Abuse-Related Injury and Symptoms of Posttraumatic Stress Disorder as Mechanisms of Chronic Pain in Survivors of Intimate Partner Violence
Corresponding Author
Judith Wuest RN, PhD
Faculty of Nursing, University of New Brunswick, Fredericton, New Brunswick;
Judith Wuest, RN, PhD, Faculty of Nursing, University of New Brunswick, PO Box 4400, Fredericton, N.B., E3B 5A3 Canada. Tel: 506-458-7666; Fax: 506-453-4519; E-mail: [email protected].Search for more papers by this authorMarilyn Merritt-Gray RN, MN
Faculty of Nursing, University of New Brunswick, Fredericton, New Brunswick;
Search for more papers by this authorColleen Varcoe RN, PhD
School of Nursing, University of British Columbia, British Columbia;
Search for more papers by this authorBarbara Lent MD
Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario;
Search for more papers by this authorPiotr Wilk PhD
Public Health Research, Middlesex-London Health Unit, London, Ontario, Canada;
Search for more papers by this authorJacquelyn Campbell RN, PhD
School of Nursing, The Johns Hopkins University, Baltimore, Maryland, USA
Search for more papers by this authorCorresponding Author
Judith Wuest RN, PhD
Faculty of Nursing, University of New Brunswick, Fredericton, New Brunswick;
Judith Wuest, RN, PhD, Faculty of Nursing, University of New Brunswick, PO Box 4400, Fredericton, N.B., E3B 5A3 Canada. Tel: 506-458-7666; Fax: 506-453-4519; E-mail: [email protected].Search for more papers by this authorMarilyn Merritt-Gray RN, MN
Faculty of Nursing, University of New Brunswick, Fredericton, New Brunswick;
Search for more papers by this authorColleen Varcoe RN, PhD
School of Nursing, University of British Columbia, British Columbia;
Search for more papers by this authorBarbara Lent MD
Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario;
Search for more papers by this authorPiotr Wilk PhD
Public Health Research, Middlesex-London Health Unit, London, Ontario, Canada;
Search for more papers by this authorJacquelyn Campbell RN, PhD
School of Nursing, The Johns Hopkins University, Baltimore, Maryland, USA
Search for more papers by this authorABSTRACT
Objective. To examine the role of abuse-related injury and posttraumatic stress disorder (PTSD) symptom severity in mediating the effects of assaultive intimate partner violence (IPV) severity, psychological IPV severity, and child abuse severity on chronic pain severity in women survivors of IPV.
Methods. Using data collected from a community sample of 309 women survivors of IPV, structural equation modeling was used to test a theoretical model of the relationships among the key variables.
Results. The theoretical model accounted for almost 38% of the variance in chronic pain severity. PTSD symptom severity was a significant mediator of the relationships of both child abuse severity (beta = 0.13) and assaultive IPV severity (beta = 0.06) with chronic pain severity. Lifetime abuse-related injury was also a significant mediator of the relationships between both child abuse severity (beta = 0.05) and assaultive IPV severity (beta = 0.06) and chronic pain severity. Child abuse severity made the largest significant contribution to the model (beta = 0.35). Assaultive IPV severity had a significant indirect effect (beta = 0.12) on chronic pain severity while psychological IPV severity had a significant direct effect (beta = 0.20).
Conclusions. Management of chronic pain in IPV survivors requires attention to symptoms of PTSD, abuse-related injury, and lifetime experiences of violence. Ensuring that acute pain from injury is adequately treated and followed over time may reduce the extent of chronic pain in abused women. The results also support the importance of routine assessment for IPV and child abuse.
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