Associations of adverse childhood experiences and bullying on physical pain in the general population of Germany

Rebecca C Brown,1,* Paul L Plener,1,2,* Elmar Braehler,3,4 Joerg M Fegert,1 Markus Huber-Lang5 1Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany; 2Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria; 3Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of The Johannes Gutenberg University of Mainz, Mainz, Germany; 4University of Leipzig, Department of Medical Psychology and Medical Sociology, Leipzig, Germany; 5Institute of Clinical and Experimental Trauma-Immunology, University of Ulm, Ulm, Germany *These authors contributed equally to this work Background: Chronic pain is a frequent burden in the general population. Child maltreatment and bullying are risk factors for the development of chronic pain. Aim of this cross-sectional study was to investigate the association of child maltreatment and bullying and pain experiences in a representative sample of the general population.Materials and methods: A total of N=2,491 people from the general population of Germany participated in the study (Mage=48.3 years [SD=18.2], 53.2 % female). Child maltreatment was assessed with the Childhood Trauma Questionnaire (CTQ), pain was rated with the Polytrauma Outcome (POLO)-physical state domain, depression scores were assessed with the Patient Health Questionnaire, and anxiety scores via the General Anxiety Disorder Questionnaire. Regression analyses were calculated to investigate the effect of bullying and child maltreatment, as well as depression, anxiety, and gender on pain experiences.Results: A significant correlation between increasing pain levels and number of adverse childhood experiences was found. With regard to specific types of maltreatment, largest effect sizes were found for emotional abuse. Bullying was significantly, but overall rather moderately, related to pain suffering. In women, all forms of maltreatment were associated with pain, while in men only sexual and physical abuse revealed significant effects. Although depression and anxiety scores were significantly associated with the experience of current pain, they did not change the effect of child maltreatment on pain significantly.Conclusion: In this sample of the general population, adverse childhood experiences were significantly associated with pain and showed cumulative effects, over and above depressive and anxiety symptoms. Keywords: child maltreatment, adulthood, depression, anxiet