Health Outcomes
There is increasing speculation over the past decade that childhood maltreatment might have a detrimental effect on physical health. This revelation underscores the associated public health and healthcare costs associated with childhood maltreatment. Aside from the direct costs incurred via the protective, criminal justice and psychiatric systems, the costs of childhood maltreatment likely extend to long-term biologic and physical health consequences, many of which are of grave public health concern including obesity, sexually transmitted diseases, smoking and immunologic disorders. Further, the chronic stress which often accompanies abuse as well as the hyperarousal of trauma reactions associated with PTSD may have lasting effects on brain development and cognitive functioning.
Jennie Noll’s publications regarding physical health consequences include sexual abuse victims reporting more sleep disturbances, more GI and GYN complaints, greater healthcare utilization and higher rates of obesity. In our 20-year longitudinal analyses of nonstressed, basal cortisol levels, sexually abused victims displayed significantly higher basal cortisol in the acute phases of recovery but showed markedly attenuation later in adolescence and early adulthood providing evidence for the attenuation hypothesis, i.e., the development of hypocortisolism following chronic stress. Finally, in longitudinal analyses we have reported that abuse victims acquire receptive language more slowly during development than nonvictims and have lower overall educational attainment. These results provide some empirical support for models of developmental traumatology, which posit that the chronic stress of abuse may manifest in cognitive deficits that may, in turn, have lasting effects on academic successes and achievements.