Research | Articles | Yeager 18 CALIFORNIA SOCIOLOGY FORUM VOL. 7 The Long-Term Effects of Child Physical Abuse Serena Yeager Department of Sociology California State University, Los Angeles ABSTRACT This paper explores the lasting effects of childhood physical abuse (or CPA), with a specific focus on its role in perpetuating chronic pain, intergenerational cycles of abuse, and mental health deterioration. CPA continues to be a significant societal issue, with long-term repercussions extending beyond the immediate physical harm experienced by victims. Victims of CPA are more likely to develop medical issues in adulthood, including chronic pain and neurological changes that exacerbate mental health disorders such as anxiety, depression, and suicidal ideation. Additionally, CPA can contribute to heightened emotional sensitivity and disruption of emotional regulation, which can increase the likelihood of victims perpetuating abusive behaviors in adulthood. While education and therapeutic interventions are shown to mitigate some adverse effects of CPA, challenges in accessibility remain. Through an interdisciplinary approach, incorporating literature review and personal reflections, this paper highlights the interconnected physical, emotional, and societal consequences of CPA. By fostering awareness and improving intervention strategies, this paper advocates for continued discourse and systemic change in addressing the needs of victims. Childhood physical abuse (or CPA) has undergone extensive reform through various legislative measures over time; however, it is still a prevalent social issue. CPA tends to be defined as the non-accidental physical injury of a child by a parent/caregiver, the injuries sustained can include bruises, fractures, cuts, burns, welts and other physical injuries (Valle and Lutzker 2006). CPA can cause long-term harm to victims in a variety of ways that does not exclude physical harm. Some might say that CPA only affects children in regard to short-term physical health but there are other non-physical effects of such abuse. These seemingly ‘invisible’ effects do not disappear like bruises but stay present in the body and mind for many years. This abuse has long-lasting, diverse, negative effects. By long-lasting, I refer to the notion that the Research | Articles | Yeager 19 CALIFORNIA SOCIOLOGY FORUM VOL. 7 effects of CPA can have enduring consequences for the victims throughout their lives and the next generations. This paper presents a literature review of existing research on CPA and its long-term implications, along with personal reflections on my own experiences with this issue. These insights aim to encourage further discussions on the topic. I will explore some of the facets that child physical abuse affects, focusing on three principal areas: the manifestation of chronic and gendered pain in adulthood, the perpetration of violence, and mental health issues. Through this examination, I aim to address the difficulties faced by victims of CPA as they transition into adulthood, while also considering the broader societal implications of these challenges. This paper will not specifically address the lack of support available to victims; however, it will discuss studies explaining the impacts of CPA and how resources used helped victims to a certain degree. It is important to note that this paper does not suggest that the methods reviewed will resolve all issues caused by CPA. CHRONIC AND GENDERED PAIN IN ADULTHOOD CPA is associated with an elevated likelihood of reporting chronic pain. A study conducted on adults suffering from chronic pain revealed that individuals who experienced physical abuse during childhood are 45% more likely to endure chronic pain in adulthood (Bussières et al. 2023). Furthermore, chronic pain is associated with substantial economic implications. Medical expenses and lost productivity associated with chronic pain exceed those of heart disease and cancer combined. This shows CPA can have negative financial implications for individuals who developed chronic pain into adulthood. They can be burdened with increased medical expenses associated with their conditions. Additionally, chronic pain can cause other financial stressors such as finding or holding a job. Chronic pain can include calling out more or needing extra accommodations at work. This could result in those adults getting unjustly fired, having financial instability would leave them unable to fight these actions in court. This is particularly significant for individuals who are in a lower tax bracket or possess lower levels of education, as they may have limited access to employment opportunities that are not labor intensive. Research | Articles | Yeager 20 CALIFORNIA SOCIOLOGY FORUM VOL. 7 Continuing