Academic journal article Violence and Victims

Exposure to Child Abuse and Risk for Mental Health Problems in Women

Academic journal article Violence and Victims

Exposure to Child Abuse and Risk for Mental Health Problems in Women

Article excerpt

Risk for adult mental health problems associated with child sexual, physical, or emotional abuse and multiple types of child abuse was examined. Logistic regression analyses were used to test study hypotheses in a population-based sample of women (N = 3,936). As expected, child sexual, physical, and emotional abuse were independently associated with increased risk for mental health problems. History of multiple types of child abuse was also associated with elevated risk for mental health problems. In particular, exposure to all three types of child abuse was linked to a 23-fold increase in risk for probable posttraumatic stress disorder (PTSD). Findings underscore relations between child emotional abuse and adult mental health problems and highlight the need for mental health services for survivors of multiple types of child abuse.

Keywords: child maltreatment; emotional abuse; PTSD; women's mental health

Child maltreatment represents a significant public health concern in the United States, with recent estimates indicating more than 900,000 children are abused or neglected each year (Administration on Children, Youth, and Families, 2005). Although child maltreatment has been associated with adverse psychosocial outcomes in previous research, questions regarding relations between specific child abuse types and adult mental health problems remain. Additionally, research on relations between exposure to multiple types of child abuse and adult anxiety is noticeably lacking. The present study utilized data obtained from a population-based survey of California women to assess risk for adult mental health problems and probable PTSD diagnosis associated with exposure to child sexual, physical, or emotional abuse and multiple types of child abuse in a culturally and economically diverse sample of women. Findings are expected to have important implications for the allocation of mental health resources and may be used to inform the development of effective interventions for women with a history of multiple types of child abuse.

EXPOSURE TO INDIVIDUAL CHILD ABUSE TYPES AND ADULT MENTAL HEALTH PROBLEMS

Results from numerous studies demonstrate significant relations between child maltreatment and impaired psychosocial functioning in adulthood. In particular, previous findings reveal elevated rates of depression and anxiety disorders, including PTSD, among adult survivors of child sexual abuse (CSA) presenting for psychological treatment (cf., Gibb, Butler, & Beck, 2003; Mancini, van Ameringen, & MacMillan, 1995; Rodriguez, Ryan, Vande Kemp, & Foy, 1997). Population-based studies also report increased rates of affective and anxiety symptomatology among survivors of CSA even after controlling for other types of child abuse (Hill et al., 2000; Molnar, Buka, & Kessler, 2001), and prospective research further implicates CSA as a causal factor in the etiology of adult mental health problems (Swanston et al., 2003; Widom, 1999).

Similarly, child physical abuse has been associated with increased risk for symptoms of depression and anxiety in clinical research (cf., Gibb et al., 2003), and among women recruited from the community, child physical abuse has been linked to elevated risk for a lifetime diagnosis of major depression or an anxiety disorder (MacMillan et al., 2001). However, past research has not ruled out comorbid child sexual or emotional abuse as an alternative explanation for relations between physical abuse and adult depression and anxiety (Mullen, Martin, Anderson, & Romans, 1996). Additional research is therefore needed to determine whether physical abuse is independently associated with adult mental health problems, including PTSD.

To date, a majority of research on adult survivors of child abuse has focused on child sexual and physical abuse with little attention directed to relations between child emotional abuse and adult mental health problems. Contrary to the implicit assumption that emotional abuse is less injurious relative to sexual or physical abuse (Kaplan, Pelcovitz, & Labruna, 1999), research with health care and psychiatric patients suggests that child emotional abuse is associated with long-term mental health problems, including adult depression, anxiety, and PTSD, even after controlling for child sexual and physical abuse (Chapman et al. …

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