Dalechek Danielle E, Caes Line, McIntosh Gwenne, Whittaker Anna C
From the Faculty of Health Sciences and Sport (Dalechek, McIntosh, Whittaker) and Division of Psychology, Faculty of Natural Sciences (Dalechek, Caes), University of Stirling, Stirling, United Kingdom.
Biopsychosoc Sci Med. 2025 Jan 1;87(1):59-73. doi: 10.1097/PSY.0000000000001350.
This study used the Midlife-Development in the United States (MIDUS) dataset to a) examine relationships between reported childhood adversity (CA), anxiety, and pain; b) assess associations between CAs, anxiety, C-reactive protein (CRP) levels, and pain; and c) explore how CAs, anxiety, and CRP are associated with pain medication consumption.
Data were from Project-4 of MIDUS-II (n = 1225), which utilized Project-1 demographics and supplemental chart review. For objectives 1-2, structural equational modeling (SEM) followed by general linear modeling (GLM) regression was conducted. For objective 3, all variables from the objective 1-2 dataset were used as possible independent variables for the exploratory regression.
For objectives 1-2, CRP was significantly correlated with anxiety, emotional abuse, physical neglect, and chronic pain (n = 1173). The SEM (n = 1173) indicated that CAs, anxiety, and CRP all played a role in predicting chronic pain. Regression results (n = 1173) indicated that gender, total income, and highest education were significant predictors of chronic pain. Significant interactions to explain chronic pain included physical abuse/emotional neglect, emotional abuse/physical abuse, physical abuse/minimization, physical neglect/education, CRP/income, and CRP/education. For objective 3 (n = 600), there were no significant main effects, but a large variety of interactions contributed to predicting pain medication consumption. CAs interacting significantly to explain this included emotional abuse/physical abuse, physical abuse/emotional neglect, physical abuse/minimization, and sexual abuse/minimization. There were also significant interactions between CRP/income and CRP/education.
Based on a large US sample, sociodemographics played a meaningful role in predicting chronic pain in adults, and CRP was significantly correlated with anxiety, emotional abuse, physical neglect, multiple sociodemographic variables, and chronic pain. The influence of CAs on predicting long-term medication use for chronic pain was complex and warrants further study.
本研究使用美国中年发展（MIDUS）数据集来：a）检验报告的童年逆境（CA）、焦虑和疼痛之间的关系；b）评估CA、焦虑、C反应蛋白（CRP）水平和疼痛之间的关联；c）探究CA、焦虑和CRP如何与止痛药消费相关。
数据来自MIDUS-II的项目4（n = 1225），该项目利用了项目1的人口统计学数据和补充图表审查。对于目标1-2，进行了结构方程模型（SEM），随后进行一般线性模型（GLM）回归。对于目标3，目标1-2数据集中的所有变量被用作探索性回归的可能自变量。
对于目标1-2，CRP与焦虑、情感虐待、身体忽视和慢性疼痛显著相关（n = 1173）。SEM（n = 1173）表明，CA、焦虑和CRP在预测慢性疼痛中均起作用。回归结果（n = 1173）表明，性别、总收入和最高学历是慢性疼痛的显著预测因素。解释慢性疼痛的显著交互作用包括身体虐待/情感忽视、情感虐待/身体虐待、身体虐待/最小化、身体忽视/教育、CRP/收入和CRP/教育。对于目标3（n = 600），没有显著的主效应，但多种交互作用有助于预测止痛药消费。显著交互作用以解释这一点的包括情感虐待/身体虐待、身体虐待/情感忽视、身体虐待/最小化和性虐待/最小化。CRP/收入和CRP/教育之间也存在显著交互作用。
基于大量美国样本，社会人口统计学在预测成年人慢性疼痛中发挥了有意义的作用，并且CRP与焦虑、情感虐待、身体忽视、多个社会人口统计学变量和慢性疼痛显著相关。CA对预测慢性疼痛长期用药的影响是复杂的，值得进一步研究。