to focus on the realities of pain in adulthood, I will examine how women experience sexual pain because of CPA. Women who have experienced CPA are 1.5 times more likely to experience pain during sexual intercourse. Researchers (Talmon, Uysal, and Gross 2021) found that physical abuse significantly predicted increases in pain during sex for women but not for men, this information was gathered by researchers over a ten-year longitudinal study. The study, which comprised 410 women and 397 men, revealed that there were no significant associations for men who experienced CPA. However, the study also showed that physical neglect was identified as a significant predictor of increased pain among men. Additionally, the experience of pain during sexual intercourse can adversely affect these women's relationships. Consequently, they may require additional therapeutic interventions, such as counseling or physical therapy, depending on the severity of the pain. It is important to keep in mind these services can be costly, further adding marital strain. Troubles during intimacy can cause other marital problems; it can lead to numerous unfair outcomes like infidelity or marital abuse. The physical abuse received in childhood can have a profound domino effect on the individual throughout their life and their interpersonal relationships. This study demonstrated that childhood abuse can cause varying experiences for both men and women, while furthermore perpetuating violence across generations. CONTINUING OR BREAKING THE CYCLE OF ABUSE Experiencing CPA increases the chances of abusing your own children. Researchers (Voorthuis et al. 2014) conducted a study involving 337 female college students that revolved around their childhood trauma and temperament. Both emotional neglect and physical abuse significantly predicted the likelihood of increased child abuse potential by 1.5 times; however, this association was observed exclusively among individuals exhibiting high levels of temperamental orienting sensitivity. What this means is that those with heightened sensitivity are more vulnerable to the negative effects of their childhood abuse making them also more likely to experience negative effects like pain during sex (Talmon et al. 2021) which was mentioned previously. Not only that but Research | Articles | Yeager 21 CALIFORNIA SOCIOLOGY FORUM VOL. 7 according to the systematic review and meta-analysis of researchers (Zhang et al. 2020), for females there is significant association between adverse childhood experiences and the subsequent development of ADHD. Drawing on my personal experiences as a woman with ADHD and a background of CPA, it has been noted by myself and others around me that I have higher sensitivity compared to others. Managing these intensified emotions is an ongoing learning process for others and myself. In circumstances where individuals have experienced trauma during childhood and may be at risk of perpetuating this cycle, therapy can be an effective intervention. Such therapeutic efforts aim not only to address childhood trauma, but also to enhance emotional well-being, and manage any associated mental health challenges that individuals may encounter because of their early experiences. Understanding this highlights the interconnectedness of CPA and its enduring impact on future generations. Therapeutic interventions may serve as a significant support mechanism for children who have experienced abuse. Psychotherapeutic experiences following CPA may reduce the likelihood of violence in adulthood. Researchers (Maxwell et al. 2016) found that receiving psychotherapy resulted in a reduction of approximately 30% in the likelihood of perpetrating physical violence during adulthood. This information indicates that we have the capacity to help reduce and ultimately prevent violence. The CPA can adversely affect others and perpetuate the cycle of abuse through generations (Voorthuis et al. 2014). Furthermore, this abuse is not solely physical; it can also manifest in emotional and psychological forms, as noted by Maxwell et al. (2016). However, through the incorporation of therapy or counseling, society can effectuate a change in these statistics. As someone who regularly participated in talk therapy, I have experienced significant positive changes in my ability to manage my heighted sensitivity. It is essential to acknowledge that therapy can be a fundamental component of healing to improve our society. Mental health professionals are essential in supporting individuals as they navigate the healing process and work towards personal growth goals. It can be beneficial to discuss the potential opportunity to enhance the implementation and accessibility of Research | Articles | Yeager 22 CALIFORNIA SOCIOLOGY FORUM