Mary Free Bed Rehabilitation Hospital.
Michigan State University College of Human Medicine, Grand Rapids, MI.
Clin J Pain. 2022 Sep 1;38(9):551-561. doi: 10.1097/AJP.0000000000001054.
Adverse childhood experiences (ACEs) have been linked to the development and impact of chronic pain in adulthood. The goal of this study was to investigate the prevalence of ACEs in a treatment-seeking sample of adults with chronic pain and the relationship between number and type(s) of ACEs and pain-related outcomes.
Adults (N=1794) presenting for treatment at a multidisciplinary pain management center completed self-report measures of childhood adversity, pain, functioning, emotional distress, and adjustment to pain.
Participants endorsing ≥4 ACEs had significantly worse pain-related outcomes and lower quality of life compared with individuals reporting fewer ACEs. Having ≥3 ACEs was associated with higher anxiety and depression levels. Experiences of childhood neglect negatively affected mental health-related outcomes independent of the number of ACEs. Significant sex differences were found in the number and type of ACEs reported but not in the relationship between ACEs and outcome variables.
Findings suggest that the number and the type of self-reported ACE(s) are associated with pain-related variables and psychosocial functioning in adults with chronic pain. The results highlight the importance of assessment of ACEs and trauma-informed care with patients with chronic pain.
不良的童年经历(ACEs)与成年人慢性疼痛的发展和影响有关。本研究的目的是调查在寻求治疗的慢性疼痛成年患者样本中 ACEs 的发生率,以及 ACEs 的数量和类型与疼痛相关结果之间的关系。
在一家多学科疼痛管理中心接受治疗的成年人(N=1794)完成了儿童期逆境、疼痛、功能、情绪困扰和疼痛适应的自我报告测量。
与报告 ACEs 较少的个体相比,报告≥4 项 ACEs 的个体疼痛相关结果明显更差,生活质量更低。有≥3 项 ACEs 与更高的焦虑和抑郁水平相关。童年忽视的经历对心理健康相关结果的影响独立于 ACEs 的数量。在报告的 ACEs 的数量和类型方面发现了显著的性别差异,但在 ACEs 与结果变量之间的关系方面没有发现性别差异。
研究结果表明,报告的 ACEs 的数量和类型与慢性疼痛成年患者的疼痛相关变量和心理社会功能有关。研究结果强调了对慢性疼痛患者进行 ACEs 评估和以创伤为中心的护理的重要性。