Childhood abuse in adults in primary care: Empirical findings and clinical implications. (May 2017)

• Record Type: Journal Article
• Authors: Porcerelli, John H; Jones, John R; Klamo, Rachel; Heeney, Rebecca
• Other Names: Butler Dennis J guest-editor.; Freedy John R guest-editor.
• Is Part Of: International journal of psychiatry in medicine. Volume 52:Number 3(2016)
• Page Start: 265
• Page End: 276
• Publication Date: 2017-05
• Subjects: primary care -- childhood physical and sexual abuse -- psychopathology -- doctor-patient relationship.; Psychiatry -- Periodicals; Sick -- Psychology -- Periodicals; Medicine, Psychosomatic -- Periodicals; 616.89005
• DOI: 10.1177/0091217417730290
• Languages: English
• ISSNs: 0091-2174

Abstract

In the healthcare setting, adult patients with histories of childhood abuse are of significant concern and are frequently encountered in the primary care setting. However, there is a dearth of studies investigating the relationships between psychopathology, overall health, healthcare utilization, physician ratings of patient difficulty, and childhood abuse. The present study examines these relationships in primary care patients with (N = 45) and without (N = 129) histories of childhood abuse (physical, sexual, and both). Findings revealed that adult patients with histories of childhood abuse generally scored significantly higher on measures of psychopathology, emergency room use, and doctor–patient relationship difficulty, and lower on a measure of mental and physician-rated physical health. In a multiple regression analysis, income and a history of childhood sexual abuse significantly predicted overall mental health. In a second multiple regression analysis, income, depression, somatization, borderline personality disorder, and difficult doctor–patient relationship ratings significantly predicted physician-rated physical health. Overall, these findings suggest that a history of childhood abuse is associated with a host of negative health outcomes. Findings also suggest that negative feelings about a patient may help physicians identify patients with histories of childhood abuse. It is especially important for physicians to routinely include an assessment of childhood abuse during the psychosocial portion of the medical interview or through screening instruments.