Dissociation, somatization, substance abuse, and coping in women with chronic pelvic pain

Obstet Gynecol. 1997 Sep;90(3):405-10. doi: 10.1016/s0029-7844(97)00287-1.


Objective: To examine the relationships between histories of sexual or physical abuse and current reports of dissociation, somatization, substance abuse, adaptive coping, and maladaptive coping strategies among chronic pelvic pain patients.

Methods: Using a structured interview, we assessed sexual and physical abuse and somatization. The Dissociative Experiences Scale was used to assess dissociation, and an abbreviated version of the COPE scale was employed to assess adaptive and maladaptive coping strategies as well as substance abuse. Participants included 46 women with chronic pelvic pain.

Results: Women with self-reported sexual or physical abuse histories were found to have significantly higher dissociation, somatization, and substance abuse scores than women without such a history. Significant positive correlations were found between reports of both dissociation and somatization with maladaptive coping strategies and among dissociation, somatization, and substance abuse.

Conclusion: These results support the association between a positive abuse history and the high levels of dissociation, somatization, and substance abuse often noted in the chronic pelvic pain population. Findings suggest that such psychological variables are more likely to be associated with abuse than with the general medical condition. These psychological variables are conceptualized as maladaptive coping, which may be addressed as part of a biopsychosocial model of treatment for chronic pelvic pain patients.

MeSH terms

  • Adaptation, Psychological*
  • Adolescent
  • Adult
  • Child Abuse / psychology
  • Chronic Disease
  • Dissociative Disorders / etiology*
  • Female
  • Humans
  • Middle Aged
  • Pelvic Pain / complications*
  • Pelvic Pain / psychology*
  • Somatoform Disorders / etiology*
  • Substance-Related Disorders / etiology*