Wegman HL, Stetler C. 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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    • "Intriguingly, adverse life events in childhood were associated with FBS in females but not in males. Recent meta-analyses have also suggested that the health effects of childhood adversities seem larger in females than in males [9]. Potentially , the type of events might explain the sex difference. "
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    ABSTRACT: To test age- and sex-specific associations between adverse life events and functional bodily symptoms (FBS) in the general population. In a population-based cohort, 964 participants (mean age 55 years SD 11, 48% male) completed two measurements waves of the present study. Lifetime exposure to 12 adverse life events was assessed through a modified version of the List of Threatening Experiences. Stress-sensitive personality was assessed with the 12-item neuroticism scale of the Eysenck Personality Questionnaire-Revised. Socio-economic status was retrieved from questionnaires. Participants completed the somatization section of the Composite International Diagnostic Interview to survey the presence of 42 FBS in the previous year. Regression analyses, adjusted for age, revealed that lifetime scores of adverse life events were significantly associated with FBS in the previous year, an association that was nearly identical for females (beta=0.18, t=4.07, p<0.01) and males (beta=0.19, t=4.24, p<0.01). This association remained statistically significant when stress-sensitive personality and socio-economic status were added to the model. Associations between adverse life events during childhood and FBS were statistically significant in females (beta=0.13, t=2.90, p=0.04) but not in males (beta=0.06, t=1.24, p=0.22), whereas there was a stronger association with adverse life events during adulthood in males (beta=0.20, t=4.37, p<0.01) compared to females (beta=0.15, t=3.38, p=0.01). Life events in the previous year were not associated with FBS in the previous year. Adverse life events during lifetime were associated with FBS in the previous year. This association was dependent on age and sex but largely independent of having a stress-sensitive personality or low socio-economic status. Future studies could adopt a life course perspective to study the role of adverse life events in FBS. Copyright © 2015 Elsevier Inc. All rights reserved.
    Journal of psychosomatic research 05/2015; 79(2). DOI:10.1016/j.jpsychores.2015.05.013 · 2.84 Impact Factor
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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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