Childhood Sexual Abuse and Psychiatric Disorder in Young Adulthood: II. Psychiatric Outcomes of Childhood Sexual Abuse
This is the second in a series of articles that describe the prevalence, correlates, and consequences of childhood sexual abuse (CSA) in a birth cohort of more than 1,000 New Zealand children studied to the age of 18 years. This article examines the associations between reports of CSA at age 18 and DSM-IV diagnostic classifications at age 18.
A birth cohort of New Zealand children was studied at annual intervals from birth to age 16 years. At age 18 years retrospective reports of CSA prior to age 16 and concurrently measured psychiatric symptoms were obtained.
Those reporting CSA had higher rates of major depression, anxiety disorder, conduct disorder, substance use disorder, and suicidal behaviors than those not reporting CSA (p < .002). There were consistent relationships between the extent of CSA and risk of disorder, with those reporting CSA involving intercourse having the highest risk of disorder. These results persisted when findings were adjusted for prospectively measured childhood family and related factors. Similar but less marked relationships between CSA and nonconcurrently measured disorders were found.
The findings suggest that CSA, and particularly severe CSA, was associated with increased risk of psychiatric disorder in young adults even when due allowance was made for prospectively measured confounding factors.
Available from: Mario Müller
- "A conceptual model of long-term correlates of sexual abuse suggests that tension-reducing behaviors, such as the increased use of alcohol, may be seen as an attempt to cope with traumatic experiences (Polusny & Follette, 1995). Sexual abuse, especially at an early age, is often a persistent experience rather than restricted to a single event, such as an accident, and may therefore be more prone to severe psychopathological and developmental consequences in later adulthood , including high levels of anxiety and emotional distress (De Bellis, 2002; Fergusson, Horwood, & Lynskey, 1996; Whiffen & Macintosh, 2005). This often includes the development of symptoms, such as autonomic hyperarousal, avoidant behaviors , and re-experiencing phenomena, which constitute the core diagnostic criteria for posttraumatic stress disorder (PTSD) according to the DSM-IV (APA, 1994). "
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ABSTRACT: This study examined the role of posttraumatic stress disorder (PTSD) symptoms of re-experience, avoidance, and hyperarousal in the relationship between different types of trauma and alcohol use disorders (AUD). We used data from 731 trauma-exposed individuals who participated in the first wave of the PsyCoLaus-study. Trauma characteristics were assessed relatively to the occurrence of lifetime PTSD symptoms and AUD. The results suggest that lifetime and childhood sexual abuse as well as overall childhood trauma were directly linked to AUD and PTSD symptoms, in particular to avoidance symptoms. From single symptom clusters PTSD avoidance was found to specifically mediate the trauma-AUD pathway. Both childhood and sexual trauma strongly contribute to the comorbidity of PTSD and AUD and avoidance-type symptoms appear to play a central role in maintaining this association. Hence, the alleviation of avoidance symptoms might be an important target for therapeutic intervention among victims of sexual abuse before specific addiction treatment is initiated.
Copyright © 2015 Elsevier Ltd. All rights reserved.
- "On the other hand, history of abuse has been associated with substance use disorders. Other disorders associated with history of abuse are affective disorders, anxiety disorder, post-traumatic stress disorders , eating disorders, psychosis, conduct disorder and personality disorders (Fergusson et al., 1996; Putnam, 2003; Hussey et al., 2006; Tyrka et al., 2009; Carr et al., 2013; Cohen et al., 2014; Hecht et al., 2014). The relationship between addiction and history of emotional, physical and sexual abuse has been well known. "
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ABSTRACT: Sexual, emotional or physical abuse history is a risk factor for mental disorders in addicted patients. However, the relationship between addiction and abuse lifespan is not well known. This study aims to compare clinical and psychopathological features of addicted patients according to the experience of abuse and to the number of different types of abuse suffered. Bivariate and multivariate analyses were conducted. 512 addicted patients seeking treatment were included, 45.9% reported abuse throughout life (38.9% emotional, 22.3% physical and 13.5% sexual abuse). It was found that female gender; depressive symptoms and borderline personality disorder were independently associated with history of any abuse throughout life. As well, it was found that 14% have been suffered from all three types of abuse (sexual, emotional and physical), 34.5% from two and 55.5% from one type. Female gender and borderline personality disorder were independently associated independently with a greater number of different types of abuse. Results suggest that history of abuse is frequent among substance-dependent patients and these experiences are more prevalent in women and are associated with more psychiatric comorbidity.
Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
- "States has experienced childhood sexual abuse (CSA; Bensley et al., 2000; Dube et al., 2003; Molnar et al., 2001), and some evidence indicates that Africans Americans are disproportionally affected (Hussey et al., 2006; McCutcheon et al., 2010; Ullman & Filipas, 2005). Women with a history of CSA are at increased risk for a wide range of psychiatric disorders (Fergusson et al., 1996a; Molnar et al., 2001; Nelson et al., 2002) that include cannabis and other substance use disorders (Kendler et al., 2000; Kilpatrick et al., 2000). CSA is also associated with early initiation of marijuana use (Bensley et al., 1999; Harrison et al., 1997; Kilpatrick et al., 2000; Nelson et al., 2006), a marker of risk for the development of cannabis use disorder (CUD; Anthony & Petronis, 1995; King & Chassin, 2007). "
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ABSTRACT: Childhood sexual abuse (CSA) is associated with elevated risk of early marijuana use and cannabis use disorder (CUD). Both the prevalence of CSA and the course of marijuana use differ between African Americans and European Americans. The current study aimed to determine whether these differences manifest in racial/ ethnic distinctions in the association of CSA with early and problem use of marijuana.
Data were derived from female participants in a female twin study and a high-risk family study of substance use (n = 4,193, 21% African-American). Cox proportional hazard regression analyses using CSA to predict initiation of marijuana use and progression to CUD symptom(s) were conducted separately by race/ethnicity. Sibling status on the marijuana outcome was used to adjust for familial influences.
CSA was associated with both stages of marijuana use in African-American and European-American women. The association was consistent over the risk period (hazard ratio [HR] = 1.57, 95% confidence interval [CI] [1.37, 1.79] for initiation; HR = 1.51, 95% CI [1.21, 1.88] for CUD symptom onset) in European-American women. In African-American women, the HRs for initiation were 2.52 (95% CI [1.52, 4.18]) before age 15, 1.82 (95% CI [1.36, 2.44]) at ages 15-17, and nonsignificant after age 17. In the CUD symptom model, CSA predicted onset only at age 21 and older (HR = 2.17, 95% CI [1.31, 3.59]).
The association of CSA with initiation of marijuana use and progression to problem use is stable over time in European-Ameri-can women, but in African-American women, it varies by developmental period. Findings suggest the importance of considering race/ethnicity in prevention efforts with this high-risk population.
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