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Author Notes:

Correspondence concerning this article should be addressed to Abigail Powers, PhD, adpower@emory.edu, Attn: Grady Trauma Project, 49 Jesse Hill Jr Dr Atlanta GA 30303.


Research Funding:

This work was primarily supported by the National Institute of Mental Health (MH071537).

Support also included Emory and Grady Memorial Hospital General Clinical Research Center, NIH National Centers for Research Resources (M01 RR00039), and the Burroughs Welcome Fund.


  • Science & Technology
  • Social Sciences
  • Life Sciences & Biomedicine
  • Psychiatry
  • Psychology

Childhood Abuse and the Experience of Pain in Adulthood: The Mediating Effects of PTSD and Emotion Dysregulation on Pain Levels and Pain-Related Functional Impairment


Journal Title:



Volume 55, Number 5


, Pages 491-499

Type of Work:

Article | Post-print: After Peer Review


Background: Previous findings suggest a relationship between childhood abuse and pain-related conditions. It is yet to be determined whether adult posttraumatic stress disorder (PTSD) symptoms may mediate the association between the experience of childhood abuse and reported pain in adulthood. Objective: We sought to determine if emotion dysregulation may also play a role in mediating PTSD and pain levels. Methods: We examined subjects (N = 814) recruited from the primary care clinics of an urban public hospital as part of an National Institute of Mental Health-funded study of trauma-related risk and resilience. We evaluated childhood abuse with the Childhood Trauma Questionnaire, PTSD symptoms with the PTSD Symptom Severity scale, and emotional dysregulation with the Emotion Dysregulation Scale. Pain and functional limitations of pain were assessed through self-report. Results: We found that both childhood abuse and current PTSD symptoms predicted higher levels of reported pain. Childhood abuse, PTSD symptoms, and emotion dysregulation all predicted higher levels of functional impairment related to pain. Using the Sobel method and bootstrapping techniques and controlling for current level of negative affect, we found that PTSD fully mediated the effect of childhood abuse on pain level and pain-related limitations; emotion dysregulation partially mediated the effect of PTSD symptoms in predicting higher levels of pain-related limitations. Conclusions: Although causality cannot be determined in the present study, these findings suggest that PTSD may serve as the pathway between exposure to childhood abuse and the development of pain-related conditions in adulthood, and that emotion dysregulation is a significant factor in understanding how PTSD relates to specific pain-related functional impairment.

Copyright information:

© 2014 The Academy of Psychosomatic Medicine.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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