Girls who suffer maltreatment and abuse may be less likely to survive into middle age than their peers who don't experience physical or mental torment growing up, a U.S. study suggests.
Researchers examined data on self-reported abuse from a national sample of almost 6,300 adults, and then followed them for two decades to see how many of them remained alive by 2015.
Women who reported physical childhood abuse were 58 percent more likely to die from all causes during the study period, while women who said they were emotionally abused as kids were 22 percent more likely to die.
"There are not just psychiatric consequences of childhood abuse, but also there appear to be physical health consequences, at least based on self-reports of childhood abuse," said lead study author Edith Chen, a psychology researcher at Northwestern University in Evanston, Illinois.
For men, however, there wasn't an association between reports of physical or emotional abuse in childhood and lower survival odds, the study found.
"We cannot tell from the data, but we speculate that there may be differences in how men and women cope with stress, or that there may be differences in men's and women's biological (e.g., hormonal) responses to stress," Chen added by email.
To explore the long-term impact of child abuse on longevity, Chen and colleagues examined data on self-reported maltreatment from questionnaires participants completed in 1995 and 1996 when they were typically in their late 20s.
By the end of the study period, almost 1,100 of the participants had died, or about 17 percent of the original survey population. Survivors were 47 years old on average.
Men were more likely to report severe or moderate physical abuse than women, the study found.
But women who reported experiencing severe physical abuse, moderate physical abuse or emotional abuse from a parent were at increased risk of death during the study period, researchers report in JAMA Psychiatry.
Mitigating factors such as childhood socioeconomic status, adult depression or personality traits did not explain the association between childhood abuse and greater risk of death in women, the study found.
The findings don't explain the connection between abuse and survival odds or the gender differences in the lasting impact of abuse.
It's possible that abuse can heighten vulnerability to psychiatric conditions or that children who experience abuse may develop negative health behaviors such as drug use to cope with stress, the authors speculate.
It's also possible that childhood adversities might affect how biological systems like immune and stress responses operate throughout life.
Limitations of the study include its reliance on self-reported abuse, which might not accurately represent what all of the participants actually experienced during childhood, the authors note. The survey participants were also predominantly white, making it possible that the results might not be applicable to a more racially and ethnically diverse group of people.
Even so, the findings add to a large and growing body of evidence linking child abuse to a wide range of physical and mental health problems, said Dr. Idan Shalev, a behavioral health researcher at Pennsylvania State University in State College, Pennsylvania.
"The current findings suggest that women survivors of child abuse are at increased risk of premature death, even after controlling for other factors that can explain this association such as personality, depression or socioeconomic status," Shalev, author of an editorial accompanying the study, said by email.
"This raises important questions about potential mechanisms and how we can intervene to improve health and quality of life among survivors of child abuse," he said.