VOL. 7 mental health services for CPA victims. This type of initiative could prevent harm to themselves and others. MENTAL HEALTH REPERCUSSIONS Physical abuse is associated with a higher risk of suicidal ideation. Researchers (Yıldız, Orak and Aydoğdu 2023) found that those who experience physical abuse as a child were 2.5 times more likely to have suicidal thoughts into adulthood. The research conducted by Yıldız et al. (2023) also indicated that experiencing CPA is linked to increased levels of depression, anxiety, and feelings of powerlessness, which in turn contributed to an increase in suicidal thoughts and ideation. Self-harm may result in hospitalization, resulting in debt that jeopardizes the survivor’s economic stability and that of their families. If a victim ultimately commits suicide, their family will also face financial and emotional burdens, potentially requiring government assistance and impacting taxpayers. Having experienced CPA, I faced challenges such as mild depression and anxiety, which is consistent with the findings of Yıldız et al. (2023). Additionally, I dealt with self-harming behaviors and suicidal thoughts; however, therapy helped reduce these thoughts and actions. Referring again to the work of Maxwell et al. (2016), it is evident that therapy can be instrumental not only in mitigating harm to others but also in alleviating self-inflicted distress. It is essential for society to continue advocating for mental health and to convey to individuals that they are not alone in their struggles. Additionally, mental health professionals who understand these CPA and mental health correlations can better support CPA victims in addressing their internal challenges. Children who were physically abused before the age of 5 were more likely to score in the clinical range for internalizing disorders. Researchers (Lansford et al. 2021) also found that those who were physically abused as children reported lower levels of physical health and their chances of meeting the clinical range for internalized disorders was 2.10 times higher. To provide additional information, the study's internalizing disorders included depression, anxiety, and somatic complaints. Internalized disorders can lead to chronic mental health issues, adversely affecting an individual's ability to establish healthy Research | Articles | Yeager 23 CALIFORNIA SOCIOLOGY FORUM VOL. 7 relationships, maintain employment, and uphold an overall quality of life. Additionally, somatic complaints may result in frequent medical visits, contributing to increased healthcare costs. This observation aligns with the findings of researchers Bussières et al. (2023), who noted that chronic pain is associated with higher healthcare utilization and more frequent hospital visits. Frequent hospital visits can significantly diminish an individual's quality of life and place considerable strain on healthcare resources, ultimately affecting both the healthcare system and the economic well-being of patients. Addressing this issue effectively begins with preventing child abuse from occurring in the first place. It is important to consider how childhood experiences of abuse can shape an individual’s perception of the world and influence societal norms. Ultimately, prioritizing the mental well-being of children can increase the development of a healthy self-image. Those who experienced CPA reported significantly lower self-rated health scores in adulthood. Wang and Zhao (2022) found that the pursuit and continuation of higher education can alleviate the negative effects of CPA and other related traumatic events by 25%. It is important to note, however, that this does not eliminate completely the adverse negative impacts associated with CPA. This concept may prove advantageous for survivors of CPA who are contemplating the pursuit of further education. Additionally, it would enable them to take an active role in shaping their own futures, progressively acquiring knowledge and fostering personal healing. Higher education can instill a sense of accomplishment and expand access to higher-paying employment opportunities. Through these job prospects, individuals who may have previously faced barriers due to their childhood circumstances or lower socioeconomic status can ascend the socio-economic ladder. This provides a compelling rationale for making higher education more accessible and even tuition-free. Moreover, education fosters critical thinking skills and diminishes the likelihood of repeating historical errors. This is especially pertinent in disrupting the cycle of abuse that individuals who have suffered CPA may feel compelled to perpetuate, as evidenced by Voorthuis et al. (2014). Ultimately, attaining a higher education can enable individuals to transform