title: Impact of Childhood Abuse on Physical and Mental Health Status and Health Care Utilization Among Female Veterans.
abstract: OBJECTIVE
  To determine whether childhood abuse predicts health symptoms and health care use among female veterans.
  
  
  METHODS
  Participants were 369 female patients at Veterans Affairs hospitals in New England who completed a mail survey. Multiple regression analyses were conducted to determine the differential impact of childhood physical abuse and childhood sexual abuse on health symptoms and health care use, while accounting for age, race, military branch, and military sexual trauma (MST).
  
  
  RESULTS
  In our sample, 109 (29%) female veterans reported experiencing childhood abuse. After adjusting for age, race, military branch, childhood sexual abuse, and MST, childhood physical abuse was predictive of poorer physical health, and greater depressive and post-traumatic stress disorder symptoms. No significant association was found between childhood sexual abuse and poor physical or mental health status. After adjusting for other factors, childhood physical abuse was associated with more frequent use of medical health care. Childhood sexual abuse was not a predictor for health care use.
  
  
  CONCLUSIONS
  Childhood physical abuse remains an important contributor to physical health and mental health, even after adjusting for the more proximate experience of MST. Screening for adverse childhood experiences may facilitate access to appropriate physical and mental health treatment among female veterans.
authors.affiliation: Harvard South Shore Psychiatry Residency Training Program, VA Boston Healthcare System, 940 Belmont Street, Brockton, MA 02301.
authors.forename: Rowena C
authors.initials: RC
authors.lastname: Mercado
authors.affiliation: Women's Health Sciences Division of the National Center for PTSD, VA Boston Healthcare System, 150 South Huntington Street, Boston, MA 02130.
authors.forename: Shannon
authors.initials: S
authors.lastname: Wiltsey-Stirman
authors.affiliation: Women's Health Sciences Division of the National Center for PTSD, VA Boston Healthcare System, 150 South Huntington Street, Boston, MA 02130.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Iverson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002649:Child Abuse / Q000523:psychology*; D003863:Depression / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology*; D009511:New England / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D014481:United States; D014493:United States Department of Veterans Affairs / Q000706:statistics & numerical data*; D014728:Veterans / Q000523:psychology*; D055815:Young Adult