Childhood experiences, personality development and marital interactional patterns in women with chronic benign back pain

Abstract

The present research consisted of a series of two interrelated studies that explored the role of childhood experience, personality development and marital interactional patterns in shaping adult responses to physical pain. The first study utilized a case-control design to explore the role of traumatic childhood experiences in developing chronic benign back pain in a group of women drawn from a large urban health center. Within this study, the developmental variables of primary caretaker alcoholism and childhood sex abuse, were combined with the psychological variables of alexithymia, Health Locus of Control and Physical Self-Efficacy in an attempt to discriminate between groups of women with chronic benign back pain (n = 59) and control subjects (n = 53). Participants were screened for chronic benign back pain by two physicians who utilized a back pain checklist. All participants comprising the cases and controls sampling frame were then surveyed on the predictor variables. A hierarchical logistic regression model was utilized to ascertain the utility of the proposed model in predicting group membership. The results suggest that the proposed psycho-social model was useful in identifying subjects with this debilitating condition. The individual predictor variables of increasing age, being married and exposure to an alcoholic caretaker were associated with an increased risk of developing chronic benign back pain. Perceived self-efficacy physical presentation confidence was found to be protective.;The second study utilized methods of qualitative or naturalistic inquiry to explore the role of chronic benign back pain within the marriages of twelve women, drawn from the original case's sampling frame, who were sexually abused by a male alcoholic caretaker. Detailed social histories were compiled on the back pain subject and her spouse and used to create a psychosocial impairment typology consisting of three categories: (1) dysfunctional couples group, (2) dysfunctional husbands group and (3) dysfunctional wives group. Couples were then assessed regarding the impact of the chronic pain complaint on eight key areas of their marital relationship: (1) sexual adjustment, (2) emotional intimacy, (3) verbal expressions of emotions, (4) self esteem, (5) conflict resolution, (6) decision making styles, (7) social activities and (8) roles. Findings suggest that chronic benign pain and its associated emotional suffering, differentially served six interpersonal functions for the couples. These functions were related to their classification within the psychosocial impairment typology and consisted of: (1) legitimizing the expression of affects, (2) realigning hierarchical structures, (3) enhancing self presentation, (4) legitimizing pre-pain sexual dysfunction, (5) regulating emotional intimacy and (6) protection/reduction of violence. Implications for future research and social work practice are discussed. (Abstract shortened by UMI.)