SEXUAL ABUSE AND CHRONIC MUSCULOSKELETAL PAIN - PREVALENCE AND PSYCHOLOGICAL-FACTORS

Objective: We investigated the prevalence of a history of sexual abuse among patients with long-term musculoskeletal pain. Psychological fac tors associated with abuse and pain were also studied. Design: First, the prevalence of abuse was determined based on self-report on a valid and reliable abuse questionnaire. Subsequently, a cross-sectional met hod, in which patients were categorized as abused or nonabused, was em ployed and responses to a battery of questionnaires compared. Patients : Seventy-five consecutive patients undergoing assessment for chronic musculoskeletal pain participated. Outcome Measures: These included Be ck's Depression Inventory, the Coping Strategies Questionnaire, the Mu ltidimensional Pain Inventory, the Uppsala Type A Behavior Questionnai re, the Pain and Impairment Rating Scale, as well as ratings of pain i ntensity. Results: Thirty-eight percent of the women and 10% of the me n reported some form of sexual abuse, usually during adulthood. A majo rity (77%) had disclosed the abuse to someone, but >85% did not believ e that the abuse negatively affected their pain or sex lives. Abused w omen, relative to nonabused ones, had poorer scores on 27 of the 29 as sessment variables. Abused female patients had significantly higher le vels of depression, stress from daily hassles, affective distress, and more frequent negative responses from spouses, in addition to having lower levels of social activities, life control and effective coping f or pain than did the nonabused female patients. Conclusion: These data extend the relationship between sexual abuse and pain to a Swedish po pulation suffering from musculoskeletal complaints. Our findings sugge st that intervention in the pain treatment setting may need to address further the problems of effective coping strategies and depression.