Differences in Depression,Posttraumatic Stress Disorder,and Lifetime Trauma Exposure in Formerly Abused Women With Mild Versus Moderate to Severe Chronic Pain
Restricted accessOtherFirst published online December, 2010
Differences in Depression,Posttraumatic Stress Disorder,and Lifetime Trauma Exposure in Formerly Abused Women With Mild Versus Moderate to Severe Chronic Pain
Although associations between intimate partner violence, chronic pain, depression, posttraumatic stress disorder (PTSD), and lifetime trauma exposure are well known, previous studies are limited by their recruitment of women from shelters. These relationships were explored with a community-based sample of formerly abused women ( N = 84). Seventy-seven percent of women reported pain of >" xbd="604" xhg="581" ybd="1721" yhg="1685"/>3 months duration, and 75% had moderate to severe pain. Based on logistic regression analysis, women with moderate to severe chronic pain were significantly less likely to be employed, had more depressive symptoms, and were in the abusive relationship longer than women in mild chronic pain. Both pain severity groups had equally high levels of depressive and PTSD symptoms and multiple trauma exposures. Findings document the persistence of significant symptomatology in formerly abused women.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author .
2.
Arias, I., & Pape, K.T. ( 1999). Psychological abuse: Implications for adjustment and commitment to leave violent partners. Violence and Victims , 14(1), 55-67.
3.
Baccini, F., Pallotta, N., Calabrese, E., Pezzotti, P., & Corazziari, E. (2003). Prevalence of sexual and physical abuse and its relationship with symptom manifestations in patients with chronic organic and functional gastrointestinal disorders. Digestive and Liver Disease: Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, 35, 256-261.
4.
Blyth, F.M., March, L.M., Brnabic, A.J., Jorm, L.R., Williamson, M., & Cousins, M.J. ( 2001). Chronic pain in Australia: A prevalence study. Pain, 89, 127-134.
5.
Bodden-Heidrich, R., Kuppers, V., Beckmann, M.W., Rechenberger, I., & Bender, H.G. ( 1999). Chronic pelvic pain syndrome (CPPS) and chronic vulvar pain syndrome (CVPS): Evaluation of psychosomatic aspects. Journal of Psychosomatic Obstetrics and Gynaecology, 20, 145-151.
6.
Breiding, M.J., Black, M.C., & Ryan, G.W. ( 2008). Prevalence and risk factors of intimate partner violence in eighteen U.S. states/territories, 2005. American Journal of Preventive Medicine, 34, 112-118.
7.
Brown, P.J., Stout, R.L., & Mueller, T. ( 1999). Substance use disorder and posttraumatic stress disorder comorbidity: Addiction and psychiatric treatment rates. Psychology of Addictive Behaviors, 13, 115-122.
8.
Campbell, J.C., & Lewandowski, L.A. (1997). Mental and physical health effects of intimate partner violence on women and children. Psychiatric Clinics of North America, 20, 353-374.
9.
Campbell, J.C., & Soeken, K. ( 1999). Forced sex and intimate partner violence: Effects on women’s health. Violence Against Women, 5, 1017-1035.
10.
Campbell, R., Greeson, M.R., Bybee, D., & Raja, S. ( 2008). The co-occurrence of childhood sexual abuse, adult sexual assault, intimate partner violence, and sexual harassment: A mediational model of posttraumatic stress disorder and physical health outcomes. Journal of Consulting and Clinical Psychology, 76, 194-207.
11.
Catala, E., Reig, E., Artes, M., Aliaga, L., Lopez, J.S., & Segu, J.L. ( 2002). Prevalence of pain in the Spanish population: Telephone survey in 5000 homes. European Journal of Pain, 6(2), 133-140.
12.
Coker, A.L., Smith, P.H., Bethea, L., King, M.R., & McKeown, R.E. ( 2000). Physical health consequences of physical and psychological intimate partner violence. Archives of Family Medicine, 9, 451-457.
13.
Daut, R.L., Cleeland, C.S., & Flanery, R.C. ( 1983). Development of the Wisconsin brief pain questionnaire to assess pain in cancer and other diseases. Pain, 17, 197-210.
14.
Demyttenaere, K., Bonnewyn, A., Bruffaerts, R., Brugha, T., De Graaf, R., & Alonso, J. ( 2006). Comorbid painful physical symptoms and depression: Prevalence, work loss, and help seeking. Journal of Affective Disorders , 92, 185-193.
15.
