Abstract Introduction: Child maltreatment has been linked to elevated pain symptoms and more chronic pain in adults. The hypothalamic–pituitary–adrenal (HPA) axis may be a mechanism connecting maltreatment to pain, where early life stressors are thought to impact HPA axis function, leading to increased inflammation and pain. Objectives: This study explored pathways associated with pain in young adult women with and without maltreatment exposure. Maltreatment was expected to be associated with increased exposure to interpersonal violence, inflammation, and negative affect which, in turn, would be associated with more pain in adulthood. Methods: Fifty women randomly selected from a prospective longitudinal cohort (n = 25 with confirmed child maltreatment, n = 25 demographically similar women without history of maltreatment) completed comprehensive assessments of risk factors for pain, including collecting inflammatory biomarkers. Results: Women who had experienced child maltreatment reported more exposure to interpersonal violence as young adults (χ 2 1 = 6.52, P = 0.01). Small effect size differences were observed between women with maltreatment exposure and those without for inflammation in young adulthood ( d = 0.29) and negative affect scores ( d = 0.47), although not statistically significant. Small-to-moderate effect sizes differences were also observed between women exposed to interpersonal violence and those without interpersonal violence exposure for negative affect ( d = 0.62) and inflammation ( d = 0.46). Negative affect was significantly associated with experiencing any pain in young adulthood (odds ratio = 1.12, P = 0.03, 95% confidence interval = 1.01, 1.24). Conclusion: Mechanisms connecting maltreatment to pain are complex. Studies that account for the effect-moderating impact of early life stress on inflammatory pathways alongside psychological effects of stress exposures more proximal to pain (eg, interpersonal violence, mood) are needed.
Beal et al. (Fri,) studied this question.