title: Associations between body mass index, post-traumatic stress disorder, and child maltreatment in young women.
abstract: The objective of this study was to examine interrelationships between child maltreatment, post-traumatic stress disorder (PTSD) and body mass index (BMI) in young women. We used multinomial logistic regression models to explore the possibility that PTSD statistically mediates or moderates the association between BMI category and self-reported childhood sexual abuse (CSA), physical abuse (CPA), or neglect among 3,699 young women participating in a population-based twin study. Obese women had the highest prevalence of CSA, CPA, neglect, and PTSD (p<.001 for all). Although all three forms of child maltreatment were significantly, positively associated with overweight and obesity in unadjusted models, only CSA was significantly associated with obesity after adjusting for other forms of maltreatment and covariates (OR=2.21, 95% CI: 1.63, 3.00). CSA and neglect, but not CPA, were associated with underweight in unadjusted models; however, after adjusting for other forms of maltreatment and covariates, the associations were no longer statistically significant (OR=1.43, 95% CI: 0.90-2.28 and OR=2.16, 95% CI: 0.90-5.16 for CSA and neglect, respectively). Further adjustment for PTSD generally resulted in modest attenuation of effects across associations of child maltreatment forms with BMI categories, suggesting that PTSD may, at most, be only a weak partial mediator of these associations. Future longitudinal studies are needed to elucidate the mechanisms linking CSA and obesity and to further evaluate the role of PTSD in associations between child maltreatment and obesity.
authors.affiliation: George Warren Brown School of Social Work, Washington University, St. Louis, MO, USA; Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO, USA; Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Alexis E
authors.initials: AE
authors.lastname: Duncan
authors.affiliation: Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Carolyn E
authors.initials: CE
authors.lastname: Sartor
authors.affiliation: George Warren Brown School of Social Work, Washington University, St. Louis, MO, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Jonson-Reid
authors.affiliation: Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO, USA; Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Munn-Chernoff
authors.affiliation: E. Kenneth Hatton Institute for Research and Education, Cincinnati, OH, USA.
authors.forename: Michaela A
authors.initials: MA
authors.lastname: Eschenbacher
authors.affiliation: George Warren Brown School of Social Work, Washington University, St. Louis, MO, USA.
authors.forename: Elizabeth W
authors.initials: EW
authors.lastname: Diemer
authors.affiliation: Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO, USA; Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Elliot C
authors.initials: EC
authors.lastname: Nelson
authors.affiliation: Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO, USA; School of Education, Indiana University, Bloomington, IN, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Waldron
authors.affiliation: Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO, USA; Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Kathleen K
authors.initials: KK
authors.lastname: Bucholz
authors.affiliation: Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO, USA; Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Pamela A F
authors.initials: PA
authors.lastname: Madden
authors.affiliation: Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO, USA; Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Heath
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data; D015992:Body Mass Index; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008923:Missouri / Q000453:epidemiology; D050177:Overweight / Q000453:epidemiology* / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology*; D055815:Young Adult
keywords: BMI; Child maltreatment; Obesity; PTSD