Anxiety, history of childhood adversity, and experiencing chronic pain in adulthood: A systematic literature review and meta-analysis

IF 3.5 2区医学 Q1 ANESTHESIOLOGY European Journal of Pain Pub Date : 2024-01-08 DOI:10.1002/ejp.2232

Danielle E. Dalechek, Line Caes, Gwenne McIntosh, Anna C. Whittaker

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Abstract

Background

When considering factors that may impact chronic pain experiences in adulthood, adverse childhood experiences (ACEs) and anxiety should be considered. The literature on the associations between these 3 variables remains unclear.

Objective

To summarize the existing literature on the relationship between ACEs and anxiety on chronic pain experience in adults, and examine the association between ACEs and anxiety.

Methods

A systematic literature review (SLR) and meta-analysis was used to examine adults (≥18) with a reported history of ACEs, self-reported and/or diagnosed anxiety, and chronic pain. The SLR included quality appraisal according to the Joanna Briggs Institute tool.

Results

The narrative summary indicated a significant association between ACEs, anxiety, and chronic pain experiences in adults. Of 52 selected studies, 79% reported a moderate–strong association. For ACE prevalence, the majority reported experiencing sexual abuse (50% [SD 16.01]), followed by physical abuse (46% [SD 20.7]). Other ACEs included emotional abuse (33% [SD 17.17]), emotional neglect (25% [SD 21.02]), and physical neglect (23% [SD 22.44]). Meta-analyses showed moderate associations between anxiety and chronic pain (r = 0.30; 95% CI = [0.14, 0.45], p < 0.01) and between ACEs and anxiety (r = 0.26; 95% CI = [0.15, 0.36], p < 0.01), and that participants who experienced ACEs are around twice as likely to present chronic pain during adulthood (OR = 1.99; 95% CI = [1.53, 2.60], p < 0.01).

Conclusion

The results of the SLR and meta-analysis indicated that ACEs and anxiety influence chronic pain experience in adults. Given the relationship between ACEs and anxiety, there would be value in exploring this as a potential mediator in future studies.

Significance

There was an unmet need to summarize the existing literature on the relationship between ACEs and anxiety on chronic pain experience in adults and the association between ACEs and anxiety. The results of this systematic review and meta-analysis indicated that both ACEs and anxiety influenced chronic pain experience in adults and helped to inform the diverse literature on these potential relationships to date.

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焦虑、童年逆境史与成年后的慢性疼痛经历：系统性文献回顾和荟萃分析。

背景：在考虑可能影响成年后慢性疼痛经历的因素时，应考虑童年的不良经历（ACE）和焦虑。关于这三个变量之间关系的文献仍不明确：总结有关 ACE 和焦虑与成人慢性疼痛经历之间关系的现有文献，并研究 ACE 和焦虑之间的关联：方法：采用系统文献综述（SLR）和荟萃分析的方法，对报告有ACE史、自我报告和/或诊断为焦虑以及慢性疼痛的成年人（≥18岁）进行研究。SLR包括根据乔安娜-布里格斯研究所工具进行的质量评估：结果：叙述性摘要显示，成人的 ACE、焦虑和慢性疼痛经历之间存在显著关联。在所选的 52 项研究中，79% 的研究报告了中强关联。就 ACE 发生率而言，大多数人报告曾遭受性虐待（50% [SD 16.01]），其次是身体虐待（46% [SD 20.7]）。其他 ACE 包括情感虐待（33% [SD 17.17]）、情感忽视（25% [SD 21.02]）和身体忽视（23% [SD 22.44]）。元分析表明，焦虑与慢性疼痛之间存在中度关联（r = 0.30；95% CI = [0.14，0.45]，p 结论：焦虑与慢性疼痛之间存在中度关联（r = 0.30；95% CI = [0.14，0.45]）：SLR和荟萃分析的结果表明，ACE和焦虑会影响成年人的慢性疼痛体验。鉴于 ACE 与焦虑之间的关系，在未来的研究中将其作为潜在的中介因素进行探讨：我们需要总结现有文献，了解 ACE 与焦虑对成人慢性疼痛体验的影响，以及 ACE 与焦虑之间的关系。本系统综述和荟萃分析的结果表明，ACE 和焦虑都会影响成年人的慢性疼痛体验，并有助于为迄今为止有关这些潜在关系的各种文献提供信息。

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来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.