The Association Between Trauma and Chronic Medical Conditions in Individuals With Severe Mental Illness

Abstract

Based on the concept of allostatic load, this study proposed and evaluated a model for the relationship between childhood trauma, chronic medical conditions, and intervening variables affecting this relationship in individuals with severe mental illness. Childhood trauma, adult trauma, major depressive disorder symptoms, posttraumatic stress disorder symptoms, health risk factors, and chronic medical conditions were retrospectively assessed using a cross-sectional survey design in a sample of 117 individuals with severe mental illness receiving public mental health services. Path analyses produced a good-fitting model, with significant pathways from childhood to adult trauma and from adult trauma to chronic medical conditions. Multisample path analyses revealed the equivalence of the model across sex. The results support a model for the relationship between childhood and adult trauma and chronic medical conditions, which highlights the pathophysiological toll of cumulative trauma experienced across the life span and the pressing need to prevent retraumatization in this population.

Differentiating Adults With Mixed Age Victims From Those Who Exclusively Sexually Assault Children or Adults

“…Heart disease, fractures, alcoholism, diabetes, obesity, and other medical issues have been found more frequently in adults with adverse childhood experiences (ACEs; Felitti, 2002). Subsequent research corroborated the correlation between trauma and chronic medical conditions, specifically in a psychiatric population (Raab, Claypoole, Hayashi, & Baker, 2012). These findings imply that trauma may contribute to subsequent medical problems, though the causal direction and the generalization of these findings beyond those with mental illness or psychophysiological disorders has not been established.…”

Supporting trauma-informed recovery care through clinical feedback in community mental health research.

“…Trauma and posttraumatic stress disorder (PTSD) are pervasive among individuals with serious mental illness (SMI; Cusack, Frueh, & Brady, 2004; Mueser et al, 1998; Subica, Claypoole, & Wylie, 2012) and are associated with numerous adverse mental and physical health outcomes likely to undermine psychosocial recovery (Mueser, Rosenberg, Goodman, & Trumbetta, 2002; Raab, Claypoole, Hayashi, & Baker, 2012; Subica, 2013). Despite this, trauma and PTSD are routinely underassessed in public-sector settings (Cusack, Grubaugh, Knapp, & Frueh, 2006; Grubaugh, Zinzow, Paul, Egede, & Frueh, 2011; Mueser et al, 1998), partially due to unsupported provider perceptions that addressing traumatic experiences will exacerbate psychiatric difficulties (Frueh, Cusack, Grubaugh, Sauvageot, & Wells, 2006) or that consumers will be unwilling or unable to disclose trauma-related events and symptoms with recovery providers (Salyers, Evans, Bond, & Meyer, 2004).…”

Psychiatric and Physical Sequelae of Childhood Physical and Sexual Abuse and Forced Sexual Trauma Among Individuals With Serious Mental Illness

“…Increased exposure to traumatic events across the lifespan has been associated with reduced physical health, including increased rates of chronic health problems and medical conditions (Cusack, Frueh, & Brady, 2004;Raab, Claypoole, Hayashi, & Baker, 2012) and greater health care utilization among individuals with serious mental illness (Calhoun, Bosworth, Stechuchak, Strauss, & Butterfield, 2006;Mueser, Salyers, et al, 2004). The specific relationship between childhood physical and sexual abuse and physical health in those with serious mental illness is less understood.…”