A review of childhood abuse, health, and pain-related problems: the role of psychiatric disorders and current life stress.

The current article reviews recent research demonstrating the relationship between childhood physical and sexual abuse and adult health problems. Adult survivors of childhood abuse have more health problems and more painful symptoms. We have found that psychiatric disorders account for some, but not all, of these symptoms, and that current life stress doubles the effect of childhood abuse on health problems. Possible etiologic factors in survivors' health problems include abuse-related alterations in brain functioning that can increase vulnerability to stress and decrease immune function. Adult survivors are also more likely to participate in risky behaviors that undermine health or to have cognitions and beliefs that amplify health problems. Psychiatric disorders, although not the primary cause of difficulties, do have a role in exacerbating health and pain-related problems. We conclude by outlining treatment recommendations for abuse survivors in health care settings.