Child Abuse Dials Up the Volume on Pain

About one in 50 infants in the United States experience abuse or neglect in the first year of life, according to a government report published this week. And experts say this maltreatment can also have serious health consequences later in life.

"Kids unfortunately who are being maltreated show problems in brain development," said Ileana Arias, director of the CDC National Center for Injury Prevention and Control, who, along with the Administration for Children and Families, created the report. Maltreatment can begin "a trajectory of a number of negative outcomes, including health outcomes," according to Arias.

Now, the mechanism behind those problems may have been pinned down.

A recent study revealed a physiological connection between child abuse and feelings of intense pain. Researchers at UCLA and the University of North Carolina compared pain responses in a group of women with and without irritable bowel syndrome (IBS), with surprising results.

In a test group of 20 women, 10 suffered from IBS and 10 did not. Both groups had people with a history of abuse, both physical and sexual. When subjected to mildly painful stimuli, the subjects with both IBS and a history of abuse reported feeling more intense pain than their counterparts.

In addition to self-reported data from the test subjects, the authors were able to document the pain experience using fMRI brain imaging. This data showed that the women who reported the most pain had heightened activity in the sensation and emotion regions of the brain. In addition, the brain areas that normally help to dampen negative sensations and emotions were inhibited.

"It's the first time we are able to show a mechanistic explanation for a clinical observation," said Dr. Yehuda Ringel, an assistant professor of medicine at the University of North Carolina at Chapel Hill. "It provides patients reassurance. They are not crazy, but there is a physiological explanation for why they experience more sensation."

A Painful Past

Based on their study, Ringel and Dr. Doug Drossman, a professor of medicine and psychiatry at UNC, reported that the link between abuse and IBS-related pain can apply to other physical conditions.

That link is well-known among clinicians, therapists, counselors and pain specialists.

"It's something that we've seen for some time in victims of [abuse]," said Thomas Miller, emeritus professor of psychology at the University of Connecticut. "Individuals who complain of pain-related symptoms may have experienced other forms of pain."

Though the stigma associated with abuse, in which survivors are brushed off or their claims are minimized, is one of the strongest deterrents to reporting, survivors feel the need to voice that something is wrong.

Nissa Howard, 30, was sexually abused by her mother's boyfriend between the ages of 5 and 8. Around that time, she developed stomach aches, extreme nausea and trouble eating food.

"When I felt the pain in [my] abdomen, it reminded me of being assaulted. It's the same feeling," Howard said. "I was emotionally overwhelmed and it manifested physically. … I didn't want [food], I didn't want anything. I just wanted help."

This may be one of the reasons why people with a history of abuse frequently seek out treatment for physical ailments as adults. It is much easier to go to a doctor and get treated for a headache than to face the stigma of having been abused.

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