Dienemann, J., Boyle, E., Baker, D., Resnick, W., Wiederhorn, N., & Campbell, J. ( 2000). Intimate partner abuse among women diagnosed with depression . Issues in Mental Health Nursing, 21, 499-513.
16.
Dutton, M.A., Goodman, L.A., & Bennett, L. ( 1999). Court-involved battered women’s responses to violence: The role of psychological, physical, and sexual abuse. Violence and Victims, 14(1), 89-104.
17.
Dutton, M.A., Green, B.L., Kaltman, S.I., Roesch, D.M., Zeffiro, T.A., & Krause, E.D. ( 2006). Intimate partner violence, PTSD, and adverse health outcomes . Journal of Interpersonal Violence, 21, 955-968.
18.
Foa, E.B., Riggs, D.S., Dancu, C.V., & Rothbaum, B.O. (1993). Reliability and validity of a brief instrument for assessing post-traumatic stress disorder. Journal of Traumatic Stress, 6, 459-473.
19.
Ford, D.E. ( 2004). Depression, trauma, and cardiovascular health. In P. P. Schnurr & B. L. Green (Eds.), Trauma and health: Physical health consequences of exposure to extreme stress (pp. 73-97). Washington, DC: American Psychological Association.
20.
Garcia-Moreno, C., Heise, L., Jansen, H.A., Ellsberg, M., & Watts, C. ( 2005). Public health: Violence against women. Science, 310, 1282-1283.
21.
Gerber, M.R., Wittenberg, E., Ganz, M.L., Williams, C.M., & McCloskey, L.A. (2008). Intimate partner violence exposure and change in women’s physical symptoms over time. Journal of General Internal Medicine: Official Journal of the Society for Research and Education in Primary Care Internal Medicine, 23(1), 64-69.
22.
Golding, J.M. ( 1999a). Intimate partner violence as a risk factor for mental disorders: A meta-analysis. Journal of Family Violence, 14, 99-132.
23.
Golding, J.M. ( 1999b). Sexual assault history and headache: Five general population studies. Journal of Nerve and Mental Disease, 187, 624-629.
24.
Green, B.L., & Kimerling, R. ( 2004). Physical health outcomes in traumatized populations. In P. P. Schnurr & B. L. Green (Eds.), Trauma and health: Physical health consequences of exposure to extreme stress (pp. 13-42). Washington, DC: American Psychological Association.
25.
Jones, A.S., Carlson Gielen, A., Campbell, J.C., Schollenberger, J., Dienemann, J., Kub, J., et al. (1999). Annual and lifetime prevalence of partner abused in a sample of female HMO enrollees. Women’s Health Issues, 9, 295-305.
26.
Kendall-Tackett, K.A., Marshall, R., & Ness, K. ( 2003). Chronic pain syndromes and violence against women. Women & Therapy, 26(1/2), 45-56.
27.
Kessler, R.C. ( 2003). Epidemiology of women and depression. Journal of Affective Disorders, 74, 5-13.
28.
Kessler, R.C., Berglund, P., Demler, O., Jin, R., Koretz, D., Merikangas, K.R., et al. (2003). The epidemiology of major depressive disorder: Results from the national comorbidity survey replication (NCS-R). JAMA: The Journal of the American Medical Association, 289, 3095-3105.
29.
Kessler, R.C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C.B. ( 1995). Posttraumatic stress disorder in the national comorbidity survey. Archives of General Psychiatry, 52, 1048-1060.
30.
Kimerling, R., Calhoun, K.S., Forehand, R., Armistead, L., Morse, E., Morse, P., et al. (1999). Traumatic stress in HIV-infected women . AIDS Education and Prevention: Official Publication of the International Society for AIDS Education, 11, 321-330.
31.
Koopman, C., Ismailji, T., Palesh, O., Gore-Felton, C., Narayanan, A., Saltzman, K.M., et al. (2007). Relationships of depression to child and adult abuse and bodily pain among women who have experienced intimate partner violence. Journal of Interpersonal Violence, 22, 438-455.
32.
Koziol-McLain, J., Giddings, L., Rameka, M., & Fyfe, E. ( 2008). Intimate partner violence screening and brief intervention: Experiences of women in two New Zealand health care settings. Journal of Midwifery & Women’s Health, 53, 504-510.
33.
Krause, E.D., Kaltman, S., Goodman, L.A., & Dutton, M.A. ( 2008). Avoidant coping and PTSD symptoms related to domestic violence exposure: A longitudinal study. Journal of Traumatic Stress, 21, 83-90.
34.
