Pathways of chronic pain in survivors of intimate partner violence
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OBJECTIVE: To examine the roles of lifetime abuse-related injury, posttraumatic stress disorder (PTSD) symptom severity, and depressive symptom severity in mediating the effects of severity of assaultive intimate partner violence (IPV), psychological IPV, and child abuse on chronic pain severity in women survivors of IPV. METHODS: Structural equation modeling of data from a community sample of 309 women survivors of IPV was used to test partial and full theoretical models of the relationships among the variables of interest. RESULTS: The full model had good fit and accounted for 40.2% of the variance in chronic pain severity. Abuse-related injury, PTSD symptom severity, and depressive symptom severity significantly mediated the relationship between child abuse severity and chronic pain severity, but only abuse-related injury significantly mediated the relationship between assaultive IPV severity and chronic pain severity. Psychological IPV severity was the only abuse variable with significant direct effects on chronic pain severity but had no significant indirect effects. CONCLUSIONS: These findings can inform clinical care of women with chronic pain in all areas of healthcare delivery by reinforcing the importance of assessing for a history of child abuse and IPV. Moreover, they highlight the relevance of routinely assessing for abuse-related injury and PTSD and depressive symptom severity when working with women who report chronic pain.
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“The associations between depressive symptoms, opioid misuse, and pain intensity among individuals with a history of IPT are consistent with the extant literature [13, 22, 25, 29].”
ResultCerulli, C., Poleshuck, E. L., Raimondi, C., Veale, S., & Chin, N. P. (2012) · Journal of Family Violence · doi:10.1007/s10896-012-9469-6 · Cited by 49 · see citing works
“Pain is a common and debilitating concern among those experiencing intimate partner violence (IPV; Wuest et al. 2010).”
The Impact of Psychological Interventions on Posttraumatic Stress Disorder and Pain Symptoms
Goldstein, E., McDonnell, C., Atchley, R., Dorado, K., Bedford, C. E., Brown, R., & Zgierska, A. E. (2019) · Clinical Journal of Pain · doi:10.1097/ajp.0000000000000730 · Cited by 46 · see citing works
Wuest, J., Merritt‐Gray, M., Dubé, N., Hodgins, M. J., Malcolm, J., Majerovich, J. A., Scott‐Storey, K., Ford‐Gilboe, M., & Varcoe, C. (2015) · Research in Nursing & Health · doi:10.1002/nur.21636 · Cited by 46 · see citing works
“…data gathered in our longitudinal study of Research in Nursing & Health women’s health after leaving (Ford-Gilboe et al., 2009; Varcoe et al., 2011; Wuest et al., 2007, 2008, 2009, 2010), we modified the SCLI theory to include six approaches used by women to strengthen capacity to manage…”
MethodSelf-citationVarcoe, C., Browne, A. J., Ford‐Gilboe, M., Stout, M. D., McKenzie, H. A., Price, R., Bungay, V., Smye, V. L., Inyallie, J., Day, L., et al. (2017) · Research in Nursing & Health · doi:10.1002/nur.21795 · Cited by 44 · see citing works
“…these forms of intrusion in detail (Davies et al., 2015; Ford-Gilboe et al., 2009; Guruge et al., 2012; Ponic et al., 2012; Varcoe et al., 2011; Wuest et al., 2008, 2009, 2010), and we used the findings to inform the development of iHEAL. iHEAL was designed to be delivered by a…”
MethodSelf-citationWalker, N., Beek, K., Chen, H., Shang, J., Stevenson, S., Williams, K., Herzog, H. L., Ahmed, J., & Cullen, P. (2020) · Trauma Violence & Abuse · doi:10.1177/1524838020957989 · Cited by 47 · see citing works
Ford-Gilboe, M., Varcoe, C., Wuest, J., Campbell, J., Pajot, M., Heslop, L., & Perrin, N. (2023) · Journal of Interpersonal Violence · doi:10.1177/08862605221090595 · Cited by 40 · see citing works
Self-citationPain beliefs mediate relations between general resilience and dysfunction from chronic back pain.
