Recalled early life adversity and pain: the role of mood, sleep, optimism, and control

Abstract

Early life adversity (ELA) has been associated with pain symptomatology in adulthood, but mechanisms and moderators of these associations are unclear. Using recall based and concurrently assessed self-report data, we examined associations between ELA, mood, sleep, and recent pain intensity and interference, and whether optimism and perceived control weakened these associations in a midlife community sample of diverse adults reporting some ELA. Controlling for demographic variables and BMI, higher levels of ELA were associated with more pain intensity and interference; greater sleep disturbance and negative mood accounted for these associations. When moderation was examined, only the path from sleep disturbance to pain interference was significantly attenuated for those with higher optimism and higher perceived control. These findings suggest that higher levels of ELA may link with pain in adulthood through poorer mood and sleep, and that resilience resources such as optimism and control may buffer some of these pathways.

Keywords: Early life adversity; Mood disturbance; Optimism; Pain; Perceived control and mastery; Sleep disturbance; Structural equation modeling.

Fig. 1

Structural model. Note structural model of early life adversity, mood and sleep disturbances, and pain intensity and pain interference with covariates, χ²(48, N = 265) = 65.63, p = 0.05, CFI = 0.98, RMSEA = 0.04 (0.01–0.06). Unidirectional arrows between variables represent regression coefficients, whereas bidirectional arrows represent covariances. Darker arrows represent key paths of interest. For simplicity of presentation, error variances are not shown. ^†p < 0.10; *p < 0.05; **p < 0.01