Adverse childhood experiences such as sexual violence, physical violence, serious illness, and bereavement may be associated with urologic chronic pelvic pain syndrome (UCPPS) symptoms, according to a study published in the Annals of Behavioral Medicine.

The study included participants with UCPPS (n=421) and healthy controls (n=414). On entry into the study, participants underwent physical examination and completed questionnaires regarding mood, coping, and childhood adversity.

Severity of adverse childhood experiences was elevated in participants with UCPPS vs healthy controls (P <.001). Study participants with UCPPS were more likely to report sexual violence, physical violence, illness/injury, and “other trauma” compared with healthy controls (P <.01 for all). The rates of death of family members/close friends and parental separation/divorce were comparable in participants with and without UCPPS (P <.13). Severity of adverse childhood experiences was found to be most strongly associated with complex chronic pain (eg, more diffuse pain), comorbid functional symptoms/syndromes, and worse perceived physical well-being (P <.001 for all). Worse physical well-being was found to mediate the relationship between the severity of adverse childhood experiences severity and a reduced likelihood of painful symptom improvement (odds ratio, 0.871; P =.007) and an increased likelihood of painful symptom worsening at 1 year (odds ratio, 1.249; P =.003).

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“These analyses suggest that adverse childhood experiences may be associated with elements of the ‘centralized’ pain phenotype,” the researchers wrote. “It remains to be determined if well-documented effects of early adversity on pain perception and stress responsiveness are responsible for these clinical observations.”

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Schrepf A, Naliboff B, Williams DA, et al. Adverse childhood experiences and symptoms of urologic chronic pelvic pain syndrome: a multidisciplinary approach to the study of chronic pelvic pain research network study. Ann Behav Med. 2018;52:865-877.