Dissociation in women with chronic pelvic pain.
OBJECTIVE
The authors' goal was to determine if women with chronic pelvic pain are significantly more likely to use dissociation as a coping mechanism than women without pain.


METHODS
The subjects were recruited from women who attended a university women's clinic during a 1-month period. Twenty-two women who reported that they had at any time in their lives experienced pelvic pain nearly every day for a period of at least 6 months were included in the study, along with 21 randomly selected women without a history of chronic pelvic pain. The 43 women were given structured sexual assault interviews and completed psychological self-report measures.


RESULTS
The women with chronic pain were significantly more likely to use dissociation as a coping mechanism, to show current psychological distress, to see themselves as medically disabled, to experience vocational and social decrements in function, and to amplify physical symptoms. They were also significantly more likely to have experienced severe childhood sexual abuse. In the total study group, women with a childhood history of sexual abuse had significantly higher scores on measures of psychological distress, somatization, and dissociation and viewed their physical health and functioning as more impaired.


CONCLUSIONS
The authors discuss a model for the development of somatization, dissociation, and pain symptoms in victims of early sexual abuse.
Walker
E A
EA
Department of Psychiatry and Behavioral Sciences, University of Washington 98195.
Katon
W J
WJ
Neraas
K
K
Jemelka
R P
RP
Massoth
D
D
D000328:Adult; D001294:Attitude to Health; D002648:Child; D002650:Child Abuse, Sexual / Q000150:complications; D002908:Chronic Disease; D004213:Dissociative Disorders / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D010146:Pain / Q000209:etiology / Q000523:psychology*; D010388:Pelvis; D011569:Psychiatric Status Rating Scales; D011581:Psychological Tests; D013001:Somatoform Disorders / Q000175:diagnosis / Q000523:psychology; D013315:Stress, Psychological / Q000175:diagnosis / Q000523:psychology