Child abuse and physical health: A population-based study on physical health complaints among adolescents and young adults.

Aims: To investigate whether adolescents and young adults with a history of child abuse had more physical health complaints compared to their unexposed peers. We also aimed to estimate associations between different child abuse types with physical health complaints and associations between the number of child abuse types and physical health complaints. Methods: This population-based telephone survey over two waves included 506 adolescents and young adults exposed to child abuse and 504 non-abused peers aged 16-33 years. We applied linear regression analyses to investigate associations between child abuse types and physical health complaints, unadjusted and mutually adjusted for co-occurring abuse, and to investigate how the number of child abuse types associated with physical health complaints. Results: Participants exposed to child abuse reported significantly more physical health complaints. The child abuse types strongly co-occurred. When adjusting for co-occurring child abuse, only sexual and emotional abuse were significantly associated with physical health complaints. Physical health complaints increased with the higher number of child abuse types experienced. Conclusions: Our findings suggest that exposure to abuse, particularly sexual and emotional, during childhood predicts physical health complaints in adolescence and early adulthood. In a public health perspective, early identification of child abuse may be beneficial in preventing physical health complaints later in life.

Adolescent abuse victims displayed physical health complaints and trauma symptoms during post disclosure interviews.

AIM: We investigated whether adolescents who had recently disclosed sexual abuse or family violence displayed more psychological trauma symptoms and physical health complaints than unaffected controls. We also investigated to what degree physical health complaints were associated with trauma symptoms in these abuse victims. METHODS: Abuse, trauma symptoms and physical health complaints were assessed during face-to-face interviews with 40 sexual abuse victims and 35 family violence victims aged 10-18 years. They had all attended forensic interviews at the Barnehus in Oslo, a specialised Norwegian police unit where evidence is gathered in adolescent-friendly surroundings, from October 2016 to November 2018. Their symptoms were compared with 41 controls from the general population. Linear regression analyses investigated associations between trauma symptoms and physical health complaints. RESULTS: Sexually abused adolescents displayed higher levels of post-traumatic stress reactions, depression, dissociation and physical health complaints than unaffected controls. Family violence victims displayed higher levels of post-traumatic stress reactions. Trauma symptoms were associated with physical health complaints, and these were most prominent in the adolescents with the highest burden of symptoms. CONCLUSION: Based on the high burden of symptoms revealed, clinical examinations of abused adolescents should include a systematic assessment of trauma symptoms and physical health complaints.

The human sex ratio: effects of maternal age.

BACKGROUND: Previous studies suggest that stressful pregnancies may be associated with a lower proportion of male relative to female offspring. Low or high maternal age may represent stress for the fetus. Our aim was therefore to study whether the sex ratio differs by maternal age in all pregnancies, and in separate analyses, to assess the sex ratio in pregnancies complicated by pre-eclampsia, fetal death, preterm delivery or small for gestational age (SGA) offspring. METHODS: Data from all births in Norway from 1967 through 2006, a total of 2 206 040 births, were used to estimate sex ratios (the number of male per 100 female offspring) according to maternal age. The analyses were done among all pregnancies, and within subgroups of complicated pregnancies. In addition, we estimated the odds ratio (OR) of having a male offspring by maternal age in all pregnancies with adjustment for pre-eclampsia, fetal death, preterm delivery or SGA offspring. RESULTS: Overall, there was no association of maternal age with the human sex ratio. In subgroups of complicated pregnancies (pre-eclampsia, fetal death, preterm delivery and SGA offspring) the sex ratio was increased. However in pregnancies with pre-eclampsia, the proportion of males decreased with increasing maternal age. In multivariable analyses including all pregnancies, with adjustment for complications, there was still no association of maternal age with offspring sex. However, in pregnancies with SGA offspring, the adjusted OR of delivering a boy at term was lower than expected (OR 0.87, 95% confidence interval 0.85-0.89). CONCLUSIONS: The lower proportion of male births at high maternal age in pregnancies with pre-eclampsia and in pregnancies with live born SGA offspring born at term, supports the hypothesis that male fetuses are more vulnerable to maternal stress than female fetuses. The main limitation of our findings is lack of statistical power due to small study subpopulations.