Lemmey, D., Malecha, A., McFarlane, J., Willson, P., Watson, K., Gist, J.H., et al. (2001). Severity of violence against women correlates with behavioral problems in their children. Pediatric Nursing , 27, 265-270.
35.
Leserman, J., & Drossman, D.A. (2007). Relationship of abuse history to functional gastrointestinal disorders and symptoms: Some possible mediating mechanisms. Trauma, Violence & Abuse, 8, 331-343.
36.
Lewis, C.S., Griffing, S., Chu, M., Jospitre, T., Sage, R.E., Madry, L., et al. (2006). Coping and violence exposure as predictors of psychological functioning in domestic violence survivors. Violence Against Women, 12, 340-354.
37.
Linton, S.J. ( 1997). A population-based study of the relationship between sexual abuse and back pain: Establishing a link. Pain, 73, 47-53.
38.
Linton, S.J. ( 2002). A prospective study of the effects of sexual or physical abuse on back pain. Pain, 96, 347-351.
39.
Marshall, L.L. ( 1992). Development of the Severity Of Violence Against Women Scales. Journal of Family Violence, 7, 103-121.
40.
McFarlane, J.M., Groff, J.Y., Brien, J.A., & Watson, K. ( 2006). Secondary prevention of intimate partner violence: A randomized controlled. Nursing Research, 55(1), 52-61.
41.
McFarlane, J., Parker, B., Soeken, K., & Bullock, L. ( 1992). Assessing for abuse during pregnancy: Severity and frequency of injuries and associated entry into prenatal care. JAMA: The Journal of the American Medical Association, 267, 3176-3178.
42.
McFarlane, J., Soeken, K., & Wiist, W. ( 2000). An evaluation of interventions to decrease intimate partner violence to pregnant women. Public Health Nursing, 17, 443-451.
43.
Meltzer-Brody, S., Leserman, J., Zolnoun, D., Steege, J., Green, E., & Teich, A. ( 2007). Trauma and posttraumatic stress disorder in women with chronic pelvic pain. Obstetrics and Gynecology, 109, 902-908.
44.
Melzack, R. ( 1999a). From the gate to the neuromatrix. Pain, Suppl. 6, S121-S126.
Ng, K.F., Tsui, S.L., & Chan, W.S. ( 2002). Prevalence of common chronic pain in Hong Kong adults . Clinical Journal of Pain, 18, 275-281.
47.
Parker, B., McFarlane, J., Soeken, K., Silva, C., & Reel, S. ( 1999). Testing an intervention to prevent further abuse to pregnant women. Research in Nursing & Health, 22(1), 59-66.
Phillips, K.E., Rosen, G.M., Zoellner, L.A., & Feeny, N.C. ( 2006). A cross-cultural assessment of posttrauma reactions among Malaysian and US women reporting partner abuse. Journal of Family Violence, 21, 259-262.
50.
Pimlott-Kubiak, S., & Cortina, L.M. ( 2003). Gender, victimization, and outcomes: Reconceptualizing risk. Journal of Consulting and Clinical Psychology, 71, 528-539.
51.
Radloff, L.S. ( 1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement , 1, 385-401.
52.
Rand, M.R. ( 1997). Violence-related injuries treated in hospital emergency department. Bureau of justice statistics special report. Washington, DC: U.S. Department of Justice.
53.
Ratner, P.A. ( 1993). The incidence of wife abuse and mental health status in abused wives in Edmonton, Alberta. Canadian Journal of Public Health: Revue Canadienne De Sante Publique, 84, 246-249.
54.
Resnick, H.S., Kilpatrick, D.G., Dansky, B.S., Saunders, B.E., & Best, C.L. ( 1993). Prevalence of civilian trauma and posttraumatic stress disorder in a representative national sample of women. Journal of Consulting and Clinical Psychology, 61, 984-991.
55.
Rowbottom, K.A., Gordon, E.E., Jarvis, K.L., & Novaco, R.W. ( 2005). Life constraints and psychological well-being of domestic violence shelter graduates. Journal of Family Violence, 20, 109-121.
56.
Rustoen, T., Wahl, A.K., Hanestad, B.R., Lerdal, A., Paul, S., & Miaskowski, C. (2004). Gender differences in chronic pain-Findings from a population-based study of Norwegian adults. Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses, 5(3), 105-117.
57.
Saltzman, L.E., Fanslow, J.L., McMahon, P.M., & Shelley, G.A. ( 1999). Intimate partner violence surveillance: Uniform definitions and recommended data elements. Atlanta, GA: Centers of Disease Control and Prevention.
58.