Chen, S., & Jackson, T. (2018) · Rehabilitation Psychology · doi:10.1037/rep0000244 · Cited by 36 · see citing works
Alhalal, E., Ford‐Gilboe, M., Wong, C. A., & AlBuhairan, F. S. (2018) · BMC Women s Health · doi:10.1186/s12905-018-0642-9 · Cited by 35 · see citing works
Self-citationGendered Worlds of Pain: Women, Marginalization, and Chronic Pain
Rice, K., Connoy, L., & Webster, F. (2024) · Journal of Pain · doi:10.1016/j.jpain.2024.104626 · Cited by 33 · see citing works
Intimate Partner Violence in Saudi Arabia: A Systematic Review
Alhalal, E., Ta’an, W., & Alhalal, H. (2019) · Trauma Violence & Abuse · doi:10.1177/1524838019867156 · Cited by 32 · see citing works
“In general, abused women have been found to experience PTSD, heart diseases, arthritis, fibromyalgia, asthma, strokes, gastrointestinal disorders, and cancers (Dillon, Hussain, Loxton, & Rahman, 2013; Garcı́aMoreno et al., 2013; Leserman, Zolnoun, Meltzer-Brody, Lamvu, & Steege, 2006; Wuest et al., 2010), but less is…”
BackgroundChronic struggle: an institutional ethnography chronic pain and marginalization.
Webster, F., Connoy, L., Sud, A., Rice, K., Katz, J., Pinto, A., Upshur, R., & Dale, C. M. (2022) · Journal of Pain · doi:10.1016/j.jpain.2022.10.004 · Cited by 26 · see citing works
Poleshuck, E. L., Mazzotta, C. M., Resch, K., Rogachefsky, A., Bellenger, K., Raimondi, C., Stone, J. T., & Cerulli, C. (2016) · Journal of Interpersonal Violence · doi:10.1177/0886260516628810 · Cited by 28 · see citing works
Obesity in women who have experienced intimate partner violence
Alhalal, E. (2018) · Journal of Advanced Nursing · doi:10.1111/jan.13797 · Cited by 24 · see citing works
Tutty, L., Radtke, H. L., Thurston, W. E. (., Nixon, K. L., Ursel, E. J., Ateah, C., & Hampton, M. (2019) · Violence against Women · doi:10.1177/1077801219884123 · Cited by 18 · see citing works
“The high proportion of women with disabilities and child abuse histories is congruent with other research (i.e., Ballan et al., 2014; Wuest et al., 2010), and the women with disabilities identified more problematic mental health than women without disabilities, although, on average, their mental health status was in t…”
Terrazas-Carrillo, E. C., McWhirter, P. T., & Martel, K. M. (2016) · Journal of Family Violence · doi:10.1007/s10896-016-9827-x · Cited by 22 · see citing works
“…severity of abuse with poorer mental and physical health, quality of life, and higher levels of depression, PTSD, and substance abuse across highly developed countries like the U.S. and Canada (Dutton et al. 2005b; Golding 1999; Straus et al. 2009; Wathen and MacMillan 2003; Wuest et al. 2010).”
BackgroundPrzekop, P., Haviland, M. G., Oda, K., & Morton, K. R. (2014) · Journal of Bodywork and Movement Therapies · doi:10.1016/j.jbmt.2014.04.011 · Cited by 21 · see citing works
“Traumatic experiences—Traumatic events during one’s lifetime have been associated with the development of pain in later life (Hart-Johnson and Green, 2012; Jones et al., 2009; Paras et al., 2009; Wuest et al., 2010).”
BackgroundÁsgeirsdóttir, H. G., Valdimarsdóttir, U. A., Fürst, C. J., Steineck, G., & Hauksdóttir, A. (2013) · Psycho-Oncology · doi:10.1002/pon.3345 · Cited by 19 · see citing works
“Studies have indicated that experiencing psychological trauma such as intimate partner violence, sexual abuse, and surviving the holocaust can increase the risk of chronic pain symptoms [47,48].”
