We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Clinical Characteristics of Women With a History of Childhood Abuse Unhealed Wounds

Jeanne McCauley, MD, MPH; David E. Kern, MD, MPH; Ken Kolodner, ScD; Laurie Dill, MD; Arthur F. Schroeder, MD; Hallie K. DeChant, MD; Janice Ryden, MD; Leonard R. Derogatis, PhD; Eric B. Bass, MD, MPH
JAMA. 1997;277(17):1362-1368. doi:10.1001/jama.1997.03540410040028.
Text Size: A A A
Published online


Objectives.  —To determine the prevalence of childhood physical or sexual abuse in women seen in primary care practices; to identify physical and psychologic problems associated with that abuse; and to compare the effects of childhood physical vs sexual abuse and childhood vs adult abuse.

Design.  —Cross-sectional, self-administered, anonymous survey.

Setting.  —Four community-based, primary care internal medicine practices.

Patients.  —A total of 1931 women of varied age and marital, educational, and economic status examined from February through July 1993.

Main Outcome Measures.  —Prevalence of physical and sexual abuse, physical symptoms, psychological symptoms (Symptom Checklist-22), alcohol abuse (CAGE questions), and street drug use.

Results.  —Of the 1931 respondents, 424 (22.0%) reported childhood or adolescent physical or sexual abuse. Compared with women who reported never having experienced abuse (n=1257), women who reported abuse as children but not adults (n=204) had more physical symptoms (mean±SE, 6.2±0.2 vs 4.0±0.9; P<.001) and had higher scores for depression, anxiety, somatization, and interpersonal sensitivity (low self-esteem) (P<.001); were more likely to be abusing drugs (prevalence ratio [PR], 4.7; 95% confidence interval [CI], 2.9-7.6) or to have a history of alcohol abuse (PR, 2.2; 95% CI, 1.5-3.2); were more likely to have attempted suicide (PR, 3.7; 95% CI, 2.6-5.1); and were more likely to have had a psychiatric admission (PR, 3.2; 95% CI, 2.2-4.7). Women abused only as children did not differ from women who reported current, but not childhood, abuse in number of physical symptoms, emotional distress, substance abuse, or suicide attempts. Patients who reported both childhood and adult abuse had higher levels of psychological problems and physical symptoms than those who reported childhood or adult abuse alone.

Conclusions.  —Childhood physical or sexual abuse is associated with adult health problems including physical symptoms, psychological problems, and substance abuse; for many variables, this association is as strong as for patients experiencing current abuse.


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.