Pathways of chronic pain in survivors of intimate partner violence.
OBJECTIVE
To examine the roles of lifetime abuse-related injury, posttraumatic stress disorder (PTSD) symptom severity, and depressive symptom severity in mediating the effects of severity of assaultive intimate partner violence (IPV), psychological IPV, and child abuse on chronic pain severity in women survivors of IPV.


METHODS
Structural equation modeling of data from a community sample of 309 women survivors of IPV was used to test partial and full theoretical models of the relationships among the variables of interest.


RESULTS
The full model had good fit and accounted for 40.2% of the variance in chronic pain severity. Abuse-related injury, PTSD symptom severity, and depressive symptom severity significantly mediated the relationship between child abuse severity and chronic pain severity, but only abuse-related injury significantly mediated the relationship between assaultive IPV severity and chronic pain severity. Psychological IPV severity was the only abuse variable with significant direct effects on chronic pain severity but had no significant indirect effects.


CONCLUSIONS
These findings can inform clinical care of women with chronic pain in all areas of healthcare delivery by reinforcing the importance of assessing for a history of child abuse and IPV. Moreover, they highlight the relevance of routinely assessing for abuse-related injury and PTSD and depressive symptom severity when working with women who report chronic pain.
Wuest
Judith
J
University of New Brunswick, Faculty of Nursing, Fredericton, New Brunswick, Canada. wuest@unb.ca
Ford-Gilboe
Marilyn
M
Merritt-Gray
Marilyn
M
Wilk
Piotr
P
Campbell
Jacquelyn C
JC
Lent
Barbara
B
Varcoe
Colleen
C
Smye
Victoria
V
D000328:Adult; D018585:Battered Women / Q000523:psychology*; D002648:Child; D002649:Child Abuse / Q000523:psychology*; D059350:Chronic Pain / Q000209:etiology* / Q000523:psychology; D003863:Depression / Q000209:etiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D008960:Models, Psychological; D013179:Spouse Abuse / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000209:etiology; D055815:Young Adult