Chronic pain and childhood adversity

Introduction: Chronic pain in a military population is prevalent, costly, and can limit

daily activities and affect soldier readiness. It has been associated with childhood

adversity (CA) within the veteran, adult, and pediatric populations. Given the need to

maximize soldier resiliency, an examination of the link between CA and chronic pain in

an active-duty population for a better understanding that informs treatment options is

warranted.

Materials and Methods: The analytic sample comprised 32 men and 8 women drawn

from a retrospective review of 203 intake assessments at an Interdisciplinary Pain

Management Center (IPMC). We identified a group (CA) of 20 patients who endorsed a

history of pre-adolescent sexual abuse or living in an “abusive” childhood home and

compared it with a control group (no-CA) of 20 patients, matched for age, gender, pain

history duration, and pain problem. Validated measures were used to assess pain

intensity, interference in functioning and well-being, emotional sequelae of pain as

reflected in symptoms of depression and anxiety, and pain-related catastrophic

thinking. Data were analyzed using descriptive statistics and independent samples ttest

analyses.

Results: Differences in current, worst, and average pain ratings were non-significant

between groups. The CA group reported significantly greater effect of pain on mood

(Mean: 6.20 versus 4.25, P < .02) and showed a trend toward higher pain interference

in functioning (Mean: 17.70 versus 15.05, P = .053). The CA patients had significantly

more serious depression (Mean: 12.65 versus 4.50, P < .001) and anxiety symptoms

(Mean: 10.60 versus 2.35, P < .001), and significantly higher pain catastrophizing

tendency (Mean: 30.05 versus 20.50, P < .03).