Mediators of the association between childhood trauma and pain sensitivity in adulthood: a Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network analysis.

ABSTRACT: Urologic chronic pelvic pain syndrome (UCPPS) is a complex, debilitating condition in which patients often report nonpelvic pain in addition to localized pelvic pain. Understanding differential predictors of pelvic pain only vs widespread pain may provide novel pathways for intervention. This study leveraged baseline data from the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network's Symptom Pattern Study to investigate the impact of childhood sexual and nonsexual violent trauma on pelvic and nonpelvic pain sensitivity among adult patients with UCPPS, as well as potential mediators of this association. Study participants who met inclusion criteria for UCPPS completed questionnaires assessing childhood and recent trauma, affective distress, cognitive dysfunction, and generalized sensory sensitivity. Experimental pain sensitivity was also evaluated using standardized pressure pain applied to the pubic region and the arm. Bivariate analyses showed that childhood violent trauma was associated with more nonviolent childhood trauma, more recent trauma, poorer adult functioning, and greater pain sensitivity at the pubic region, but not pain sensitivity at the arm. Path analysis suggested that childhood violent trauma was indirectly associated with pain sensitivity at both sites and that this indirect association was primarily mediated by generalized sensory sensitivity. More experiences of recent trauma also contributed to these indirect effects. The findings suggest that, among participants with UCPPS, childhood violent trauma may be associated with heightened pain sensitivity to the extent that trauma history is associated with a subsequent increase in generalized sensory sensitivity.

Anxiety sensitivity and posttraumatic stress symptoms in sexual assault survivors.

Anxiety sensitivity (AS), the fear of anxiety-related physiological sensations, is a predictor of posttraumatic stress symptoms (PTSS) following a traumatic event, yet there is limited research on the relationship between AS and PTSS among sexual assault survivors. The present study was designed to test the hypothesis that AS would emerge as a statistical predictor of PTSS dimensions among community members and undergraduate students endorsing lifetime exposure to sexual trauma. Adults endorsing a history of sexual assault (N = 52) completed an online battery, including self-report measures of AS, general distress, dysfunctional trauma-related beliefs (i.e., posttraumatic cognitions), and PTSS. Although AS was associated with PTSS dimensions at the bivariate level (rs ranged .68-82), AS did not emerge as a significant unique predictor of PTSS dimensions in linear regression analyses after controlling for general distress and posttraumatic cognitions. In fact, general distress was the only significant statistical predictor of PTSS total and dimension scores (ps < 01). Study implications, limitations, and future directions are discussed.

The closed response style and posttraumatic stress: Examining the interaction between experiential avoidance and cognitive fusion among women experiencing sexual trauma.

OBJECTIVE: Experiential avoidance and cognitive fusion synergistically form what is known as the closed response style. Prior study findings indicate that the closed response style, examined as an interaction between experiential avoidance and cognitive fusion, relates to posttraumatic stress symptom severity among a heterogeneous sample of trauma survivors. The present study sought to extend those findings by examining the association between the closed response style and posttraumatic stress symptom severity specifically among women who survived a Criterion A sexual trauma. METHOD: The sample was 136 women attending a southern U.S. university who reported Criterion A sexual trauma exposure. Participants completed self-report measures assessing the study variables. RESULTS: The predicted interaction between experiential avoidance and cognitive fusion accounted for unique variance in posttraumatic stress symptom severity (total symptom severity, along with hyperarousal and alterations in cognitions and mood). Simple effects indicated that experiential avoidance and cognitive fusion only shared associations with posttraumatic stress symptom severity when coupled with high levels of the other process (i.e., cognitive fusion or experiential avoidance, respectively). CONCLUSIONS: Results provide further support for the potential relevance of the closed response style to posttraumatic stress. (PsycInfo Database Record (c) 2020 APA, all rights reserved).