The Relation of Trauma to the Persistence of Functional Abdominal Pain from Childhood into Adolescence and Young Adulthood

Abstract

Traumatic life experiences in childhood, particularly sexual and physical assault and abuse, have been consistently related to poor physical and mental health outcomes later in life. There is some evidence linking such childhood trauma to subsequent medically unexplained, or “functional,” abdominal pain (FAP). However, the clinical significance and course of the symptomology within this relationship have yet to be fully understood. To examine this, the current study followed a cohort of pediatric FAP patients from childhood into adolescence and young adulthood. We hypothesized that, at the time of the long-term follow-up, adolescents and young adults who reported a history of trauma would be more likely than those without a history of trauma to report clinically significant abdominal pain as defined by the Rome III diagnostic criteria for an abdominal pain-related functional gastrointestinal disorder (FGID). We also hypothesized that, among individuals who met criteria for an FGID at follow-up, those who reported a history of trauma would be at increased risk for developing psychiatric comorbidities and additional sites of chronic pain beyond the gastrointestinal system. Results supported both hypotheses, suggesting that trauma may contribute to the persistence of clinically significant FAP over time. Implications of these findings and directions for future research will be discussed.