The Impact of Sexual or Physical Abuse History on Pain-Related Outcomes Among Blacks and Whites with Chronic Pain: Gender Influence


Carmen R. Green, MD, Department of Anesthesiology, 1H247 University Hospital, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-0048, USA. Tel: 734-936-4240; Fax: 734-936-9091; E-mail:


Objectives.  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.