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Long-term Neuroendocrine Effects of Childhood Maltreatment
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To the Editor: Dr Heim and colleagues1 found that childhood abuse was associated with changes in hormonal and neurological responses in adult women; however, it is regrettable that they chose to exclude men from this important study. According to the latest results from the National Child Abuse and Neglect Data System, boys experience 48.5% of all incidents of childhood abuse.2 Compared with girls, boys are more likely to suffer from physical abuse, general neglect, and medical neglect. There is also evidence that sexual abuse of boys is underrecognized, underreported, and undertreated.3 Most troubling is the fact that the incidence of fatalities from maltreatment is 3 times higher for boys than for girls.4 There is no sound basis for omitting persons from this research solely on the basis of their sex.
Edward E. Bartlett, PhD
School of Public Health and Health Services George Washington University Washington, DC
1. Heim C, Newport DJ, Heir S, et al. Pituitary-adrenal and autonomic responses to stress in women after sexual and physical abuse in childhood. JAMA. 2000;284:592-597.
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2. Department of Health and Human Services. Child Maltreatment 1997: Reports From the States to the National Child Abuse and Neglect Data System. Washington, DC: Government Printing Office; 1999.
3. Sedlack AJ, Broadhurst DD. Third National Incidence Study of Child Abuse and Neglect. Washington, DC: Government Printing Office; 1996.
4. Holmes WC, Slap GB. Sexual abuse of boys. JAMA. 1998;280:1855-1862.
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