Cortisol Profile Mediates the Relation Between Childhood Neglect and Pain and Emotional Symptoms among Patients with Fibromyalgia

Abstract

Background The relation between childhood trauma and chronic pain and emotional symptoms in adulthood has been well-documented, although physiological mechanisms mediating this link have not been elaborated. Purpose This study examined the mediating role of cortisol profile in the linkage between childhood maltreatment and pain and emotional symptoms in individuals with fibromyalgia (FM). Methods 179 adults with FM first provided retrospective self-reports of childhood maltreatment; then attended a standardized session during which cortisol was sampled across 1.5 hours; and subsequently, completed assessments of daily pain, depressive symptoms, and anxiety. Latent growth curve modeling estimated the hypothesized mediation models. Results Childhood neglect predicted a flattened cortisol profile, which, in turn, predicted elevated daily pain and emotional symptoms. The cortisol profile partially mediated the neglect-symptom relation. Conclusions Early maltreatment may exert enduring effects on endocrine regulation that contributes to pain and emotional symptoms in adults with chronic pain.

When Emotional Pain Becomes Physical: Adverse Childhood Experiences, Pain, and the Role of Mood and Anxiety Disorders

“…In particular, chronic stressors affect the HPA stress response, influencing cortisol patterns and the autoimmune system. Dysregulation of the HPA and autoimmune functioning may, in turn, be the neurological substrate linking ACEs to mood and anxiety disorders (Heim et al., ) and painful medical conditions later in adulthood (Blackburn‐Munro & Blackburn‐Munro, ; Denk, McMahon, & Tracey, ; Slavich & Irwin, ; Weissbecker, Floyd, Dedert, Salmon, & Sephton, ; Yeung, Davis, & Ciaramitaro, ).…”

The association of carotid intima-media thickness with body mass index and cortisol level in fibromyalgia syndrome

“…IMT is a complex process and depends on several factors such as local hemodynamics, blood pressure, and stres [1][2][3][4]. The symptoms of chronic stress-related diseases, such as obesity, hyperactivity in CRH neurons, disrupted cortisol secretion on a daily basis, common anxiety disruption, obsessive-compulsive personality and Atype personality disorder, sleep disorder, and chronic pain, are significant in the patients with FMS [10][11][12]. Chronic pain and stress-related deviations in hormonal secretion occur in patients with FMS.…”

Pressure Pain Phenotypes in Women Before Breast Cancer Treatment

“…Maladaptive pain cognitions (e.g., locus of control, catastrophizing) may increase the complexity of pain relationships by influencing the development and/or perception of pain severity and sensitivity and by interacting centrally with other symptoms, such as anxiety and fatigue (Campbell et al, 2015;Kjøgx et al, 2016;Yeung et al, 2016). Belief in pain control is an important factor associated with an individual's cognitive processing and report of pain, coping, help-seeking behavior, compliance to pain treatment, and expectations and perceptions of treatment efficacy (Ang et al, 2010;Higgins et al, 2015;Oliveira et al, 2009;Shen, Redd, Winkel, & Badr, 2014).…”

“…Physiologic factors, such as younger age, female gender, and genetics, also correlate with or predict chronic pain (Andersen et al, 2015;Fernández-de-las-Peñas et al, 2012;Gärtner et al, 2009;Langford et al, 2015;Wang et al, 2016). Psychosocial factors influencing chronic pain severity may include childhood trauma (Häuser, Kosseva, Üceyler, Klose, & Sommer, 2011;Jones, Power, & Macfarlane, 2009;Yeung, Davis, & Ciaramitaro, 2016) and maladaptive pain cognitions (Edwards et al, 2013;Higgins, Bailey, LaChapelle, Harman, & Hadjistavropoulos, 2015). Childhood trauma linked with chronic pain refers primarily to experiences of physical abuse, sexual abuse, and neglect prior to age 17 years.…”