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.