Child abuse and dissociation in patients with complex regional pain syndrome

Abstract

OBJECTIVE: In the absence of a proven medical explanation for the chronic pain syndrome Complex Regional Pain Syndrome type I (CRPS I), this study explored a hypothetical link between childhood physical and sexual abuse, and the subsequent development of CRPS I. The hypothesis predicts the existence of a sub-population of CRPS I patients with a high frequency of dissociative experiences corresponding to a history of childhood trauma. DESIGN: To test this theory, CRPS I patients attending the Auckland Hospital Pain Clinic, Auckland, New Zealand were assessed by self-report questionnaires for their frequency of dissociative experiences and for a history of childhood abuse. The data were compared with those of a low back pain control group and a healthy, pain-free control group. RESULTS: CRPS I patients were not unusually dissociative and had not experienced significantly higher rates of childhood abuse than the general population. Two of the 18 CRPS I patients were highly dissociative; both reported childhood sexual abuse. CONCLUSIONS: A trauma-dissociation pathway to CPRS I was not found. The desirability of screening for that subpopulation of CPRS I sufferers who may have been abused is discussed.