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Childhood trauma has been linked to an increased risk of chronic pain in adulthood. One potential mechanism is via childhood trauma's impact on the hypothalamic-pituitary-adrenal axis (HPA) response to stress, reflected in changes in salivary cortisol levels (Nicolson et al., 2010). This study sought to determine the relations between childhood

Childhood trauma has been linked to an increased risk of chronic pain in adulthood. One potential mechanism is via childhood trauma's impact on the hypothalamic-pituitary-adrenal axis (HPA) response to stress, reflected in changes in salivary cortisol levels (Nicolson et al., 2010). This study sought to determine the relations between childhood trauma, increases in cortisol levels following induced pain, and pain perceptions in adults with fibromyalgia, a chronic pain condition. It drew on data collected from participants enrolled in an investigation comparing the effectiveness of behavioral treatments for chronic pain. Before receiving treatment, participants attended a laboratory session during which they first rested, and then were exposed to heat stimuli to assess pain threshold and tolerance. Saliva samples were collected from each participant immediately following the rest, and twice during pain induction. Fibromyalgia participants with a history of childhood trauma were expected: 1) to report lower pain threshold and tolerance levels (i.e., have higher pain sensitivity), 2) to exhibit a higher resting cortisol level, and 3) to have greater increases in cortisol in response to acute pain induction than fibromyalgia participants without a history of childhood trauma. Findings showed that childhood trauma scores were: 1) related to lower pain tolerance (but not pain threshold), 2) unrelated to resting cortisol levels, and 3) unrelated to changes in cortisol in response to pain induction and pain tolerance, contrary to prediction. However, a subtype of childhood trauma, i.e., emotional maltreatment: 1) predicted lower pain tolerance, and 2) moderated the cortisol changes over time in response to pain induction during the laboratory session in the expected direction. That is, individuals who reported higher levels of childhood emotional maltreatment showed greater cortisol responses to the pain induction than individuals who reported lower levels of exposure to emotional maltreatment. Cortisol responses did not relate to pain perception. Thus, childhood emotional trauma predicted greater pain sensitivity and cortisol reactivity, but cortisol did not relate to pain perception. The findings suggest that early childhood trauma predicts cortisol reactivity and pain sensitivity, but that cortisol reactivity is not a mediator in the trauma-pain relation.
ContributorsCiaramitaro, Marissa Catherine (Author) / Davis, Mary (Thesis director) / Glenberg, Arthur (Committee member) / Doane, Leah (Committee member) / Yeung, Wan (Committee member) / Barrett, The Honors College (Contributor) / Department of Psychology (Contributor)
Created2013-12
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Description

Pediatric chronic pain is common and predicts risk for psychological and pain problems into adulthood. Biopsychosocial risk factors for the development of chronic pediatric pain have been examined, but the key health behavior of caloric consumption has not been explored. Adult and animal data suggest that caloric intake is positively

Pediatric chronic pain is common and predicts risk for psychological and pain problems into adulthood. Biopsychosocial risk factors for the development of chronic pediatric pain have been examined, but the key health behavior of caloric consumption has not been explored. Adult and animal data suggest that caloric intake is positively related to chronic pain, and that adiposity and stress-related biological factors may serve as potential mediators. This study predicted that among children: 1) adiposity, flattened diurnal cortisol slopes, and caloric consumption are related to chronic pain, and 2) the caloric consumption—pain relation is mediated by elevated adiposity and/or flattened diurnal cortisol slopes. Methods: Twin children (N = 733) were drawn from the Arizona Twin Project sample. Measures included caregiver-reported caloric intake via five daily food diaries (Age-8); adiposity (composite of waist circumference, body mass index, body fat percentage) and diurnal cortisol slopes via three days of salivary cortisol sampling (Age-9); and caregiver-reported monthly chronic pain (Age-10). Results: Multilevel models (accounting for clustering within families) with sex, age, socioeconomic status, puberty, race/ethnicity as covariates, showed that caloric intake predicted greater waist circumference, which in turn predicted elevated chronic pain. However, adiposity, waist circumference, and diurnal cortisol slopes did not mediate the caloric intake-chronic pain relation. Discussion: Consistent with the literature, caloric intake predicted adiposity, and adiposity predicted pain in a diverse sample of children. More comprehensive assessment of behavioral (sleep, diet quality) and biopsychosocial factors (e.g. inflammation, cortisol; injury; catastrophizing) may aid efforts to prevent pediatric chronic pain.

