Dennis Catlin H, Clohessy Denae S, Stone Amanda L, Darnall Beth D, Wilson Anna C
Department of Pediatrics, Institute on Development and Disability, Oregon Health & Science University, Portland, Oregon.
Department of Pediatrics, Institute on Development and Disability, Oregon Health & Science University, Portland, Oregon; Department of Psychology, Portland State University, Portland, Oregon.
J Pain. 2019 Oct;20(10):1209-1217. doi: 10.1016/j.jpain.2019.04.004. Epub 2019 Apr 18.
Adverse childhood experiences (ACEs; eg, parental divorce, physical or sexual abuse) are more prevalent in individuals with chronic pain compared with the general population. Both increased maternal ACEs and chronic pain have been associated with poor physical and emotional functioning in offspring. However, the mechanisms driving these associations are poorly understood. Thus, this cross-sectional study evaluated the relation between maternal ACEs, mothers' current functioning, and children's physical and emotional functioning in a sample of mothers with chronic pain and their 8- to 12-year-old children. Results indicated a higher prevalence of ≥1 ACE in this sample of mothers with chronic pain (84%) compared with normative data from a community sample of women. Higher maternal ACE scores corresponded with lower physical and social functioning, greater anxiety and depressive symptoms, greater fatigue and sleep disturbances, and greater pain intensity and pain interference in mothers. Higher maternal ACE scores significantly correlated with higher child self-reported depressive symptoms, but not somatic symptoms or functional impairment. A path model indicated that maternal depressive symptoms accounted for the relation between higher maternal ACE scores and children's depressive symptoms. Intervening on maternal depression among mothers with chronic pain may reduce the impact of intergenerational ACE transmission. Perspective: This article presents evidence regarding the intergenerational impact of ACEs in a large sample of mothers with chronic pain and their school-aged children. Maternal depressive symptoms accounted for the relation between maternal ACEs and children's depressive symptoms providing evidence regarding targets for preventive interventions.
与普通人群相比,童年不良经历(如父母离异、身体或性虐待)在慢性疼痛患者中更为普遍。母亲的童年不良经历增加和慢性疼痛都与后代身体和情感功能不佳有关。然而,导致这些关联的机制尚不清楚。因此,这项横断面研究评估了患有慢性疼痛的母亲及其8至12岁孩子样本中,母亲的童年不良经历、母亲当前的功能以及孩子的身体和情感功能之间的关系。结果表明,与来自社区女性样本的标准数据相比,在这个患有慢性疼痛的母亲样本中,≥1种童年不良经历的患病率更高(84%)。母亲童年不良经历得分越高,其身体和社会功能越低,焦虑和抑郁症状越严重,疲劳和睡眠障碍越严重,疼痛强度和疼痛干扰越大。母亲童年不良经历得分越高,与孩子自我报告的抑郁症状显著相关,但与躯体症状或功能损害无关。一个路径模型表明,母亲的抑郁症状解释了母亲童年不良经历得分较高与孩子抑郁症状之间的关系。对患有慢性疼痛的母亲的抑郁进行干预,可能会减少代际童年不良经历传递的影响。观点:本文提供了关于童年不良经历在大量患有慢性疼痛的母亲及其学龄儿童中的代际影响的证据。母亲的抑郁症状解释了母亲童年不良经历与孩子抑郁症状之间的关系,为预防性干预目标提供了证据。