DISSOCIATION, SOMATIZATION, SUBSTANCE-ABUSE, AND COPING IN WOMEN WITHCHRONIC PELVIC PAIN

Objective: To examine the relationships between histories of sexual or physical abuse and current reports of dissociation, somatization, sub stance abuse, adaptive coping, and maladaptive coping strategies among chronic pelvic pain patients. Methods: Using a structured interview, we assessed sexual and physical abuse and somatization. The Dissociati ve Experiences Scale was used to assess dissociation, and an abbreviat ed version of the COPE scale was employed to assess adaptive and malad aptive coping strategies as well as substance abuse. Participants incl uded 46 women with chronic pelvic pain. Results: Women with self-repor ted sexual or physical abuse histories were found to have significantl y higher dissociation, somatization, and substance abuse scores than w omen without such a history. Significant positive correlations were fo und between reports of both dissociation and somatization with maladap tive coping strategies and among dissociation, somatization, and subst ance abuse. Conclusion: These results support the association between a positive abuse history and the high levels of dissociation, somatiza tion, and substance abuse often noted in the chronic pelvic pain popul ation. Findings suggest that such psychological variables are more lik ely to be associated with abuse than with the general medical conditio n. These psychological variables are conceptualized as maladaptive cop ing, which may be addressed as part of a biopsychosocial model of trea tment for chronic pelvic pain patients. ((C) 1997 by The American Coll ege of Obstetricians and Gynecologists).