Childhood Victimization and Physical Health in Women: The Mediating Role of Adult Attachment

Research has shown that female survivors of childhood abuse (CA) are more likely than nonabused women to experience long-term physical health concerns. Adult attachment may influence this relationship given that attachment insecurity has been linked to poorer physical health and postulated mechanisms of action are similar. This study used structural equation modeling to investigate whether adult attachment insecurity mediates the relationship between four types of CA and self-reported physical health in 538 undergraduate women. CA prevalence rates ranged from 11.7% (sexual abuse) to 34.9% (psychological abuse). In separate structural equation models, direct pathways were significant between CA and adult attachment insecurity, CA and adult physical health, and adult attachment insecurity and adult physical health. Adult attachment insecurity was found to partially mediate health outcomes in CA survivors, S–B χ2 = 116.60 (58), p < .001; comparative fit index = .95; Tucker–Lewis index = .94; root mean square error of approximation = .05; and confidence interval = [.03, .06]. Physical health is a significant concern for survivors of CA, and these results suggest improving attachment security may represent an important avenue of intervention.

Genetic and Environmental Overlap Between Childhood Maltreatment and Adult Physical Health

Past research demonstrates a phenotypic relationship between childhood maltreatment and adult health problems. Explanations of this association usually point to either: (a) a direct causal link, whereby exposure to early stress disrupts biological functioning during sensitive periods of development; or (b) an indirect effect operating through socioeconomic attainment, poor health behaviors, or some other pathway leading from childhood to adulthood. The current study examined whether the association between childhood maltreatment and adult health reflects genetic or environmental mediation. Using a large sample of adult American twins, we separately estimated univariate biometric models of child maltreatment and adult physical health, followed by a bivariate biometric model to estimate genetic and environmental correlations between the two variables. We found that a summary count of chronic health conditions shared non-trivial genetic overlap with childhood maltreatment. Our results have implications for understanding the relationship between maltreatment and health as one of active interplay rather than a simple cause and effect model that views maltreatment as an exogenous shock.