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. 2008 Winter;33(4):125-35.
doi: 10.3200/BMED.33.4.125-136.

Direct and indirect links between childhood maltreatment, posttraumatic stress disorder, and women's health

Ariel J Lang  1 , Gregory A Aarons, James Gearity, Charlene Laffaye, Leslie Satz, Timothy R Dresselhaus, Murray B Stein
Affiliations

Direct and indirect links between childhood maltreatment, posttraumatic stress disorder, and women's health

Ariel J Lang et al. Behav Med. 2008 Winter.

Abstract

The authors evaluated the relationships among childhood maltreatment, sexual trauma in adulthood, posttraumatic stress disorder (PTSD), and health functioning in women. Female Veterans' Affairs (VA) primary care patients (N = 200) completed self-report measures of childhood maltreatment, adult sexual trauma, PTSD symptoms, and current health functioning. The authors used structural equation modeling to test models of the relationship among these variables. Childhood nonsexual maltreatment and adult sexual assault were positively associated with PTSD. Childhood nonsexual maltreatment (beta = -.20) and PTSD (beta = -.75) were significantly associated with poorer physical and mental health functioning. Adult sexual assault negatively affected health functioning through its association with PTSD. Thus, poor health outcomes associated with childhood maltreatment in women may be conveyed through PTSD. These findings should strengthen efforts directed at identifying and treating PTSD in female victims of childhood maltreatment with the aim of preventing or attenuating poor health outcomes.

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Figures

FIGURE 1
FIGURE 1
Model 2: Full hypothesized structural model of the links between childhood maltreatment, adult sexual trauma and posttraumatic stress disorder and their relationship to health functioning in women in primary health care χ2(109, N = 200) = 215.08, p < .001, comparative fit index (CFI) = .96, Tucker-Lewis Index (TLI) = .95, root mean square error of approximation (RMSEA) = .07, standardized root mean residual (SRMR) = .04. All factor loadings and correlations were significant at p < .001; for path coefficients: ns = nonsignificant. **p < .01. ***p < .001.
FIGURE 2
FIGURE 2
Model 3: Mediation only model, χ2(112, N = 200) = 222.19,p < .001, χ2/df = 1.98, comparative fit index (CFI) = .955, Tucker-Lewis Index (TLI) = .945, root mean square error of approximation (RMSEA) = .07, standardized root mean residual (SRMR) = .046, weighted root mean square residual (WRMR) = .821. All factor loadings and correlations were significant at p < .001; for path coefficients: ns = nonsignificant. **p < .01. ***p < .001.
FIGURE 3
FIGURE 3
Model 4: No mediation model, χ2(112, N = 200) = 273.38, p < .001, χ2/df = 2.44, comparative fit index (CFI) = .933, Tucker-Lewis Index (TLI) = .919, root mean square error of approximation (RMSEA) = .085, standardized root mean residual (SRMR) = .181, weighted root mean square residual (WRMR) = 3.27. All factor loadings and correlations were significant at p < .001; for path coefficients: ns = nonsignificant. **p < .01. ***p < .001.
FIGURE 4
FIGURE 4
Model 5: Parsimony trimmed model, χ2(112, N = 200) = 218.68, p < .001, comparative fit index (CFI) = .96, Tucker-Lewis Index (TLI) = .95, root mean square error of approximation (RMSEA) = .07, standardized root mean residual (SRMR) = .05. All factor loadings and correlations were significant at p < .001; for path coefficients: ns = nonsignificant. **p < .01. ***p < .001.
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