Sexual abuse and psychiatric disorder in England: Results from the 2007 Adult Psychiatric Morbidity Survey

Department of Mental Health Sciences, University College London, UK.
Psychological Medicine (Impact Factor: 5.94). 04/2011; 41(4):709-19. DOI: 10.1017/S003329171000111X
Source: PubMed


Evidence is accumulating that child sexual abuse (CSA) is associated with many psychiatric disorders in adulthood. This paper uses the detailed information available from the 2007 Adult Psychiatric Morbidity Survey of England (APMS 2007) to quantify links between CSA and a range of psychiatric conditions.
The prevalence of psychiatric disorder was established in a random sample of the English household population (n=7403), which also provided sociodemographic and experiential information.
We analyzed six types of common mental disorder, alcohol abuse and drug abuse, and people who screened positively for post-traumatic stress disorder (PTSD) and eating disorders. All were strongly and highly significantly associated with CSA, particularly if non-consensual sexual intercourse was involved, for which odds ratios (ORs) ranged from 3.7 to 12.1. These disorders were also related to adult sexual abuse (ASA), although the likelihood of reverse causality is then increased. Revictimization in adulthood was common, and increased the association of CSA with disorder. For several disorders, the relative odds were higher in females but formal tests for moderation by gender were significant only for common mental disorders and only in relation to non-consensual sexual intercourse. The population attributable fraction (PAF) was higher in females in all cases.
The detailed and high-quality data in APMS 2007 provided important confirmation both of the strength of association of CSA with psychiatric disorder and of its relative non-specificity. Our results have major implications at the public health level and the individual level, in particular the need for better recognition and treatment of the sequelae of CSA.

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Available from: Michael B King, Jul 17, 2015
    • "Individuals exposed to childhood maltreatment (CM) are at increased risk for psychological and global functioning deficits (Adams, 2006; Jonas et al. 2011). In adolescence , these individuals are at increased risk for conduct disorder, early onset alcohol and substance use, depression, and suicidality (Kilpatrick et al. 2000; Sartor et al. 2013). "
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    ABSTRACT: Childhood maltreatment (CM) has consistently been linked with adverse outcomes including substance use disorders and adult sexual revictimization. Adult sexual victimization itself has been linked with psychopathology but has predominately been studied in women. The current investigation examines the impact of CM and co-occurring psychopathology on adult sexual victimization in men and women, replicating findings in three distinct samples. Method We investigated the association between continuous CM factor scores and adult sexual victimization in the Childhood Trauma Study (CTS) sample ( N = 2564). We also examined the unique relationship between childhood sexual abuse (CSA) and adult sexual victimization while adjusting for co-occurring substance dependence and psychopathology. We replicated these analyses in two additional samples: the Comorbidity and Trauma Study (CATS; N = 1981) and the Australian Twin-Family Study of Alcohol Use Disorders (OZ-ALC; N = 1537). Results Analyses revealed a significant association with CM factor scores and adult sexual victimization for both men and women across all three samples. The CSA factor score was strongly associated with adult sexual victimization after adjusting for substance dependence and psychopathology; higher odds ratios were observed in men (than women) consistently across the three samples. Conclusions A continuous measure of CSA is independently associated with adult sexual trauma risk across samples in models that included commonly associated substance dependence and psychopathology as covariates. The strength of the association between this CSA measure and adult sexual victimization is higher in magnitude for men than women, pointing to the need for further investigation of sexual victimization in male community samples.
    No preview · Article · Oct 2015 · Psychological Medicine
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    • "Studies reporting insufficient data to record penetration and/or physical threat or force were coded as ''other.'' These aspects of victimization were coded in light of research that suggests that more severe forms of victimization , such as rape, as well as physical injury during sexual assault, are associated with poorer outcomes (Jonas et al., 2011; Leserman, Drossman, Toomey, Nachman, & Glogau, 1997). Gender. "
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    ABSTRACT: The current meta-analysis examined the effects of sexual victimization (SV) on attentional bias for sexual threat. This relationship was also examined among victims of SV with and without a current diagnosis of post-traumatic stress disorder (PTSD). The broader aim was to elucidate potential mechanisms operating between SV and negative health outcomes. As hypothesized, the findings supported a positive relationship between SV and attentional bias toward sexual threat stimuli, and subanalyses indicated that PTSD symptomatology significantly contributed to this association. © The Author(s) 2015.
    Full-text · Article · Sep 2015 · Trauma Violence & Abuse
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    • "Sexually abused men have high levels of clinical conditions such as posttraumatic stress disorder (PTSD) when compared with nonabused men (O'Leary, 2009; Wolfe, Francis, & Straatman, 2006). In a study based on a random population sample, CSA had a greater effect on the mental health of men (compared with women) and was strongly correlated with psychiatric disorders (Jonas et al., 2011). Suicidal ideation and attempts have been shown to be highly prevalent among men who report CSA (Easton, Renner, & O'Leary, 2013; O'Leary & Gould, 2009). "
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    ABSTRACT: Child sexual abuse (CSA) is a trauma that affects males in substantial numbers, sometimes in ways that are gender-specific (e.g., compromised masculine identity, confusion regarding sexuality). Much of the identification of the male-specific outcomes has been derived from practitioner experience and small qualitative studies. The current study explores gender-specific outcomes and describes the development of a scale to measure the effects of CSA on men. First, qualitative interviews with 20 men who were sexually abused in childhood were thematically analyzed. The emergent themes of sexuality, self-concept, psychological and emotional well-being, and social functioning were used to construct a 30-item instrument which was later completed by 147 men with histories of CSA. The dimensionality of the 30 items was then assessed for suitability as scales using confirmatory factor analysis (CFA). The final instrument, the Male Sexual Abuse Effects Scale (MSAES), combines three subscales: Negative Identity, Guilt and Self-Blame, and Psychological and Emotional Well-Being. Items concerning masculine identity were shown to be valid in the scale. MSAES scores were compared with the General Health Questionnaire-28 (GHQ-28) and found to be significantly correlated. GHQ-28 clinical thresholds were applied to differentiate clinical from nonclinical cases; an independent-samples t test showed that the clinical cases from the GHQ-28 had high scores on the MSAES. The new scale has the potential to help clinicians and researchers identify men who have been severely affected by CSA and who should be of clinical concern. © The Author(s) 2015.
    Full-text · Article · Jun 2015 · Journal of Interpersonal Violence
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