A meta-analytic review of the effects of childhood abuse on medical outcomes in adulthood

Department of Psychology, Furman University, Greenville, SC 29613, USA.
Psychosomatic Medicine (Impact Factor: 4.09). 09/2009; 71(8):805-12. DOI: 10.1097/PSY.0b013e3181bb2b46
Source: PubMed

ABSTRACT To summarize the relationship between abuse during childhood and physical health outcomes in adulthood and to examine the role of potential moderators, such as the type of health outcome assessed, gender, age, and the type of abuse. Studies using self-report assessment methods were compared with studies using objective or independently verifiable methods.
The current study is a quantitative meta-analysis comparing results from 78 effect sizes across 24 studies including 48,801 individuals.
Experiencing child abuse was associated with an increased risk of negative physical health outcomes in adulthood (effect size d = 0.42, 95% Confidence Interval = 0.39-0.45). Neurological and musculoskeletal problems yielded the largest effect sizes, followed by respiratory problems, cardiovascular disease, gastrointestinal and metabolic disorders. Effect sizes were larger when the sample was exclusively female and when the abuse was assessed via self-report rather than objective, independently verifiable methods.
Child abuse is associated with an increased risk of poor physical health in adulthood. The magnitude of the risk is comparable to the association between child abuse and poor psychological outcomes. However, studies often fail to include a diverse group of participants, resulting in a limited ability to draw conclusions about the population of child abuse survivors as a whole. Important methodological improvements are also needed to better understand potential moderators.

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    • "Child maltreatment represents a serious public health concern in the United States and abroad (Gilbert et al., 2009; U.S. Department of Health and Human Services, 2013) and has been related to a number of physical health conditions, including hypertension, diabetes, asthma, heart disease, inflammation, obesity, and poor general health (Chartier, Walker, & Naimark, 2007; Danese, Pariante, Caspi, Taylor, & Poulton, 2007; Flaherty et al., 2006; Wegman & Stetler, 2009; Widom, Czaja, Bentley, & Johnson, 2012). With some exceptions, the existing literature relies heavily on cross-sectional designs that provide support for an association between childhood adversities and health outcomes. "
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    ABSTRACT: Childhood maltreatment has been linked to numerous negative health outcomes. However, few studies have examined mediating processes using longitudinal designs or objectively measured biological data. This study sought to determine whether child abuse and neglect predicts allostatic load (a composite indicator of accumulated stress-induced biological risk) and to examine potential mediators. Using a prospective cohort design, children (ages 0-11) with documented cases of abuse and neglect were matched with non-maltreated children and followed up into adulthood with in-person interviews and a medical status exam (mean age 41). Allostatic load was assessed with nine physical health indicators. Child abuse and neglect predicted allostatic load, controlling for age, sex, and race. The direct effect of child abuse and neglect persisted despite the introduction of potential mediators of internalizing and externalizing problems in adolescence and social support and risky lifestyle in middle adulthood. These findings reveal the long-term impact of childhood abuse and neglect on physical health over 30 years later. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Child Abuse & Neglect 02/2015; DOI:10.1016/j.chiabu.2015.01.016 · 2.47 Impact Factor
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    • "The current sample was gathered from six counties in Norway and is, therefore, considered to be fairly representative of the country. In addition, linking the registry data to the questionnaire data allowed us to investigate recent reports of abuse (within the past 12 months), rather than using retrospective data, which can result in recall bias (Wegman and Stetler 2009). The self-reported questionnaire also allowed us to investigate perceived social support, which is a valuable asset when studying its effects (Cohen and Wills 1985). "
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    ABSTRACT: Negative physical and psychological long-term consequences of abuse and bullying are well documented. It is reasonable to assume that abuse and bullying early in life also may have an impact on the ability to work and stay economically independent later in life, but such prospective studies are lacking. This study investigates the consequences of exposure to abuse and bullying in junior high school, as measured by receiving long-term social welfare benefits in young adulthood. In addition, it explores the potential protective role of social support. Self-reported data from 13,633 (50.3 % female) junior high school students were linked to registry data on their use of social welfare benefits from the age of 18 and for eight consecutive years. Cox regression analyses were applied to test the relationship between exposure to life adversities and the use of social welfare benefits, and the potential moderating role of social support. The analyses showed that individuals exposed to abuse and bullying had an increased likelihood of receiving social-welfare benefits compared with individuals not exposed to these types of abuse. Exposure to multiple types of abuse led to a higher likelihood of using social welfare benefits compared with single types of abuse and no abuse. The findings on the potential moderating role of social support were mixed, depending on the source of social support. Family support and classmate relationships were protective in reducing the likelihood of the use of social welfare benefits, whereas peer and teachers' support showed inconsistent patterns. These results are promising in terms of preventing the long-term negative consequences of abuse and bullying.
    Journal of Youth and Adolescence 07/2014; 43(10). DOI:10.1007/s10964-014-0145-4 · 2.72 Impact Factor
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    • "There are well-established links between childhood social adversity and mortality–morbidity in later life (Roustit et al., 2011; Schwartz et al., 1995; Wegman & Stetler, 2009). For the internal prediction model, such links are expected, and indeed their existence is the reason that psychosocial acceleration is adaptive. "
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    ABSTRACT: Children, particularly girls, who experience early familial adversity tend to go on to reach sexual maturity relatively early. This feature of adolescent development is believed to be an evolved strategy that arose because individuals with genes that caused them to mature relatively early under certain conditions left behind more descendants than those who did not. However, although much has been done to uncover the psychological and physiological mechanisms underlying this process, less attention has been paid to the evolutionary reasons behind why it might be advantageous. It has previously been suggested that this strategy evolved because early familial adversity accurately indicated later environmental adversity, under which conditions early reproduction would likely maximize evolutionary fitness. In this article, we contrast this external prediction model with an alternative explanation, which builds on the existing explanation and is mutually compatible with it but also distinct from it. We argue that accelerated development is advantageous because early adversity detrimentally affects the individual's body, increasing later morbidity and mortality; individuals may adapt to this internal setback by accelerating their development. Unlike the external prediction model, this internal prediction relies not on temporal environmental continuity but on long-term effects of early circumstances on the body.
    Perspectives on Psychological Science 01/2014; 9(1):3-15. DOI:10.1177/1745691613513467 · 4.89 Impact Factor


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