Pain-prone theory: Interrelationships between childhood abuse history and chronic pain in adults

The present study examined the interrelationships between childhood abuse history and chronic-pain in a population of adult chronic-pain patients (N = 379). The findings were assessed within the context of the work of George Engel (1959), who reported a high degree of history of abuse and neglect amongst his "pain-prone" patients.;Up to 42% of patients reported at least one type of pain-prone history: physical, sexual, verbal abuse, parental alcoholism, and/or early loss of parent(s). Predicted differences were found between pain patients with and without pain-prone history on a number of psychological and medical variables. In addition, the different types of pain-prone history were associated with different patterns of response. The abuse histories tended to have the most similar correlates. History of parental alcoholism shared some correlates with the abuse histories, while history of parental loss had the most unique pattern of associations.;Overall, pain-prone patients were not found to have greater evidence of psychosomatic pain. However, they were found to have higher utilization of medical and mental health services, more suicide attempts, and elevated scores on affective and sensory pain rating scales. It was concluded that there was no difference in physical experience of pain between patients with and those without pain-prone history, but there was a difference in terms of their response to the pain. This pattern of responses was most pronounced in patients with abuse histories, moderately evident in patients with parental alcoholism, and not apparent in patients with parental loss.;The results of the present study provided evidence of a pain-prone syndrome as a subgroup of chronic pain, with common history, presentation, and treatment needs. Patients with histories of abuse and parental alcoholism demonstrated exaggerated response to pain, although their pain did not differ from those who were not pain-prone in terms of physical evidence. Treatment recommendations were made to meet the specific needs of pain-prone patients. Given the prevalence of pain-prone history in the present sample, it is important for practitioners to inquire for such history when treating chronic-pain patients.