Age of first exposure and duration of child physical and sexual abuse - Links to adolescent psychological and somatic health.

BACKGROUND

Child abuse is a well-established predictor of poorer health outcomes. The temporal aspects of child abuse, the timing (developmental stage) and duration (chronicity), however, remain understudied.

OBJECTIVE

To examine the association between 1) the timing of first exposure to abuse; 2) duration of childhood abuse; 3) the interaction between timing and duration, and the level of psychological distress and somatic health complaints in adolescence.

METHODS

Data was drawn from the Norwegian Youth Study on Child Maltreatment (The UEVO study), a nationwide youth survey in Norway with 9240 respondents between the age of 12 and 16 years. Questionnaires were administered digitally in schools. We used comprehensive assessments of physical and sexual abuse during childhood, including the assessment of timing and duration, as well as established instruments to assess psychological distress (HSCL-10) and somatic health complaints (CSSI-8) in adolescence. Generalized linear models were applied to examine associations between timing and duration of childhood maltreatment and health outcomes.

RESULTS

When timing and duration of the exposure were examined individually, they were both significantly related to more psychological distress and somatic health complaints during adolescence. However, when adjusted for each other, only age at first exposure remained a significant predictor of higher psychological distress and somatic health complaints. The association was robust across most model specifications, including covariates such as age at assessment, immigrant status, gender and perceived family affluence. However, the association was attenuated and no longer statistically significant when additionally adjusting for household mental health problems in sensitivity analyses. There were no significant interactions between the timing and duration of physical violence on any health outcomes. No association was found between either timing or duration of sexual abuse and health outcomes.

CONCLUSION

Earlier onset of childhood physical abuse was associated with greater psychological distress and somatic health complaints in adolescence, although these associations were attenuated after accounting for household mental health problems, highlighting the importance of developmental timing and family context.