BackgroundWathen, C. N., Tanaka, M. N., MacGregor, J. C. D., Ferro, M. A., McKee, C., Boyle, M., Ford‐Gilboe, M., & MacMillan, H. L. (2016) · International Journal of Public Health · doi:10.1007/s00038-016-0852-6 · Cited by 15 · see citing works
“…such as those showing that both injuries and mental health symptoms may mediate the relationship between severity of IPV and physical health (Wuest et al. 2010), and that physical health consequences of IPV are linked to longer-term cellular and epigenetic changes (Newton et al. 2011;…”
BackgroundSelf-citationCampbell, K., Ford‐Gilboe, M., Kennedy, K., Jackson, K. T., Mantler, T., & Oudshoorn, A. (2022) · Women s Health · doi:10.1177/17455057221103994 · Cited by 15 · see citing works
Self-citationValidation of the Psychological Maltreatment of Women Inventory for Chinese Women
Cheung, D. S. T., Tiwari, A., Chan, K. L., Fong, D., Chau, P. H., Yuen, F., & Tolman, R. M. (2017) · Journal of Interpersonal Violence · doi:10.1177/0886260517715602 · Cited by 14 · see citing works
“Specifically, women who experience psychological abuse are at higher risk for chronic pain, even when physical violence is absent (Wuest et al., 2010).”
BackgroundLies, J., Jones, L. E., & Ho, R. (2019) · BJPsych Advances · doi:10.1192/bja.2019.7 · Cited by 13 · see citing works
Rasmussen, V., Spangaro, J., Steel, Z., Briggs, N., & Torok, M. H. (2023) · Journal of Family Violence · doi:10.1007/s10896-023-00640-5 · Cited by 16 · see citing works
“…as experiencing multiple types of abuse, frequent incidents of abuse, specific types of abuse over others (e.g., sexual vs financial) or specific behaviours (e.g., use of a weapon) (Cole et al., 2008; Dutton et al., 2005; Hegarty et al., 2013; Rancher et al., 2021; Wuest et al., 2010).”
Nowak, Y. E., Backman-Enelius, M. M., Jonas, W., Eriksson, J. A., Åhlund, D. S., & Barimani, M. M. (2023) · Scandinavian Journal of Public Health · doi:10.1177/14034948221148056 · Cited by 13 · see citing works
“[5] Wuest J, Ford-Gilboe M, Merritt-Gray M, et al.”
BackgroundResultParker, M. K., Lehman, E. B., Abram, M. C., Weisman, C. S., & McCall‐Hosenfeld, J. S. (2020) · Women s Health Issues · doi:10.1016/j.whi.2020.04.005 · Cited by 11 · see citing works
Tracing the Emotional Roadmap of Depressive Users on Social Media Through Sequential Pattern Mining
Giuntini, F. T., de Moraes, K. L., Cazzolato, M. T., Kirchner, L. D. F., dos Reis, M. D. J. D., Traina, A. J. M., Campbell, A. T., & Ueyama, J. (2021) · IEEE Access · doi:10.1109/access.2021.3095759 · Cited by 11 · see citing works
“In [66] the authors point out that experiences of pain and violence may be related and also corroborate the theory that stressful events, such as child abuse and domestic violence, may contribute to the etiology or maintenance of chronic pain [66], [67].”
BackgroundIntimate Partner Violence, Disability, and Pain: A Retrospective Study
Ballan, M. S., Freyer, M. B., & Romanelli, M. (2021) · Journal of Family Violence · doi:10.1007/s10896-021-00331-z · Cited by 11 · see citing works
Eckerström, J., Mårtensson, S. K., Larsson, M., Knez, R., Ljudvåg, M., Alaoui, S. E., Dahlström, K., Nowak, Y. E., Stenfors, T., Jayaram‐Lindström, N., et al. (2025) · Frontiers in Digital Health · doi:10.3389/fdgth.2025.1516379 · Cited by 7 · see citing works
“Unexplained somatic pain has also been shown in studies to have a very strong connection to psychological violence exposure in particular (20, 21).”
