Child Abuse Causes Lifelong Health Problems For Women

Physically, women abused only as children complained of many more symptoms than never abused women.

Compared with women who were never abused, patients abused only as children were nearly four times more likely to have attempted suicide, more than three times more likely to have been hospitalized for an emotional or mental problem, and more than twice as likely to have considered suicide the previous week. They had lower self-esteem and higher scores for anxiety, depression and anxiety-related physical symptoms. They also were more likely than never-abused patients to have problems with alcohol and drugs.

These findings, described in "Clinical Characteristics of Women with a History of Childhood Abuse: Unhealed Wounds," an article in the May 7 issue of The Journal of the American Medical Association, are based on research at Baltimore medical clinics.

Among the patients, 22 percent reported physical or sexual abuse before age 18. Of this group, those who said they were abused as children, but not as adults, were generally younger and better educated than the rest of the study participants. They were usually single, separated or divorced.

These health problems included back pain, frequent or severe headaches, pelvic and genital pain, frequent tiredness, chest pain, abdominal or stomach pain, vaginal discharge, breast pain, diarrhea and shortness of breath.

Overall reported symptoms of patients abused only as children were worse than those of patients who were never abused and comparable to those of patients who currently are being abused, but who had not been abused as children. The least healthy group were the respondents who said they were abused as both children and adults 50 percent of women abused as children were also abused as adults.

"Our study suggests that the wounds' of childhood abuse may go unhealed," said Dr. Jeanne McCauley, lead researcher. "The effect of childhood abuse is an important area for future research." Each year about 1.4 million children in the United States suffer some form of physical, sexual or emotional abuse or neglect.

This is McCauley's second published study about the association of violence and medical problems in adult women. In 1995 The Annals of Internal Medicine printed an article in which she and her colleagues developed a clinical model to help physicians identify and diagnose women who experienced domestic violence.

Nearly 2,000 adult women of varied ages, races, educational backgrounds, marital status and family income participated in this study of the influences of childhood versus adult abuse on women's health. They took a self-administered, anonymous survey in the privacy of their doctors' offices. The questionnaire asked about the patient's experience with physical and sexual abuse. It also explored the patient's general health, emotional status, experience with drugs and alcohol and psychological and past medical history.