Effects of childhood trauma on pain‐related distress in adults

Abstract

Background Much of the work in post‐musculoskeletal (MSK) trauma and distress has been conducted through frameworks that start from the injury and go forward to better understand the trajectories and predictors of recovery. However, stress–diatheses models suggest that reactions to trauma are shaped by pre‐existing experiences of the person more than the parameters of the event itself. In this study, we explore the effects of adverse childhood experiences (ACEs) on traumatic threat appraisal, distress and pain‐related functional interference in adulthood. Methods Adult participants with acute, non‐catastrophic musculoskeletal trauma completed a battery of questionnaires that included the Adverse Childhood Experiences Questionnaire (ACEQ), the Brief Illness Perceptions Questionnaire (BIPQ), the Traumatic Injuries Distress Scale (TIDS) and the Brief Pain Inventory (BPI). An a priori model was evaluated through path analysis to determine the variance in BPI Interference scores explained through direct or indirect pathways between these variables (ACEQ‐>BIPQ, BIPQ‐>TIDS, TIDS‐>BPI). The analysis was repeated for the sample when disaggregated by sex. Results In n = 114, the base model was saturated. After removing non‐significant pathways, the ACEQ‐>BIPQ‐>TIDS‐>BPI paths were significant and in the expected direction, explaining 57.1% of variance in acute BPI Interference score. When disaggregated by sex, the effect of ACEs on threat appraisal was only significant in men and not women, although this analysis was exploratory. Conclusions Acute pain‐related interference could be predicted by post‐traumatic distress and threat appraisal. Threat appraisal could be further predicted through ACEs, more childhood adversities were associated with more threatening appraisal of trauma in adulthood. The disaggregated finding that the effects of childhood adversities were only significant in males requires further exploration. Significance This study explores the potential pathways of the stress–diathesis model while focusing on adverse childhood experiences as a novel contribution to the field of acute post‐trauma pain. The findings may inform future research design and interpretation of acute‐to‐chronic pain risk stratification tools.

Global, regional, and national burden of neck pain, 1990–2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021

“…Whether those responses are driven by the pain experience, genetics, microbiome, life experiences, cultural beliefs and pressures, or (more likely) some contribution from all of these, the challenge for clinicians and researchers is to work beyond their typical academic boundaries to find points of convergence that can start to unravel what continues to be a burdensome and recalcitrant problem: acute and chronic neck pain. 7 , 27 , 28 …”

Using Microbiome-Based Approaches to Deprogram Chronic Disorders and Extend the Healthspan following Adverse Childhood Experiences

“…[34][35][36] Substance Misuse/Abuse/Addiction Smoking/Alcohol/Drugs [37,38] Additional Risky Behavior Early sex, multiple partners/early pregnancy [39] Chronic pain Both adolescent and adult onset; cortisol levels can be a biomarker. [40][41][42][43][44] Table 1. Cont.…”

“…Several studies have specifically examined the relationship between childhood adverse experiences and the appearance and persistence of adolescent and adult pain. Examples of recent ACE-pain studies are shown in Table 3 [40][41][42][43][44]96].…”

Using Microbiome-Based Approaches to Deprogram Chronic Disorders and Extend the Healthspan Following Adverse Childhood Experiences

“…With this in mind, effective approaches to correcting and rebalancing the early life damages to the human holobiont need to include not only the microbiome but also the larger inflammation-controlling unit, the microimmunosome. Early sex, multiple partners/early pregnancy [39] Chronic pain Both adolescent and adult onset; cortisol levels can be a biomarker [40][41][42][43][44] Unfavorable pregnancy outcomes In women, one example is premature deliveries. For this outcome, a primary driver is childhood sexual abuse [45] Neural wiring alterations/Cognitive impairment…”

“…Several studies have specifically examined the relationship between childhood adverse experiences and the appearance and persistence of adolescent and adult pain. Examples of recent ACE-pain studies are shown in Table 3 [40][41][42][43][44]96]. [96]…”