Does Child Abuse Predict Poor Mental Health?

Are people who face maltreatment in early life primed for a future of recurring or chronic mental, emotional and physical health issues?  More and more studies indicate the answer is unfortunately, yes.

The World Health Organization defines child abuse, or child maltreatment, as the abuse and neglect that happens to children less than 18 years of age.  It includes any type of physical and/or emotional ill-treatment, sexual abuse, neglect, negligence and commercial or other exploitation that results in actual or potential harm to the child’s health, survival, development or dignity in the context of a relationship of responsibility, trust or power. According to WHO’s reports, the global prevalence of child abuse include:

• One quarter of all adults report having been physically abused as children.
• One in 5 women and 1 in 13 men report being sexually abused as a child.

The long-term consequences of child abuse have been shown to include an overall impaired functioning in both physical and mental health, with impacts on relationships, family life, occupation and mortality.  In fact, a study done at Harvard University reported that child abuse and maltreatment can shrink important parts of the brain.  In the study, when compared to children who weren’t abused, abused children had reduced volume in certain areas of the hippocampus by about 6 percent, as well as size reductions in a related brain area called the subiculum, which relays the signals from the hippocampus to other areas of the brain, including the dopamine system, known as the brain’s “reward center.”  These differences could explain why these children are at an increased risk for psychiatric disorders including depression, PTSD and drug addiction.

Associations between child abuse and these longterm mental and physical issues have been found:

Mental Health

Many studies have linked childhood maltreatment in any form with increase prevalence of mental health disorders including depression, mood and personality disorders and others:

• In a study done at St Patrick’s Hospital in Dublin that was published in the British Medical Journal, researchers examined the link between sexual abuse in childhood and the rate of depression in adult women. After screening over 1,000 women, thirty-seven percent of those who had depression experienced sexual abuse when they were less than 16 years old.
• A study published in the British Journal of Psychiatry showed both male & female victims had significantly higher rates of psychiatric treatment than the general population for mental disorders, personality disorders, anxiety and major affective disorders.

Addiction

According to the US National Institute on Drug Abuse, two-thirds of people in treatment for drug abuse report that they were physically, sexually, or emotionally abused during childhood.

• A paper published in Oxford University Press “Childhood Trauma in Alcoholics” found that inappropriate parental treatment and some other traumas in childhood seem to precede alcoholism. A history of childhood physical violence was found to occur six to 12 times, and sexual abuse 18 to 21 times more often in alcoholics than in the control groups.
• A study published in the journal Obesity examined information compiled on more than 57,000 women from the Nurses’ Health Study II found that women who were abused physically or sexually before age 18 were nearly twice as likely as others to develop a food addiction by the time they were middle-aged.  For women who endured both physical and sexual abuse, the odds of developing a food addiction were even greater.

Overall Health

According to a study done at the University of Wisconsin, “The Long-term Health Outcomes Childhood Abuse” compared with non-abused adults, those who experienced childhood abuse are more likely to engage in high-risk health behaviors including smoking, alcohol and drug use, and unsafe sex; to report an overall lower health status; and to use more health services.  Increased disease risks include:

• A study published in the Cambridge University Press found adults who experienced abuse or neglect during childhood are more likely to suffer from cardiovascular disease, lung and liver disease, hypertension, diabetes, asthma, and obesity.
• In a study reported by the Child Welfare Information Gateway showed that children who experienced neglect were at increased risk for diabetes and poorer lung functioning, while physical abuse was shown to increase the risk for diabetes and malnutrition.
• Researchers from the American Headache Society found that a higher incidence of childhood maltreatment, especially emotional abuse and neglect, are prevalent in migraine patients as well as a significantly higher number of comorbid pain conditions compared with those without a history of maltreatment.

To date, one of the largest studies into the connection between childhood maltreatment and health later in life is The Adverse Childhood Experiences (ACE) Study, a collaboration between the Centers for Disease Control and Prevention and Kaiser Permanente’s Health Appraisal Clinic.  In this study, more than 17,000 patients completed a standardized physical examination and provided detailed information about their childhood experience of abuse, neglect, and family dysfunction. The ACE Study findings also confirm that certain childhood experiences are major risk factors for the leading causes of illness, death and poor quality of life in the US.

To read more about the connection between child abuse and overall health outcomes, visit www.psychcentral.com.