Bridges to Wellness: Protective Adults During Childhood Mitigate the Toll of Childhood Abuse Among Indigenous Adults

Childhood physical and/or sexual abuse are associated with negative physical and mental health outcomes in adulthood. Protective factors may contribute to resilience and reduce the risk of these adult health outcomes. This study aims to determine if the presence of a protective adult can mitigate the association between childhood abuse and negative adult health outcomes. Data were obtained from the 2021 and 2022 Behavioral Risk Factor Surveillance System (n = 83,495). Binary logistic regression was used to compare the odds of health outcomes in adults who experienced abuse before age 18 compared to those who did not, adjusting for the presence of a protective adult and socio-demographic, socioeconomic, and health behavior factors. Childhood physical and/or sexual abuse were associated with higher odds of physical and mental health conditions in adulthood. Adjusting for the presence of a protective adult partially attenuated the odds of many adult health outcomes. Understanding protective factors associated with childhood abuse may improve targeted outreach and provide helpful direction for the development of effective programs for children experiencing abuse.

Does adult attachment style mediate the relationship between childhood maltreatment and mental and physical health outcomes?

Examining exposure to adverse childhood experiences and later outcomes of poor physical and mental health among South Carolina adults

Assessing the interrelatedness of multiple types of adverse childhood experiences and odds for poor health in South Carolina adults

The number of physically and mentally unhealthy days as a measure of health-related quality of life (HRQOL) is used to examine the different effects of the adverse childhood experiences (ACEs) on physical and mental health outcomes. The data, a cross-sectional state-level survey, is obtained from the Behavioral Risk Factor Surveillance System (BRFSS) collected by the Centers for Disease Control and Prevention (CDC) in 2012. Multiple regression analyses are conducted for the study. The results indicate that all individual ACE categories are inversely associated with both physical and mental health, as respondents who exposed to any adverse childhood experience are likely to have physically- and mentally-related poor HRQOL in adulthood. The estimated coefficients for individual ACEs in magnitude on the mental health outcome are, in overall, greater than the estimated coefficients on the physical health outcome. The regression results with accumulative ACE scores indicate that higher levels of the ACE score would affect higher negative health outcomes, such as the dosage effects that appear again in this study. The estimated coefficients of accumulative ACE scores on the mental health outcome exceed the coefficients of ACE scores on physical health outcome for an ACE score of 2 and above. The gap in the estimated coefficients of ACE scores between physically and mentally unhealthy days increases as the ACE score rises. The estimated coefficient at the score ACE8 for the mentally unhealthy days becomes almost twice as large as the coefficient for the physically unhealthy days. Importantly, the negative effects of ACEs on mental health outcomes are significantly greater than the negative effects on physical health outcomes.

Race, Ethnicity and Experienced Racism Are Associated with Adverse Physical and Mental Health Outcomes Among Cancer Survivors

To determine whether childhood physical and sexual abuse are associated with poor mental and physical health outcomes in older age. Cross-sectional, postal questionnaire survey. Medical clinics of 383 general practitioners (GPs) in Australia. More than 21,000 older adults (aged > or = 60) currently under the care of GPs participating in the Depression and Early Prevention of Suicide in General Practice (DEPS-GP) Study. Participants were divided into two groups according to whether they acknowledged experiencing childhood physical or sexual abuse. Main outcome measures targeted participants' current physical health (Medical Outcomes Study 12-item Short Form Survey, Version 2 and Common Medical Morbidities Inventory) and mental health (Patient Health Questionnaire-9 and Hospital Anxiety and Depression Scale). One thousand four hundred fifty-eight (6.7%) and 1,429 participants (6.5%) reported childhood physical and sexual abuse, respectively. Multivariate models of the associations with childhood abuse indicated that participants who had experienced either childhood sexual or physical abuse had a greater risk of poor physical (odds ratio (OR)=1.35, 95% confidence interval (CI)=1.21-1.50) and mental (OR=1.89, 95% CI=1.63-2.19) health, after adjustments. Older adults who reported both childhood sexual and physical abuse also had a higher risk of poor physical (OR=1.60, 95% CI=1.33-1.92) and mental (OR=2.40, 95% CI=1.97-2.94) health. The effects of childhood abuse appear to last a lifetime. Further research is required to improve understanding of the pathways that lead to such deleterious outcomes and ways to minimize its late-life effects.

