Unexplained Gastrointestinal Symptoms After Abuse in a Prospective Study of Children at Risk for Abuse and Neglect

Miranda A. L. van Tilburg; Desmond K. Runyan; Adam J. Zolotor; J. Christopher Graham; Howard Dubowitz; Alan J. Litrownik; Emalee Flaherty; Denesh K. Chitkara; William E. Whitehead

doi:10.1370/afm.1053

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Table 1.

Demographics and Study-Related Variables in Children: Maltreated vs Not Maltreated and Abused vs Not Abused

	CPS-Reported Maltreatment			Child Self-Reported Abuse
Variable	Maltreated (n=559)	Not Maltreated (n=286)	P Value	Abused (n=402)	Not Abused (n=425)	P Value
CPS=Child Protective Services; NS=not significant.
^a On a scale ranging from 0 to 30.
Sex, male, %	49.4	48.6	NS	45.8	51.3	NS
Race, %			<.001			NS
White	31.1	17.5		27.1	25.2
African American	45.8	73.1		54.2	56.7
Other	23.1	9.4		18.7	18.1
Age, years	12	12	NS	12	12	NS
Nausea/vomiting, %	47.6	43.5	NS	53.4	38.0	<.001
Abdominal pain, %	59.3	52.1	.04	63.1	51.1	<.001
Psychological distress, mean (SD)^a	4.8 (4.7)	3.7 (3.7)	<.001	5.7 (4.8)	3.1 (3.4)	<.001

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Table 2.

Logistic Regression Analyses of the Association Between Child Protective Services Maltreatment Allegations and Gastrointestinal Symptoms, Controlling for Data Collection Site and Sex

	Abdominal Pain		Nausea/Vomiting
Variable	Odds Ratio	95% CI	Odds Ratio	95% CI
CI=confidence interval.
Sexual abuse	1.5	1.1–2.4	1.3	0.8–1.9
Physical abuse	0.7	0.5–1.0	1.3	0.9–1.9
Emotional abuse	1.0	0.7–1.4	0.8	0.5–1.1
Lack of supervision	1.2	0.0–1.7	1.1	0.8–1.5
Failure to provide	1.1	0.8–1.6	1.3	0.9–1.9

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Table 3.

Odds Ratios for Self-Reported Abuse and Gastrointestinal Symptoms After Controlling for Data Collection Site and Sex

	Abdominal Pain		Nausea/Vomiting
Self-Reported Abuse	Odds Ratio	95% CI	Odds Ratio	95% CI
CI=confidence interval; OR = odds ratio.
Psychological maltreatment	1.5	1.1–2.0	1.7	1.3–2.3
Physical abuse	1.7	1.2–2.4	2.1	1.5–2.9
Sexual abuse/assault	1.8	1.2–2.6	1.7	1.2–2.5

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Supplemental Appendix

Supplemental Appendix 1. Longitudinal Studies of Child Abuse and Neglect (LONGSCAN).

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Supplemental data: Appendix - PDF file, 1 page, 87 KB
The Article in Brief

Unexplained Gastrointestinal Symptoms After Abuse in a Prospective Study of Children at Risk for Abuse or Neglect

Miranda A. L van Tilburg , and colleagues

Background Research has shown that adults who were abused as children are more likely to have unexplained gastrointestinal symptoms.This study investigated whether there is a relationship between abused children and development of gastrointestinal symptoms.

What This Study Found There is a high prevalence of unexplained abdominal pain and nausea/vomiting among children?both boys and girls?who have been abused. The study findings suggest that any type of abuse (sexual, psychological, and physical) has the potential to increase the risk of suffering from unexplained gastrointestinal problems.

Implications

When treating at-risk children, clinicians should consider prior abuse when unexplained gastrointestinal symptoms are present.