Childhood Trauma and Adult Somatic Symptoms

Abstract

Objective: Childhood trauma is a key public health risk factor for developing physical illness. This study examined how childhood abuse and neglect predict adult somatic symptoms assessed retrospectively and in real time.

Methods: Participants in the HowNutsAreTheDutch project completed the Childhood Trauma Questionnaire-Short Form and, to assess somatic symptoms, the cross-sectional Patient Health Questionnaire ( n = 406) or a longitudinal ecological momentary assessment protocol that included responding to an item on physical discomfort 3 times a day for 30 days ( n = 290).

Results: As hypothesized, childhood trauma was positively associated with adult somatic symptoms assessed using the Patient Health Questionnaire ( d = 0.30) and assessed using the ecological momentary assessment item ( d = 0.31), also after adjustment for age, sex, educational level, and relationship status. Longitudinally, we also explored whether interpersonal context moderated abuse outcomes, and observed that social company dampened momentary physical discomfort among people with a history of more physical neglect ( d = 0.04).

Conclusions: Childhood trauma, especially emotional and sexual abuse, predicts specific adult somatic symptoms. Future work may examine how symptom expression is influenced by the social lives of traumatized individuals.

FIGURE 1

A, Adjusted means and standard deviations of somatic symptom burden (PHQ-15) among childhood trauma (CTQ) severity groups (b = 406). B, Adjusted means and standard deviations of momentary physical discomfort (EMA) among childhood trauma (CTQ) severity groups (n = 290). Lower physical discomfort scores in the severe to extreme trauma group than in the moderate to severe trauma group probably reflect the small number of participants in the former group. However, alternative explanations remain possible, such as a nonlinear association between trauma and physical discomfort, via physical decoupling in the latter group. CTQ-SF = Childhood Trauma Questionnaire Short Form; EMA = ecological momentary assessment; PHQ-15 = Patient Health Questionnaire; SD = standard deviation.