Research on the etiology of dissociation in adults has focused primarily on childhood sexual abuse. The role of co-occurring childhood stressors and of more chronic adverse conditions such as neglect is less clear. This study examined the level of dissociation in relation to childhood trauma (sexual/physical abuse, witnessing interparental violence), early separation from a parent, and perceived parental dysfunction. One hundred sixty inpatients consecutively admitted to a general psychiatric hospital were administered the Dissociative Experiences Scale and the Structured Trauma Interview. The mean Dissociative Experiences Scale score was 17.4; 18.0% of the patients scored beyond 30. Early separation was reported by 26.4% of the patients; 30.1% had witnessed interparental violence; 23.6% reported physical abuse; 34.6% reported sexual abuse; 11.7% reported rape before age 16; and 42.1% reported sexual and/or physical abuse. The level of dissociation was primarily related to reported overwhelming childhood experiences (sexual and physical abuse). When sexual abuse was severe (involving penetration, several perpetrators, lasting more than 1 year), dissociative symptoms were even more prominent. Highest dissociation levels were found in patients reporting cumulative sexual trauma (intrafamilial and extrafamilial) or both sexual and physical abuse. In particular, maternal dysfunction was related to the level of dissociation. With control for gender and age, stepwise multiple regression analysis indicated that the severity of dissociative symptoms was best predicted by reported sexual abuse, physical abuse, and maternal dysfunction. These findings indicate that dissociation, although trauma-related, is neglect-related as well. This implies the importance of object relations and attachment in the diagnosis and treatment of patients with dissociative disorders.

Low birthweight is associated with poor health, developmental, and social outcomes throughout the lifespan. Exposure to adverse childhood experiences (ACEs) is also associated with negative mental and physical health outcomes in adulthood. The aims of this study were to explore the relationship between low birthweight (LBW), exposure to ACES, and subsequent utilization of mental health service. Data analysis was conducted using a subset of data from children ages 6-17 years from the National Survey of Children's Health (NSCH) for 2018-2019 (n = 40,656). Welch ANOVA, Pearson's chi-square, and logistic regression investigated the relationship between LBW, ACEs, and mental health. LBW children in this sample had higher exposure to ACEs when compared to not low birthweight (NBW) children. LBW children also had a higher reported incidence of identified mental health (MH) issues. There was no significant association between birthweight and unmet MH service needs. LBW children with an ACE score or two or more were more likely to have an unidentified MH issue and/or an unmet MH service need. The results demonstrate LBW children experience higher levels of adversity. Children with ACE scores of two or more and those with unidentified MH issues have a higher likelihood of unmet MH needs. Professionals working in the health, education, and social service sectors can use this information to raise awareness of the increased vulnerability and more effectively meet the mental health needs of LBW children.

Background: Studies continue to investigate the relationship between adverse childhood experiences (ACEs) and their negative mental and physical health outcomes in adulthood. The current paper replicated the landmark Adverse Childhood Experience (ACE) study previously done in the United States, with an adult primary care population within Canada (N = 3,924). Methods: Measures were completed by the participants to identify their ACE history and a range of physical health diagnoses. To determine the effects of ACEs on adult physical health outcomes, odds ratios were calculated with multivariate logistic regression separately for both males and females. Results: Results indicated that the risk of many physical health problems generally increased in a dose-response pattern. The dose-response relationship was especially strong for physiological conditions such as irritable bowel syndrome, chronic bronchitis, gastro-esophageal reflux, intestinal and abdominal discomfort, fibromyalgia, and behavior problems. These results were generally consistent in both males and females, although somewhat stronger overall for females. The association between ACEs and cardiovascular disorders was generally not significant. Discussion: These results contribute to the conceptualization of factors that predict higher risk for adulthood physical disorders, which is key to the development of intervention and prevention strategies. The implications for ACEs screening and interventions within the primary care population are discussed.

