Adverse childhood experiences and multisite pain among adolescents in the United States

Childhood adversity can have a lasting negative impact throughout one's life. Youth with pain conditions consistently report a higher rate of adverse childhood experiences (ACEs) when compared with their healthy peers. Adolescents experiencing pain in more than 1 region tend to have greater symptom burden and reduced quality of life. Research on the association between ACEs and multisite pain in adolescents is sparse.

The objective of our study was to investigate the association between cumulative ACEs and self-report of multisite pain in early adolescence using data from the Adolescent Brain Cognitive Development study.

We used a 19-region body map to evaluate the presence of regional pain (1-2 regions) and multisite pain (≥3 regions). We analyzed data using multinominal logistic regression, adjusting for sociodemographic factors including pubertal status, sex, race/ethnicity, and income-to-needs ratio.

We included a total of 7582 children aged 12 to 13 years, with 33.4%, 24.0%, 13.2%, and 8.6% reporting 1, 2, 3, and 4+ ACEs, respectively. Moreover, 30.7%, 24.2%, 15.2%, and 10.1% of children with multisite pain reported 1, 2, 3, and 4+ ACEs, respectively. Those with 4+ ACEs (adjusted odds ratio 1.62, 95% confidence interval 1.24-2.12) and 3 ACEs (adjusted odds ratio 1.44, 95% confidence interval 1.14-1.82) were more likely to report multisite pain compared with the children with no ACEs.

We showed a potential dose-response relationship between cumulative ACEs and multisite pain, suggesting that the impact of ACEs on pain, particularly multisite pain, may emerge earlier than previously documented. Keywords: Adverse childhood experiences, Multisite pain, Adolescent pain.