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Assessing the association between child maltreatment and chronic pain: a cross-sectional co-twin control study
Alynna G Summit1, Hsien-Chang Lin2, Krista M Wisner3
1Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, United States.
Pain
|October 1, 2025
Summary
Child maltreatment (CM) is linked to chronic pain conditions like chronic widespread pain (CWP), lower back pain (LBP), and irritable bowel syndrome (IBS). These associations persist even when accounting for genetic and shared environmental factors using twin studies.
Area of Science:
- Psychiatry
- Pain Medicine
- Genetics
Background:
- Child maltreatment (CM) is associated with various chronic pain conditions.
- Unmeasured confounding factors may influence these associations.
- The co-twin control method can help disentangle genetic and environmental influences.
Purpose of the Study:
- To assess the association between child maltreatment (CM) and chronic widespread pain (CWP), lower back pain (LBP), and irritable bowel syndrome (IBS).
- To determine the extent to which these associations are attributable to genetic and shared environmental confounding using a co-twin control approach.
Main Methods:
- Utilized cross-sectional data from the Swedish Study of Twin Adults: Genes and Environment (N=25,418).
- Employed negative binomial generalized estimating equation models to analyze self-reported CM experiences and pain condition criteria.
- Conducted co-twin control analyses, including comparisons of differentially exposed co-twins and analyses restricted to monozygotic twins.
Main Results:
- Increased CM counts were significantly associated with higher odds of CWP, LBP, and IBS.
- Associations between CM and these conditions remained significant after controlling for genetic and shared environmental factors.
- Attenuations in effect sizes were minimal in co-twin comparisons and monozygotic twin analyses.
Conclusions:
- The observed associations between child maltreatment and chronic pain conditions (CWP, LBP, IBS) are not solely due to genetic or shared environmental factors.
- Child maltreatment appears to be an independent risk factor for developing chronic pain conditions.
- The findings underscore the importance of addressing childhood adversity in the prevention and treatment of chronic pain.
