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In a sample of pregnant US women, Benedict et al. Bonomi et al, in a Seattle-based health maintenance organization, found that women with history of psychical and sexual childhood abuse had significantly lower functional health and well-being scores as measured using the Item Short Form Survey Instrument 2.
In sum, our findings and those of others [ 72 , 73 , 76 ] indicate that childhood abuse has long lasting implications for general and mental health.
Issue Brief: Sexual Violence Against Women in Canada
Child abuse, a severe early life stressor, is thought to disrupt neurodevelopmental processes that contribute to physical, behavioral and mental health problems later in life. The influences of early life abuse are thought to be modulated, in part, via three neurobiological stress response systems: 1 the serotonin system; 2 the sympathetic nervous system; and 3 the hypothalamic-pituitary-adrenal axis [ 77 — 79 ].
Disruptions to any or all of these systems are known to promote a cascade of physiological, neurochemical, and hormonal changes, which can lead to alterations in brain structure and function and contribute to a myriad of enduring behavioral and cognitive problems[ 77 , 78 ]. For instance, childhood abuse has been linked to behavioral outcomes including internalizing behavioral problems such as limited stress tolerance, anxiety, affective instability, dissociative disturbances, depression and suicidality; as well as externalizing behavioral symptoms including poor impulse control, episodic aggression, substance abuse, attention deficit hyperactivity disorder and conduct disorder [ 78 , 80 — 84 ].
Childhood abuse has also been associated with a number of cognitive problems including low academic performance and IQ, as well as language, memory, and attention deficits [ 85 ]. Taken together, evidence of neuropsychological impairments associated with childhood abuse are consistent with the thesis that early childhood stressors and trauma predispose individuals to subconscious beliefs of unworthiness which may lead to the avoidance of those who truly care and instead a tendency to gravitate towards chaotic relationships [ 86 , 87 ].
In addition findings from structural neuroimaging studies provide evidence of deficits in brain volume, gray and white matter of several regions, most prominently the dorsolateral and ventromedial prefrontal cortex but also hippocampus, amygdala, and corpus callosum among victims of childhood abuse [ 78 ]. These data also add biological plausibility to our findings and those of others [ 2 , 16 , 19 ]. Our study reinforces numerous previous studies confirming high prevalence of childhood abuse [ 57 , 88 ] and high prevalence of lifetime IPV [ 23 , 24 ].
The high frequencies of exposure coupled with the complexity and interrelationships among the types of exposure support arguments for much more systematic, frequent, and intensive efforts to monitor the epidemiology of violence across the life course. Considering that victimization experiences accumulate across the life course, intervention should also target child victims and aim to prevent their future re-victimization. Policies and programs for preventing childhood abuse and its underlying causes are needed. There is a limited but promising body of evidence for preventative intervention programs for childhood abuse such as training in parenting and home visitations [ 22 , 89 — 91 ].
Careful cross-cultural adaptation of these programs and rigorous evaluation to monitor their impact is warranted.
Our findings also suggest that childhood abuse and abuse by an intimate partner in adulthood are factors associated with maternal self-reported health status and antepartum depression. Asking pregnant women during early prenatal care visits about their experience with current and childhood violence may open a discussion about the potential risk of coping with these traumatic events through substance use during the pregnancy. Providing treatment for depression early in pregnancy may significantly improve pregnancy and early child developmental outcomes. Women abused as children are set on a trajectory for subsequent abuse and are a particularly vulnerable population.
Public health efforts should be made to prevent childhood abuse, identify women with a history of childhood abuse and provide these women assistance with management of risky health behaviors, mental health issues and ongoing IPV. The NIH had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.
Conceived and designed the experiments: MAW. Browse Subject Areas? Click through the PLOS taxonomy to find articles in your field. Abstract Objective We examined associations of childhood physical and sexual abuse with risk of intimate partner violence IPV.
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Methods In-person interviews were conducted to collect information regarding history of childhood abuse and IPV from 1, women during early pregnancy. Results Any childhood abuse was associated with 2. Conclusion These data indicate that childhood sexual and physical abuse is associated with IPV, poor general health and depressive symptoms in early pregnancy.
This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Data Availability: All relevant data are within the paper and its Supporting Information files. Introduction Childhood abuse has been shown to be associated with serious adverse health consequences across the life course [ 1 — 4 ]. Statistical Analyses Frequency distributions of maternal sociodemographic and reproductive characteristics were examined.
Results In this cohort, the vast majority of participants reported exposure to physical or sexual abuse as a child. Download: PPT.
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Figure 1. Table 1. Sociodemographics and reproductive characteristics of the study population. Table 2. Table 3. Table 4. Table 5. Figure 2. Discussion Our study extends the literature by adding evidence of increased odds of adult physical and sexual abuse among pregnant Peruvian women with a history of childhood physical and sexual abuse.
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Special issue: Group treatment after child and adolescent sexual abuse: Introduction | SpringerLink
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