Comparative relationships between physical and verbal abuse of children, life course mental well-being and trends in exposure: a multi-study secondary analysis of cross-sectional surveys in England and Wales

Abstract

Objectives: To test associations between mental well-being across the life course and exposure to childhood physical and/or verbal abuse.

Design: Secondary analysis of combined data from seven cross-sectional general adult population surveys measuring childhood experience of physical and/or verbal abuse and current mental well-being.

Setting: Households across England and Wales.

Participants: 20 687 residents in England and Wales aged 18 years or over.

Measures: Self-reported childhood physical and verbal abuse using questions from an Adverse Childhood Experiences tool. Individual and combined components of adult mental well-being measured using the short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS).

Results: Exposure to either childhood physical abuse or verbal abuse was associated independently with a similar significant increase in likelihood of low adult mental well-being, with exposure to both abuse types compounding increases (adjusted ORs 1.52, 1.64, 2.15 respectively, reference category: neither abuse type). Individual components of mental well-being showed similar associations, with adjusted prevalence of never or rarely having felt close to people in the last 2 weeks rising from 7.7% (neither abuse type) to 9.9% (physical abuse), 13.6% (verbal abuse) and 18.2% (both types of abuse). Within sample trends showed a significant drop in the prevalence of child physical abuse from around 20% in those born from 1950 to 1979 to 10% in those born in 2000 or after. However, verbal abuse rose from 11.9% in those born before 1950 to nearly 20% in those born in 2000 or after.

Conclusion: Exposure to childhood physical or verbal abuse have similar associations with lower mental well-being during adulthood. Interventions to reduce child abuse, including physical chastisement, should consider both physical and verbal abuse and their individual and combined consequences to life course health. The potential role of childhood verbal abuse in escalating levels of poor mental health among younger age groups needs greater consideration.

Keywords: Child; MENTAL HEALTH; Non-accidental injury; PUBLIC HEALTH; Quality of Life.

Figure 1. Adjusted percentage of respondents reporting low mental well-being and SWEMWBS components with exposure to childhood abuse. For full questions see online supplemental table 2. Adjusted means are based on models in table 2. See Methods for more details.

Figure 2. Adjusted percentage reporting any childhood physical abuse, any childhood verbal abuse, or experiencing both physical abuse and verbal abuse. Physical abuse and verbal abuse categories are not exclusive and include individuals who reported both types of abuse. Adjusted means are based on models in table 3. See Methods for more details.