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Autonomic dysregulation mediates the association between childhood trauma and pain severity: evidence from a mediation model

2025-09-16Artigo de investigação Acesso aberto
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datacite.subject.sdg16:Paz, Justiça e Instituições Eficazes
dc.contributor.authorCosta, Eleonora C. V.
dc.contributor.authorGonçalves, Patrícia
dc.contributor.authorMartins, Fernando
dc.contributor.authorMonteiro, Sílvia
dc.contributor.authorPais-Vieira, Carla
dc.date.accessioned2025-10-10T09:06:03Z
dc.date.available2025-10-10T09:06:03Z
dc.date.issued2025-09-16
dc.description.abstractBackground: Childhood trauma is increasingly recognized as a key risk factor for autonomic nervous system (ANS) dysregulation and chronic pain. However, the mechanisms underlying this association remain insufficiently explored, particularly within integrated healthcare frameworks. Objective: This study examined whether autonomic reactivity mediates the relationship between childhood trauma and pain severity while accounting for age and gender. Methods: A total of 124 participants—64 with formally documented interpersonal trauma and 60 without—completed validated measures of childhood trauma (CTQ), cumulative trauma (LEC-17), autonomic reactivity (BPQ), and pain severity (BPI). Group comparisons, correlation analyses, and hierarchical regressions were used to assess associations among variables. A mediation model was used to test whether autonomic reactivity explained the trauma–pain relationship. Results: Trauma-exposed participants showed significantly higher autonomic reactivity than those without, while pain severity did not differ significantly between groups (p < 0.001). Childhood physical and emotional abuse was strongly associated with autonomic reactivity and moderately associated with pain severity but not directly linked to pain. Mediation analysis supported a full mediation, with childhood trauma predicting pain severity indirectly via autonomic reactivity (? = 0.220, 95% CI [0.087–0.422], p = 0.009). A preliminary gender effect on the trauma–ANS pathway was observed but was not sustained in weighted models correcting for sample imbalance. Conclusions: Autonomic dysregulation was found to mediate the link between childhood trauma and pain vulnerability. Incorporating autonomic assessment into trauma-informed, integrated healthcare could inform early detection and tailored interventions, with preliminary evidence suggesting generalizability across gender.eng
dc.identifier.citationCosta, E. C. V., Gonçalves, P., Martins, F., & Monteiro, S. et al. (2025). Autonomic dysregulation mediates the association between childhood trauma and pain severity: evidence from a mediation model. Healthcare (Switzerland), 13(18), Article 2310. https://doi.org/10.3390/healthcare13182310
dc.identifier.doi10.3390/healthcare13182310
dc.identifier.eid105017398948
dc.identifier.issn2227-9032
dc.identifier.other13207526-e346-4e60-ab2b-0fbf78537b72
dc.identifier.pmcPMC12470192
dc.identifier.pmid41008440
dc.identifier.urihttp://hdl.handle.net/10400.14/55253
dc.identifier.wos001581496400001
dc.language.isoeng
dc.peerreviewedyes
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectAutonomic reactivity
dc.subjectChildhood trauma
dc.subjectIntegrated healthcare
dc.subjectMediation analysis
dc.subjectPain severity
dc.subjectTrauma-informed care
dc.titleAutonomic dysregulation mediates the association between childhood trauma and pain severity: evidence from a mediation modeleng
dc.typeresearch article
dspace.entity.typePublication
oaire.citation.issue18
oaire.citation.titleHealthcare (Switzerland)
oaire.citation.volume13
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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