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- Creators: Davis, Mary
Description
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
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 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