title: Utilizing the salutogenic paradigm to investigate well-being among adult survivors of childhood sexual abuse and other adversities.
abstract: The long-term negative consequences of adverse childhood experiences are well documented. However, less is known about salutogenesis (well-being) among adult survivors of childhood adversity. The 2010 Behavioral Risk Factor Surveillance System data were analyzed to assess the contribution of four health promoting factors (physical activity, smoking abstinence, educational level, social-emotional support) with positive health-related quality of life (HRQoL), among adults who retrospectively reported childhood abuse or exposure to other childhood toxic stressors (n=12,032) and separately for adults who reported childhood sexual abuse (CSA). Outcomes examined included positive self-rated health (good/very good/excellent); mentally unhealthy days (MUDS) and physically unhealthy days (PUDS) in the past 30 days. After controlling for demographic characteristics and existing health conditions, physical activity (p<.05), smoking abstinence (p<.05), education of high school or greater (p<.05), and social-emotional support (p<.05) were associated with positive HRQoL outcomes among adult survivors of childhood adversity and adult survivors of CSA. Each unit increase of the health promoting factor score (0-4) resulted in adjusted odds ratio of 2.1 (95% CI: 1.3-2.4) for self-rated health and 1.6 (95%CI: 1.1-2.6) for <14 PUDs among male CSA survivors; among female survivors the adjusted odds ratios were 2.4 (95% CI: 1.8-3.2) for self-rated health, 2.3 (95% CI: 1.7-3.1) for <14 MUDs, and 2.2 (95% CI: 1.6-3.0) for <14 PUDs. The study validates that a large proportion of adults survive childhood adversities and underscores the importance of the salutogenic paradigm to identify strategies that may contribute to well-being.
authors.affiliation: Associate Professor, Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University; Affiliated Faculty, Center for the Study on Stress, Trauma, and Resilience, Department of Counseling & Psychological Services, Georgia State University. Electronic address: sdube2@gsu.edu.
authors.forename: Shanta R
authors.initials: SR
authors.lastname: Dube
authors.affiliation: Education Program Consultant, California Department of Education, Sacramento, CA, USA; Research Associate, Omkar Mission Research Institute, Pune, India.
authors.forename: Shobhana
authors.initials: S
authors.lastname: Rishi
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology; D040343:Behavioral Risk Factor Surveillance System; D002648:Child; D002649:Child Abuse / Q000523:psychology; D002650:Child Abuse, Sexual / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006293:Health Promotion; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D016017:Odds Ratio; D011788:Quality of Life; D012189:Retrospective Studies; D012944:Social Support
keywords: Adult survivors; Childhood emotional abuse; Childhood physical abuse; Childhood sexual abuse; Salutogenesis or health promoting strategies