Lifetime physical and sexual abuse in chronic pain patients: Psychological correlates and treatment outcomes

B. E. Bailey, R. N. Freedenfeld, R. Sanford Kiser, Robert J. Gatchel

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Purpose: This study describes a subgroup of diagnostically heterogeneous chronic pain patients, with a lifetime history of physical and/or sexual abuse, who underwent a pain management programme. A battery of psychosocial and pain measures were assessed, as well as 1-year post-treatment socio economic outcomes. Method: The prevalence of a history of abuse was assessed via a semi-structured interview of 162 consecutive patients (112 females and 50 males) presenting for 4-8 weeks of treatment in an interdisciplinary, outpatient rehabilitation programme. Treatment outcome data were gathered immediately, 6 months and 1 year following discharge. The chronic pain patients with a history of abuse were compared to those without a history of abuse on several pre-treatment psychosocial variables - pain severity, psychological distress, DSM-IV Axis I comorbidity and health care utilization. Patient groups were matched on age, race, primary pain diagnosis, time in pain prior to treatment and gender. Results: Results indicated that 61% of patients had a history of lifetime physical and/or sexual abuse. Rates of sexual, and combined sexual and physical, abuse across the lifespan were higher for women than for men. Abused patients had a greater number of psychiatric diagnoses than nonabused patients. Abused patients also reported greater affective distress, less perceived life control, and a greater number of ER visits in the 6 months prior to treatment than their nonabused counterparts. A model consisting of gender (female), a higher number of psychiatric diagnoses, and higher affective distress was found to be a sensitive and relatively accurate predictor of abuse history. Finally, analyses indicated that, despite having greater psychosocial risk factors during the pre-treatment period, chronic pain patients with a history of abuse benefited from treatment and maintained treatment gains to a degree similar to nonabused chronic pain patients. Conclusions: Chronic patients with an abuse history can successfully complete a rehabilitation programme if the programme is designed to treat their psychosocial distress. Moreover, this also carries over to treatment outcome. A history of abuse does not have to negatively impact long-term treatment outcomes in this population of chronic pain patients.

Original languageEnglish
Pages (from-to)331-342
Number of pages12
JournalDisability and Rehabilitation
Volume25
Issue number7
DOIs
StatePublished - 8 Apr 2003

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Sex Offenses
Chronic Pain
Psychology
Pain
Therapeutics
Mental Disorders
Physical Abuse
Rehabilitation
Patient Acceptance of Health Care
Pain Management
Diagnostic and Statistical Manual of Mental Disorders
Comorbidity
Research Design
Outpatients
Economics
Interviews

Cite this

Bailey, B. E. ; Freedenfeld, R. N. ; Sanford Kiser, R. ; Gatchel, Robert J. / Lifetime physical and sexual abuse in chronic pain patients : Psychological correlates and treatment outcomes. In: Disability and Rehabilitation. 2003 ; Vol. 25, No. 7. pp. 331-342.
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Lifetime physical and sexual abuse in chronic pain patients : Psychological correlates and treatment outcomes. / Bailey, B. E.; Freedenfeld, R. N.; Sanford Kiser, R.; Gatchel, Robert J.

In: Disability and Rehabilitation, Vol. 25, No. 7, 08.04.2003, p. 331-342.

Research output: Contribution to journalArticle

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