title: The impact of sexual or physical abuse history on pain-related outcomes among blacks and whites with chronic pain: gender influence.
abstract: OBJECTIVE
  Physical and sexual abuses commonly co-occur with chronic pain. We hypothesized that: 1) abuse history questions would form distinct factors that relate differently to pain perceptions and pain outcomes; 2) abuse history consequences on physical and mental health differ by gender; and 3) different abuse types and age of occurrence (childhood vs adolescent/adulthood) predict different negative outcomes.
  
  
  METHODS
  Chronic pain patients at a tertiary care pain center provided data (64% women, 50% black) through a confidential survey. Factors were formed for abuse type and age. Linear regression, controlling for socio-demographic information, was used to examine the relationship between abuse and abuse by sex interactions with pain-related outcomes.
  
  
  RESULTS
  Six 3-item abuse factors (α = 0.77-0.91)-sexual molestation, sexual penetration, and physical abuse-were identified in both childhood and adulthood. Lifetime prevalence of abuse was 70% for men and 65% for women. Women experienced lower physical abuse (P = 0.01) in childhood, and higher penetration (P = 0.02) in adulthood. Decreased general health was associated with all abuse types (P < 0.05) in childhood. Affective pain was associated with all childhood abuse scales and adulthood molestation, though childhood molestation only for men (P = 0.04). Disability was associated with childhood (P = 0.02) and adulthood rape (P = 0.04). Men with childhood or adulthood molestation (P = 0.02; P = 0.02) reported higher post-traumatic stress disorder.
  
  
  CONCLUSIONS
  Our study confirms physical and mental health, and pain-related outcomes are affected by abuse history for men and women. These results support screening all patients for abuse to improve the survivor's overall health and well-being.
authors.affiliation: Department of Anesthesiology, University of Michigan Medical School, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, USA.
authors.forename: Tamera
authors.initials: T
authors.lastname: Hart-Johnson
authors.forename: Carmen R
authors.initials: CR
authors.lastname: Green
mesh_terms: D000293:Adolescent; D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D001741:Black or African American / Q000523:psychology; D059350:Chronic Pain / Q000453:epidemiology* / Q000523:psychology* / Q000628:therapy; D017579:Domestic Violence / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012737:Sex Factors; D012742:Sex Offenses / Q000523:psychology*; D044465:White People / Q000523:psychology; D055815:Young Adult