ABSTRACT
OBJECTIVES: Although the relationship between traumatic experiences (TEs) and psychosomatic manifestations (pain, somatization, somatosensory amplification [SSA], and alexithymia) has been widely described, very few studies have investigated how these variables correlate with each other and with a history of TEs. The aim of this study was to investigate whether and how current psychosomatic manifestations are correlated with major and minor adult- and childhood TEs. METHODS: One hundred and forty-six patients (91 with pain) from the Pisa Gift Institute for Integrative Medicine Psychosomatics Lab., Italy, were assessed for pain, history of TEs (divided into major and minor based on whether or not they meet the DSM-5 Criterion A for post-traumatic stress disorder), alexithymia, somatization, and SSA. RESULTS: TEs were positively correlated with age, the sensorial dimension and intensity of pain, somatization, psychopathology index, SSA, and alexithymia. Using the somatization score (controlled for age) as a covariate, the previous correlations between psychosomatic dimensions and TEs lost their statistical significance: SSA (total TEs: from r = 0.30, p = 0.000 to r = -0.04, p = 0.652); alexithymia (total TEs: from r = 0.28, p = 0.001 to r = 0.04, p = 0.663); sensorial dimension of pain (total TEs: from r = 0.30, p = 0.015 to r = 0.12, p = 0.373); and pain intensity (total TEs: from r = 0.38, p = 0.004 to r = -0.15, p = 0.317). Interestingly, the tendency to report more intense pain was mainly predicted by minor TEs in childhood (ß = 0.28; p = 0.030). CONCLUSIONS: The number of lifetime TEs is positively correlated with the sensorial dimension and intensity of pain but not its affective and cognitive dimensions. However, the former relationship depends on the presence of somatization. The intensity of pain is associated with minor rather than major TEs, especially when they occur in childhood.
Subject(s)
Affective Symptoms , Somatoform Disorders , Humans , Male , Female , Affective Symptoms/psychology , Adult , Middle Aged , Somatoform Disorders/psychology , Psychophysiologic Disorders/psychology , Psychophysiologic Disorders/epidemiology , Pain/psychology , Stress Disorders, Post-Traumatic/psychology , Stress Disorders, Post-Traumatic/epidemiology , Young Adult , Aged , Italy/epidemiologyABSTRACT
Although previous studies have shown that psychiatric and personality disorders are more prevalent in chronic pain than in pain-free groups, few studies have investigated the prevalence of personality disorders (PerDs) in patients with chronic pain with and without a psychiatric comorbidity. The aim of the present study was therefore designed to investigate the burden of PerDs on the prevalence and perception of chronic pain in patients with and without psychiatric comorbidity. 232 patients from the Gift Institute for Integrative Medicine in Pisa, Italy, of which n = 161 (69.4%) were patients with chronic pain, were administered the SCID II for personality disorders and MINI for DSM IV-TR criteria. Both psychiatric and personality disorders were more prevalent in the chronic pain group than in the pain-free group (χ2 = 5.9, p = .015, φ = .16; χ2 = 7.2, p = .007, φ = .18). Cluster A and C PerDs were more prevalent in patients with chronic pain than in subjects without pain (χ2 = 8.1, p = .004, φ = .19; χ2 = 4.7, p = .030, φ = .14, respectively). Unlike Cluster C PerDs, however, Cluster A PerDs were more prevalent in the absence of psychiatric comorbidity (χ2 = 5.0, p = .024, φ = .29), and by themselves worsened the pain perceived. An appropriate PerD diagnosis can be helpful in the treatment of patients with chronic pain.
