ACEs. Having ≥3 ACEs was associated with higher anxiety and depression levels. Experiences of childhood neglect negatively affected mental health–related outcomes independent of the number of ACEs. Significant sex differences were found in the number and type of ACEs reported but not in the relationship between ACEs and outcome variables. Conclusion: Findings suggest that the number and the type of self-reported ACE(s) are associated with pain-related variables and psychosocial functioning in adults with chronic pain. The results highlight the importance of assessment of ACEs and trauma-informed care with patients with chronic pain.

Back Pain without Disease or Substantial Injury in Children and Adolescents: A Twin Family Study Investigating Genetic Influence and Associations

“…We have recently shown in four studies in children, adolescents and adults, that a history of iron deficiency is associated, probably causally, with multiple pain conditions [66] (see Supplementary Information). Other shared risk factors for multiple pain conditions include some bidirectional factors such as impaired sleep [67][68][69], restless legs syndrome [56,70], early childhood adversity [71,72], although bias [73] is acknowledged, and anxiety and depression [74][75][76][77]. Consistent with the anxiety and depression studies cited, both categories of back pain were associated with the measure of anxious depression.…”

Interdisciplinary pain rehabilitation and sexual functioning: Treatment outcomes and patient preferences

“…Most participants were married ( n = 42, 59.2%), single ( n = 17, 23.9%), or divorced ( n = 9, 12.7%). (For comparison to the general treatment population at the pain management center, including patients who did not consent for this study or who did not complete surveys at both time points, see Craner et al 22 ).…”

Adverse Childhood Experiences and Tobacco Use Patterns Among Adults in the United States: Exploring sex differences

“…Nevertheless, although the validity of self-reported ACEs needs to be explored further, self-reported tobacco status correlates highly with serum cotinine levels (Caraballo et al, 2001). Third, ACEs are often portrayed as count variables given their complexity and it may not reflect their severity or impact (Craner et al, 2022). Likewise, categorizing ACE variables (such as the maltreatment variables) originally asked as frequencies are debatable as to whether an ever or never experience is the best measure, as results suggest that measuring maltreatment severity may be a more optimal approach (Litrownik et al, 2005).…”

“…For each of the above questions, dummy variables were created, coded as “0” if the participant answered “never” or “no” and “1” if the participant reported in the affirmative. An ACE composite score was calculated using affirmative responses ranging from 0 to 11 and categorized as 0, 1, 2, 3, or ≥4, consistent with previous literature (Baiden et al, 2022; Craner et al, 2022; Felitti et al, 1998; Hu et al, 2021; Melka et al, 2019).…”