Adverse Childhood Experiences and Pain in Early Adolescence: A Study in the Generation XXI Cohort

Background The cross-sectional association between Adverse Childhood Experiences (ACEs) reports and adult pain conditions is well-established. Studies in children are scarce, yet evidence indicates that ACEs may trigger a health-damaging cascade, especially in stress-sensitive developmental stages of higher brain plasticity. We aimed to examine the associations between ACEs and pain experiences in childhood and adolescence. Methods Participant data from the third (2016-17) and fourth waves (2018-20) of the Generation XXI birth cohort study (2005-06) was used. ACEs were reported by children aged 10 and 13 using a 15-item questionnaire. Recent pain experiences (i.e., presence of pain episodes, number of pain sites, and pain intensity) were measured using structured questionnaires. Pain episodes were reported a week prior to the interview at age 10 and in the previous three months at age 13. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were obtained from binary and multinomial logistic regression analyses. Results ACEs reported until the age of 10 were associated with pain experiences (i.e., presence of pain episodes, number of pain sites, and pain intensity), with higher number of events conferring a greater risk of experiencing pain at age 10 (aOR 3.18 for ≥6 ACEs; 95% CI [2.19, 4.74]). ACEs until age 10 were associated with pain reports at 13 years. Further, each point increase in ACEs at age 10 increased 9% the odds of reporting pain at age 13 (OR 1.09; 95% CI [1.07, 1.12]). No interaction was observed between ACEs score at ages 10 and 13 was (OR 0.99; CI [0.98-1.00]), showing that the effect of ACEs at age 10 on recent pain at age 13 was not moderated by the ACEs at age 13. Conclusions Adverse experiences occurring during the first years of life may predict pain conditions later in life. Key messages • A dose-response association was observed between the cumulative number of ACEs and reports of pain in 10-year-old children. • Embodiment of ACEs starts as early as childhood, and pain related to ACEs begins earlier than previously reported.