This article discusses a study that explored the role of a selected range of adverse life events in the possible causes of medical conditions. The study used interview data with a random community sample of New Zealand women, half of whom reported childhood sexual abuse and half who did not. Details about childhood physical abuse and adult abuse were also collected. The study was conducted in two phases: one in 1989, and a follow-up in 1995. In general, 1995 variables are analysed for this report, as they were contemporaneous with the physical health data. The mean age of the subjects in 1995 was 46.6 years. Results indicate complex relationships were found, as abuses tended to co-occur. Seven of 18 potentially relevant medical conditions emerged as significantly increased in women with one or more types of abuse. These were chronic fatigue, bladder problems, headache including migraine, asthma, diabetes and heart problems. The authors conclude that causal relationships cannot be studied in a cross-sectional retrospective design, but immature coping strategies and increased rates of dissociation appeared important only in chronic fatigue and headache, suggesting that these are not part of the causal pathway between abuse experiences and the other later physical health problems. Limitations of the study are discussed.

sz

Psychotherapy and Psychosomatics 71(3) May/June : 141-150