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. Last Updated: 07/27/2016

Study Shows Abused Children's Wounds Don't Heal

BALTIMORE, Maryland -- Women who were abused as children still feel the hurt years later as adults, when they find themselves dealing with medical symptoms ranging from back pain and fainting to chronic tiredness and depression.


In a study of about 1,900 Baltimore women who were surveyed at their doctors' offices, Johns Hopkins researchers discovered that the victims of childhood violence suffered from health problems similar to those encountered by women who had been abused in the past year.


"It looks like people have this trauma and for whatever reason they don't get better. These are unhealed wounds," said the study's lead author, Dr. Jeanne McCauley of the Department of Internal Medicine at Johns Hopkins Bayview Medical Center.


Researchers found that about one in five of the women had been the victims of childhood sexual or physical abuse. Their backgrounds varied by income and in other ways, making the sample representative of the larger population.


Published this week in the Journal of the American Medical Association, the study expands on earlier research done in specialty areas and adds to knowledge about the way childhood abuse shapes the victims' adult lives.


It also emphasizes the importance of training physicians to look for abuse and to ask questions not just about the possibility of current abuse, but about what might have happened in the past. What they find could redirect therapy and potentially save health care dollars.


Analyzing their responses, researchers first linked women who had been battered as adults to a range of chronic health problems and developed a model physicians can use to identify victims. But the data was so intriguing they looked at it again from a different angle -- childhood abuse. "It got more and more frightening," McCauley said.


Victims are often ashamed and unlikely to reveal their early trauma. In focus groups, they told McCauley that they're afraid to bring it up, for fear the doctor will laugh at them or judge them.


Many physicians have been trained to screen women for domestic abuse. But the realities of being a doctor today don't make it easy, experts say. Managed care puts pressure on physicians to spend less time with patients. It also decreases their decision-making power.


"They don't have the time to deal with this, and it's very difficult to do this kind of work," said Dr. Elaine Alpert, assistant professor of public health and medicine at the Boston University School of Medicine.