Smith Tristin, Kheirabadi Dorna, Guo Yijun, Sun Junzhi, Pierce Jennifer, Bergmans Rachel S, Boehnke Kevin F, Schrepf Andrew, Clauw Daniel, Kaplan Chelsea M, Arewasikporn Anne
Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA.
Department of Anesthesiology, Henry Ford Hospital, Detroit, MI, USA.
Pain Rep. 2025 Apr 28;10(3):e1279. doi: 10.1097/PR9.0000000000001279. eCollection 2025 Jun.
Childhood adversity can have a lasting negative impact throughout one's life. Youth with pain conditions consistently report a higher rate of adverse childhood experiences (ACEs) when compared with their healthy peers. Adolescents experiencing pain in more than 1 region tend to have greater symptom burden and reduced quality of life. Research on the association between ACEs and multisite pain in adolescents is sparse.
The objective of our study was to investigate the association between cumulative ACEs and self-report of multisite pain in early adolescence using data from the Adolescent Brain Cognitive Development study.
We used a 19-region body map to evaluate the presence of regional pain (1-2 regions) and multisite pain (≥3 regions). We analyzed data using multinominal logistic regression, adjusting for sociodemographic factors including pubertal status, sex, race/ethnicity, and income-to-needs ratio.
We included a total of 7582 children aged 12 to 13 years, with 33.4%, 24.0%, 13.2%, and 8.6% reporting 1, 2, 3, and 4+ ACEs, respectively. Moreover, 30.7%, 24.2%, 15.2%, and 10.1% of children with multisite pain reported 1, 2, 3, and 4+ ACEs, respectively. Those with 4+ ACEs (adjusted odds ratio 1.62, 95% confidence interval 1.24-2.12) and 3 ACEs (adjusted odds ratio 1.44, 95% confidence interval 1.14-1.82) were more likely to report multisite pain compared with the children with no ACEs.
We showed a potential dose-response relationship between cumulative ACEs and multisite pain, suggesting that the impact of ACEs on pain, particularly multisite pain, may emerge earlier than previously documented. Adverse childhood experiences, Multisite pain, Adolescent pain.
童年逆境会对人的一生产生持久的负面影响。与健康同龄人相比,患有疼痛疾病的青少年报告的童年不良经历(ACEs)发生率始终较高。在多个部位经历疼痛的青少年往往症状负担更重,生活质量更低。关于ACEs与青少年多部位疼痛之间关联的研究很少。
我们研究的目的是利用青少年大脑认知发展研究的数据,调查青少年早期累积ACEs与多部位疼痛自我报告之间的关联。
我们使用一张包含19个区域的身体图来评估局部疼痛(1 - 2个区域)和多部位疼痛(≥3个区域)的存在情况。我们使用多项逻辑回归分析数据,并对社会人口学因素进行调整,包括青春期状态、性别、种族/民族和收入需求比。
我们共纳入了7582名12至13岁的儿童,分别有33.4%、24.0%、13.2%和8.6%的儿童报告有1次、2次、3次和4次以上的ACEs。此外,多部位疼痛儿童中分别有30.7%、24.2%、15.2%和10.1%报告有1次、2次、3次和4次以上的ACEs。与没有ACEs的儿童相比,有4次以上ACEs的儿童(调整后的优势比为1.62,95%置信区间为1.24 - 2.12)和有3次ACEs的儿童(调整后的优势比为1.44,95%置信区间为1.14 - 1.82)更有可能报告多部位疼痛。
我们发现累积ACEs与多部位疼痛之间存在潜在的剂量反应关系,这表明ACEs对疼痛,尤其是多部位疼痛的影响可能比之前记录的出现得更早。童年不良经历、多部位疼痛、青少年疼痛。