Reaching Out To Women Who Are Victims of Intimate Partner Violence
Svavarsdóttir, E. K., Örlygsdóttir, B., & Guðmundsdóttir, B. (2014) · Perspectives In Psychiatric Care · doi:10.1111/ppc.12080 · Cited by 7 · see citing works
Sójta, K., Margulska, A., Jóźwiak-Majchrzak, W., Grażka, A., Grzelczak, K., & Strzelecki, D. (2023) · Brain Sciences · doi:10.3390/brainsci13071118 · Cited by 6 · see citing works
“Physical health issues included but were not limited to an increased risk of injury [4,5], chronic pain [6,7], headaches [8,9], diabetes [10,11] and higher rates of sexually transmitted infections [12–14].”
BackgroundTutty, L., & Nixon, K. L. (2024) · Journal of Interpersonal Violence · doi:10.1177/08862605241243344 · Cited by 7 · see citing works
“Interestingly, as part of the same large study, Ford-Gilboe et al. (2015) and Wuest et al. (2010) examined populations of women with IPV and whether they reported a disability (similar to the current research) but neither study documented differences in mental health scores comparing whether or not…”
BackgroundResultInfluentialYamada, K., Kimura, T., Cui, M., Kubota, Y., Tanaka, E., Wakaizumi, K., Ikehara, S., Kimura, T., Iso, H., & the Japan Environment and Children's Study Group (2020) · Pain · doi:10.1097/j.pain.0000000000002084 · Cited by 6 · see citing works
Syndemics and the etiology of opioid misuse among women: A qualitative study
Spector, A. L., Quinn, K. G., deRoon‐Cassini, T. A., Young, S. A., O’Brien, M., & Dickson‐Gómez, J. (2021) · SSM - Qualitative Research in Health · doi:10.1016/j.ssmqr.2021.100028 · Cited by 5 · see citing works
Chronic Environmental Diseases
Beyer, K. M. M. (2015) · Elsevier eBooks · doi:10.1016/b978-0-12-394847-2.00013-9 · Cited by 4 · see citing works
Pebole, M. M., Beck, B. M., Mahoney, C. T., & Iverson, K. M. (2024) · Brain Sciences · doi:10.3390/brainsci14101008 · Cited by 3 · see citing works
“Co-occurring Co-occurring physical health concerns such as chronic pain and inflammation, poor sleep, and high risk for cardiometabolic disease also contribute to poor functional status among women who have experienced IPV [15–18].”
BackgroundA scoping review of intimate partner violence in hospitalized patients
Maitra, A., Schnipper, J. L., Bain, P. A., & Mueller, S. K. (2023) · Journal of Hospital Medicine · doi:10.1002/jhm.13094 · Cited by 3 · see citing works
Pebole, M. M., Iverson, K. M., Bolduc, C. M., Joyce, J. M., Sablone, C. A., & Fortier, C. B. (2024) · Brain Sciences · doi:10.3390/brainsci14080814 · Cited by 3 · see citing works
“Further, detriments in physical and mental health may persist chronically, contributing to heightened risk for suicidality and long-term functional disability for WVs [50,56,57].”
BackgroundRisk Factors for Chronic Pain in Women: The Role of Violence Exposure in a Case–Control Study
Uvelli, A., Pugliese, E., & Ferretti, F. (2025) · Life · doi:10.3390/life15060976 · Cited by 3 · see citing works
“Among violence-exposed individuals, anxiety is particularly prevalent and often accompanied by hypervigilance and muscle tension, which may contribute to somatic symptoms such as myalgia and inflammation, increasing the likelihood of chronic pain [49–51].”
Vakili, N., Rezaei, F., & Hosseini, N. (2020) · Research Square · doi:10.21203/rs.3.rs-120596/v1 · Cited by 3 · see citing works
AİLE İÇİ ŞİDDETİN KADIN SAĞLIĞINA ETKİSİ ve HEMŞİRELİK YAKLAŞIMI
Berber, M. A., & Şahin, N. H. (2022) · Sağlık Akademisi Kastamonu · doi:10.25279/sak.1075161 · Cited by 2 · see citing works
Machorrinho, J., Marmeleira, J., Santos, G., & Veiga, G. (2025) · Women s Health · doi:10.1177/17455057251326013 · Cited by 2 · see citing works
“81,82 Cross-cultural adaptation of such measures will be crucial to replicate the findings of the present study and enrich its discussion.”
