(PS4-C58) The Tolls of Trauma: Adverse Childhood Experiences (ACEs) Are Linked to Increased Chronic Pain Severity and Disordered Eating Symptoms in Late Adolescents and Young Adults

Introduction: Adverse childhood experiences (ACEs) impart lifelong health repercussions, acting as a severe public health risk. Chronic pain and disordered eating are both highly prevalent among young people and contribute to increased morbidity and mortality. Recent evidence has revealed a higher than expected incidence of eating disorders among individuals with chronic pain, suggesting that they may share vulnerabilities or a common developmental pathway. One potential risk mechanism includes a history of adverse childhood experiences, such as abuse, neglect, and household dysfunction. The primary purpose of this ongoing study is to estimate the prevalence of chronic pain, eating disorder risk, and their overlap in a sample of late adolescents and young adults. We also examine associations between ACES and these health outcomes.

Methods: Participants include 109 young adults recruited from a research subject pool at a large university in the Pacific Northwest (ages 18-25; 93% female; 64% White; planned n=450). All completed a set of questionnaires assessing their adverse childhood experiences (ACE-Questionnaire; Felitti et al., 1998), pain characteristics (Graded Chronic Pain Scale-Revised; Von Korff et al., 2020; PROMIS-Pain Interference, Amtmann et al., 1010; Pain Catastrophizing Scale, Sullivan et al., 1995), and disordered eating attitudes and behaviors (Eating Attitudes Test-26; Garner et al., 1982).

Results: Consistent with expectations, exposure to childhood adversity was common. Over a quarter of the sample (26.6%) reported clinically significant trauma history (an ACE score of 4 or higher), placing those participants at “high risk” for toxic stress physiology. In addition, nearly 30% reported experiencing pain most days or daily over the past 3 months, with 9.2% reporting bothersome chronic pain and 2.8% reporting high-impact chronic pain (i.e., pain that limits their life or work activities most days or daily). 18% of participants reported clinically elevated symptoms of disordered eating. Contrary to hypotheses, chi-square analyses revealed no significant overlap between eating disorder risk and chronic pain. However, individuals with a history of trauma reported significantly higher disordered eating symptoms (F(1,106)=3.85, p=.05) as well as greater pain severity (F(1,107)=7.77, p=.006), increased past week pain intensity F(1,106)=4.18, p=.04) and elevated pain catastrophizing symptoms (F(1,106)=8.92, p=.003).

Conclusion: Chronic pain and disordered eating symptoms are strikingly prevalent within the young college population– and a history of childhood trauma may increase the severity of those symptoms to a concerning degree. Adverse childhood experiences may be a vital component in the development, maintenance, and worsening of these symptoms and should be addressed in young adult populations. Data collection from the present study is ongoing, and we anticipate being adequately powered to test potential risk (e.g., perfectionism, body dissatisfaction) and protective factors (social support) that may moderate the link between ACEs and adverse health outcomes in the coming months.