Child Abuse and Other Traumatic Experiences, Alcohol Use Disorders, and Health Problems in Adolescence and Young Adulthood

, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 1521, USA.
Journal of Pediatric Psychology (Impact Factor: 2.91). 12/2009; 35(5):499-510. DOI: 10.1093/jpepsy/jsp117
Source: PubMed


We prospectively examined the health effects of child abuse and other traumatic events, with objective health indicators and consideration of alcohol use disorders (AUD).
Adolescents (n = 668) were recruited from clinical and community sources. At baseline, we examined child abuse and other traumas, AUD, health-related symptoms, physical findings, and blood assays. Subjects were assigned to Trauma Classes (TC), including witnessing violence, physical abuse, and sexual abuse. Health outcomes were again determined at 1-year and young adult follow-up.
In adolescence, higher TC severity was associated with more health-related symptoms, increased age-adjusted body mass index, and stress-response immune system indices. In adolescence and young adulthood, the relationships between TC and health-related symptoms were mediated by anxiety. AUD was associated with liver injury, and cigarette smoking with heart/lung symptoms.
Child abuse predicted persistently elevated health-related symptoms primarily attributable to anxiety, and early signs of liver disease were attributable to AUD.

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    • "Again, the focus of this study did not extend beyond sexual abuse. In their examination of the relationship between trauma severity, AUDs, and health status in older adolescence/emerging adulthood, Clark et al. (2010) found that trauma severity was associated with an AUD diagnosis. Although this study included multiple types of trauma, only sexual and physical abuse were included in the family-related trauma category, and the sample primarily consisted of older adolescents (i.e., 13-to 19-year-olds). "
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    ABSTRACT: Objective: The purpose of this study was to examine the relationship between childhood maltreatment and alcohol use disorders (AUDs), treatment utilization, and barriers to treatment in a national sample of emerging adults. Multiple types of maltreatment were examined, including childhood emotional abuse and neglect. Method: The analyses are based on data from 18- to 25-year-olds (N = 4,468) who participated in the National Epidemiologic Survey on Alcohol and Related Conditions. Results: Adjusted for sociodemographic characteristics, we found that childhood maltreatment was associated with a greater likelihood of an AUD and a greater likelihood of accessing treatment, although these relationships were no longer significant once psychiatric comorbidities and other substance use disorders were included as control variables. We also found significant interaction effects for age; differences in the prevalence of AUDs among those who experienced physical abuse and multiple types of maltreatment were larger for the older age group. Finally, among those with AUDs, maltreatment was associated with specific perceived barriers to treatment. Conclusions: The current findings highlight childhood maltreatment, including emotional abuse and neglect, as important correlates of AUDs among emerging adults but indicate that these relationships may be accounted for by other psychiatric comorbidities. Barriers to treatment among individuals with AUDs may reflect maltreatment experiences and should be addressed in both policy and practice.
    Full-text · Article · Mar 2013 · Journal of studies on alcohol and drugs
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    • "Furthermore, our findings may provide further insight into a physiological mechanism associated with early childhood trauma and cardiovascular disease. Indeed, recent reports have demonstrated that early trauma is associated with the presence of various pathological states including cardiovascular disease, liver disease and stroke (Draper et al., 2008; Clark et al., 2010; Roy et al., 2010). "

    Full-text · Article · Dec 2012 · International Journal of Psychophysiology
    • "Sexually abused individuals have an earlier onset and a longer duration of depression (Zlotnick et al., 2001). Additionally, child maltreatment is associated with obesity, social problems, low self-esteem, decreased school performance and absenteeism, re-victimisation in adulthood, drug and alcohol misuse, criminal behaviour, risky sexual behaviour, teenage pregnancies and promiscuity (Frothingham et al., 2000; Hillis et al., 2004; Sachs-Ericsson et al., 2006; Webb et al., 2007; Black et al., 2009; Gilbert et al., 2009a, b; Clark et al., 2010; Hahm et al., 2010; Turner et al., 2010). What is becoming increasingly evident is that maltreated children are often subject to more than one form of maltreatment. "
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    ABSTRACT: Background: It is becoming increasingly evident that children often suffer from a combination of different categories of maltreatment, namely physical, sexual and emotional abuse, and neglect. Objective: The aim of this study was to determine whether multi-type child maltreatment was associated with higher levels of health risk behaviours and mental ill health. Methods: Four hundred and six, 15-16 year-old students from secondary schools in Malta participated in the study. The self-report “Child maltreatment physical and mental health questionnaire” by Nguyen, Dunne and Le, was used to assess the demographics, health risk behaviour, mental health and child maltreatment. Results: Students experienced all four types of maltreatment. 27.4%, 16.6%, 11.1% and 6.5% experienced one, two, three and four categories of maltreatment respectively. As regards health risk behaviours, there were statistically significant positive relationships between multi-type maltreatment and school fights (r=.27, p<0.01); breaking school rules (r=.19, p<0.01); illicit drug use (r<.14, p<0.05); and alcohol use (r=.10, p<0.05). As regards mental health, depression was positively associated with multi-type maltreatment (r=.38, p=0.01). Similarly, anxiety(r=.23, p=0.01) and low self esteem (r=-.266, p=0.01) were positively associated with multi-type maltreatment. Multi-type child maltreatment also showed graded worsening responses for anxiety, depression, general ill-health, selfesteem, breaking school rules, school fights and smoking. Conclusion: This study showed that multi-type child maltreatment is prevalent and that it resulted in graded worsening responses for mental health outcomes and risky behaviour the higher the number of categories of exposure. These findings are relevant to policy makers in the preventive and therapeutic services in this area, as well as in raising their awareness that different types of child maltreatment often co-exist.
    No preview · Article · Nov 2012 · The European Journal of Public Health
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