The Unholy Trinity: Childhood Trauma, Adulthood Anxiety, and Long-Term Pain

Abstract

Background: Childhood trauma is considered to be a risk factor for developing anxiety as well as chronic pain. The aim of this study was to assess the association between childhood trauma and reporting anxiety and long-term pain conditions in the general and clinical populations. Methods: Respondents from a representative sample in the Czech Republic (n = 1800, mean age: 46.6 years, 48.7% male) and patients with a clinically diagnosed anxiety or adjustment disorder (n = 67, mean age: 40.5 years, 18.0% male) were asked to report anxiety, various chronic and pain-related conditions, and childhood trauma (The Childhood Trauma Questionnaire, CTQ) in a cross-sectional questionnaire-based survey conducted in 2016 and 2017. Results: Reporting emotional abuse (Odds ratio OR from 2.14 to 14.71), emotional neglect (OR from 2.42 to 10.99), or physical neglect (OR from 2.24 to 3.30) was associated with reporting anxiety and long-term pain both in the general and clinical populations and reporting physical abuse moreover with reporting anxiety or adjustment disorder with concurrent long-term pain (OR from 4.04 to 6.39). Conclusion: This study highlights the relevance of childhood trauma as a possible factor contributing to anxiety with concurrent pain conditions in adulthood in both the general and clinical populations.

Trends in prescribing pattern of opioid and benzodiazepine substitutes among Medicare part D beneficiaries from 2013 to 2018: a retrospective study

“…The most common serotonergic anxiolytics are the selective serotonin reuptake inhibitors (SSRI) and serotonin norepinephrine reuptake inhibitors (SNRI), and because of their safety profile even in overdose, they are possible substitutes for benzodiazepines in patients with co-occurring anxiety and pain. [24][25][26][27] There are no studies on whether the use of potential substitute drugs (gabapentinoids and SSRIs/SNRIs) increased as opioids and benzodiazepines decreased. We hypothesised that opioid and benzodiazepine prescriptions would decrease while substitute medications, gabapentinoids and SSRIs/SNRIs, would increase in response to the published and widely disseminated 2016 CDC opioid and benzodiazepine guidelines.…”

Validation and Adaptation of the Slovak Version of the Childhood Trauma Questionnaire (CTQ)

“…The CTQ has been validated in several countries: On representative samples in Germany [ 18 , 19 ], in the Czech Republic [ 20 ], in Memphis, USA [ 21 ], and on clinical samples in Brazil [ 22 ], Spain [ 23 ], the Netherlands [ 24 ], Germany [ 25 ], and Denmark [ 26 ]. The CTQ has also been used in many association studies, e.g., to monitor the associations between childhood trauma experiences and chronic pain and anxiety [ 27 ], substance use disorder in Taiwanese patients [ 28 ], to compare the experiences of trauma in South African women with or without HIV [ 29 ], and to support the idea that childhood trauma experiences and adult attachment style are associated with higher use of negative religious coping strategies [ 30 ]. The CTQ was also used to examine the prevalence of traumatic experiences in South Korean adults [ 31 ].…”

When a Head Is about to Burst: Attachment Mediates the Relationship Between Childhood Trauma and Migraine

“…This is in contrast with large ACE studies [12][13][14]53] and meta-analytic studies [15,18] confirming links between childhood trauma and various chronic conditions, or between childhood trauma and chronic pain [17,18,58]. In a recent study analyzing the same Czech representative sample, a group of chronic pain conditions (including migraine) with/without anxiety was assessed, and the link between chronic pain and childhood trauma was confirmed [58]. The negative relationship between childhood trauma and no chronic conditions in our study revealed the empirical knowledge and experience that people raised in good conditions early in life, without excessive stress caused by abuse and neglect, are more likely to have good health in later life.…”

“…However, in our study, no direct effect was found between childhood trauma and adulthood pain conditions other than migraine and other chronic conditions. This is in contrast with large ACE studies [12][13][14]53] and meta-analytic studies [15,18] confirming links between childhood trauma and various chronic conditions, or between childhood trauma and chronic pain [17,18,58]. In a recent study analyzing the same Czech representative sample, a group of chronic pain conditions (including migraine) with/without anxiety was assessed, and the link between chronic pain and childhood trauma was confirmed [58].…”