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Am J Psychiatry 1992; 149:534-537
Copyright © 1992 by American Psychiatric Association
Dissociation in women with chronic pelvic pain
EA Walker, WJ Katon, K Neraas, RP Jemelka and D Massoth
Department of Psychiatry and Behavioral Sciences, University of Washington 98195.
OBJECTIVE: The authors' goal was to determine if women with chronic pelvic
pain are significantly more likely to use dissociation as a coping
mechanism than women without pain. METHOD: The subjects were recruited from
women who attended a university women's clinic during a 1-month period.
Twenty-two women who reported that they had at any time in their lives
experienced pelvic pain nearly every day for a period of at least 6 months
were included in the study, along with 21 randomly selected women without a
history of chronic pelvic pain. The 43 women were given structured sexual
assault interviews and completed psychological self-report measures.
RESULTS: The women with chronic pain were significantly more likely to use
dissociation as a coping mechanism, to show current psychological distress,
to see themselves as medically disabled, to experience vocational and
social decrements in function, and to amplify physical symptoms. They were
also significantly more likely to have experienced severe childhood sexual
abuse. In the total study group, women with a childhood history of sexual
abuse had significantly higher scores on measures of psychological
distress, somatization, and dissociation and viewed their physical health
and functioning as more impaired. CONCLUSIONS: The authors discuss a model
for the development of somatization, dissociation, and pain symptoms in
victims of early sexual abuse.
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