Article summary of The health effects of childhood abuse: four pathways by which abuse can influence health by Kendall-Tackett - Chapter

Preface

Survivors of child abuse often suffer from health problems that come to light long after the abuse has stopped. The percentage of health problems with a background of abuse is much higher than with people who have not been abused. This article examines why this is the case.

Effects of abuse on behavior

Behavior has often been investigated. Anyone familiar with child abuse is not surprised to hear that adults survivors of child abuse are more likely to participate in harmful activities.

Substance abuse

Child abuse survivors have an increased risk of alcohol and drug abuse.

Obesity and eating problems

People who have been abused have an increased risk of being overweight. In addition, some studies show that sexual abuse is associated with eating problems in women.

Suicide

There is an increased risk of suicide attempts and ideas about suicide.

Risky sexual behavior

Risky sexual behavior is the most documented form of harmful behavior as a result of abuse. A study of risky sexual behavior in four different countries shows that young women with a history of sexual abuse were previously sexually active, more likely to have teenage pregnancy, often had more bed partners and had more unsafe sex. Men and women who had experienced four or more types of family mistreatment were more likely to have 50 or more bed partners and sexually transmitted diseases.

Smoking

Problems in family functioning lead to a greater risk of smoking.

Sleep problems

Sufficient sleep is essential for good health. Sleep is not really a form of behavior, but the effects do occur in behavior. People with a history of child abuse often have problems with sleep. People who are chronically deficient in sleep are more vulnerable to infections and diseases and are more likely to have accidents. It can also give an increased chance of severe and chronic depression.

Social effects as a result of abuse

The ability to form social relationships is essential to people's health. The ability to develop and maintain a relationship is also influenced by abuse in youth. These people often have fewer relationships and are more likely to get divorced.

Child abuse and the interpersonal style

Survivors of mistreatment often have an avoiding or intrusive (intrusive) style. Avoidance is characterized by low dependence and low heat. Intrusiveness is related to an extreme need for proximity to people. People without social support participated less often in health promotion activities and were more likely to have irregular sleep times. Social support also appears to be important for people with a lower income, because the social support amounts to better health.

Being a victim again

Being victims again reflects a problem with social connections and occurs regularly with survivors of child abuse. It is also more common in clinical groups. A study of 290 patients with borderline shows that half are victims as adults. The trauma affects health. It also increases the risk of sexually transmitted diseases and chronic stress.

Homelessness

Homelessness is another example of what can be the result of poor social networks. It seems to be related to a history of abuse. Homeless women more often had trauma and a history of abuse than women of equal SES who did have a place of residence. Family violence creates social isolation which makes women more vulnerable to homelessness. Being homeless has health effects. You can become malnourished, exposed to bad weather, have no hygiene and no medical care. It is also a risk for substance abuse.

Cognitive effects as a result of abuse

Internal working model

The internal work model refers to a mental framework with which a person interprets stressful events and motives and actions of others. The model also responds to people's beliefs about how much power they have in situations and what they can do to help themselves. The working model is related to depression, health perception and self-motivation. Research by Briere and Elliot shows that abused children develop an internal work model in which they see the world as a dangerous place. The children will overestimate danger and as adults underestimate themselves. They will also have chronic perceptions of helplessness, danger and powerlessness, which can lead to emotional problems and a risk of depression. These negative ideas can also affect health. The amount of confidence that someone has in themselves can even influence how long they live.

Health perception

Health perceptions concern why someone considers themselves healthy. The observation that someone has about their health can be a predictor of illness and death.

Emotional effects as a result of abuse

Depression

Depression is one of the most preventable consequences of abuse. Survivors of abuse are four times more likely to develop depression compared to people without a history of abuse. Some wonder whether child abuse causes mental health problems or whether depression is caused by poor family functioning that makes abuse possible. Depression has consequences for health. Depression is associated with not having breakfast, irregular sleep times, not using a belt and missing physical activity. Women with depression also have an increased risk of heart disease.

PTSD

PTSD is also a common consequence of abuse and it has a serious impact on health. Many victims of sexual abuse do not fully meet the criteria for PTSD, more than 80% have PTSD related symptoms such as hyper vigilance, intrusive thoughts and flashbacks of the experience. Child abuse makes people vulnerable to the development of PTSD when exposed to a current stressor. PTSD is often co-morbid with depression, anxiety disorder, smoking and substance abuse. PTSD gives an increased chance of divorce and family problems, stopping education, thoughts about suicide and sleeping problems such as nightmares.

Clinical implications

Health depends on a complex web of behaviors, thoughts, emotions and social connections. These not only influence each other, but also health. Abuse can affect health and these four components. To improve health outcomes, clinicians need to look at all avenues that can affect the health of the victim.