Prospective study of sexually abused girls (Putnam et.al.) SOMATIC PROBLEMS ABUSEDCONTROL Limb pain34%18% Joint pain25% 9% Chest pain10% 0% Headaches11/month 6/year Self-injury50% 8% Asthma50% 4% Skin rashes55% 14%

History of either physical or sexual abuse associated with : * Higher incidence of early illness * Faster cycling frequencies * Lifetime Axis I and II disorders, including lifetime history of alcohol and substance abuse * Higher prevalence of medical illness * Pattern of increasing severity of mania in those who reported history of physical abuse (Early physical and sexual abuse associated with adverse course of bipolar illness. Leverich et al., Biol. Psych., 2000)

Organ transplant study- (Stuber et. al.) Recipients of heart, liver or kidney transplants Age 12 to 20 years at time of interview Varying lengths of time since transplant

PTSD in Adolescents (Stuber et.al.) N= % had diagnostic levels of PTSD symptoms occurring at least two times per month 13.3% had diagnostic levels of PTSD symptoms occurring at least two times each week

Parental PTSD (Stuber et.al.) 27.8% (44/158) of parents of solid organ transplant recipients reported diagnostic levels of PTSD symptoms This is similar to levels of responses to natural disaster or interpersonal violence

Mount Sinai Study 19 pediatric liver transplant recipients PTSD associated with non-adherence Treatment of PTSD improved adherence