Association of Reports of Childhood Abuse and All-Cause Mortality Rates in Women

Abstract

Importance: Research has linked childhood abuse to a variety of adult psychiatric problems, but little is known about associations of child abuse with adult mortality.

Objective: To test associations of retrospective reports of physical and emotional abuse in childhood with all-cause mortality rates in adulthood.

Design, setting, and participants: National sample of 6285 adults (aged 25-74 years at baseline) from the survey of Midlife Development in the United States. Baseline psychosocial data were collected in 1995 and 1996, with follow-up mortality data collected through October 2015.

Main outcomes and measures: Participants completed questionnaires at baseline about self-report of childhood emotional abuse, moderate physical abuse, and severe physical abuse. Mortality data during the next 20 years was tracked using the National Death Index.

Results: Of the 6285 participants included in the study sample, 2987 were men (48%) and 5581were white (91%), with a mean (SD) age of 46.9 (12.95) years. Women who reported childhood emotional abuse (hazard ratio [HR], 1.22; 95% CI, 1.01-1.49; P = .04), moderate physical abuse (HR, 1.30; 95% CI, 1.05-1.60; P = .02), or severe physical abuse (HR, 1.58; 95% CI, 1.20-2.08; P = .001) were at increased risk for all-cause mortality during the follow-up period. Reports of more types of childhood abuse were also associated with a greater risk of all-cause mortality in women (all vs none HR, 1.68; 95% CI, 1.24-2.30; P = .001; some vs none HR, 1.24; 95% CI, 1.01-1.52; P = .04). These effects could not be accounted for by childhood socioeconomic status, personality traits, or adult depression. No associations were observed in men.

Conclusions and relevance: These results suggest that in addition to the established psychiatric consequences of abuse, women who report childhood abuse also remain vulnerable to premature mortality into adulthood. Thus, reported childhood abuse may have long-term ramifications for health and longevity in women.

Figure. Cumulative Hazard Plots by Abuse Group

A, Plot of cumulative mortality hazard by years since study entry for women with and without reported severe childhood physical abuse. B, Cumulative mortality hazard for women with all types of reported childhood abuse (emotional, moderate physical, and severe physical), some types of reported abuse, and no reported abuse. Analyses control for age, race/ethnicity, education, history of heart disease, history of cancer, alcohol use, and smoking.