Not Just What Happened, But How it Felt: Subjective Distress and its Role in Adolescent Health After Childhood Physical Abuse.

The role of subjective experience in understanding the links between childhood physical abuse and mental and somatic outcomes is gaining recognition but remains underexplored. Using data from a large population-based sample of youth (12-16 years) and generalized linear models, we examined whether current and past peak subjective distress following physical abuse were associated with symptoms, measured by the Hopkins Symptom Checklist (HSCL-10) and the Children's Somatic Symptoms Inventory (CSSI-8). Causal mediation analyses were conducted to investigate whether subjective distress mediated the relationship between physical abuse and health outcomes. Subjective distress accounted for variation in symptoms, above and beyond severity and frequency of physical abuse. The impact of physical abuse on health was largely transmitted through subjective distress. While severity and frequency of maltreatment remain independent predictors of health outcomes, this study underscores the necessity of incorporating measures of subjective experience to understand the pathways linking childhood physical abuse to later health outcomes.