*Atlanta Trauma Study

Edwards et al, 2003



members of a health maintenance organization (HMO) – 8,667 adult members

completed measures of childhood exposure to family dysfunction including items on physical and sexual abuse, witnessing of maternal battering, and emotional abuse in the childhood family environment – with current mental health assessment


[this is not representative of the general population as many members do not have access to health care or participate in HMOs]

prevalence:  sexual abuse 21.6% —  physical abuse 20.6% —- witnessing of maternal violence 14%

among respondents reporting any of the maltreatment types, 34.6% reported more than one type of maltreatment

lower mean mental health scores were associated with higher numbers of abuse categories

both an emotionally abusive family environment and interaction of emotionally abusive family environment with various maltreatment types had significant effect on mental health scores

CONCLUSIONS:  “Childhood physical and sexual abuse, as well as witnessing of maternal battering, were common among the adult members of an HMO in this study.  Among those reporting any maltreatment, more than one-third had experienced more than one type of maltreatment.  A dose-response relation was found between the number of types of maltreatment reported and mental health scores.  In addition, an emotionally abusive family environment accentuated the decrements in mental health scores.  Future research examining the effects of childhood maltreatment on adult mental health should include assessments of a wide range of abusive experiences, as well as the family atmosphere in which they occur.”


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