Department of Anesthesiology, University of Michigan, Back and Pain Center, Ann Arbor, MI, USA.
Center for Pain and the Brain, Department of Anesthesia, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, MA, USA.
Ann Behav Med. 2021 Aug 23;55(9):853-869. doi: 10.1093/abm/kaaa105.
Childhood trauma and adversity have been linked to chronic pain and pain sensitivity, particularly centralized pain. Yet, there remain numerous gaps in our understanding of this link.
We explored the association between nonviolent and violent childhood trauma and a component of centralized pain (i.e., generalized sensory sensitivity) and pain sensitivity using self-report measures of centralized pain and quantitative sensory testing (QST).
Patients scheduled for a total knee arthroplasty (n = 129) completed questionnaires and QST prior to surgery.
We found that self-report measures of centralized pain (i.e., widespread pain, somatic awareness, and sensory sensitivity) displayed a graded relationship across trauma groups, with patients with a history of violent trauma reporting the highest scores. Univariable multinomial logistic regression analyses showed that higher sensory sensitivity was associated with increased risk of being in the nonviolent trauma group compared to the no trauma group. Furthermore, higher widespread pain, higher somatic awareness, and higher sensory sensitivity distinguished the violent trauma group from the no trauma group. In multivariable analyses, sensory sensitivity is uniquely distinguished between the violent trauma group and the no trauma group. QST did not distinguish between groups.
The findings highlight the need for future research and interventions that reduce sensory sensitivity for chronic pain patients with a history of violent childhood trauma.
童年创伤和逆境与慢性疼痛和疼痛敏感性有关，尤其是中枢性疼痛。然而，我们对这种联系的理解仍然存在许多空白。
我们使用中枢性疼痛（即广泛的感觉敏感性）和定量感觉测试（QST）的自我报告测量来探讨非暴力和暴力童年创伤与中枢性疼痛的一个组成部分（即广泛的感觉敏感性）和疼痛敏感性之间的关联。
计划接受全膝关节置换术的患者（n=129）在手术前完成了问卷和 QST。
我们发现，中枢性疼痛的自我报告测量（即广泛疼痛、躯体意识和感觉敏感性）在创伤组之间呈梯度关系，有暴力创伤史的患者报告的得分最高。单变量多项逻辑回归分析表明，与无创伤组相比，感觉敏感性较高与处于非暴力创伤组的风险增加相关。此外，较高的广泛疼痛、较高的躯体意识和较高的感觉敏感性将暴力创伤组与无创伤组区分开来。在多变量分析中，感觉敏感性可将暴力创伤组与无创伤组区分开来。QST 无法区分组间差异。
这些发现强调了需要进行未来的研究和干预，以减少有暴力童年创伤史的慢性疼痛患者的感觉敏感性。
