Pathways linking childhood maltreatment and adult physical health

Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
Child abuse & neglect (Impact Factor: 2.34). 11/2012; 37(6). DOI: 10.1016/j.chiabu.2012.09.008
Source: PubMed


OBJECTIVES: This study examined whether a self-reported history of childhood maltreatment (physical, emotional, and sexual abuse and physical and emotional neglect) is related to poor adult physical health through health risk behaviors (obesity, substance dependence, and smoking), adverse life events, and psychological distress. METHODS: Two hundred and seventy nine (279) women aged 31-54, primarily poor, urban, and African American with a history of substance use during pregnancy, were assessed for perceived physical health status using the Health Status Questionnaire (SF-36) and any reported chronic medical condition. Hierarchical multiple and logistic regression were used to test mediation, as well as to assess relative contributions of multiple mediators on physical health. RESULTS: More than two-thirds (n=195, 70%) of the sample reported at least 1 form of childhood maltreatment, with 42% (n=110) having a lifetime history of substance dependence and 59% (n=162) having a chronic medical condition. Controlling for age, education, and race, childhood maltreatment was related to increased likelihood of lifetime history of substance dependence (OR=1.19, 95% CI=1.01-1.39), more adverse life events (β=.14), and greater psychological distress (β=.21). Psychological distress and adverse life events partially mediated the relationship between childhood maltreatment and perceived physical health, accounting for 42% of the association between childhood maltreatment and perceived physical health. Adverse life events accounted for 25% of the association between childhood maltreatment and chronic medical condition. CONCLUSIONS: Our findings provide additional evidence that the ill health effects associated with childhood maltreatment persist into adulthood. Adverse life events and psychological distress were key mechanisms shaping later physical health consequences associated with childhood maltreatment among relatively young urban women with a history of substance use. PRACTICE IMPLICATIONS: Health care providers should be aware that childhood maltreatment contributes to adult health problems. Interventions aimed at preventing child maltreatment and addressing life stress and psychological distress will improve long-term physical health among abused children, adults with such histories, as well as children who are likely to be affected by maternal history of childhood maltreatment.

Download full-text


Available from: Lynn T Singer,
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Severe obesity has increased, yet childhood antecedents of adult severe obesity are not well understood. Estimate adult-onset severe obesity risk in individuals with history of childhood physical and/or sexual abuse compared with those who did not report abuse. Longitudinal analysis of participants from the US National Longitudinal Study of Adolescent Health (n = 10 774) wave II (1996; aged 12–22 years) followed through wave IV (2008–2009; aged 24–34 years). New cases of adult-onset severe obesity (body mass index [BMI] ≥ 40 kg/m2 using measured height and weight) in individuals followed over 13 years who were not severely obese during adolescence (BMI <120% of 95th percentile Centers for Disease Control and Prevention National Center for Health Statistics growth curves). The combined occurrence of self-reported sexual and physical abuse during childhood was associated with an increased risk of incident severe obesity in adulthood in non-minority females (hazard ratio [HR; 95% Confidence Interval] = 2.5; 1.3, 4.8) and males (HR = 3.6; 1.5, 8.5) compared with individuals with no history of abuse. In addition to other social and emotional risks, exposure to sexual and physical abuse during childhood may increase risk of severe obesity later in life. Consideration of the confluence of childhood abuse might be considered as part of preventive and therapeutic approaches to address severe obesity.
    Pediatric Obesity 09/2013; 9(5). DOI:10.1111/j.2047-6310.2013.00196.x · 4.57 Impact Factor
  • Source

    Maltrattamento e Abuso all'Infanzia 03/2014; 16(1):11-35. DOI:10.3280/MAL2014-001002

  • Maltrattamento e Abuso all'Infanzia 03/2014; 16(1):7-10. DOI:10.3280/MAL2014-001001
Show more