Adverse childhood experiences (ACEs) affect approximately half of all children worldwide. These experiences have been linked to increased pain sensitivity in adulthood and a higher likelihood of developing severe chronic pain. However, most studies have assessed the effects of ACEs retrospectively, long after they occurred, leaving room for other factors to influence the observed outcomes. We investigated, for the first time, the association between ACEs and concurrent pain perception among young children who live in a conflict zone and are consistently exposed to potentially traumatic experiences. Participants were 60 elementary school children (ages 8-11 years) living in conflict regions (n = 39) or nonconflict regions (n = 21). Posttraumatic stress symptom (PTSS) severity, traumatic exposure, pressure pain threshold (PPT), and mechanical detection threshold (MDT) were measured. Trauma-exposed children had significantly lower PPT than did controls, but MDT was similar across groups. Pressure pain threshold correlated positively with proximity to the conflict zone and inversely with traumatic exposure magnitude and PTSS severity. In addition, PTSSs moderated the relationship between repeated traumatic exposure and PPT. Children with higher PTSS severity displayed pain hypersensitivity regardless of their traumatic exposure level, whereas in children with lower PTSS severity, greater traumatic exposure correlated with pain hypersensitivity. The results suggest that ACEs among children lead to concurrent pain hypersensitivity and distress and may put them at elevated risk of chronic pain early in life. In addition, our findings emphasize the need for identifying children with various PTSS levels to provide tailored interventions and mitigate the long-term negative effects of ACEs.

中文翻译：

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儿童创伤暴露与疼痛感知之间的关系：创伤后症状的调节作用。

不良童年经历 (ACE) 影响着全世界大约一半的儿童。这些经历与成年后疼痛敏感性的增加以及患严重慢性疼痛的可能性增加有关。然而，大多数研究都是在 ACE 发生很久之后才对其影响进行回顾性评估，为其他因素影响观察到的结果留下了空间。我们首次调查了生活在冲突地区并经常遭受潜在创伤经历的幼儿中 ACE 与并发疼痛感知之间的关联。参与者是生活在冲突地区 (n = 39) 或非冲突地区 (n = 21) 的 60 名小学生（8-11 岁）。测量创伤后应激症状（PTSS）严重程度、创伤暴露、压痛阈值（PPT）和机械检测阈值（MDT）。遭受创伤的儿童的 PPT 显着低于对照组，但各组间的 MDT 相似​​。压痛阈值与冲突区域的接近程度呈正相关，与创伤暴露程度和 PTSS 严重程度呈负相关。此外，PTSS 调节了重复创伤暴露与 PPT 之间的关系。 PTSS 严重程度较高的儿童无论其创伤暴露水平如何都表现出疼痛超敏反应，而在 PTSS 严重程度较低的儿童中，更大的创伤暴露与疼痛超敏反应相关。结果表明，儿童中的 ACE 会导致并发的疼痛过敏和痛苦，并可能使他们在生命早期面临慢性疼痛的风险增加。此外，我们的研究结果强调需要识别患有不同 PTSS 水平的儿童，以提供量身定制的干预措施并减轻 ACE 的长期负面影响。