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. 2024 Jun 6;24(1):10.1515/sjpain-2023-0122.
doi: 10.1515/sjpain-2023-0122. eCollection 2024 Jan 1.

A preliminary examination of the effects of childhood abuse and resilience on pain and physical functioning in patients with knee osteoarthritis

JiHee Yoon  1 , Ayeong Jenny Kim  2   3 , Jenna M Wilson  1 , Jolin B Yamin  1 , Kristin L Schreiber  1 , Robert R Edwards  1 , Marise C Cornelius  1 , Claudia M Campbell  4 , Michael T Smith  4 , Jennifer A Haythornthwaite  4 , Christine B Sieberg  2   3   5 , Samantha M Meints  1
Affiliations

A preliminary examination of the effects of childhood abuse and resilience on pain and physical functioning in patients with knee osteoarthritis

JiHee Yoon et al. Scand J Pain. .

Abstract

Objectives: We examined associations of a self-reported history of childhood abuse with pain and physical functioning in patients with knee osteoarthritis (KOA) awaiting total knee arthroplasty (TKA). We also explored the potential moderating effects of positive childhood experiences (PCEs), an index of resilience, on these associations.

Methods: Prior to TKA, participants with KOA awaiting surgery (N = 239) completed self-report measures of adverse childhood experiences (ACEs), PCEs, pain, and physical functioning. We evaluated associations of pain and physical functioning (Brief Pain Inventory [BPI] and Western Ontario and McMaster University of Osteoarthritis Index [WOMAC]) based on the experience of ACEs (childhood abuse), with PCEs (childhood happiness and supportive parental care) as potential moderators.

Results: Greater exposure to childhood abuse was positively correlated with BPI pain interference as well as WOMAC pain and functioning scores. Additionally, childhood happiness and supportive parental care moderated the positive associations of childhood abuse with pain and physical functioning; though, surprisingly, the adverse effects of childhood abuse on these outcomes were more pronounced among participants with high levels of childhood happiness and supportive parental care.

Conclusion: Overall, results show an association between a self-reported history of childhood abuse and pain and functioning in patients with KOA awaiting TKA. However, PCEs did not protect against the negative consequences of childhood abuse in our cohort. Further research is needed to validate these associations and gain a more comprehensive understanding of the complex interplay between childhood abuse and PCEs and their potential influences on pain experiences in adults with chronic pain conditions, including KOA.

Keywords: childhood abuse; knee osteoarthritis; pain; physical functioning; positive childhood experiences.

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Conflict of interest statement

Competing interests: The authors state no conflict of interest.

Figures

Figure 1:
Figure 1:
Moderating effects of childhood happiness on the association of childhood abuse with pain and physical functioning, while controlling for sex and race. Childhood happiness as a moderator of (a) the association between childhood abuse and BPI pain severity (higher score = worse pain), (b) the association between childhood abuse and BPI pain interference (higher score = greater interference), (c) the association between childhood abuse and WOMAC pain (higher score = worse pain), and (d) the association between childhood abuse and WOMAC physical functioning (higher score = poorer functioning). CA = childhood abuse; BPI = Brief Pain Inventory; WOMAC = Western Ontario and McMaster University of Osteoarthritis Index; PF = physical functioning.
Figure 2:
Figure 2:
Moderating effects of supportive parental care on the association of childhood abuse with pain and physical functioning, while controlling for sex and race. Childhood happiness as a moderator of (a) the association between childhood abuse and BPI pain severity (higher score = worse pain), (b) the association between childhood abuse and BPI pain interference (higher score = greater interference), (c) the association between childhood abuse and WOMAC pain (higher score = worse pain), and (d) the association between childhood abuse and WOMAC physical functioning (higher score = poorer functioning). CA = childhood abuse; BPI = Brief Pain Inventory; WOMAC = Western Ontario and McMaster University of Osteoarthritis Index; PF = physical functioning.
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