University of Victoria, Department of Psychology, PO Box 3050 STN CSC, Victoria, BC, Canada V8W 3P5.
Child Abuse Negl. 2012 May;36(5):393-403. doi: 10.1016/j.chiabu.2012.02.002. Epub 2012 May 19.
This retrospective, cross-sectional study investigated the association between childhood physical and psychological maltreatment and self-reported physical health concerns in adult women. The mediating roles of perceived stress and coping strategies were examined.
Participants were 235 women (aged 18-59 years) recruited from the community. Semi-structured interviews and questionnaires were used to assess self-reported childhood maltreatment and current perceived stress, coping strategies, and health status. Data were analyzed using structural equation modeling.
After controlling for a history of child sexual abuse and relevant demographic variables, child physical and psychological maltreatment were significantly associated with greater physical health concerns. Support was found for models in which perceived stress and emotion-focused coping partially mediate the relation between maltreatment and health problems; problem-focused and avoidance coping did not operate as mediators. Multi-mediation model testing indicated that emotion-focused coping and perceived stress together better explain the relationship between child maltreatment and physical health than either variable alone.
Findings suggest that child maltreatment is an important risk factor for adverse health outcomes in later life and that current stress and coping strategies may influence this relationship. Implications for the physical health of maltreatment survivors are discussed.
The management of perceived stress and the use of adaptive emotion-focused coping responses in the everyday lives of maltreated women may be particularly useful points of intervention in order to mitigate physical health concerns in adulthood.
本回顾性、横断面研究调查了儿童期身体和心理虐待与成年女性自述身体健康问题之间的关联。研究考察了感知压力和应对策略的中介作用。
参与者为 235 名(年龄 18-59 岁)来自社区的女性。采用半结构式访谈和问卷评估了自我报告的儿童期虐待经历以及当前的感知压力、应对策略和健康状况。使用结构方程模型进行数据分析。
在控制了儿童性虐待史和相关人口统计学变量后,儿童期身体和心理虐待与更大的身体健康问题显著相关。感知压力和情绪聚焦应对部分中介了虐待与健康问题之间的关系的模型得到了支持;问题聚焦应对和回避应对则没有起到中介作用。多中介模型测试表明,情绪聚焦应对和感知压力共同比任何单一变量更好地解释了儿童虐待与身体健康之间的关系。
研究结果表明,儿童虐待是晚年不良健康结果的一个重要危险因素,当前的压力和应对策略可能会影响这种关系。讨论了对虐待幸存者身体健康的影响。
在虐待女性的日常生活中管理感知压力和使用适应性情绪聚焦应对反应可能是特别有用的干预点,以减轻成年后的身体健康问题。