title: Relationships among childhood maltreatment, PTSD, and health in female veterans in primary care.
abstract: OBJECTIVE
  Women with histories of childhood maltreatment (CM) have higher rates of physical health problems and greater medical utilization compared to women without abuse histories. This study examined whether current post-traumatic stress disorder (PTSD) symptoms mediate the relationship between CM and indicators of physical health and medical utilization in female veterans.
  
  
  METHODS
  Respondents were 221 female veterans (56% of the potential sample), who received medical care from the San Diego VA Healthcare System during a 12-month period. Respondents provided self-report information about CM, PTSD symptoms, use of pain medication, and physical symptoms and functioning. Additional information about medical utilization was extracted from respondents' medical charts. Regression-based models were conducted to test whether PTSD symptoms mediate the relationships between CM and physical symptoms and between CM and medical utilization.
  
  
  RESULTS
  Emotional abuse was associated with poorer role-physical functioning, increased bodily pain and greater odds of using pain medication in the past 6 months. Physical abuse was associated with poorer general health. Contrary to prediction, emotional neglect was associated with better role-physical functioning, and CM was not associated with increased healthcare utilization. PTSD was shown to mediate the relationship between emotional and physical abuse and health outcomes.
  
  
  CONCLUSIONS
  PTSD, or psychopathology more generally, appears to be an important factor in the negative health impact of CM. Given that several empirically supported interventions are available for PTSD, there may be physical health benefits in early identification and treatment of psychopathology related to CM.
authors.affiliation: VA San Diego Healthcare System, 8810 Rio San Diego Drive (MC116A4Z), San Diego, CA 92108, USA.
authors.forename: Ariel J
authors.initials: AJ
authors.lastname: Lang
authors.forename: Charlene
authors.initials: C
authors.lastname: Laffaye
authors.forename: Leslie E
authors.initials: LE
authors.lastname: Satz
authors.forename: John R
authors.initials: JR
authors.lastname: McQuaid
authors.forename: Vanessa L
authors.initials: VL
authors.lastname: Malcarne
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Dresselhaus
authors.forename: Murray B
authors.initials: MB
authors.lastname: Stein
mesh_terms: D002140:California; D002648:Child; D002649:Child Abuse / Q000145:classification* / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D011320:Primary Health Care; D013313:Stress Disorders, Post-Traumatic / Q000145:classification* / Q000523:psychology; D011795:Surveys and Questionnaires; D014728:Veterans