Adverse Childhood Experiences (ACEs) and Internalizing Mental Health, Pain, and Quality of Life in Youth With Chronic Pain: A Longitudinal Examination

Apr 2, 2021The journal of pain

Childhood Trauma Linked to Mental Health, Pain, and Life Quality Over Time in Young People with Chronic Pain

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Abstract

Youth with a history of 3+ adverse childhood experiences (ACEs) reported significantly higher posttraumatic stress symptoms, depressive and anxiety symptoms, and poorer quality of life.

Adverse childhood experiences include neglect, abuse, and household dysfunction.
Youth exposed to 3 or more ACEs experienced worse mental health outcomes compared to those with no ACE history.
Different types of ACEs were associated with varying levels of functioning in youth.
Posttraumatic stress symptoms were found to moderate the relationship between ACEs and anxiety and depressive symptoms.
The influence of ACEs on long-term functioning in youth with chronic pain was evident.

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The aims of this longitudinal study were to 1) identify categories of adverse childhood experiences (ACEs) (ie, neglect, abuse, household dysfunction in childhood) that increase risk for internalizing mental health problems, pain-related impairment, and poorer quality of life and 2) examine the moderating role of posttraumatic stress symptoms (PTSS) in these associations, in a clinical sample of youth with chronic pain. At 2 timepoints, youth (N = 155; aged 10-18 years) completed measures of exposure to ACEs, PTSS, depressive and anxiety symptoms, pain intensity, pain interference, and quality of life. Multivariate analyses of variance, linear mixed modeling, and moderation analyses were conducted. Results from cross-sectional and longitudinal analyses were similar; youth with a history of 3+ ACEs reported significantly higher PTSS, depressive and anxiety symptoms, and poorer quality of life than youth with no ACE history. Results also revealed differences in functioning between youth exposed to different types of ACEs (ie, maltreatment only, household dysfunction only, both, none). Finally, PTSS was found to moderate the association between ACEs and anxiety and depressive symptoms. Findings underscore the influence that ACEs can have on the long-term functioning of youth with chronic pain as well as the important role of current PTSS in this association. PERSPECTIVE: This study found that the risk of poorer outcomes imposed by ACEs at baseline remains longitudinally and that posttraumatic stress symptoms (PTSS) moderate the relationship between ACEs and anxiety and depressive symptoms in youth with chronic pain. These results underscore the importance of assessing for ACEs and PTSS alongside chronic pain in youth.

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Adverse Childhood Experiences (ACEs) and Internalizing Mental Health, Pain, and Quality of Life in Youth With Chronic Pain: A Longitudinal Examination

Abstract

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