The Polytrauma Clinical Triad Among Women with a History of Intimate Partner Violence
Leong, S. E., Logan, T., Badour, C. L., & Karr, J. E. (2025) · Journal of Neurotrauma · doi:10.1089/neu.2025.0064 · Cited by 2 · see citing works
“Considering women with a history of IPV may already report elevated rates of depression, 87,88 PTSD, 83,89,90 and sleep disturbance, 91 researchers could examine how chronic pain relates to other domains of mental and behavioral health among women with IPV-related TBI.”
Wuest, J., O’Donnell, S., Scott-Storey, K. A., Vincent, C. D., & Malcolm, J. (2025) · Research in Nursing & Health · doi:10.1002/nur.70040 · Cited by 2 · see citing works
“In a previous study of chronic pain severity in women, injury, PTSD and depression each significantly mediated the relationship between child abuse severity, but not IPV severity, and chronic pain severity (Wuest et al. 2010).”
Self-citationPitre, N. Y., Kushner, K. E., Hegadoren, K., & Raine, K. D. (2014) · Health Care For Women International · doi:10.1080/07399332.2014.943837 · Cited by 2 · see citing works
“…devastating physical and mental health consequences (Holt, Buckley & Whelan, 2008; Krug et al, 2002; Lang, Stein, Kennedy, & Foy, 2004; WHO, 2010; Wuest et al. 2010), and can ultimately lead to detrimental social and economic development outcomes (Bowlus, McKenna, Day, & Wright, 2003; WHO, 2010).”
BackgroundMcCall, M. (2014) · UA Campus Repository (The University of Arizona) · Cited by 2 · see citing works
Leveque, L., Papadodima, S. A., Toutin, R., Fraigneau, M., Baccino, É., & Martrille, L. (2023) · Healthcare · doi:10.3390/healthcare11060832 · Cited by 1 · see citing works
“Chronic pain [15], injuries [15], pregnancy complications (such as reduced birth weight, premature birth, infection, and miscarriage/abortion) [16], sexually transmitted diseases, such as HIV [17], menstrual disorders [18,19], and cardiovascular problems [20], have been reported as the most frequently reported physica…”
BackgroundMaitra, A., Schnipper, J. L., Yoon, C. S., & Mueller, S. K. (2025) · Journal of General Internal Medicine · doi:10.1007/s11606-025-09663-8 · Cited by 1 · see citing works
“33,34 It is therefore possible that the gap in diagnosis and interventions in our findings is due to forms of bias that result in minimization of medical symptoms, perceptions that patients’ reported pain is somatic in origin, or less extensive workup in patients experiencing IPV.”
Training Medical Students to Respond to Intimate Partner Violence: Pilot Study
Cruz-Sánchez, M., Bhuptani, P. H., & Orchowski, L. M. (2025) · NASPA Journal · doi:10.1080/19496591.2025.2505850 · Cited by 1 · see citing works
Chapter 5Post-Traumatic Stress Disorder and Chronic Pain
Runnals, J. J., Voorhees, E. E. V., & Calhoun, P. S. (2013) · American Public Health Association eBooks · doi:10.2105/9780875530161ch05 · Cited by 1 · see citing works
Best, D., van Wersch, A., & Carthy, N. (2021) · The European Journal of Counselling Psychology · doi:10.46853/001c.22008 · Cited by 1 · see citing works
Symptom Trajectory among Formerly Abused Women: An Exploratory Study
Cao, J., Yang, Q., Steinberg, D., Convoy, S. P., & Humphreys, J. C. (2021) · Issues in Mental Health Nursing · doi:10.1080/01612840.2021.1919806 · Cited by 1 · see citing works
Genetics, Lifestyle and Psychosocial Considerations in Orofacial Pain
Weerakkody, L., Lau, J., Vegunta, K., Thomas, D. C., & Balasubramaniam, R. (2024) · Wiley eBooks · doi:10.1002/9781119989233.ch35 · Cited by 1 · see citing works
Chronic pain in widowers 4-5 years after loss
Ásgeirsdóttir, H. G. (2011)
Findings on Differential Vulnerability to Poor Health
Larsen, M. M. (2016) · Springer eBooks · doi:10.1007/978-3-319-29565-7_8
Brain in women with intimate partner violence
김영윤 (2014) · The Korean Journal of Woman Psychology · doi:10.18205/kpa.2014.19.4.003
Larsen, M. M. (2016) · Springer eBooks · doi:10.1007/978-3-319-29565-7_1
Huhn, A. S. (2023) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780197618431.013.34
Jaquier, V., Haenni, M., Bovay, R., & Iglesias, K. (2024) · Mains Libres · doi:10.55498/mainslibres.2024.12.1.27
Yeager, K. R., Roberts, A. R., Roberts, B. S., & Galligher, A. (2025) · Oxford University Press eBooks · doi:10.1093/oso/9780197687833.003.0012
Nardi-Rodríguez, A., Bernardes, S. F., Pastor-Mira, M. D. L. Á., López-Roig, S., Pamies-Aubalat, L., Sánchez-Prada, A., Pérez, V. A. F., Rodríguez‐Rodríguez, I., & Heras-González, P. (2025) · JMIR Research Protocols · doi:10.2196/66396
“We believe that this result will be independent of the type of violence experienced because studies have shown that psychological violence alone can negatively impact CP severity and disability [166,167].”
