In a review of 24 studies of more than 48,000 adults, researchers found that child abuse raises the risk of physical illness as much as psychological problems, according to a recent article in Medical News Today.

The study was published in this month’s issue of Psychosomatic Medicine: Journal of Biobehavioral Medicine.

According to study co-author Cinnamon Stetler, Ph.D., an assistant professor of psychology at Furman University in South Carolina:

“Your exposure to really severe stressors like abuse in childhood may program the body’s stress system to respond in ways that may be adaptive in the immediate environment, but over the long term can be maladaptive and take their toll.”

In the study’s conclusions, the researchers said:

However, studies often fail to include a diverse group of participants, resulting in a limited ability to draw conclusions about the population of child abuse survivors as a whole.

That’s one reason so many organizations are starting ACE Studies of their own. This year, six states — Arkansas, California, Louisiana, South Carolina, Montana, New Mexico and Washington — are including the ACE questionnaire in their Behavioral Risk Factors Surveillance System (BRFSS), which each state does every year to assess its population’s health status.