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全国共病调查中的童年期虐待、慢性疼痛和抑郁症

Childhood abuse, chronic pain, and depression in the National Comorbidity Survey.

作者信息

Sachs-Ericsson Natalie, Kendall-Tackett Kathleen, Hernandez Annya

机构信息

Department of Psychology, Florida State University, Tallahassee, FL 32306, USA.

出版信息

Child Abuse Negl. 2007 May;31(5):531-47. doi: 10.1016/j.chiabu.2006.12.007.

Abstract

OBJECTIVE

The current study examined the effects of childhood sexual and physical abuse on reports of pain in men and women (N=1,727).

METHODS

Data from the National Comorbidity Survey, a nationally representative sample, were utilized. Childhood experiences of physical and sexual abuse were assessed, and pain reports in relation to current health problems were obtained. Regression and mediation analyses were used to examine the relationship between childhood abuse and current pain reports and to determine whether depression mediated this relationship.

RESULTS

Individuals who experienced abuse reported more health problems compared to those participants without abuse histories. Among participants with a current health problem, those who experienced abuse reported more pain compared to those participants without abuse histories. Because childhood abuse is associated with depression and depression is associated with more reported pain, the influence of depression on the relationship between childhood abuse and adult pain reports was examined. After controlling for differences between the abused and non-abused participants on specific health problems, depression was not found to have mediated the relationship.

CONCLUSIONS

Childhood abuse was associated with more reported pain. The higher rate of depression found among adults who experienced childhood abuse was not the primary factor for these increased pain reports. Rather, childhood abuse and depression independently contributed to pain reports. Treatment of both underlying problems (i.e., pain and depression) is recommended in addressing the needs of abused individuals with these comorbid disorders.

摘要

目的

本研究调查了童年期性虐待和身体虐待对男性和女性(N = 1727)疼痛报告的影响。

方法

使用来自全国共病调查的数据,该调查样本具有全国代表性。评估童年期身体虐待和性虐待经历,并获取与当前健康问题相关的疼痛报告。采用回归分析和中介分析来检验童年期虐待与当前疼痛报告之间的关系,并确定抑郁是否介导了这种关系。

结果

与无虐待史的参与者相比,有虐待经历的个体报告的健康问题更多。在有当前健康问题的参与者中,有虐待经历的人比无虐待史的参与者报告了更多的疼痛。由于童年期虐待与抑郁相关,而抑郁又与更多的疼痛报告相关,因此研究了抑郁对童年期虐待与成人疼痛报告之间关系的影响。在控制了受虐待和未受虐待参与者在特定健康问题上的差异后,未发现抑郁介导了这种关系。

结论

童年期虐待与更多的疼痛报告相关。在有童年期虐待经历的成年人中发现的较高抑郁率并非这些增加的疼痛报告的主要因素。相反,童年期虐待和抑郁独立地导致了疼痛报告。建议针对有这些共病障碍的受虐待个体的需求,同时治疗两个潜在问题(即疼痛和抑郁)。

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