Stressful Social Networks and PTSD as Mediators of Child Abuse and Health Outcomes in Patients with Chronic Pain

Child abuse is known to have long-term effects on the health of adult survivors, including cardiovascular disease, depression, musculoskeletal conditions and chronic pain. A recent report by the Institute of Medicine confirms that the latter condition, chronic pain, has reached epidemic proportions in this country. Focusing on this special population, our study will help us better understand how abuse in childhood continues to affect the health of adult survivors with chronic pain. Evidence suggests two interrelated factors that may contribute to the long-term effect of abuse are stressful social relationships and symptoms due to Posttraumatic Stress Disorder (PTSD). We will interview 100 adults with chronic pain who are seen in four family medicine clinics that are part of the Department of Family and Community Medicine at Saint Louis University. Specially trained Research Assistants will conduct in-depth interviews with patients about the characteristics of their close social relationships (e.g., is a source of stress, helps with physical help, offers advice, support of health lifestyle behavior, provides positive feedback, listens to problems, helps with daily living expenses). Patients will also be asked about symptoms of PTSD, including those known to affect the quality of close social relationships. Adverse childhood experiences, including emotional, physical and sexual abuse, will also be assessed. Because chronic pain seriously affects the daily lives of people and is challenging to treat, it is our hope that the findings from this study will contribute to new, innovative and adapted pain therapies to help this special population.


Cynthia A. Loveland Cook, PhD
F. David Schneider, MD, MSPH

Centers for Disease Control and Prevention (CDC)