We investigated whether abused and neglected children are at risk for negative physical health outcomes in adulthood. Using a prospective cohort design, we matched children (aged 0-11 years) with documented cases of physical and sexual abuse and neglect from a US Midwestern county during 1967 through 1971 with nonmaltreated children. Both groups completed a medical status examination (measured health outcomes and blood tests) and interview during 2003 through 2005 (mean age=41.2 years). After adjusting for age, gender, and race, child maltreatment predicted above normal hemoglobin, lower albumin levels, poor peak airflow, and vision problems in adulthood. Physical abuse predicted malnutrition, albumin, blood urea nitrogen, and hemoglobin A1C. Neglect predicted hemoglobin A1C, albumin, poor peak airflow, and oral health and vision problems, Sexual abuse predicted hepatitis C and oral health problems. Additional controls for childhood socioeconomic status, adult socioeconomic status, unhealthy behaviors, smoking, and mental health problems play varying roles in attenuating or intensifying these relationships. Child abuse and neglect affect long-term health status-increasing risk for diabetes, lung disease, malnutrition, and vision problems-and support the need for early health care prevention.

IntroductionResearch suggests that adverse childhood experiences can have a lasting influence on children’s development that result in poorer health outcomes in adulthood. Like other exposure-outcome relationships, however, there is uncertainty...

BackgroundPerceived household support during childhood defined as the presence of an adult who consistently tried to ensure that basic needs were met has lasting effects on mental and physical health across the life course. While its protective role is well recognized, less is known about whether these associations vary across gender and racial/ethnic groups.MethodsWe conducted a cross-sectional analysis of 31,233 U.S. adults from the 2021–2024 Behavioral Risk Factor Surveillance System (BRFSS). The primary exposure was self-reported childhood household support, categorized as “Never,” “A Little of the Time,” “Some of the Time,” “Most of the Time,” or “All of the Time.” Outcomes included lifetime diagnosis of depression, average monthly poor mental health days, and poor physical health days. Analyses used inverse probability weighting and survey-adjusted regression, controlling for sociodemographic characteristics, state, year, and month fixed effects. Models were stratified by gender and race/ethnicity to evaluate moderating effects.ResultsAmong respondents (mean age 52.2 years; 63.4% female; 76.0% White), Individuals who reported “Never” being supported were 19.4 percentage points more likely to report a depression diagnosis (95% CI, 11.6–27.2), experienced 5.33 more poor mental health days (95% CI, 3.64–7.03), and 2.77 more poor physical health days (95% CI, 1.23–4.32) per month compared to those “Always” supported. A clear dose–response gradient was observed across all categories of support. Gender-stratified analyses revealed that women had consistently higher adjusted probabilities of depression than men across most support categories. Race/ethnicity-stratified analyses indicated that Black respondents consistently exhibited lower adjusted probabilities of depression compared with White respondents, while Hispanic respondents reported more poor mental health days in the “A little of the time” category.ConclusionsPerceived childhood household support is strongly and progressively protective against depression and poor mental and physical health outcomes in adulthood. However, its benefits are not uniformly distributed: women remain disproportionately vulnerable to depressive outcomes even with partial support, while race/ethnicity-specific differences suggest the presence of resilience as well as distinct vulnerabilities. These findings highlight the universal importance of stable, supportive caregiving environments and underscore the need for prevention and intervention strategies that are both gender-sensitive and culturally tailored to reduce lifelong health disparities.

This article provides an overview of mental and physical health outcomes of child maltreatment to help health care providers identify the consequences of maltreatment and consider treatment options. Child maltreatment is associated with a variety of negative physical and mental health outcomes that affect the individual throughout the lifespan and place a substantial burden on both victims and the population as a whole. The review begins with an overview of the role of physicians in identifying abuse and neglect in the clinic setting. Next, current research findings on physical and mental health outcomes in children, adolescents, and adults are reviewed. Finally, opportunities for primary prevention of abuse and neglect are discussed. Primary prevention strategies can avoid risk for maltreatment, and subsequent interventions for victims have the potential to greatly improve their health.

What factors attenuate the relationship between childhood neglect and adverse health outcomes? Examining the role of socioeconomic status, health behaviors, and the presence of a protective adult