title: Cumulative childhood maltreatment and its dose-response relation with adult symptomatology: Findings in a sample of adult survivors of sexual abuse.
abstract: In the present study, we examined the role of cumulative childhood maltreatment experiences for several health related outcomes in adulthood, including symptoms of psychological distress as well as perceived social support and hardiness. The sample comprised adult survivors of sexual abuse (N=278, 95.3% women, mean age at first abusive incident=6.4 years). One-way ANOVAs revealed a statistically significant dose-response relation between cumulative childhood maltreatment scores and self-reported symptoms of posttraumatic stress (PTSS), anxiety, depression, eating disorders, dissociation, insomnia, nightmare related distress, physical pain, emotional pain, relational problems, self-harm behaviors as well as on a measure of symptom complexity. Cumulative childhood maltreatment was also associated with lower levels of work functioning. An inverse dose-response relation was found for perceived social support and hardiness. Using a Bonferroni corrected alpha level, cumulative childhood maltreatment remained significantly associated with all outcome measures with the exception of eating disorder symptoms after controlling for abuse-related independent variables in hierarchical regression analyses. Results add to previous literature by showing that dose-response relation between cumulative childhood adversities and adult symptom outcomes could also be identified in a sample characterized by high exposure to adversities, and lends support to the notion put forth by previous authors that cumulative childhood adversities seem to be related to the severity of adult health outcomes in a rule-governed way.
authors.affiliation: Visiting Scholar, UC Berkeley, Department of Psychology, 4123 Tolman Hall, Berkeley, CA 94720-1690, USA; Department of Clinical Psychology, University of Bergen, Christiesgate 12, 5015 Bergen, Norway. Electronic address: iris.steine@uib.no.
authors.forename: Iris M
authors.initials: IM
authors.lastname: Steine
authors.affiliation: Department of Clinical Psychology, University of Bergen, Christiesgate 12, 5015 Bergen, Norway.
authors.forename: Dagfinn
authors.initials: D
authors.lastname: Winje
authors.affiliation: Clinical Neuroscience Division, VA National Center for PTSD, 950 Campbell Avenue, West Haven, CT 06516, USA; Department of Psychiatry, Yale University School of Medicine, 300 George Street, Suite 901, New Haven, CT 06511 USA.
authors.forename: John H
authors.initials: JH
authors.lastname: Krystal
authors.affiliation: Department of Global Public Health and Primary Health Care, University of Bergen, Kalfarveien 31, 5018 Bergen, Norway; Norwegian Competence Center of Sleep Disorders, Haukeland University Hospital, PO Box 1400, 5021 Bergen, Norway.
authors.forename: Bjørn
authors.initials: B
authors.lastname: Bjorvatn
authors.affiliation: Regional Centre for Violence and Traumatic Stress Studies, Region West, Helse Bergen HF, 5021 Bergen, Norway; Department of Biological and Medical Psychology, University of Bergen, Jonas Lies vei 91, 5009 Bergen, Norway.
authors.forename: Anne Marita
authors.initials: AM
authors.lastname: Milde
authors.affiliation: Department of Biological and Medical Psychology, University of Bergen, Jonas Lies vei 91, 5009 Bergen, Norway; Washington State University, PO BOX 1495 Spokane, WA 99210-1495, USA.
authors.forename: Janne
authors.initials: J
authors.lastname: Grønli
authors.affiliation: Department of Clinical Psychology, University of Bergen, Christiesgate 12, 5015 Bergen, Norway; Institute of Basic Medical Sciences, University of Oslo, PO Box 1110 Blindern, 0317 Oslo, Norway.
authors.forename: Inger Hilde
authors.initials: IH
authors.lastname: Nordhus
authors.affiliation: Norwegian Competence Center of Sleep Disorders, Haukeland University Hospital, PO Box 1400, 5021 Bergen, Norway; Department of Psychosocial Science, University of Bergen, Christiesgate 12, 5015 Bergen, Norway.
authors.forename: Ståle
authors.initials: S
authors.lastname: Pallesen
mesh_terms: D000293:Adolescent; D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D000368:Aged; D001008:Anxiety Disorders; D002648:Child; D002649:Child Abuse / Q000523:psychology*; D002675:Child, Preschool; D003866:Depressive Disorder; D004213:Dissociative Disorders; D001068:Feeding and Eating Disorders; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D057566:Self Report; D012742:Sex Offenses; D012944:Social Support; D055815:Young Adult
keywords: Adult sexual abuse survivors; Adult symptomatology; Cumulative childhood maltreatment; Dose-response relation; Sexual abuse