Adverse Childhood Experiences and Urogenital Pain: Examining the Mediating Effects of Negative Affect and Pain Catastrophizing.

Abstract

BACKGROUND : Adverse childhood experiences (ACE) are associated with later psychological and somatic problems, including the emotional sequelae of adverse events (depression, anxiety, and catastrophizing) and outcomes such as chronic pain intensity and pain-related functioning. ACE have rarely been studied in women with pelvic, urogenital, and/or bladder pain (PUBP).

Aims: Thus, we examined how childhood adversities are related to psychological and pain-related outcomes in adult women. We also tested whether negative affect and pain catastrophizing mediated the relationship between ACE and pain-related outcomes.

Methods: A consecutive series of 310 adult women who presented at a tertiary urology center and reported PUBP completed an intake packet, which included the ACE Questionnaire as well as measures of psychological mediators and pain-related outcomes.

Results: Elevated ACEs were significantly associated with higher pain interference and vaginal insertion pain, as well as significantly related to negative affect (depression and anxiety) and pain catastrophizing. Both negative affect and pain catastrophizing were found to mediate the relationship of ACE to pain intensity and interference; however, only pain catastrophizing mediated the relationship between ACE and vaginal insertion pain.

Conclusions: These results suggest that ACEs may impact some pain-related outcomes in women with PUBP by influencing negative affect and pain catastrophizing. Thus, these processes are important targets for intervention in individuals with PUBP and a history of adverse childhood events.

Trial registration: This study does not require a clinical trial registration because it is not a clinical trial.