Characterizing Chronic Pain and Adverse Childhood Experiences in the Lesbian, Gay, Bisexual, Transgender, or Queer Community.

IF 4.6 2区 医学 Q1 ANESTHESIOLOGY
Anesthesia and analgesia Pub Date : 2024-10-01 Epub Date: 2024-02-27 DOI:10.1213/ANE.0000000000006922
Nikita Shirsat, Nicole Finney, Sami Strutner, Joseph Rinehart, K Elliott Higgins, Shalini Shah
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引用次数: 0

Abstract

Background: Childhood adversity is associated with chronic pain in adulthood. Additionally, individuals identifying as lesbian, gay, bisexual, transgender, or queer (LGBTQ+) report a greater prevalence of chronic pain and increased adverse childhood experiences (ACEs). While the LGTBQ+ community has a disproportionately high chronic disease burden, limited research has been conducted on the associations between chronic pain conditions or intensity and childhood adversity in this population.

Methods: In this cross-sectional study, participants were 18 years or older, LGBTQ+ identifying, and reported chronic pain. Surveys were electronically distributed from August to November 2022 via LGBTQ+ organization email listservs and social media platforms. The survey included demographics and validated questionnaires measuring chronic pain (The Chronic Pain Questionnaire) and childhood adversity (ACE score). In analysis, ACE scores of 4 or more were defined as high.

Results: Responses from 136 individuals (average age of 29 ± 7.4 years) were analyzed. The mean for participants' average pain rating in the last 6 months was 5.9 of 10. Participants' worst pain was rated at least a 7 of 10 for 80% of respondents. Half (47%) had high ACE scores, and high ACE scores were significantly associated with higher average pain scores (6.27 ± 1.79, mean difference = -2.22, P = .028, 95% confidence interval [CI], -1.2 to -0.0), and higher perceived current pain ratings (4.53 ± 2.16, mean difference = -2.78, P = .007, 95% CI, -1.9 to -0.3). Transgender and gender diverse (TGD) participants (n = 75) had higher ACE scores (3.91 ± 1.78) and current pain scores compared to cisgender individuals (3.9 ± 1.8 vs 3.0 ± 1.9, P = .009, 95% CI, 0.0-0.3). History of any sexual trauma was prevalent in 36.7% and was associated with chronic pain located in the pelvic region ( P = .016, effect size estimate 0.21). Specific histories of forced sexual and touch encounters were associated with a specific diagnosis of fibromyalgia ( P = .008, effect size estimate 0.31 and P = .037, effect size estimate 0.31, respectively).

Conclusions: Childhood adversity and chronic pain's dose-dependent relationship among our LGBTQ+ sample indicates a need to explore trauma's role in perceived pain. Given sexual trauma's association with pain location and diagnosis, type of trauma may also be crucial in understanding chronic pain development. Research into the relationships between childhood adversity, sexuality, gender identity, and chronic pain could improve chronic pain prevention and management for the LGBTQ+ community.

描述女同性恋、男同性恋、双性恋、变性人或同性恋群体中的慢性疼痛和童年不良经历。
背景:童年逆境与成年后的慢性疼痛有关。此外,女同性恋、男同性恋、双性恋、跨性别者或同性恋者(LGBTQ+)报告的慢性疼痛发病率更高,童年逆境经历(ACEs)也更多。虽然 LGBTBQ+ 群体的慢性病负担过重,但有关该群体慢性疼痛状况或强度与童年逆境之间关系的研究却十分有限:在这项横断面研究中,参与者年龄在 18 岁或以上,认同 LGBTQ+ 并报告有慢性疼痛。调查问卷于 2022 年 8 月至 11 月期间通过 LGBTQ+ 组织的电子邮件列表服务和社交媒体平台以电子方式发放。调查内容包括人口统计学和测量慢性疼痛(慢性疼痛问卷)和童年逆境(ACE 评分)的有效问卷。在分析中,ACE 分数达到或超过 4 分被定义为高分:对 136 人(平均年龄为 29 ± 7.4 岁)的回答进行了分析。参与者在过去 6 个月中的平均疼痛评分为 5.9(满分 10 分)。80%的受访者对最严重疼痛的评分至少为 7 分(满分 10 分)。半数受访者(47%)的 ACE 分数较高,而 ACE 分数较高与平均疼痛评分较高(6.27 ± 1.79,平均差 = -2.22,P = .028,95% 置信区间 [CI],-1.2 至 -0.0)和感知到的当前疼痛评分较高(4.53 ± 2.16,平均差 = -2.78,P = .007,95% 置信区间 [CI],-1.9 至 -0.3)显著相关。变性和性别多元化 (TGD) 参与者(n = 75)的 ACE 评分(3.91 ± 1.78)和当前疼痛评分(3.9 ± 1.8 vs 3.0 ± 1.9,P = .009,95% CI,0.0-0.3)均高于顺性别者。36.7%的人有过性创伤史,并且与骨盆区域的慢性疼痛有关(P = .016,效应大小估计为 0.21)。特定的强迫性接触史和触摸史与纤维肌痛的特定诊断有关(P = .008,效应估计值分别为 0.31 和 P = .037,效应估计值分别为 0.31):结论:在我们的 LGBTQ+ 样本中,童年逆境与慢性疼痛之间存在剂量依赖关系,这表明有必要探讨创伤在感知疼痛中的作用。鉴于性创伤与疼痛部位和诊断的关系,创伤类型可能也是了解慢性疼痛发展的关键。研究童年逆境、性行为、性别认同和慢性疼痛之间的关系可以改善 LGBTQ+ 群体的慢性疼痛预防和管理。
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来源期刊
Anesthesia and analgesia
Anesthesia and analgesia 医学-麻醉学
CiteScore
9.90
自引率
7.00%
发文量
817
审稿时长
2 months
期刊介绍: Anesthesia & Analgesia exists for the benefit of patients under the care of health care professionals engaged in the disciplines broadly related to anesthesiology, perioperative medicine, critical care medicine, and pain medicine. The Journal furthers the care of these patients by reporting the fundamental advances in the science of these clinical disciplines and by documenting the clinical, laboratory, and administrative advances that guide therapy. Anesthesia & Analgesia seeks a balance between definitive clinical and management investigations and outstanding basic scientific reports. The Journal welcomes original manuscripts containing rigorous design and analysis, even if unusual in their approach.
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