Childhood Exposure to Violence and Chronic Physical Conditions in a National Sample of US Adolescents
Date
2016
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Psychosomatic Medicine
Abstract
Exposure to violence is associated with chronic physical conditions in adults.
Although violence exposure is common among youths, it is unknown whether violence is
associated with chronic physical conditions in childhood and adolescence. We examined the
associations of violence exposure with chronic physical conditions in a population-representative
sample of US adolescents and determined whether associations were explained by co-occurring
mental disorders.
Methods—Data were drawn from the National Comorbidity Survey Replication–Adolescent
Supplement (NCS-A), a national cross-sectional survey of 6,483 adolescents (ages 13–17).
Lifetime exposure to violence; Diagnostic and Statistical Manual of Mental Disorders, Fourth
Edition mood, anxiety, and substance disorders; and self-reported arthritis, frequent headaches,
back or neck problems, other chronic pain, asthma, and allergies were assessed.
Results—One in 4 (24.99%) adolescents reported exposure to violence. Violence exposure was
associated with elevated odds of back/neck pain, headaches, chronic pain, allergies, and asthma
(odds ratio [OR], 1.5–2.1; 95% confidence interval [CI], 1.1–3.5) after adjustment for
sociodemographics, socioeconomic status, and lifetime mental disorders. Regarding new onsets,
violence exposure was associated with greater hazard for subsequent first-onset only of back/neck
pain (hazard ratio, 1.9; 95% CI, 1.2–3.0) and headaches (hazard ratio, 1.4; 95% CI, 1.1–1.8), and
these associations were explained by early-onset mental disorders.
Conclusions—Childhood violence exposure is associated with chronic physical conditions that
emerge early in the life course, although associations are stronger for prevalent than incident
conditions. Violence exposure predicts incident pain conditions only, and these associations are
explained by mental disorders that begin after violence exposure. Interventions and policies aimed
at preventing violence and detecting and treating early-onset mental disorders have the potential to
reduce morbidity, mortality, and health disparities beginning early in development
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Keywords
exposure to violence, child abuse, outcomes, research, adolescense, adversity, chronic conditions, pain
Citation
McLaughlin, K. A., Basu, A., Walsh, K., Slopen, N., Sumner, J. A., Koenen, K. C., & Keyes, K. M. (2016). Childhood Exposure to Violence and Chronic Physical Conditions in a National Sample of US Adolescents. Psychosomatic Medicine, 78(9), 1072–1083.