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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 non-victims 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.
Noll JG, Shenk CE. Introduction to the special issue: the physical health consequences of childhood maltreatment—implications for public health. Journal of Pediatric Psychology. 35: 447-449. 2010.
Noll JG, Shenk CE, Yeh M, Ji JE, Putnam FW, Trickett PK. Receptive language and educational attainment for sexually abused females. Pediatrics. 126(3):e615-22. 2010.
Trickett PK, Noll JG, Susman EJ, Shenk CE, Putnam FW. Attenuation of cortisol across development for victims of sexual abuse. Development and Psychopathology. 22:165-175. 2010.
Noll JG, Zeller ME, Trickett PK, Putnam FW. Obesity risk for female victims of childhood sexual abuse: A prospective study. Pediatrics. 120(1):e61-e67. 2007.
Sickel, AS, Noll, JG, Moore, PJ, Putnam, FW, Trickett, PK. Long term physical health and healthcare utilization of women who were sexually abused as children: A prospective study. Journal of Health Psychology. 7(5):583-597. 2002.
Abused and non-abused females’ high-risk online behaviors: Impact on development. Principal Investigator Noll: NIH/NICHD R01HD073130-012012-2017
A Prospective Investigation of the Mechanisms Involved in Teen PregnancyPrincipal Investigator Noll: NIH/NICHD R01HD0525332007-2012
20-year intergenerational longitudinal follow-up of females abused as children.Principal Investigator Noll: NIH/NICHD R03HD0606042010-2012
Cortisol activity and sexual abuse: effects across development.Principal Investigator Noll: NIH/NICHD R03 HD0453462004-2006
The offspring of maltreated mothers: prenatal and infant health.Principal Investigator Noll: NIH/NICHD K01 HD414022002-2007
click to enlarge
Average Body Mass Index (BMI) growth trajectories across development for sexually abused (N=69) and comparison (N=75) females. The average linear slope was significantly steeper for abused females (red) than for comparison females (blue). The average quadratic function was not significantly different across groups (full sample curve depicted in purple). Minority status and parity covaried. Females who were obese at study entry excluded.
*Population growth trends were obtained from the Centers for Disease Control and Disease Prevention and Health Promotion (CDC) presented by the National Center for Health Statistics (published in May, 2000; http://www.ccd.gov/growthcharts). Parallel trajectories representing the 75th and 25th population percentiles for females are depicted (black). The average linear slope for abused females was significantly steeper than the population slope whereas the linear slope for comparison females was similar to the population slope.
Please use the following link to view the publication in its entirety. http://pediatrics.aappublications.org/cgi/reprint/120/1/e61
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