IC & Trauma History Survey

Childhood or Adult Trauma and It's Relationship to IC/BPS

One of the associations we have seen in some IC patients is a history of trauma, often the result of physical injury at any age in life, or a history of emotional trauma, bullying or abuse. Our goal with this survey is to try to identify correlations between types of trauma and the onset of IC/BPS and/or widespread pain.

Absolutely no identifying information will be collected other than your gender, age and the country that you live in. Your privacy is very important. Thank you for your help!
1.Have you been diagnosed with IC/BPS?
2.Have you suffered with any other pain conditions? Select all that apply.
3.Have you suffered from any sensitivities? Please check all that apply.
4.How old were you when you first experience ANY urinary symptoms or any painful conditions, such as IC?
5.Were you an athlete BEFORE the onset of your urinary symptoms or chronic pain? Please select your sports, even if you were just a casual player.
6.Did you sustain any injuries from any accidents (i.e. cars, bicycle, horses, etc.) BEFORE your symptoms began?
7.Have you experienced any of these injuries BEFORE the onset of your symptoms? Check all that apply.
8.Have you had any surgeries to your pelvic area? Check all that apply
9.Did you experience emotional trauma during your childhood? Please check all that apply.
10.Did you feel safe in your childhood home?
11.Did you feel safe in your community? Neighborhood? Schools??
12.Do you or have you struggled with anxiety and/or catastrophic thinking?
13.Do you believe the trauma you experienced has had a lasting impact on your mental or physical health?
14.Have you sought health care for your trauma?
15.How has your trauma impacted your life?
16.What advice would you give another patient who has struggled with trauma?
17.How old are you?
18.What country do you live in?
19.What sex were you when your symptoms began?