Adverse Childhood Experiences and Multisite Pain Among Children in the United States

Childhood adversity has a lasting negative impact throughout one's life. Adolescents with pain conditions consistently report a higher prevalence of adverse childhood experiences (ACEs) when compared to their healthy counterparts. Adolescents experiencing pain in more than one region tend to have a greater symptom burden and a reduced quality of life. The objective of our study is to explore the association between cumulative ACEs and pain regions prevalence before adolescence in population-based research. Data from the second year follow up of Adolescent Brain and Cognitive Development (ABCD) study was analyzed. Parents and children reported on 9 ACE domains. We adapted the Collaborative Health Outcomes Information Registry (CHOIR) body map by modifying it to include 19 regions, which we subsequently employed for evaluating regional pain (1-2 regions) and multisite pain (≥3 regions). Multinominal and binominal logistic regression analysis adjusted for sociodemographic factors. Most individuals experienced at least one ACE (79.2%) with 8.6% experiencing +4 ACEs. Those with 4+ACEs were more likely to have multisite pain (adjusted odds ratio [aOR]: 1.62 times, 95% confidence interval [CI]: 1.24-2.12), and more likely to have regional pain (aOR: 1.77 times more likely, 95% CI: 1.42-2.22) compared to the no pain group. We found no significant difference in the rate of multisite pain between boys and girls. Children with ACEs, particularly 4+ ACEs, had increased risk for regional and multisite pain with a dose-response association which indicates that the manifestation of ACEs begins in childhood and that ACE-related pain prevalence may emerge earlier than previously documented