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A Meta-Analytic Review of the Effects of Childhood Abuse on Medical Outcomes in Adulthood

From the Department of Psychology (H.L.W.), Wake Forest University, Winston-Salem, North Carolina; and the Department of Psychology (C.S.), Furman University, Greenville, South Carolina.

Address correspondence and reprint requests to Cinnamon Stetler, Department of Psychology, Furman University, 3300 Poinsett Hwy., Greenville, SC 29613. E-mail: cinnamon.stetler{at}furman.edu

Objective: To summarize the relationship between abuse during childhood and physical health outcomes in adulthood and to examine the role of potential moderators, such as the type of health outcome assessed, gender, age, and the type of abuse. Studies using self-report assessment methods were compared with studies using objective or independently verifiable methods.

Method: The current study is a quantitative meta-analysis comparing results from 78 effect sizes across 24 studies including 48,801 individuals.

Results: Experiencing child abuse was associated with an increased risk of negative physical health outcomes in adulthood (effect size d = 0.42, 95% Confidence Interval = 0.39-0.45). Neurological and musculoskeletal problems yielded the largest effect sizes, followed by respiratory problems, cardiovascular disease, gastrointestinal and metabolic disorders. Effect sizes were larger when the sample was exclusively female and when the abuse was assessed via self-report rather than objective, independently verifiable methods.

Conclusions: Child abuse is associated with an increased risk of poor physical health in adulthood. The magnitude of the risk is comparable to the association between child abuse and poor psychological outcomes. However, studies often fail to include a diverse group of participants, resulting in a limited ability to draw conclusions about the population of child abuse survivors as a whole. Important methodological improvements are also needed to better understand potential moderators.

Key Words: child abuse • physical health • medical outcomes • meta-analysis

Abbreviations: CI = confidence interval; ES = effect size.

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