Author(s): Costa, Eleonora C. V. ; Gonçalves, Patrícia ; Martins, Fernando ; Monteiro, Sílvia ; Pais-Vieira, Carla
Date: 2025
Persistent ID: http://hdl.handle.net/10400.14/55253
Origin: Veritati - Repositório Institucional da Universidade Católica Portuguesa
Subject(s): Autonomic reactivity; Childhood trauma; Integrated healthcare; Mediation analysis; Pain severity; Trauma-informed care
Background: 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.
