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Adverse Childhood Experiences and Symptoms of Urologic Chronic Pelvic Pain Syndrome: A Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network Study

Andrew Schrepf · Bruce D. Naliboff · David A. Williams · Alisa J. Stephens‐Shields · John Richard Landis · Arpana Gupta +7 more

76 citations0/0 files storedAnnals of Behavioral Medicine

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Child Abuse and Trauma Urinary Bladder and Prostate Research Sexual function and dysfunction studies

Abstract

Background: Adverse Childhood Experiences (ACEs) such as sexual and physical violence, serious illness, and bereavement have been linked to number of chronic pain conditions in adulthood, and specifically to urologic chronic pelvic pain syndrome (UCPPS). Purpose: We sought to characterize the prevalence of ACEs in UCPPS using a large well-characterized cohort in comparison with a group of healthy controls. We also sought to determine the association of ACE severity with psychological factors known to impact pain and to determine whether ACEs are associated with patterns of improvement or worsening of symptom over a year of naturalistic observation. Methods: For longitudinal analyses we used functional clusters identifying broad classes of (a) improved, (b) worsened, and (c) stable groups for genitourinary pain and urinary symptoms. We employed a mediation/path analysis framework to determine whether ACEs influenced 1 year outcomes directly, or indirectly through worse perceptions of physical well-being. Results: ACE severity was elevated in UCPPS (n = 421) participants compared with healthy controls (n = 414; p < .001), and was most strongly associated with factors associated with complex chronic pain, including more diffuse pain, comorbid functional symptoms/syndromes, and worse perceived physical well-being (all p < .001). Finally, worse physical well-being mediated the relationship between ACE severity and less likelihood of painful symptom improvement (OR = .871, p = .007)) and a greater likelihood of painful symptom worsening (OR = 1.249, p = .003) at 1 year. Conclusions: These results confirm the association between ACEs and UCPPS symptoms, and suggest potential targets for therapeutic interventions in UCPPS. Clinical Trial registration: NCT01098279.

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References

1983The Hospital Anxiety and Depression Scale 1983A Global Measure of Perceived Stress 1996A 12-Item Short-Form Health Survey 1993The MOS 36-Item Short-Form Health Survey (SF-36)2007The Patient-Reported Outcomes Measurement Information System (PROMIS)2004Validity of adult retrospective reports of adverse childhood experiences: review of the evidence 2003The impact of adverse childhood experiences on health problems: evidence from four birth cohorts dating back to 1900 2011Limbic Scars: Long-Term Consequences of Childhood Maltreatment Revealed by Functional and Structural Magnetic Resonance Imaging

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