title: Quantifying the influence of child abuse history on the cardinal symptoms of fibromyalgia.
abstract: OBJECTIVE
  To quantify the influence of abuse, particularly in childhood, with pain sensitivity and other adverse symptoms experienced by women with fibromyalgia (FM).
  
  
  METHODS
  Subjects with FM completed a detailed abuse interview, dolorimetry, and questionnaire-based assessments of fatigue, cognitive self-appraisal, and depression. Student's t- and chi-square tests were used to analyse differences in FM symptoms between those with and without a history of childhood abuse. Linear regression was used to evaluate the relationship between abuse and symptom severity, adjusting for possible confounders.
  
  
  RESULTS
  In 111 women with FM, physical abuse during childhood demonstrated a clinically modest, yet statistically significant, association with increased tenderness as measured by pain pressure thresholds (β=-0.25, p=0.011) and tender points (β=0.23, p=.022). Physical child abuse was also associated with cognitive language impairment after adjusting for depression (β=0.27, p=0.001). While emotional child abuse was associated with fatigue, the association did not persist after adjustment for depressive symptoms.
  
  
  CONCLUSIONS
  Group differences are of small magnitude and might not directly impact clinical practice, however, the experience of child abuse is associated with FM symptom severity and may shape the biological development of interoception in ways that predispose to pain and polysymptomatic distress.
authors.affiliation: National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Robin
authors.initials: R
authors.lastname: Ortiz
authors.affiliation: National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Elizabeth D
authors.initials: ED
authors.lastname: Ballard
authors.affiliation: National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Machado-Vieira
authors.affiliation: National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Leorey N
authors.initials: LN
authors.lastname: Saligan
authors.affiliation: National Institute of Nursing Research, National Institutes of Health, Bethesda, MD; and Medstar Research Institute, Washington Hospital Center, Washington, DC, USA. brian.walitt@nih.gov.
authors.forename: Brian
authors.initials: B
authors.lastname: Walitt
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology / Q000706:statistics & numerical data; D002648:Child; D002649:Child Abuse / Q000523:psychology / Q000706:statistics & numerical data; D059350:Chronic Pain / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D003863:Depression / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D059026:Diagnostic Self Evaluation; D005260:Female; D005356:Fibromyalgia / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D008016:Life Change Events; D008875:Middle Aged; D058748:Pain Perception / Q000502:physiology; D017288:Pain Threshold / Q000502:physiology / Q000523:psychology; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D014481:United States