EMOTIONAL HEALTH
September 1, 2016

Child Abuse Shortens Lives

Women who were abused in childhood don't live as long as those who weren't. Men are less affected.

Child abuse, both physical, sexual and emotional, has immediate negative consequences for the health of the victims. It also has long-term consequences. Victims of child abuse have an increased risk for depression, substance abuse and post traumatic stress disorder.

A recent study details how when a child is mistreated, it can create long-term health problems, particularly for women, which can lead to an early death.

Because of the length of the study period, the researchers believe that the deaths were not related to complications from the abuse itself, or from suicide, but were more likely from increases in the rates of chronic diseases.

Northwestern University researchers asked whether victims of child abuse tended to die sooner than peers. Using questionnaires, the team assessed the childhood abuse history of over 6200 men and women between 1995-1996 and compared them to those who did not report any history of childhood abuse. They followed the victims of abuse until 2015, tracking their mortality.

Seventeen percent, 1091, of the people in the study had died by October 31, 2015. Among women, all three types of abuse, severe physical, moderate physical and emotional, were associated with an increased mortality from any cause and those who reported a higher number of abuse types were at even greater risk of mortality.

Even when the researchers controlled for the socioeconomic status, depression and personality traits of the victims, the greater risk of dying remained. Because of the length of the study period, the researchers believe that the deaths were not related to complications from the abuse itself, or from suicide, but were more likely from increases in the rates of chronic diseases.

By contrast, the same finding was not true of the men in the study group; the men did not demonstrate any increased risk of all-cause mortality from any of the three categories of abuse. It is also unclear why women are impacted though men are not, but the study authors suggest that different psychological and physiological coping strategies between the two sexes may influence vulnerability.

The researchers offer several possible explanations for their findings. It is possible that the increased depression seen among abuse victims makes them more subject to chronic physical illnesses, and less inclined to care for themselves properly once they are ill. The victims could be inclined to self-medicate, leaving them vulnerable to drug and alcohol abuse, and these would increase the risk and severity of chronic illness. Similarly, obesity and the metabolic problems that come with overweight may be increased in abuse victims.

Finally, stress can change the way the physiologic and immune systems function, promoting increased vulnerability to inflammation, which is known to lead to chronic diseases.

The authors suggest that additional research is necessary to investigate all these hypotheses and argue that women who are survivors of abuse should receive more health surveillance and interventions to decrease their risk of premature mortality.

The study is published in JAMA Psychiatry. An editorial accompanying the study notes that child maltreatment is a global problem: “According to the World Health Organization, 1 in 4 adults report having been physically maltreated and 1 in 5 women disclose having been sexually abused in childhood. The extent of the problem is even larger when considering neglect as well as psychological and emotional abuse, affecting more than half of the population in many parts of the world.”

The editorial urges that the study's findings be used to “ promote the long-term global well-being of survivors and improve the probability that they can lead healthy, productive lives.”

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