Purpose Very few studies have examined the relationship between childhood violence and health/mental health outcomes among American Indian/Alaska Native (AI/AN) women. Although previous studies with AI/AN women provide an initial investigation of childhood violence, they are limited in that most focus on reservation-based samples. The only nationally representative sample, the National Violence against Women Survey (NVAWS) relied on a sample of only 88 AI/AN women. While there is ample evidence that childhood trauma among Native women is high, the relationship between this trauma and health has not yet been addressed. Moreover, research exploring childhood violence among urban AI/AN is almost non-existent.

Methods This study relies on a sample of 112 urban AI/AN women surveyed between 2000 and 2003. Given the difficulty in randomly sampling urban AI/AN populations, a multiple wave sampling approach was used with modified respondent driven sampling, chain referral, and targeted sampling. Victimization experiences were assessed using the Lifetime Traumatic Events Questionnaire. Mental health, HIV sex risk behaviors, and help-seeking were assessed using a number of well relied upon measures.

Results A significant percentage of women in the sample (28.2%) had experienced some type of childhood physical abuse and 42% reported childhood sexual abuse. Results show that women who experienced childhood violence had high levels of traumatization at the time of the abuse and continue to have high levels of trauma related to the abuse as adults. Women experiencing childhood abuse were significantly more likely to report a history of depression or dysphoria and were also more likely to have sought mental health counseling or traditional mental health healing. In addition, childhood sexual assault was significantly associated with engaging in sexual HIV risk behaviors. Women who had never experienced child abuse were significantly less likely to have experienced depression or dysphoria. Moreover, they were less likely to seek counseling services or engage in sexual risk behaviors.

Implications The frequency of reports of child abuse highlight the need for strong prevention efforts targeted at urban AI/AN communities. Scholars and practitioners should promote culturally responsive standards of training for violence prevention efforts aimed at urban AI/AN women specifically. Moreover, communities are called upon to foster multi-disciplinary collaborations between Native organizations and relevant service providers to explore best practice prevention models aimed at AI/AN communities. Findings in the area of help-seeking were encouraging. Most women with a history of abuse (72%) had sought help through traditional Native healing, and 68% sought help through western counseling services. Women who experienced sexual abuse were significantly more likely to seek out all forms of help. In addition, women who had never experienced any childhood abuse were significantly less likely to seek mental health counseling. For women who have experienced child abuse, providers must focus on the prevention of related negative health consequences. Moreover, it is important to note that AI/AN women seek help through both Western and traditional Native practices. It is critical, therefore, that culturally-relevant services are offered to women in conjunction with standard mental health services or as an alternative.