The Impact of Sexual or Physical Abuse History on Pain-Related Outcomes Among Blacks and Whites with Chronic Pain: Gender Influence

Abstract

Objectives. Physical and sexual abuses commonly co-occur with chronic pain. We hypothesized that: 1) abuse history questions would form distinct factors that relate differently to pain perceptions and pain outcomes; 2) abuse history consequences on physical and mental health differ by gender; and 3) different abuse types and age of occurrence (childhood vs adolescent/adulthood) predict different negative outcomes. Methods. Chronic pain patients at a tertiary care pain center provided data (64% women, 50% black) through a confidential survey. Factors were formed for abuse type and age. Linear regression, controlling for socio-demographic information, was used to examine the relationship between abuse and abuse by sex interactions with pain-related outcomes. Results. Six 3-item abuse factors (α=0.77-0.91)-sexual molestation, sexual penetration, and physical abuse-were identified in both childhood and adulthood. Lifetime prevalence of abuse was 70% for men and 65% for women. Women experienced lower physical abuse (P=0.01) in childhood, and higher penetration (P=0.02) in adulthood. Decreased general health was associated with all abuse types (P<0.05) in childhood. Affective pain was associated with all childhood abuse scales and adulthood molestation, though childhood molestation only for men (P=0.04). Disability was associated with childhood (P=0.02) and adulthood rape (P=0.04). Men with childhood or adulthood molestation (P=0.02; P=0.02) reported higher post-traumatic stress disorder. Conclusions. Our study confirms physical and mental health, and pain-related outcomes are affected by abuse history for men and women. These results support screening all patients for abuse to improve the survivor's overall health and well-being. Wiley Periodicals, Inc.