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: 3.47). 09/2009; 71(8):805-12. DOI: 10.1097/PSY.0b013e3181bb2b46
Source: PubMed


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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    • "Childhood maltreatment is both prevalent and impactful[1,2]. Correlates of these adverse early experiences include increased stress responses[3], dysfunctional regulation of glucocorticoid signaling[4], impaired psychological functioning[5], adult intimate partner violence[6], a variety of mental illnesses[1,7,8], suicide attempts and suicides[9,10], and all cause morbidity and mortality[11,12]. Due to its ubiquity—as well as its myriad, cumulative effects on the developing mind, brain, body, and relationships—early maltreatment is perhaps the most important general historical factor to assess in a variety of health care contexts[13,14]. "
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    ABSTRACT: Childhood maltreatment has diverse, lifelong impact on morbidity and mortality. The Childhood Trauma Questionnaire (CTQ) is one of the most commonly used scales to assess and quantify these experiences and their impact. Curiously, despite very widespread use of the CTQ, scores on its Minimization-Denial (MD) subscale-originally designed to assess a positive response bias-are rarely reported. Hence, little is known about this measure. If response biases are either common or consequential, current practices of ignoring the MD scale deserve revision. Therewith, we designed a study to investigate 3 aspects of minimization, as defined by the CTQ's MD scale: 1) its prevalence; 2) its latent structure; and finally 3) whether minimization moderates the CTQ's discriminative validity in terms of distinguishing between psychiatric patients and community volunteers. Archival, item-level CTQ data from 24 multinational samples were combined for a total of 19,652 participants. Analyses indicated: 1) minimization is common; 2) minimization functions as a continuous construct; and 3) high MD scores attenuate the ability of the CTQ to distinguish between psychiatric patients and community volunteers. Overall, results suggest that a minimizing response bias-as detected by the MD subscale-has a small but significant moderating effect on the CTQ's discriminative validity. Results also may suggest that some prior analyses of maltreatment rates or the effects of early maltreatment that have used the CTQ may have underestimated its incidence and impact. We caution researchers and clinicians about the widespread practice of using the CTQ without the MD or collecting MD data but failing to assess and control for its effects on outcomes or dependent variables.
    Full-text · Article · Jan 2016 · PLoS ONE
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    • "G. Koenig et al. 2012). Many of the above studies had small samples (Ahrens et al. 2010; Pargament 1999; Schneider and Feltey 2009), poorly explicated conceptual and operational definitions of RI (Reinert and Koenig 2013), inadequate representation of ethnic minorities, males and older age groups, sole reliance on self-report methods, and confounding of socioeconomic status (SES), race/ethnicity, and education (Wegman and Stetler 2009). "
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    ABSTRACT: The purpose of this study was to determine the role of religious involvement and related indicators - religious coping, intrinsic religiosity, forgiveness and gratitude - in reducing the negative impact of early traumatic stress on the mental and physical health of adult survivors. Multiple linear regressions were used to analyze self-reported data of 10,283 Seventh-day Adventist men and women across North America. The study also included an original analysis on a subsample (n = 496) of the larger group, examining diabetes risk factors in conjunction with Adverse Childhood Events (ACE) data. Higher early trauma scores were associated with decreased mental health (B = −1.93 p < .0001) and physical health (B = −1.53, p < .0001). The negative effect of early trauma on mental health was reduced by intrinsic religiosity (B = .52, p = .011), positive religious coping (B = .61, p = .025), forgiveness (B = .32 p = .025), and gratitude (B = .87 p = .001). Adult survivors of early trauma experienced worse mental and physical health; however, forgiveness, gratitude, positive religious coping, and intrinsic religiosity were protective against poor mental health. The findings support a holistic perspective in the care of childhood trauma survivors.
    Full-text · Article · Nov 2015 · Journal of Child & Adolescent Trauma
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    • "E-mail address: psychosis, and post-traumatic stress responses (Bagley, Wood, & Young, 1994; Cheasty, Clare, & Collins, 1998; Kendler et al., 2000; Levitan et al., 1998; Steel, Sanna, Hammond, Whipple, & Cross, 2004; Teicher, Samson, Polcari, & Andersen, 2009), there is also evidence showing that CSA is related to long-term health and medical problems, such as poor general health, neurological and musculoskeletal disease, gastrointestinal problems, gynecological and cardiovascular symptoms, obesity, and immune system disorders (Irish, Kobayashi, & Delahanty, 2010; Maniglio, 2009; Wegman & Stetler, 2009; Wilson, 2010). Experience across a broad range of cultures indicates that the experience of abuse can lead to difficulties in building interpersonal and intimate relationships (Luo, Parish, & Laumann, 2008; Ozbaran et al., 2009; Vogel & Gschaider- Kassahun, 2009). "
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    ABSTRACT: Little research on dance/movement therapy (DMT) programs for childhood sexual abuse survivors has been reported. This paper presents the results of a DMT program designed to address the adaptive issue of building healthy relationships with the self and others among Chinese childhood sexual abuse (CSA) survivors. The program emphasizes development of a sense of security and the setting of appropriate boundaries, along with the concepts of place and space. Twenty-five female Chinese CSA survivors (age range 25-52 years) attended a five-session two-hour weekly DMT program in Hong Kong. The General Health Questionnaire (GHQ), Courtauld Emotional Control Scale, Rosenberg Self-Esteem Scale (RSES), and Stagnation Scale (SS) were administered before (T0), after (T1), and five weeks after the sessions (T2) to measure the program's potential effects. Qualitative feedback was also collected from the participants to better understand their experiences during the program. Analysis of the quantitative data showed changes with small effect sizes in the GHQ, RSES, and Overattachment subscale of the SS but no changes reached statistical significance. The qualitative feedback from the participants demonstrated the program's positive effects to be related primarily to its therapeutic elements. Participants reported finding their inner rhythm and space, developing greater awareness of personal boundaries, enhanced understanding of relationships, and hopes for a better future. Introducing and exploring the concepts of place and space in the DMT program not only provided the participating CSA survivors with a concrete and direct bodily experience but also helped them to articulate physical experiences with a sense of security, freedom, and boundaries. Further investigation with a more rigorous research design and a larger sample size is warranted.
    Full-text · Article · Sep 2015 · The Arts in Psychotherapy
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