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Childhood Abuse Is Associated With Adiposity in Midlife Women: Possible Pathways Through Trait Anger and Reproductive Hormones

From the Departments of Psychology (A.J.M., K.A.M.), Psychiatry (K.A.M., J.T.B.), and Epidemiology (K.A.M., J.T.B.), University of Pittsburgh, Pittsburgh, Pennsylvania.

Address correspondence and reprint requests to Karen A. Matthews, Department of Psychiatry, University of Pittsburgh, 3811 O’Hara Street, Pittsburgh, PA 15213. E-mail: matthewska{at}upmc.edu

Objective: To examine the association between childhood abuse/neglect and central adiposity and obesity in a sample of 311 women (n = 106 black, 205 white) from the Pittsburgh site of the Study of Women’s Health Across the Nation (SWAN).

Methods: SWAN included a baseline measurement of women in midlife (mean age = 45.7 years) and eight follow-up visits during which waist circumference (WC) and body mass index (BMI) were measured. The Childhood Trauma Questionnaire retrospectively assessed emotional, physical, and sexual abuse, and emotional and physical neglect in childhood.

Results: Analyses of covariance showed that women with a history of any abuse/neglect, and specifically physical and sexual abuse, had significantly higher WC and BMI at baseline than women with no abuse history. A significant interaction between abuse and BMI showed that among women with BMI of <30, any abuse/neglect and certain subtypes of abuse predicted greater increases in WC over time. Additional analyses showed that Trait Anger scores and sex hormone-binding globulin (SHBG) attenuated cross-sectional relationships between abuse/neglect and WC and BMI.

Conclusion: This study suggests that abused/neglected women seem to have greater anger and lower levels of SHBG, which are associated with adiposity in midlife.

Key Words: abuse • neglect • adiposity • obesity • women • anger

Abbreviations: SWAN = Study of Women’s Health Across the Nation; BMI = body mass index; WC = waist circumference; SHBG = sex hormone-binding globulin; FSH = follicle stimulating hormone; FEI = free estrogen index; FAI = free androgen index; CTQ = Childhood Trauma Questionnaire; SES = socioeconomic status.