posted on 2025-05-09, 16:41authored byMaurice Dillwyn Bartholomeusz
Chronic-pain (CP) is an intractable, widespread problem, a complex interplay of psychophysiological factors with distinctive characteristics compared to acute-pain. Early life stress (ELS), detrimental experiences or inadequate nurturing in childhood, has been linked to disequilibrium in immunoendocrine and autonomic function and implicated in adult disease states including the diathesis for CP, potentially explaining disparate outcomes for equivalent physical injuries. This project aimed to improve ELS measurement by identifying bio-markers for an ELS bio-index. A critical review compared CP models and reported pathophysiology, with physiological alterations from ELS. A pilot study employing childhood-trauma and childhoodattachment measures in a continuous fashion was designed, that would collect repeated plasma (immunoendocrine), continuous autonomic (ECG, BP and GSR), psychological (mood, personality) and acute pain data, from a healthy non-clinical cohort exposed to twin (physical, psychological) stressors. The design enabled the evaluation of the association between ELS and the psychophysiological recordings. The literature review revealed marked parallels in the neuro-circuitry between CP and ELS, evidence for premorbid physiological factors predisposing to CP onset, and a range of limitations in current methods of measuring ELS. When used in a continuous manner, the ELS measures showed significant robust associations with mood and personality measures, with moderate to high levels of explanatory variance in a young healthy cohort. ELS was also significantly associated with two of the four pain markers. General linear modelling showed significant interactions with a range of plasma markers and autonomic factors. Intriguingly, the ELS measures showed non-cumulative interaction effects with most measures. Assessment of childhood attachment/trauma in a continuous manner achieved a higher sensitivity to measure ELS, as evidenced by detecting statistically significant ELS effects in a healthy pilot group. This result signposts the ubiquitous nature of ELS and challenges the use of solo dichotomous assessment methods. Implications for biomarker identification are discussed.
History
Year awarded
2020.0
Thesis category
Doctoral Degree
Degree
Doctor of Philosophy (PhD)
Supervisors
Hodgson, Deborah (University of Newcastle); Callister, Robin (University of Newcastle); Bolton, Philip (University of Newcastle)