title: History of abuse and its relationship to pain experience and depression in women with chronic pelvic pain.
abstract: OBJECTIVE
  We sought to determine the relationship among a history of physical or sexual abuse, pain experience, and depressive symptoms among women with chronic pelvic pain (CPP).
  
  
  METHODS
  This was a cross-sectional study of women who presented to a tertiary referral center for evaluation of CPP (N = 273). All participants completed standardized questionnaires to assess a history of physical or sexual abuse, pain severity, pain disability, and depressive symptoms. Subjects were grouped by abuse category and compared to CPP participants without history of abuse. Multinomial logistic regression models were used to determine the association between adolescent or adult and childhood physical or sexual abuse with pain intensity, pain-related disability, and depressive symptoms.
  
  
  RESULTS
  Logistic regression analyses indicated that, after controlling for age and education, none of the abuse categories was associated with pain severity. However, adolescent or adult sexual abuse predicted greater pain-related disability (odds ratio, 2.39; 95% confidence interval, 1.05-5.40), while both adolescent or adult physical and sexual abuse were associated with higher levels of depression (both P < .05). Level of education was significantly associated with pain intensity, pain disability, and depression.
  
  
  CONCLUSIONS
  For our sample of women with CPP, a history of abuse during childhood or adulthood was not associated with differences in pain intensity, but adolescent or adult sexual abuse was associated with greater pain-related disability. A history of physical abuse or sexual abuse appears to hold a stronger relationship with current depressive symptoms than pain experience for women with CPP. Educational achievement holds a robust relationship with pain morbidity and depression for this population.
authors.affiliation: Department of Obstetrics and Gynecology, University of Michigan Health System, Ann Arbor, MI.
authors.forename: Sawsan
authors.initials: S
authors.lastname: As-Sanie
authors.affiliation: Department of Psychology, University of Michigan School of Medicine, Ann Arbor, MI.
authors.forename: Lauren A
authors.initials: LA
authors.lastname: Clevenger
authors.affiliation: Physical Medicine and Rehabilitation, University of Michigan Health System, Ann Arbor, MI.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Geisser
authors.affiliation: Anesthesiology, University of Michigan Health System, Ann Arbor, MI; Chronic Fatigue and Research Center, University of Michigan Health System, Ann Arbor, MI.
authors.forename: David A
authors.initials: DA
authors.lastname: Williams
authors.affiliation: Physical Medicine and Rehabilitation, University of Michigan Health System, Ann Arbor, MI; Department of Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI.
authors.forename: Randy S
authors.initials: RS
authors.lastname: Roth
mesh_terms: D000293:Adolescent; D000328:Adult; D059350:Chronic Pain / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D017579:Domestic Violence / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D006801:Humans; D016015:Logistic Models; D010147:Pain Measurement; D017699:Pelvic Pain / Q000453:epidemiology*; D012720:Severity of Illness Index; D012742:Sex Offenses / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
keywords: chronic pelvic pain; depression; educational achievement; physical abuse; sexual abuse