Clinical–Alimentary TractEffect of Abuse History on Pain Reports and Brain Responses to Aversive Visceral Stimulation: An fMRI Study
Section snippets
Materials and Methods
We studied 20 right-handed female subjects aged 18–65 (mean age, 27.6 ± 10.0 years) years. All subjects were recruited by advertising at UNC campus and UNC hospital general and GI clinics. Ten subjects had a diagnosis of IBS, and 10 subjects were without IBS. Non-IBS subjects served as controls and were completely asymptomatic with regard to any GI symptoms. Half of the subjects in each group reported a history of sexual and/or physical abuse (sexual abuse and physical abuse, n = 8; sexual
Results
The average age of our female study sample was 27.6 ± 10.0 years, average education was 13.8 + 2.0 years, and 65% were of white ethnicity. Abused subjects were less educated than the nonabused subjects (12.8 vs 14.7 school years, respectively) (P = .03), and those with IBS and abuse had less education than all other subjects (12.0 vs 14.3 school years, respectively) (P = .02). Subjects’ age was not different between the study subgroups.
Discussion
A history of abuse and other psychosocial factors is common in patients with IBS and can exacerbate GI symptoms, influence illness experience, and affect treatment outcome.2, 3, 4, 5, 6, 7, 8, 9, 36, 37 The association of a history of abuse with the diagnosis of IBS and its poorer outcome has suggested to some that abuse history may be associated with central mechanisms of pain amplification, resulting in greater pain reports and greater clinical behavioral responses to painful visceral stimuli.
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Cited by (0)
Supported by K23 DK075621 (to Y.R.), DK48351, RO1 MH46959 (to D.D.), R24 DK067674 (to W.E.W. and D.D.), R24 AT002681 (to E.A.M.), P50 DK64539 (to E.A.M.), and RO1 DK48351 (to E.A.M.).
Conflicts of interest: No conflicts of interest exist.