Physical and psychological maltreatment in childhood and later health problems in women: An exploratory investigation of the roles of perceived stress and coping strategies

Objective: This retrospective, cross-sectional study investigated the association between childhood physical and psychological maltreatment and self-reported physical health concerns in adult women. The mediating roles of perceived stress and coping strategies were examined. Methods: Participants were 235 women (aged 18-59 years) recruited from the community. Semi-structured interviews and questionnaires were used to assess self-reported childhood maltreatment and current perceived stress, coping strategies, and health status. Data were analyzed using structural equation modeling. Results: After controlling for a history of child sexual abuse and relevant demographic variables, child physical and psychological maltreatment were significantly associated with greater physical health concerns. Support was found for models in which perceived stress and emotion-focused coping partially mediate the relation between maltreatment and health problems; problem-focused and avoidance coping did not operate as mediators. Multi-mediation model testing indicated that emotion-focused coping and perceived stress together better explain the relationship between child maltreatment and physical health than either variable alone. Conclusion: Findings suggest that child maltreatment is an important risk factor for adverse health outcomes in later life and that current stress and coping strategies may influence this relationship. Implications for the physical health of maltreatment survivors are discussed. Practice implications: The management of perceived stress and the use of adaptive emotion-focused coping responses in the everyday lives of maltreated women may be particularly useful points of intervention in order to mitigate physical health concerns in adulthood. (C) 2012 Elsevier Ltd. All rights reserved.