"Several other studies found that sexual abuse was associated with specific types of FSSs in adolescents (Bendixen et al., 1994; Devanarayana et al., 2014; Holmberg & Hellberg, 2010; van Tilburg et al., 2010; Zafar et al., 2012). In addition, a history of sexual abuse was found to be associated with a spectrum of FSSs in children placed in a high care foster home (Kugler et al., 2012). "
[Show abstract][Hide abstract] ABSTRACT: The main aim of this study was to investigate the effect of childhood sexual abuse on medically not well explained or functional somatic symptoms (FSSs) in adolescents. We hypothesized that sexual abuse predicts higher levels of FSSs and that anxiety and depression contribute to this relationship. In addition, we hypothesized that more severe abuse is associated with higher levels of FSSs and that sexual abuse is related to gastrointestinal FSSs in particular. This study was part of the Tracking Adolescents' Individual Lives Survey (TRAILS): a general population cohort which started in 2001 (N= 2,230; 50.8% girls, mean age 11.1 years). The current study uses data of 1,680 participants over four assessment waves (75% of baseline, mean duration of follow-up: 8 years). FSSs were measured by the Somatic Complaints subscale of the Youth Self-Report at all waves. Sexual abuse before the age of sixteen was assessed retrospectively with a questionnaire at T4. To test the hypotheses linear mixed models were used adjusted for age, sex, socioeconomic status, anxiety and depression. Sexual abuse predicted higher levels of FSSs after adjustment for age sex and socioeconomic status (B= 06) and after additional adjustment for anxiety and depression (B= .03). While sexual abuse involving physical contact significantly predicted the level of FSSs (assault; B= .08, rape; B= .05), non-contact sexual abuse was not significantly associated with FSSs (B= .04). Sexual abuse was not a stronger predictor of gastrointestinal FSSs (B= .06) than of all FSSs. Further research is needed to clarify possible mechanisms underlying relationship between sexual abuse and FSSs.
"In one U.S. study, pediatric patients with chronic headaches who reported prior physical or sexual abuse were more likely to score in the clinically significant HRQL range (Zafar et al., 2012). Likewise, a Serbian study compared children in foster care (whose parents lost custody to child welfare) or in biological families with children in residential care; those in residential care had lower HRQL, particularly in psychosocial domains (Damnjanovic, Lakic, Stevanovic, & Jovanovic, 2011). "
[Show abstract][Hide abstract] ABSTRACT: Federal mandates require state child welfare systems to monitor and improve outcomes for children in three areas: safety, permanency, and well-being. Research across separate domains of child well-being indicates maltreated children may experience lower pediatric health-related quality of life (HRQL). This study assessed well-being in maltreated children using the Pediatric Quality of Life Inventory (PedsQL 4.0), a widely used measure of pediatric HRQL. The PedsQL 4.0 was used to assess well-being in a sample of children (N = 129) receiving child welfare services following reports of alleged physical abuse or neglect. We compared total scores and domain scores for this maltreated sample to those of a published normative sample. Within the maltreated sample, we also compared well-being by child and family demographic characteristics. As compared with a normative pediatric population, maltreated children reported significantly lower total, physical, and psychosocial health. We found no significant differences in total and domain scores based on child and parent demographics within the maltreated sample. This preliminary exploration indicates children receiving child welfare services have significantly lower well-being status than the general child population and have considerable deficits in social and emotional functioning. These findings support continued investment in maltreatment prevention and services to improve the well-being of victims of maltreatment.
"Taken together, we hypothesized that loneliness and psychological distress may pose as parallel mediators linking exposure to interpersonal violence to recurrent headache, whereas family cohesion and sex may serve as moderators buffering pathways. The current study was guided by this hypothetical model (Figure 1) . The model was assessed in a large population-based cohort of adolescents. "
[Show abstract][Hide abstract] ABSTRACT: Background
Recurrent headache is the most common and disabling pain condition in adolescence. Co-occurrence of psychosocial adversity is associated with increased risk of chronification and functional impairment. Exposure to interpersonal violence seems to constitute an important etiological factor. Thus, knowledge of the multiple pathways linking interpersonal violence to recurrent headache could help guide preventive and clinical interventions. In the present study we explored a hypothetical causal model where the link between exposure to interpersonal violence and recurrent headache is mediated in parallel through loneliness and psychological distress. Higher level of family cohesion and male sex is hypothesized to buffer the adverse effect of exposure to interpersonal violence on headache.
The model was assessed using data from the cross-sectional, population-based Young-HUNT 3 study of Norwegian adolescents, conducted from 2006–2008. A cohort of 10 464 adolescents were invited. The response rate was 73% (7620), age ranged from 12 and 20 years, and 50% (3832) were girls. The study comprised self-report measures of exposure to interpersonal violence, loneliness, psychological distress and family cohesion, in addition to a validated interview on headache, meeting the International Classification of Headache Disorders criteria. Recurrent headache was defined as headache recurring at least monthly during the past year, and sub-classified into monthly and weekly headache, which served as separate outcomes.
In Conditional Process Analysis, loneliness and psychological distress consistently posed as parallel mediating mechanisms, indirectly linking exposure to interpersonal violence to recurrent headache. We found no substantial moderating effect of family cohesion or sex.
Loneliness and psychological distress seem to play crucial roles in the relationship between exposure to interpersonal violence and recurrent headache. To facilitate coping and recovery, it may be helpful to account for these factors in preventive and clinical interventions. Trauma-informed, social relationship-based interventions may represent a major opportunity to alter trajectories of recurrent headache.
The Journal of Headache and Pain 06/2014; 15(1):35. DOI:10.1186/1129-2377-15-35 · 2.80 Impact Factor
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