Adverse childhood experiences and bodily pain at 10 years of age: Findings from the Generation XXI cohort

Background: Youth and young adults with pain conditions report having a history of adverse childhood experiences (ACEs) more frequently than their healthy peers. The relationship between ACEs and pain before adolescence in population-based settings is not extensively researched. Objective: To examine the association between the history of ACEs and bodily pain at 10 years of age. Participants and setting: Cross-sectional analysis of 4738 participants of Generation XXI population-based birth cohort, recruited in 2005-06 in Porto, Portugal. Methods: Study includes self-reported data on ACEs exposures and bodily pain (pain presence, sites, and intensity a week prior to the interview). Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were obtained from binary and multinomial logistic regression analyses to estimate the likelihood of various pain features according to the extent of exposure to ACEs (i.e., 0 ACEs, 1-3 ACEs, 4-5 ACEs, and >= 6 ACEs). Results: Prevalence of pain, multisite, and high-intensity pain a week prior to the interview increased with increasing exposure to ACEs. After controlling for sociodemographic characteristics, children who had experienced >= 6 ACEs were more likely to report pain [AOR 3.18 (95% CI 2.19, 4.74)], multisite pain [AOR 2.45 (95% CI 1.37, 4.40)], and high-intensity pain [AOR 4.27 (95% CI 2.56, 7.12)] compared with children with no ACEs. Conclusions: A dose-response association was observed between the cumulative number of ACEs and reports of pain in 10-year-old children, suggesting that embodiment of ACEs starts as early as childhood and that pain related to ACEs begins earlier than previously reported.