Background & Aims

Substantial findings point to the risk of chronic pain following child maltreatment (CM). However, a coherent explanation for the mechanisms underlying pain following trauma in general, and CM in particular, is lacking. This study was conducted to shed light on two potential factors that may play a significant role in chronic pain following CM. Specifically, the first aim of this study was to enable a better understanding of peritraumatic pain prevalence and phenomenology in CM. The second aim of this study was to uncover the prevalence and characteristics of intrusive pain flashbacks as well as its link with chronic pain following CM.

Methods

Two studies used secondary analyses to investigate peritraumatic pain in CM, and pain flashbacks following CM in a community sample and three samples of adults who experienced CM. Study 1 included two samples of adult CM survivors (Sample 1: N=120, Sample 2: N=164). Study 2 included 164 adult CM survivors (Sample 2), and a community sample of 430 women (Sample 3). Participants filled self-report questionnaires assessing CM characteristics, peritraumatic pain characteristics, complex posttraumatic-stress symptoms (cPTSD), pain flashbacks, and chronic pain characteristics.

Results

Study 1: Peritraumatic pain was reported by 57% (69 participants) and 42.2% (76 participants) in Samples 1 and 2, respectively. While pain was most prevalent in physical abuse (90%), it was also prevalent in sexual (63%) and emotional abuse (37.5%). Peritraumatic pain was most prevalent when the perpetrator was a family member (p=.002), and longer CM duration (p< .001). Most participants reported that the perpetrator ignored their expression of pain (73.9%). The tendency to conceal peritraumatic pain was associated with later cPTSD symptoms (p<.047). Study 2: Pain flashbacks was reported by 23.1% of Sample 2 (n = 37), and 8.9% of Sample 3 (n = 36) . In both samples, participants who experienced pain flashbacks reported more severe CM (p=0.052), more intensive peritraumatic pain during CM (p=0.001) and more cPTSD symptoms (p<0.001) compared to controls. Pain flashbacks were correlated with a higher risk of suffering from chronic pain.

Conclusions

The findings provide an initial overview of peritraumatic pain and pain flashbacks prevalence, characteristics and phenomenology. Particularly, the findings show that pain is a substantial constituent of the experience of CM incidents. The prevalence of pain flashbacks shown in this study uncover that pain may also be inherently woven within posttraumatic symptomatology. Finally, the findings of this study provide initial indication of a potential association between pain flashbacks and chronic pain, thus paving the way for new avenues explaining the trauma-chronic pain link.

References

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Katz, J., Fashler, S. R., Wicks, C., Pagé, M. G., Roosen, K. M., Kleiman, V., & Clarke, H. (2017). Sensitivity to Pain Traumatization Scale: development, validation, and preliminary findings. Journal of Pain Research, 1297-1316.

Macdonald, B., Salomons, T. V., Meteyard, L., & Whalley, M. G. (2018). Prevalence of pain flashbacks in posttraumatic stress disorder arising from exposure to multiple traumas or childhood traumatization. Canadian Journal of Pain, 2(1), 48-56.

Marin, T. J., Lewinson, R. E., Hayden, J. A., Mahood, Q., Rossi, M. A., Rosenbloom, B., & Katz, J. (2021). A systematic review of the prospective relationship between child maltreatment and chronic pain. Children, 8(9), 806.

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Tsur, N. (2023). Pain Flashbacks: Exploration of intrusive pain symptoms following child abuse. Children and Youth Services Review, 145, 106765.

Tsur, N., Katz, C., & Klebanov, B. (2022). Peritraumatic pain in child sexual abuse: Children’s descriptions of pain as conveyed in their testimonies following child sexual abuse. Journal of Interpersonal Violence, 37(7-8), NP4393-NP4414.

Presenting Author

Noga Tsur

Poster Authors

Noga Tsur

PgD

Tel Aviv University

Lead Author

E-mail

Topics

  • Pain in Special Populations: Infants/Children