Schnurr, P.P. & Green, B.L. ( 2004). An integrative model and its implications for research, practice, and policy. In P. P. Schnurr & B. L. Green (Eds). Trauma and health: Physical health consequences of exposure to extreme stress (pp. 247-275). Washington, DC: American Psychological Association .
59.
Staggs, S.L., & Riger, S. ( 2005). Effects of intimate partner violence on low-income women’s health and employment. American Journal of Community Psychology , 36, 133-145.
60.
Stein, M.B., Cox, B.J., Afifi, T.O., Belik, S.L., & Sareen, J. ( 2006). Does co-morbid depressive illness magnify the impact of chronic physical illness? A population-based perspective. Psychological Medicine, 36, 587-596.
61.
Stones, R.W., Selfe, S.A., Fransman, S., & Horn, S.A. ( 2000). Psychosocial and economic impact of chronic pelvic pain . Bailliere’s Best Practice & Research: Clinical Obstetrics & Gynaecology, 14, 415-431.
62.
Straus, M.A., Hamby, S.L., & Warren, W.L. ( 2003). Conflict tactics scales handbook. Los Angeles: Western Psychological Services.
63.
Sutherland, C., Bybee, D., & Sullivan, C. ( 1998). The long-term effects of battering on women’s health . Women’s Health, 4(1), 41-70.
64.
Sutherland, C.A., Bybee, D.I., & Sullivan, C.M. (2002). Beyond bruises and broken bones: The joint effects of stress and injuries on battered women’s health. American Journal of Community Psychology, 30, 609-636.
65.
Sutherland, C.A., Sullivan, C.M., & Bybee, D.I. ( 2001). Effects of intimate partner violence versus poverty on women’s health. Violence Against Women, 7, 1122-1143.
66.
Tjaden, P., Thoennes, N., National Institute of Justice, & Centers for Disease Control and Prevention. (1998). Prevalence, incidence, and consequences of violence against women: Findings from the national violence against women survey. Washington, DC: National Institute of Justice and Center for Disease Control and Prevention .
67.
Vetter, T.R. ( 2007). A primer on health-related quality of life in chronic pain medicine. Anesthesia and Analgesia, 104, 703-718.
68.
Weaver, T.L., Allen, J.A., Hopper, E., Maglione, M.L., McLaughlin, D., McCullough, M.A., et al. (2007). Mediators of suicidal ideation within a sheltered sample of raped and battered women. Health Care for Women International, 28, 478-489.
69.
Wells, K.B., Stewart, A., Hays, R.D., Burnam, M.A., Rogers, W., Daniels, M., et al. (1989). The functioning and well-being of depressed patients: Results from the medical outcomes study. JAMA: The Journal of the American Medical Association, 262, 914-919.
70.
Wiesenfeld-Hallin, Z. ( 2005). Sex differences in pain perception. Gender Medicine: Official Journal of the Partnership for Gender-Specific Medicine at Columbia University, 2(3), 137-145.
71.
Wijma, K., Samelius, L., Wingren, G., & Wijma, B. ( 2007). The association between ill-health and abuse: A cross-sectional population based study. Scandinavian Journal of Psychology , 48, 567-575.
72.
Wolfe, J., & Kimerling, R. ( 1997). Gender issues in the assessment of posttraumatic stress disorder. In J. P. Wilson & T. M. Keane (Eds.), Assessing psychological trauma and PTSD (pp. 192-238). New York: Guilford .
73.
Woods, A.B., Page, G.G., O’Campo, P., Pugh, L.C., Ford, D., & Campbell, J.C. (2005). The mediation effect of posttraumatic stress disorder symptoms on the relationship of intimate partner violence and IFN-gamma levels. American Journal of Community Psychology, 36, 159-175.
74.
Woods, S.J., Wineman, N.M., Page, G.G., Hall, R.J., Alexander, T.S., & Campbell, J.C. (2005). Predicting immune status in women from PTSD and childhood and adult violence. ANS: Advances in Nursing Science, 28, 306-319.
75.
Wuest, J., Merritt-Gray, M., Ford-Gilboe, M., Lent, B., Varcoe, C., & Campbell, J.C. (2008). Chronic pain in women survivors of intimate partner violence. Journal of Pain: Official Journal of theAmerican Pain Society.
76.
Zelman, D.C., Hoffman, D.L., Seifeldin, R., & Dukes, E.M. ( 2003). Development of a metric for a day of manageable pain control: Derivation of pain severity cut-points for low back pain and osteoarthritis . Pain, 106, 35-42.
