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J Pediatr Psychol. 2010 Jun;35(5):499-510. doi: 10.1093/jpepsy/jsp117. Epub 2009 Dec 4.

Child abuse and other traumatic experiences, alcohol use disorders, and health problems in adolescence and young adulthood.

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  • 1, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 1521, USA. clarkdb@upmc.edu



We prospectively examined the health effects of child abuse and other traumatic events, with objective health indicators and consideration of alcohol use disorders (AUD).


Adolescents (n = 668) were recruited from clinical and community sources. At baseline, we examined child abuse and other traumas, AUD, health-related symptoms, physical findings, and blood assays. Subjects were assigned to Trauma Classes (TC), including witnessing violence, physical abuse, and sexual abuse. Health outcomes were again determined at 1-year and young adult follow-up.


In adolescence, higher TC severity was associated with more health-related symptoms, increased age-adjusted body mass index, and stress-response immune system indices. In adolescence and young adulthood, the relationships between TC and health-related symptoms were mediated by anxiety. AUD was associated with liver injury, and cigarette smoking with heart/lung symptoms.


Child abuse predicted persistently elevated health-related symptoms primarily attributable to anxiety, and early signs of liver disease were attributable to AUD.

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