their lives and enhance their cognitive abilities. Research | Articles | Yeager 24 CALIFORNIA SOCIOLOGY FORUM VOL. 7 Physical abuse can be linked to functional reorganizations in various brain regions which have implications for mental health. Cai et al. (2023) determined that individuals who endured CPA exhibited a 1.8 times increased risk of developing mental health disorders in adulthood, attributable to stress-related functional reconfigurations in multiple regions of the brain. To clarify, the mental health disorders referred to in this study are depression, anxiety, and post-traumatic stress disorder (PTSD) in adulthood. The study also uncovered that CPA was associated with alterations in brain functional connectivity, particularly in regions pertinent to emotional regulation and stress response. These modifications in brain connectivity were correlated with an elevated risk of developing disorders, such as depression and anxiety. It is important for CPA victims to understand that any health issues they may be experiencing are not their fault, nor should they be dismissed as mere laziness. This statement is particularly relevant given the prevalent stigma surrounding mental health in certain cultures. Based on personal experience within Mexican culture, there often exists a mentality that advocates for simply overcoming challenges and continuing to work, rather than seeking help through therapy or other medical resources. Recognizing the influence that CPA has on mental well- being, society could continue to foster empathy and understanding to enhance mental health awareness and resource utilization. CPA globally impacts the control of emotion regulation. Researchers (Cheng and Langevin 2023) found that CPA can hinder a victim’s ability to identify, label and express emotions but especially fear. Victims tend to struggle understanding others and managing their own emotions which can complicate relationship building and distort their world views, which can lead to unhealthy dynamics. This ties back to the research Maxwell et al. (2016) explained that CPA can make victims engage in abuse themselves as adults. This cycle of violence affects not just the survivors but also those around them, as it increases the likelihood of unhealthy relationships and therapeutic needs for future generations. Consequently, addressing these emotional issues requires resource allocation for such support. Ultimately, understanding this issue is vital for personal development and prevention of further abuse. Violence can have a continuous effect among individuals. While Research | Articles | Yeager 25 CALIFORNIA SOCIOLOGY FORUM VOL. 7 survivors may face difficulties in recognizing and articulating their emotions, it is evident that this is not a concern that only impacts victims but those around them. CONCLUSION Overall, CPA has enduring effects that impact victims, manifesting in various ways and to varying degrees. Notably, CPA increases the likelihood of having chronic pain in adulthood, and it can also impose significant financial burdens (Bussières et al. 2023). Not only that but for adult women CPA has been associated with an increase in pain during intercourse, further underscoring its long-lasting physical implications (Talmon et al. 2021). Beyond physical and personal pain, research showed that individuals with a history of experiencing CPA were more prone to inflicting violence on their own children if they exhibited high levels of temperamental sensitivity (Voorthuis et al. 2014). On the bright side psychotherapeutic intervention can mitigate the risk of violent behavior in adults who experienced CPA, reducing the likelihood of continuing abusive behaviors to their own children (Maxwell et al. 2016). The mental health impact of CPA is equally profound. It was shown that there is an association between CPA and increased self-harming behaviors (Yıldız et al. 2023). Additionally, CPA before the age of five increases the risk of developing internalized disorders later in life (Lansford et al. 2021). Mental health outcomes can also be influenced by CPA as it alters brain structures, victims of CPA report lower self-rated health scores (Wang and Zhao 2022). Furthermore, CPA reorganized the brain causing neurological changes that increase the likelihood of developing mental health disorders and impaired fear recognition (Cai et al. 2023). In summary, CPA has long-lasting consequences that impact victims physically, mentally, and emotionally. This highlights the intricate interconnectedness between personal experiences during childhood and adulthood outcomes. In summary, CPA has lasting impacts on individuals all throughout adulthood, affecting their physical, mental, emotional, and social health. A common misconception