A study of a large number of middle-aged adults suggests self-reported childhood abuse by women was associated with an increased long-term risk of death, according to an article published online by JAMA Psychiatry.

Childhood abuse has been linked a variety of adult psychiatric problems but its association with later-life risk of death as an adult has been less understood.

Edith Chen, Ph.D., of Northwestern University, Evanston, Ill., and coauthors examined reports of physical and in childhood with all-cause mortality rates in adulthood in a national sample of 6,285 adults, who were nearly all white and were an average age of about 47.

Participants had completed questionnaires in 1995 and 1996 and follow-up mortality data was tracked over 20 years. There were 1,091 confirmed deaths - 17.4 percent - in the study group through October 2015.

The study found no association for men between self-reported and long-term risk of all-cause mortality.

The results were different for women. Women who self-reported experiencing severe physical abuse, moderate physical abuse or emotional abuse from a parent were at increased risk of death during the 20-year follow-up. And, mitigating factors such as childhood socioeconomic status, adult depression or personality traits did not explain the association between childhood abuse and greater risk of death in women, according to the study.

Authors attempt to explain the association suggesting abuse can heighten vulnerability to psychiatric conditions; children who experience abuse may develop negative health behaviors (such as drug use) to cope with stress; obesity and its consequences could be one pathway between childhood abuse and ; and may affect how biological systems operate throughout life.

The study acknowledges it is unclear why women appear to more vulnerable to the effects of abuse than men.

Study limitations including self-reported childhood abuse, which means other explanations may be possible and that the reports may not accurately represent what happened in participants' childhoods.

"These findings suggest that who report child abuse continue to be vulnerable to premature mortality and perhaps should receive greater attention in interventions aimed at promoting health," the study concludes.

More information: JAMA Psychiatry. Published online August 17, 2016. DOI: 10.1001/jamapsychiatry.2016.1786

Journal information: JAMA Psychiatry