OBJECTIVE: We investigated the prevalence of a history of sexual
abuse among patients with long-term musculoskeletal
pain. Psychological factors associated with abuse and pain were also
studied. DESIGN: First, the prevalence of abuse was determined based
on self-report on a valid and reliable abuse
questionnaire. Subsequently, a cross-sectional method, in which
patients were categorized as abused or nonabused, was employed and
responses to a battery of questionnaires compared. PATIENTS:
Seventy-five consecutive patients undergoing assessment for chronic
musculoskeletal pain participated. OUTCOME MEASURES: These included
Beck's Depression Inventory, the Coping Strategies Questionnaire, the
Multidimensional Pain Inventory, the Uppsala Type A Behavior
Questionnaire, the Pain and Impairment Rating Scale, as well as
ratings of pain intensity. RESULTS: Thirty-eight percent of the women
and 10% of the men reported some form of sexual abuse, usually during
adulthood. A majority (77%) had disclosed the abuse to someone, but
>85% did not believe that the abuse negatively affected their pain
or sex lives. Abused women, relative to nonabused ones, had poorer
scores on 27 of the 29 assessment variables. Abused female patients
had significantly higher levels of depression, stress from daily
hassles, affective distress, and more frequent negative responses from
spouses, in addition to having lower levels of social activities, life
control and effective coping for pain than did the nonabused female
patients. CONCLUSION: These data extend the relationship between
sexual abuse and pain to a Swedish population suffering from
musculoskeletal complaints. Our findings suggest that intervention in
the pain treatment setting may need to address further the problems of
effective coping strategies and depression.