Childhood abuse and the experience of pain in adulthood: the mediating effects of PTSD and emotion dysregulation on pain levels and pain-related functional impairment
Open accessAbstract
Background Previous findings suggest a relationship between childhood abuse and pain-related conditions. It is yet to be determined whether adult posttraumatic stress disorder (PTSD) symptoms may mediate the association between the experience of childhood abuse and reported pain in adulthood.Objective We sought to determine if emotion dysregulation may also play a role in mediating PTSD and pain levels.Methods We examined subjects (N = 814) recruited from the primary care clinics of an urban public hospital as part of an National Institute of Mental Health-funded study of trauma-related risk and resilience. We evaluated childhood abuse with the Childhood Trauma Questionnaire, PTSD symptoms with the PTSD Symptom Severity scale, and emotional dysregulation with the Emotion Dysregulation Scale. Pain and functional limitations of pain were assessed through self-report.Results We found that both childhood abuse and current PTSD symptoms predicted higher levels of reported pain. Childhood abuse, PTSD symptoms, and emotion dysregulation all predicted higher levels of functional impairment related to pain. Using the Sobel method and bootstrapping techniques and controlling for current level of negative affect, we found that PTSD fully mediated the effect of childhood abuse on pain level and pain-related limitations; emotion dysregulation partially mediated the effect of PTSD symptoms in predicting higher levels of pain-related limitations.Conclusions Although causality cannot be determined in the present study, these findings suggest that PTSD may serve as the pathway between exposure to childhood abuse and the development of pain-related conditions in adulthood, and that emotion dysregulation is a significant factor in understanding how PTSD relates to specific pain-related functional impairment.
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Catastrophizing positively correlates with general negative affect such as depressive symptoms and anxiety.
“While catastrophizing positively correlates with general measures of negative affect such as depressive symptoms and anxiety, it also shows a unique and specific influence on pain-related outcomes 297–299.”
From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [299]
Catastrophizing has a unique and specific influence on pain-related outcomes.
“it also shows a unique and specific influence on pain-related outcomes 297–299.”
From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [299]
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Percentages, sums and reported differences re-computed from the paper’s own numbers.
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- Authors
- Powers, A., Fani, N., Pallos, A., Stevens, J., Ressler, K. J., & Bradley, B.
- Affiliations
- Emory University (US)
- Howard Hughes Medical Institute (US)
- Corresponding author
- Powers, Abigail
- Venue
- Psychosomatics
- Publisher
- Elsevier BV
- Published
- 2014-09
- Volume
- 55
- Issue
- 5
- Pages
- 491-499
- ISSN
- 0033-3182 (ISSN-L)
- PMC
- PMC3997632
- OpenAlex
- W2155402822
- Cited by
- 43
- References
- 45
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 6 · 2023: 4 · 2022: 3 · 2021: 4 · 2020: 3 · 2019: 3 · 2018: 6 · 2017: 4 · 2016: 3 · 2015: 1 · 2014: 2
- FWCI
- 2.23
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychosomatics (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Emory University
- National Institutes of Health (RR 00039, MH071537, P51OD011132)
- National Institute of Mental Health (MH 071537, M01 RR00039, R01MH071537, R56MH071537, F32MH101976)
- National Center for Research Resources (M01-RR00039, M01RR000039)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- childhood abuse, post-traumatic stress disorder, emotional dysregulation, pain, mediation, chronic pain, trauma exposure
- MeSH terms
- Adolescent, Adult, Emotions, Female, Georgia, Humans, Male, Pain, Pain Measurement, Psychiatric Status Rating Scales, Risk Factors, Severity of Illness Index, Stress Disorders, Post-Traumatic, Causality, Adult Survivors of Child Abuse
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