Webster, F., Comer, L., Sud, A., Turcotte, K., & Katz, J. D. (2024) · Canadian Journal of Pain · doi:10.1080/24740527.2025.2533301
“11,12 In response to our call for papers, we received submissions from authors working in Canada and the United States across a wide range of disciplines, including epidemiology, Indigenous health, kinesiology, medicine, nursing, psychology, public health, rehabilitation science, science and…”
Baek, S., & Yoon, J. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.120254
Health challenges of older women following attempted intimate partner homicide
Avieli, H. (2025) · The Gerontologist · doi:10.1093/geront/gnaf287
Perinatal Intimate Partner Violence and Disability: Implications for Women’s Health Care
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Intimate Partner Violence and Nursing Practice
Ford‐Gilboe, M., Scott-Storey, K. A., Varcoe, C., & Campbell, K. (2026) · Springer eBooks · doi:10.1007/978-3-032-06072-3_13
Self-citationDrivers and Consequences of Family Violence
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- Authors
- Wuest, J., Ford-Gilboe, M., Merritt-Gray, M., Wilk, P., Campbell, J. C., Lent, B., Varcoe, C., & Smye, V.
- Affiliations
- University of New Brunswick (CA)
- The University of Western Ontario, Arthur Labatt Family School of Nursing, London, Ontario, Canada.
- University of New Brunswick, Faculty of Nursing, Fredericton, New Brunswick, Canada.
- Western University (CA)
- Johns Hopkins University (US)
- University of British Columbia (CA)
- Corresponding author
- Wuest, Judith
- Venue
- Journal of Women's Health
- Publisher
- SAGE Publications
- Published
- 2010-09
- Volume
- 19
- Issue
- 9
- Pages
- 1665-1674
- ISSN
- 1059-7115 (ISSN-L)
- 1540-9996
- 1931-843X
- PMC
- PMC3120089
- OpenAlex
- W2086085337
- Cited by
- 94
- References
- 74
- Citations by year
- 2026: 7 · 2025: 11 · 2024: 7 · 2023: 8 · 2022: 4 · 2021: 6 · 2020: 8 · 2019: 6 · 2018: 4 · 2017: 4 · 2016: 9 · 2015: 3 · 2014: 7 · 2013: 6 · 2012: 3
- FWCI
- 3.25
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Women s Health (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Canadian Institutes of Health Research (10605_4)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R24HD042854)
- Institute of Gender and Health (15156, 106054)
- Topics
- Social Sciences › Health › Intimate Partner and Family Violence
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Keywords
- chronic pain, intimate partner violence, women survivors, post-traumatic stress disorder, depressive symptoms, child abuse, psychological violence, assaultive violence, mediation, pain intensity
- MeSH terms
- Adult, Child, Child Abuse, Depression, Female, Humans, Middle Aged, Models, Psychological, Spouse Abuse, Stress Disorders, Post-Traumatic, Battered Women, Young Adult, Chronic Pain
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