Department of Anesthesiology, Perioperative, and Pain Medicine, Mass General Brigham, Harvard Medical School, 850 Boylston Street, Suite 308H, Chestnut Hill, Boston, MA 02467, United States of America.
Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States of America.
Scand J Pain. 2024 Jun 6;24(1). doi: 10.1515/sjpain-2023-0122. eCollection 2024 Jan 1.
We examined associations of a self-reported history of childhood abuse with pain and physical functioning in patients with knee osteoarthritis (KOA) awaiting total knee arthroplasty (TKA). We also explored the potential moderating effects of positive childhood experiences (PCEs), an index of resilience, on these associations.
Prior to TKA, participants with KOA awaiting surgery ( = 239) completed self-report measures of adverse childhood experiences (ACEs), PCEs, pain, and physical functioning. We evaluated associations of pain and physical functioning (Brief Pain Inventory [BPI] and Western Ontario and McMaster University of Osteoarthritis Index [WOMAC]) based on the experience of ACEs (childhood abuse), with PCEs (childhood happiness and supportive parental care) as potential moderators.
Greater exposure to childhood abuse was positively correlated with BPI pain interference as well as WOMAC pain and functioning scores. Additionally, childhood happiness and supportive parental care moderated the positive associations of childhood abuse with pain and physical functioning; though, surprisingly, the adverse effects of childhood abuse on these outcomes were more pronounced among participants with high levels of childhood happiness and supportive parental care.
Overall, results show an association between a self-reported history of childhood abuse and pain and functioning in patients with KOA awaiting TKA. However, PCEs did not protect against the negative consequences of childhood abuse in our cohort. Further research is needed to validate these associations and gain a more comprehensive understanding of the complex interplay between childhood abuse and PCEs and their potential influences on pain experiences in adults with chronic pain conditions, including KOA.
我们研究了自我报告的儿童期虐待史与等待全膝关节置换术（TKA）的膝骨关节炎（KOA）患者的疼痛和身体功能之间的关系。我们还探讨了积极的儿童期经历（PCE），即韧性指数，对这些关联的潜在调节作用。
在 TKA 之前，等待手术的 KOA 患者（n=239）完成了关于不良儿童经历（ACEs）、PCEs、疼痛和身体功能的自我报告测量。我们根据 ACEs（儿童虐待）评估了疼痛和身体功能（简明疼痛量表[BPI]和西安大略和麦克马斯特大学骨关节炎指数[WOMAC]）与 PCEs（儿童期快乐和支持性父母关爱）之间的关联。
更多的儿童虐待经历与 BPI 疼痛干扰以及 WOMAC 疼痛和功能评分呈正相关。此外，儿童时期的快乐和支持性父母关爱调节了儿童虐待与疼痛和身体功能之间的正相关关系；然而，令人惊讶的是，在儿童时期快乐和支持性父母关爱程度较高的参与者中，儿童虐待对这些结果的不良影响更为明显。
总体而言，结果表明，自我报告的儿童期虐待史与等待 TKA 的 KOA 患者的疼痛和功能有关。然而，在我们的队列中，PCE 并不能预防儿童虐待的负面影响。需要进一步的研究来验证这些关联，并更全面地了解儿童虐待和 PCE 之间的复杂相互作用及其对患有慢性疼痛疾病（包括 KOA）的成年人疼痛体验的潜在影响。
