Gender differences in associations between trauma history and adjustment among chronic pain patients

This study examines the relationship between a trauma history and emotional functioning in response to a chronic pain condition. We broadened the trad itional study of trauma in chronic pain from sexual and physical abuse to i nclude a variety of traumatic events and experiences that occurred not only during childhood, but during adulthood as well. Seventy-three (51% female, 60% lower back) chronic pain patients were administered the Trauma History Questionnaire (Green, B.L., Trauma History Questionnaire. In B.H. Stamm (E ds.), Measurement of Stress, Trauma and Adaptation, Sidran, Lutherville, MD , 1996, pp. 366-369), the Multidimensional Pain Inventory (Kerns, R.D., Tur k, D.C. and Rudy, T.E., The West Haven-Yale Multidimensional Pain Inventory (WHYMPI), Pain, 23 (1985) 345-356), The Beck Depression Inventory (Beck, A .T., Ward, C.H., Mendelson, M.; Mock, J. and Erbaugh, J., An inventory for measuring depression, Arch. Gen Psychiatry, 4 (1961) 561-571), and the Pain Anxiety Symptoms Scale (McCracken, L.M., Zayfert, C., Gross, R.T. The Pain Anxiety Symptoms Scale: development and Validation of a scale to measure f ear of pain, Pain, 50 (1992) 67-73) prior to starting a multidisciplinary p ain program. We hypothesized that high levels of emotional distress and anx iety would differentiate patients with a substantial history of trauma from those without, while levels of pain severity and disability would not. A M ANOVA revealed a significant Trauma Group (low vs. high) by Gender interact ion for the dependent variables, which included both measures of emotional distress and pain severity and disability. Univariate tests showed that the interaction was significant only for emotional distress variables and not for pain severity and disability. Further, the multivariate effect of Traum a Group and the univariate effects for emotional distress variables were si gnificant only among men. Results indicate that a substantial history of tr auma may detrimentally impact a chronic pain patient's ability to manage th eir pain effectively, particularly among men. (C) 1999 International Associ ation for the Study of Pain. Published by Elsevier Science B.V.