Adverse Childhood Experiences (ACEs) have been linked to long-term health consequences, including persistent, clinically relevant pain and psychological distress. This study investigates the prevalence and impact of ACEs among adults undergoing rehabilitation for persistent pain, focusing on their associations with pain, psychopathology, and treatment outcomes. We conducted a longitudinal cohort study with 324 inpatients enrolled in a 5-week interdisciplinary pain treatment at a psychosomatic-orthopedic rehabilitation center in Germany. Data were collected via questionnaires assessing ACEs, pain intensity, psychological distress, and well-being. The participants were categorized into three groups based on their ACEs: no ACEs, 1–3 ACEs, and four or more ACEs. Statistical analyses, including MANOVAs and regression analyses, were employed to examine the differences in psychological and pain-related distress and treatment outcomes among these groups. The study found that 83.3% of participants reported at least one ACE, with 18.5% reporting four or more. Patients with more ACEs exhibited higher levels of depression, anxiety, stress, and pain-related incapability at the beginning of the treatment. While patients showed significant improvement in these measures by the end of the rehabilitation program, those with more ACEs continued to report higher levels of distress. Regression analyses indicated that specific ACEs, such as emotional abuse, significantly predicted higher levels of psychological distress and pain-related incapability. Patients with a history of multiple ACEs experience greater initial distress and require more comprehensive, trauma-informed and psychosomatically oriented care approaches to achieve optimal rehabilitation outcomes. Future research should focus on developing and evaluating tailored interventions that address the unique needs of this population. • Most adults undergoing interdisciplinary pain rehabilitation reported at least one ACE (83%). • A higher number of ACEs was associated with greater psychological distress and pain-related incapability at intake. • Emotional abuse was the ACE most strongly associated with greater psychological distress and pain-related incapability. • Patients with ≥4 ACEs improved but remained more distressed at treatment end. • Clinicians should consider adverse childhood experiences as a relevant factor in patients seeking care for persistent pain.
Kessemeier et al. (Fri,) studied this question.