Fillingim R B, Wilkinson C S, Powell T
Department of Psychology, University of Alabama at Birmingham, 35294-1170, USA.
Clin J Pain. 1999 Jun;15(2):85-91. doi: 10.1097/00002508-199906000-00004.
Considerable evidence suggests that a self-reported history of physical and/or sexual abuse is more frequently reported among chronic pain populations and is associated with poorer adjustment to pain. However, previous research has typically included patients seeking treatment for pain, whereas few population-based studies have explored the association between abuse history and pain. This purpose of this study was to examine the association between self-reported history of sexual or physical abuse and recent pain complaints, health-related variables, and psychological disturbance among a nonclinical sample of young adults.
Subjects were 426 (275 female, 151 male) college students who completed a series of questionnaires assessing abuse history, recent pain, health care utilization, perceived health, and psychological variables.
Females reported a positive history of abuse (PHA) more frequently than males (43.5% vs. 23.8%), and females reported significantly higher rates for all types of abuse except physical abuse during childhood (p < 0.05). PHA subjects reported experiencing pain in more sites and pain of higher severity over the past month compared to subjects with a negative history of abuse (NHA) (p < 0.05). PHA subjects also reported more health care utilization and greater psychological disturbance, including depression, somatization, negative temperament, and higher levels of catastrophizing (p < 0.05). Interestingly, when somatization and depression scale scores were used as covariates, group differences in pain complaints and health care utilization became nonsignificant (p > 0.10).
These findings suggest that a self-reported history of physical or sexual abuse is associated with increased pain complaints, health care utilization, and psychological disturbance even among young adults from a nonclinical population. Moreover, the association between abuse and pain complaints appears to be moderated at least in part by the higher levels of somatization and depression observed in the PHA group.
大量证据表明,在慢性疼痛人群中,身体虐待和/或性虐待的自我报告病史更为常见,且与对疼痛的适应较差有关。然而,以往的研究通常纳入了寻求疼痛治疗的患者,而很少有基于人群的研究探讨虐待史与疼痛之间的关联。本研究的目的是在一个非临床的年轻成人样本中,检验自我报告的性虐待或身体虐待史与近期疼痛主诉、健康相关变量以及心理障碍之间的关联。
研究对象为426名大学生(275名女性,151名男性),他们完成了一系列问卷,评估虐待史、近期疼痛、医疗保健利用情况、感知健康状况和心理变量。
女性报告有虐待阳性史(PHA)的频率高于男性(43.5%对23.8%),除童年期身体虐待外,女性报告的所有类型虐待发生率均显著更高(p<0.05)。与无虐待阴性史(NHA)的受试者相比,PHA受试者在过去一个月中报告的疼痛部位更多,疼痛严重程度更高(p<0.05)。PHA受试者还报告了更多的医疗保健利用情况和更大的心理障碍,包括抑郁、躯体化、消极气质以及更高水平的灾难化思维(p<0.05)。有趣的是,当将躯体化和抑郁量表评分用作协变量时,疼痛主诉和医疗保健利用方面的组间差异变得不显著(p>0.10)。
这些发现表明,即使在非临床人群的年轻成人中,自我报告的身体虐待或性虐待史也与疼痛主诉增加、医疗保健利用和心理障碍有关。此外,虐待与疼痛主诉之间的关联似乎至少部分受到PHA组中观察到的较高水平的躯体化和抑郁的调节。