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Original Investigation
September 2016

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

Author Affiliations
  • 1Department of Psychology, Northwestern University, Evanston, Illinois
  • 2Institute for Policy Research, Northwestern University, Evanston, Illinois
  • 3Department of Psychology, Western Virginia University, Morgantown, West Virginia
  • 4Department of Medical Social Sciences, Northwestern University, Evanston, Illinois
JAMA Psychiatry. 2016;73(9):920-927. doi:10.1001/jamapsychiatry.2016.1786
Key Points

Question  What is the association of self-reports of childhood abuse with adult all-cause mortality?

Finding  In this cohort study, the experience of retrospectively reported severe physical abuse, moderate physical abuse, or emotional abuse in childhood were all associated with a higher risk of all-cause mortality during a 20-year follow-up period in women but not in men.

Meaning  In addition to its established psychiatric consequences, reports of childhood abuse may also have long-term ramifications for health and longevity among 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.

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