mentioned was that CPA solely impacted a victim's physical health, with pain diminishing as injuries heal. However, the long-term effects are Research | Articles | Yeager 26 CALIFORNIA SOCIOLOGY FORUM VOL. 7 significantly more profound, some being: influencing the perception of health, mental health issues, and the normalization of abusive behavior. This normalization can perpetuate a cycle of intergenerational abuse, replicating similar behaviors victims might have experienced. While there are many challenges to face for those who are victims of CPA, there are also many opportunities to grow and heal from the abuse. Psychotherapeutic interventions and support systems have demonstrated potential in interrupting the intergenerational cycle of abuse. Additionally, mental health services can aid in reducing the strength of mental disorders as a by-product also reducing self-harming, suicidal behaviors and idealizations. It is essential for society to prioritize the well-being of children by cultivating environments revolving around care, respect, and protection. By addressing the ongoing CPA issues and providing accessible resources for the victims, pathways can be created towards a future devoid of abuse. REFERENCES Bussières, André, Mark J. Hancock, Ask Elklit, Manuela L. Ferreira, Paulo H. Ferreira, Laura S. Stone, Timothy H. Wideman, et al. 2023. “Adverse Childhood Experience is Associated with an Increased Risk of Reporting Chronic Pain in Adulthood: A Stystematic Review and Meta-Analysis.” European Journal of Psychotraumatology 14(2), 1-38. DOI: 10.1080/20008066.2023.2284025. Cai, Jianjian, Jia Li, Dong Liu, Sikang Gao, Yunyun Zhao, Jiaxuan Zhang, and Qin Liu. 2023. “Long‐Term Effects of Childhood Trauma Subtypes on Adult Brain Function.” Brain and Behavior, 13(5):1- 9. DOI: 10.1002/brb3.2981. Cheng, Polly, and Rachel Langevin. 2023. “Unpacking the Effects of Child Maltreatment Subtypes on Emotional Competence in Emerging Adults.” Psychological Trauma: Theory, Research, Practice, and Policy 15(Suppl 1):S102-11. DOI: 10.1037/tra0001322. Lansford, Jennifer E., Jennifer Godwin, Robert J. McMahon, Max Crowley, Gregory S. Pettit, John E. Bates, John D Coie, and Kenneth A. Dodge. 2021. “Early Physical Abuse and Adult Outcomes.” Pediatrics 147(1):e20200873. DOI: 10.1542/peds.2020-0873 Maxwell, Kendal, Jennifer L. Callahan, Camilo J. Ruggero, and Beth Janis. 2015. “Breaking the Cycle: Association of Attending Therapy Following Childhood Abuse and Subsequent Perpetration of Violence.” Journal of Family Violence 31(2):251–58. DOI: 10.1007/s10896-015-9765-z Research | Articles | Yeager 27 CALIFORNIA SOCIOLOGY FORUM VOL. 7 Talmon, Anat, Ahmet Uysal, and James J. Gross. 2021. “Childhood Maltreatment and Mid-Life Adult Sexuality: A 10-Year Longitudinal Study.” Archives of Sexual Behavior 51(2):781-95. DOI: 10.1007/s10508-021-02030-8. Valle, Linda Anne and John R. Lutzker. 2006. “Child Physical Abuse.” Practitioner's Guide to Evidence-based Psychotherapy, 169-76. Boston: Springer Nature. Voorthuis, Alexandra, Ritu Bhandari, Dorothée Out, Rixt van der Veen, Marian J. Bakermans-Kranenburg, and Marinus H. Van IJzendoorn. 2014. “Childhood Maltreatment Experiences and Child Abuse Potential: Temperamental Sensitivity as Moderator?” Journal of Family Violence 29(7):749-56. DOI: 10.1007/s10896- 014-9624-3. Wang, Dianxi, and Yufeng Zhao. 2022. “The Relationship Between Adverse Family Experiences During Childhood and Self-rated Health Outcome in Adulthood.” Social Work in Public Health 37(4), 342- 55. DOI: 10.1080/19371918.2021.2013384. Yıldız, Muhammed, Uğur Orak, and Ramazan Aydoğdu. 2023. “Enduring Effects of Early Life Traumas on Adult Suicidal Ideation.” Journal of Child & Adolescent Trauma 16(2):297-307. DOI: 10.1007/s40653-022-00482-1. Zhang, Ning, Man Gao, Jinglong Yu, Qiang Zhang, Weiguang Wang, Congxiao Zhou, Lingjia Liu, Ting Sun, Xing Liao, and Junhong Wang. 2022. “Understanding the Association Between Adverse Childhood Experiences and Subsequent Attention Deficit Hyperactivity Disorder: A Systematic Review and Meta-analysis of Observational Studies.” Brain and Behavior, 12(10):1-11. DOI: 10.1002/brb3.2748. Serena Yeager (She/Her/Ella) is a first-generation college graduate. She is a CSULA alumni who graduated with a Bachelor’s in Sociology and a Minor in Communications in December of 2024. During her time at CSULA, Serena participated as a member of the sociology club and later served as treasurer in the fall of 2024. She is grateful for the numerous opportunities she has received by being a part of Cal State LA, such as submitting a paper to the CSF in the spring of 2025. Currently, Serena is a graduate student at CSUN pursuing a Master’s in Sociology. The Long-Term Effects of Child Physical Abuse - Serena Yeager