Is Child Maltreatment Painful? An Exploration of Peritraumatic Pain in Child Maltreatment.

Abstract

Substantial findings point to the risk of chronic pain following child maltreatment (CM). However, a coherent explanation for the mechanisms underlying pain following CM is lacking. Although peritraumatic pain may encompass a significant role in these processes, a systematic quantification of peritraumatic pain in CM has never been conducted. This study was conducted to provide an initial exploration of peritraumatic pain characteristics in CM, and its links with CM characteristics, pain expression, and later posttraumatic outcomes. Two samples of adult CM survivors (N = 160 and N = 120, respectively) filled out self-report questionnaires assessing peritraumatic pain characteristics, CM characteristics, peritraumatic dissociation, and complex posttraumatic-stress symptoms (cPTSD). Peritraumatic pain was reported by 42.2% (76 participants) and 57% (69 participants) in Samples 1 and 2, respectively. While pain was most prevalent in physical abuse (90%), it was also prevalent in sexual (63%) and emotional abuse (37.5%; X ² (3) = 14.65, p = .002). Peritraumatic pain was most prevalent when the perpetrator was a family member (X ² (3) = 14.65, p = .002), longer CM duration (p < .001), and in fight-or-flight peritraumatic responses (X ² (2) = 7.13, p = .028). Peritraumatic pain expression did not differ for CM type (p > .083), and most participants reported that the perpetrator ignored their pain (73.9%). Explicit and concealing expressions of pain were associated with later cPTSD symptoms (p < .047). The findings provide an initial understanding of peritraumatic pain characteristics and phenomenology, demonstrating that pain is a substantial constituent of CM experiences and potential posttraumatic outcomes.