title: Abuse-related injury and symptoms of posttraumatic stress disorder as mechanisms of chronic pain in survivors of intimate partner violence.
abstract: OBJECTIVE
  To examine the role of abuse-related injury and posttraumatic stress disorder (PTSD) symptom severity in mediating the effects of assaultive intimate partner violence (IPV) severity, psychological IPV severity, and child abuse severity on chronic pain severity in women survivors of IPV.
  
  
  METHODS
  Using data collected from a community sample of 309 women survivors of IPV, structural equation modeling was used to test a theoretical model of the relationships among the key variables.
  
  
  RESULTS
  The theoretical model accounted for almost 38% of the variance in chronic pain severity. PTSD symptom severity was a significant mediator of the relationships of both child abuse severity (beta = 0.13) and assaultive IPV severity (beta = 0.06) with chronic pain severity. Lifetime abuse-related injury was also a significant mediator of the relationships between both child abuse severity (beta = 0.05) and assaultive IPV severity (beta = 0.06) and chronic pain severity. Child abuse severity made the largest significant contribution to the model (beta = 0.35). Assaultive IPV severity had a significant indirect effect (beta = 0.12) on chronic pain severity while psychological IPV severity had a significant direct effect (beta = 0.20).
  
  
  CONCLUSIONS
  Management of chronic pain in IPV survivors requires attention to symptoms of PTSD, abuse-related injury, and lifetime experiences of violence. Ensuring that acute pain from injury is adequately treated and followed over time may reduce the extent of chronic pain in abused women. The results also support the importance of routine assessment for IPV and child abuse.
authors.affiliation: Faculty of Nursing, University of New Brunswick, Fredericton, New Brunswick;
authors.forename: Judith
authors.initials: J
authors.lastname: Wuest
authors.forename: Marilyn
authors.initials: M
authors.lastname: Ford-Gilboe
authors.forename: Marilyn
authors.initials: M
authors.lastname: Merritt-Gray
authors.forename: Colleen
authors.initials: C
authors.lastname: Varcoe
authors.forename: Barbara
authors.initials: B
authors.lastname: Lent
authors.forename: Piotr
authors.initials: P
authors.lastname: Wilk
authors.forename: Jacquelyn
authors.initials: J
authors.lastname: Campbell
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data; D000368:Aged; D018585:Battered Women / Q000523:psychology* / Q000706:statistics & numerical data; D002908:Chronic Disease / Q000523:psychology; D017579:Domestic Violence / Q000523:psychology* / Q000706:statistics & numerical data; D042241:Early Diagnosis; D005260:Female; D006297:Health Services Accessibility / Q000592:standards; D006801:Humans; D008875:Middle Aged; D015233:Models, Statistical; D010148:Intractable Pain / Q000209:etiology / Q000523:psychology*; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000523:psychology*; D014947:Wounds and Injuries / Q000150:complications / Q000523:psychology*; D055815:Young Adult