The mediating role of posttraumatic stress reactions in the relationship between child abuse and physical health complaints in adolescence and young adulthood.

Background: Child abuse is associated with physical health problems in adolescence and adulthood, but the mechanisms involved are unclear. A possible mediating effect of posttraumatic stress reactions (PTSR) linking child abuse with later physical health complaints has not been fully investigated. Objective: The current study investigated whether PTSR could be a potential mediator in the relationship between child abuse and physical health complaints in adolescents and young adults. If so, we also investigated whether this was the case for different child abuse types alone or in combination. Method: The study sample comprised 506 adolescents and young adult victims of child abuse and 504 unexposed matched controls aged 16-33 from a community sample. We measured child abuse retrospectively and current PTSR at wave 1 (2013), and current physical health complaints at wave 2 (2014/15). We tested a model of PTSR as a possible mediator between child abuse and physical health complaints and conducted causal mediation analysis to estimate direct and indirect pathways. Each child abuse type was studied in isolation and in combination with other abuse types. Results: PTSR had a notable, significant mediating effect on the relationship between child abuse and physical health complaints in our overall model (average causal mediation effect; ACME = 0.14, p < 0.001), accounting for 85% of the total effect. The mediated pathway was also significant in analyses of the different child abuse types. The mediating effect of PTSR was most prominent in individuals reporting exposure to more than one child abuse type. Conclusions: The current study indicates that PTSR may be an important mediator in the relationship between child abuse and physical health complaints. Health professionals should be aware of the important role that PTSR may have in maintaining or exacerbating physical health problems in child abuse victims. However, a reverse model could not be tested in this study and the results need confirmation in future prospective studies.

Antecedentes: El maltrato infantil se encuentra asociado con problemas de salud física en la adolescencia y en la adultez, pero los mecanismos involucrados no son claros. Un posible efecto mediador de las reacciones de estrés traumático (PTSR en su sigla en inglés) relacionando el maltrato infantil con quejas de salud física posteriores no ha sido investigado suficientemente.Objetivo: El presente estudio investigó si la PTSR podría ser un mediador potencial en la relación entre el maltrato infantil y las quejas de salud física en adolescentes y adultos jóvenes. También investigamos si esto era el caso para diferentes tipos de maltrato infantil de forma individual o en combinación.Método: La muestra del estudio consistió en 506 adolescentes y adultos jóvenes víctimas de maltrato infantil y 504 controles sin exposición al maltrato con edades de 16 a 33 años provenientes de una muestra comunitaria. Medimos el maltrato infantil retrospectivamente, el actual PTSR en la ola 1 (2013), y las quejas actuales de salud física en la ola 2 (2014/2015). Pusimos a prueba un modelo de la PTSR como un posible mediador entre el maltrato infantil y las quejas de salud física y llevamos a cabo un análisis de mediación causal para estimar los efectos directos e indirectos. Cada tipo de maltrato fue estudiado de forma separada y en combinación con otros tipos de abuso.Resultados: La PTSR tuvo un efecto mediador significativo en la relación entre el maltrato infantil y las quejas de salud física en nuestro modelo general (efecto mediador causal promedio; ACME en sus siglas en inglés = 0.14, p <0.001), correspondiendo al 85% del efecto total. La mediación fue también significativa en los análisis de los diferentes tipos de maltrato infantil. El efecto mediador de la PRSR fue más prominente en aquellos individuos que reportaron la exposición a más de un tipo de maltrato infantil.Conclusiones: PTSR podría ser un mediador importante en la relación entre el maltrato infantil y las quejas de salud física. Los profesionales de la salud deberían estar conscientes del rol que la PTSR puede tener en la mantención y la exacerbación de los problemas de salud física en las víctimas de maltrato infantil. Sin embargo, un modelo reverso no pudo ser probado y los resultados necesitan confirmación en futuros estudios prospectivos.