ContributorsFishbach, Jaclyn (Author) / Davis, Mary (Thesis director) / Doane, Leah (Committee member) / Lemery, Kathryn (Committee member) / Barrett, The Honors College (Contributor) / Department of Psychology (Contributor) / Dean, W.P. Carey School of Business (Contributor)
Created2022-12
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Description
Chronic or recurrent pain in childhood is a common and costly health problem, and increases the likelihood of experiencing chronic pain in adulthood. Existing evidence suggests that internalizing symptoms are a risk factor for the development of chronic pain in children and adults. Findings from a small body of

Chronic or recurrent pain in childhood is a common and costly health problem, and increases the likelihood of experiencing chronic pain in adulthood. Existing evidence suggests that internalizing symptoms are a risk factor for the development of chronic pain in children and adults. Findings from a small body of research also points to a flattened diurnal cortisol profile, alone and in combination with internalizing symptoms, as a risk factor for future chronic pain among adults. The present study aimed to evaluate whether internalizing, a flattened diurnal cortisol profile, and their combination prospectively predict chronic pain in middle childhood. It was hypothesized that: 1) both internalizing and a flattened diurnal cortisol profile at age 8 would independently predict acquisition of chronic pain at age 9, controlling for age 8 pain; and 2) the combination of high internalizing and a flattened diurnal cortisol rhythm would predict greater risk of increased pain over time. Multilevel models of longitudinal data collected from a sample of 748 twin children revealed that internalizing symptoms and a flattened cortisol slope independently acted as prospective risk factors for increased chronic pain in childhood one year later. However, the interaction between internalizing and diurnal cortisol did not predict future increases in pain. Exploratory analyses evaluating symptoms of overanxiousness demonstrated that the interaction between overanxiousness and a flattened cortisol profile emerged as a marginally significant predictor of future pain. The current findings point to the role of psychological and physiological risk factors for the development of chronic pediatric pain, and may help to identify early targets for prevention efforts.
ContributorsEltze, Lara Malin (Author) / Davis, Mary (Thesis director) / Doane, Leah (Committee member) / School of International Letters and Cultures (Contributor) / Department of Psychology (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2020-12
Description

Background: Unintentional injury has been the leading cause of death for children and teenagers in the United States for the past 2 decades. Its health outcomes are often studied, but it may also relate to psychological concepts such as emotion dysregulation, which may also result in severe outcomes for individuals,

Background: Unintentional injury has been the leading cause of death for children and teenagers in the United States for the past 2 decades. Its health outcomes are often studied, but it may also relate to psychological concepts such as emotion dysregulation, which may also result in severe outcomes for individuals, families, and societies. There is no consensus on a conceptual definition of emotion dysregulation, and little prior literature on the specific relation between dysregulation and injury in the transition to adolescence. Methods: The current study aims to identify latent factors of emotion dysregulation using exploratory factor analyses. Subsequently, multilevel regressions illuminate relations between dysregulation and injury at 2 late childhood and early adolescence time points in a large ethnically, socioeconomically, and regionally representative sample of Arizona twins recruited from birth records and ongoing efforts. Results: 6 total factors representing emotion dysregulation at 2 ages were created. Factors were valid when tested against temperament and psychopathology constructs. No significant longitudinal or cross-sectional associations between emotion dysregulation factors and unintentional injury were found. Sex and rurality differences were found in factor scores and dysregulation outcomes. Discussion: The current study highlights new avenues of research and funding. Future research on this topic should reflect a concentrated and nuanced focus on injury. Concordant age 9 and age 11 factors loaded differently, which urges the field to strive toward developing a standardized definition for emotion dysregulation. Covariate differences highlight target populations for interventions in unintentional injury and emotion dysregulation, which remain independent areas of concern.

ContributorsHummel, Haley (Author) / Lemery-Chalfant, Kathryn (Thesis director) / Davis, Mary (Thesis director) / Doane, Leah (Committee member) / Meier, Madeline (Committee member) / Barrett, The Honors College (Contributor) / Department of Psychology (Contributor) / School of International Letters and Cultures (Contributor) / School of Human Evolution & Social Change (Contributor)
Created2022-12