Citation

van Tilburg MA, Runyan DK, Zolotor AJ, Graham JC, Dubowitz H, Litrownik AJ, Flaherty EG, Chitkara DK, Whitehead WE. Ann. Fam. Med. 2010; 8(2): 134-140.

Affiliation

Center for Functional GI & Motility Disorders, University of North Carolina, Chapel Hill, North Carolina (van Tilburg, Chitkara, Whitehead); Department of Social Medicine, University of North Carolina, Chapel Hill, North Carolina (Runyan); Department of Family Medicine, University of North Carolina, Chapel Hill, North Carolina (Zolotor); School of Social Work, University of Washington, Seattle, Washington (Graham); Department of Pediatrics, University of Maryland, Baltimore, Maryland (Dubowitz); Department of Psychology, San Diego State University, San Diego, California (Litrownik); Department of Pediatrics, Children's Memorial Hospital and Northwestern University Feinberg School of Medicine, Chicago, Illinois (Flaherty); Division of Pediatric Gastroenterology, Department of Pediatrics, University of North Carolina, Chapel Hill, North Carolina (Chitkara).

Copyright

(Copyright © 2010, Annals of Family Medicine, Inc.)

DOI

10.1370/afm.1053

PMID

20212300

PMCID

PMC2834720

Abstract

PURPOSE: Unexplained gastrointestinal symptoms are more common in adults who recall abuse as a child; however, data available on children are limited. The aim of this study was to investigate the association of childhood maltreatment and early development of gastrointestinal symptoms and whether this relation was mediated by psychological distress. METHODS: Data were obtained from the Longitudinal Studies of Child Abuse and Neglect, a consortium of 5 prospective studies of child maltreatment. The 845 children who were observed from the age of 4 through 12 years were the subjects of this study. Every 2 years information on gastrointestinal symptoms was obtained from parents, and maltreatment allegations were obtained from Child Protective Services (CPS). At the age of 12 years children reported gastrointestinal symptoms, life-time maltreatment, and psychological distress. Data were analyzed by logistic regression. RESULTS: Lifetime CPS allegations of sexual abuse were associated with abdominal pain at age 12 years (odds ratio [OR] = 1.75; 95% confidence interval [CI] = 1.1-2.47). Sexual abuse preceded or coincided with abdominal pain in 91% of cases. Youth recall of ever having been psychologically, physically, or sexually abused was significantly associated with both abdominal pain and nausea/vomiting (range, OR = 1.5 [95% CI, 1.1-2.0] to 2.1 [95% CI, 1.5-2.9]). When adjusting for psychological distress, most effects became insignificant except for the relation between physical abuse and nausea/vomiting (OR = 1.5; 95% CI, 1.1-2.2). CONCLUSION: Youth who have been maltreated are at increased risk for unexplained gastrointestinal symptoms, and this relation is partially mediated by psychological distress. These findings are relevant to the clinical care for children who complain of unexplained gastrointestinal symptoms.

Language: en