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2014 ; 55
(5
): 491-9
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Childhood abuse and the experience of pain in adulthood: the mediating effects of
PTSD and emotion dysregulation on pain levels and pain-related functional
impairment
#MMPMID24360527
Powers A
; Fani N
; Pallos A
; Stevens J
; Ressler KJ
; Bradley B
Psychosomatics
2014[Sep]; 55
(5
): 491-9
PMID24360527
show ga
BACKGROUND: Previous findings suggest a relationship between childhood abuse and
pain-related conditions. It is yet to be determined whether adult posttraumatic
stress disorder (PTSD) symptoms may mediate the association between the
experience of childhood abuse and reported pain in adulthood. OBJECTIVE: We
sought to determine if emotion dysregulation may also play a role in mediating
PTSD and pain levels. METHODS: We examined subjects (N = 814) recruited from the
primary care clinics of an urban public hospital as part of an National Institute
of Mental Health-funded study of trauma-related risk and resilience. We evaluated
childhood abuse with the Childhood Trauma Questionnaire, PTSD symptoms with the
PTSD Symptom Severity scale, and emotional dysregulation with the Emotion
Dysregulation Scale. Pain and functional limitations of pain were assessed
through self-report. RESULTS: We found that both childhood abuse and current PTSD
symptoms predicted higher levels of reported pain. Childhood abuse, PTSD
symptoms, and emotion dysregulation all predicted higher levels of functional
impairment related to pain. Using the Sobel method and bootstrapping techniques
and controlling for current level of negative affect, we found that PTSD fully
mediated the effect of childhood abuse on pain level and pain-related
limitations; emotion dysregulation partially mediated the effect of PTSD symptoms
in predicting higher levels of pain-related limitations. CONCLUSIONS: Although
causality cannot be determined in the present study, these findings suggest that
PTSD may serve as the pathway between exposure to childhood abuse and the
development of pain-related conditions in adulthood, and that emotion
dysregulation is a significant factor in understanding how PTSD relates to
specific pain-related functional impairment.
|*Emotions
[MESH]
|Adolescent
[MESH]
|Adult
[MESH]
|Adult Survivors of Child Abuse/*psychology
[MESH]