• Alison Flehr, Jan Coles, John B Dixon, Stephen J Gibson, Samuel L Brilleman, Melissa L Harris, and Deborah Loxton.
• Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia.
• Pain Med. 2021 Sep 8; 22 (9): 1916-1929.

ObjectiveTo assess whether body pain was associated with different trauma histories (physical injury vs. interpersonal injury [IPI]) within Australian women, along with body pain and trauma history associations with biological and psychological (biopsycho) confounders.MethodsA retrospective cross-sectional analysis was conducted on the Australian Longitudinal Study on Women's Health (ALSWH) 1973-1978 birth cohort wave 6 data. Relevant life events were categorized into two types of traumatic experience and included as exposure variables in a multinomial regression model for body pain subgroups. Also, subgroup analyses considered trauma and pain effects and interactions on biopsycho burden.ResultsThe unadjusted multinomial regression model revealed that a history of physical injury was found to be significantly associated with body pain severity, as was a history of IPI trauma. After the model was adjusted to include biopsycho confounders, the association between IPI and body pain was no longer significant, and post hoc analysis revealed the relationship was instead mediated by biopsycho confounders. Women with a history of IPI and body pain were also found to have the greatest biopsycho (physical functioning, stress, anxiety, and depression) burden.DiscussionThe relationship between IPI and body pain was found to be mediated by biopsycho burden, whereas the relationship between physical injury and body pain was not. Also, a history of IPI was associated with a greater biopsycho burden than was a history of physical injury. These results suggest there is clinical value in considering the comprehensive trauma history of patients with pain when developing their biopsychosocial model of care.© The Author(s) 2021. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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