Adult health status of women with histories of childhood abuse and neglect.
OBJECTIVE
Several recent studies have found associations between childhood maltreatment and adverse adult health outcomes. However, methodologic problems with accurate case determination, appropriate sample selection, and predominant focus on sexual abuse have limited the generalizability of these findings.


METHODS
We administered a survey to 1,225 women who were randomly selected from the membership of a large, staff model health maintenance organization in Seattle, Washington. We compared women with and without histories of childhood maltreatment experiences with respect to differences in physical health status, functional disability, numbers and types of self-reported health risk behaviors, common physical symptoms, and physician-coded ICD-9 diagnoses.


RESULTS
A history of childhood maltreatment was significantly associated with several adverse physical health outcomes. Maltreatment status was associated with perceived poorer overall health (ES = 0.31), greater physical (ES = 0.23) and emotional (ES = 0.37) functional disability, increased numbers of distressing physical symptoms (ES = 0.52), and a greater number of health risk behaviors (ES = 0.34). Women with multiple types of maltreatment showed the greatest health decrements for both self-reported symptoms (r = 0.31) and physician coded diagnoses (r = 0.12).


CONCLUSIONS
Women with childhood maltreatment have a wide range of adverse physical health outcomes.
Walker
E A
EA
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle 98195, USA.
Gelfand
A
A
Katon
W J
WJ
Koss
M P
MP
Von Korff
M
M
Bernstein
D
D
Russo
J
J
D000328:Adult; D002648:Child; D002649:Child Abuse; D002650:Child Abuse, Sexual; D006233:Persons with Disabilities; D005260:Female; D006304:Health Status; D006801:Humans; D016017:Odds Ratio; D015995:Prevalence; D012309:Risk-Taking; D011795:Surveys and Questionnaires; D016387:Women's Health