Trauma and physical pain: an urban-rural comparison of sexually abused girls in Burundi.

Background: Childhood sexual abuse (CSA) is a significant risk factor for physical and psychological difficulties, especially in (post-)war- and conflict affected regions. Survivors often suffer from both post-traumatic stress disorder (PTSD) and physical pain. Avoidance may contribute to symptom chronification. Yet, in rural areas daily physical obligations may render physical activities unavoidable for survivors. Living conditions post-CSA may play a decisive role in symptom development and chronification.Objective: The aim of this study was to compare PTSD symptom severity and physical pain intensities post-CSA in rural and urban children/adolescents in Burundi. Additionally, the relationship between PTSD symptom severity and physical pain intensity was analysed.Method: The sample comprised 138 sexually abused female children/adolescents (M = 15.9, SD = 1.7), of whom 65 lived in urban and 73 lived in rural areas. Local psychologists assessed PTSD symptom severity and pain intensities using standardized questionnaires.Results: A Fisher's Exact Test revealed significantly lower pain intensities in rural compared to urban children/adolescents. No significant group differences in PTSD symptom severity were found using a T-Test. PTSD symptom severity correlated positively with pain intensity in the total sample (τOverall = .16) and in the urban subgroup (τUrban = .16).Conclusion: The results indicate a relationship between physical pain intensity and living conditions, potentially through physical activity levels post-CSA. The findings also support a link between PTSD and physical pain, highlighting the importance of avoidance for the development and maintainance of both in young female CSA survivors.