title: Impact of childhood maltreatment on physical health-related quality of life in U.S. active duty military personnel and combat veterans.
abstract: Previous studies have found an association between childhood maltreatment (CM) and health-related quality of life (HRQoL), and to a lesser extent have considered whether psychiatric symptoms may explain the relationship. This study aimed to further our understanding of the link between CM and HRQoL by testing whether posttraumatic stress disorder (PTSD) or depressive symptoms mediate the relationship between childhood maltreatment and physical HRQoL. Mediation models were examined in a sample of male Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) active duty and combat veterans (n=249). PTSD and depressive symptoms mediated the relationship between CM and overall physical HRQoL, as well as participation in daily activities due to physical health, bodily pain, and social functioning. Mediation of the relationship between childhood maltreatment and physical and social functioning by depression and PTSD symptoms may lend support to neurobiological hypotheses that childhood maltreatment sensitizes the nervous system and after repeated trauma may lead to the development of psychiatric symptoms, which have a major impact on morbidity and mortality.
authors.affiliation: Veterans Affairs San Diego Healthcare System, San Diego, CA, USA.
authors.forename: Laura H
authors.initials: LH
authors.lastname: Aversa
authors.affiliation: Veterans Affairs San Diego Healthcare System, San Diego, CA, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Lemmer
authors.affiliation: Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Nunnink
authors.affiliation: Naval Medical Center, San Diego, CA, USA.
authors.forename: Robert N
authors.initials: RN
authors.lastname: McLay
authors.affiliation: Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA; Veterans Affairs Center of Excellence for Stress and Mental Health, San Diego, CA, USA.
authors.forename: Dewleen G
authors.initials: DG
authors.lastname: Baker
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data*; D055826:Afghan Campaign 2001-; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000523:psychology; D006801:Humans; D007493:Iraq; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology*; D011788:Quality of Life; D012044:Regression Analysis; D012307:Risk Factors; D057566:Self Report; D018434:Sickness Impact Profile; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology; D014481:United States; D014728:Veterans / Q000523:psychology*; D055815:Young Adult
keywords: CTQ; Childhood maltreatment; Depression; HRQoL; PTSD