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Childhood Sexual Abuse and Mental Health in Adult Life

Published online by Cambridge University Press:  02 January 2018

Paul E. Mullen*
Affiliation:
Forensic Psychiatry, Monash University, Australia
Judy L. Martin
Affiliation:
Department of Psychological Medicine, University of Otago, Otago, New Zealand
Jessie C. Anderson
Affiliation:
Department of Psychological Medicine, University of Otago, Otago, New Zealand
Sarah E. Romans
Affiliation:
Department of Psychological Medicine, University of Otago, Otago, New Zealand
G. Peter Herbison
Affiliation:
Department of Preventive and Community Medicine, University of Otago, Otago, New Zealand
*
Rosanna Forensic Psychiatry Centre, Private Bag 1, Rosanna, Victoria 3084, Australia

Abstract

The relationship between childhood sexual abuse and mental health in adult life was investigated in a random community sample of women. There was a positive correlation between reporting abuse and greater levels of psychopathology on a range of measures. Substance abuse and suicidal behaviour were also more commonly reported by the abused group. Childhood sexual abuse was more frequent in women from disrupted homes as well as in those who had been exposed to inadequate parenting or physical abuse. While elements in the individual's childhood which increased the risks of sexual abuse were also directly associated to higher rates of adult psychopathology, abuse emerged from logistic regression as a direct contributor to adult psychopathology. Severity of abuse reported was related to the degree of adult psychopathology. The overlap between the possible effects of sexual abuse and the effects of the matrix of disadvantage from which it so often emerges were, however, so considerable as to raise doubts about how often, in practice, it operates as an independent causal element. Further, many of those reporting childhood sexual abuse did not show a measurable long-term impairment of their mental health. Abuse correlated with an increased risk for a range of mental health problems, but in most cases its effects could only be understood in relationship to the context from which it emerged.

Type
Research Article
Copyright
Copyright © The Royal College of Psychiatrists 

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References

Alexander, P. C. & Lupfer, S. L. (1987) Family characteristics and long term consequences associated with sexual abuse. Archives of Sexual Behaviour, 16, 235245.Google Scholar
Anderson, J. C., Martin, J. L., Herbison, G. P., et al (1993) The prevalence of child sexual abuse in a community sample of women. Journal of American Academy of Child and Adolescent Psychiatry, 32, 94113.Google Scholar
Bagley, C. & Ramsay, R. (1986) Sexual abuse in childhood: psychological outcomes and implications for social work practice. Journal of Social Work and Human Sexuality, 4, 3347.Google Scholar
Beitchman, J. H., Zucker, K. J., Hood, J. E., et al (1992a) A review of the long term effects of child sexual abuse. Child Abuse and Neglect, 16, 101118.CrossRefGoogle Scholar
Bifulco, A., Brown, G. W. & Adler, Z. (1991) Early sexual abuse and clinical depression in adult life. British Journal of Psychiatry, 159, 115122.Google Scholar
Briere, J. (1988) Controlling for family variables in abuse effects research. Journal of Interpersonal Violence, 3, 8089.CrossRefGoogle Scholar
Briere, J. (1992) Methodological issues in the study of sexual abuse effects. Journal of Consulting and Clinical Psychology, 60, 196203.Google Scholar
Briere, J. & Runtz, M. (1986) Suicidal thoughts and behaviours in former sexual abuse victims. Canadian Journal of Behavioural Science, 18, 413423.CrossRefGoogle Scholar
Briere, J. & Runtz, M. (1988) Symptomatology associated with childhood sexual victimisation in a non clinical adult sample. Child Abuse and Neglect, 12, 5159.Google Scholar
Browne, A. & Finkelhor, D. (1986) Impact of child sexual abuse: a review of the research. Psychological Bulletin, 99, 6677.CrossRefGoogle ScholarPubMed
Bryer, J. B., Nelson, B. A., Miller, J. B., et al (1987) Childhood sexual and physical abuse as factors in adult psychiatric illness. American Journal of Psychiatry, 144, 14261430.Google Scholar
Burgess, A. W. & Holmstrom, L. M. (1974) ‘Rape Trauma Syndrome’. American Journal of Psychiatry, 131, 981987.CrossRefGoogle ScholarPubMed
Burnam, M. A., Stein, J., Golding, J., et al (1988) Sexual assault and mental disorders in a community population. Journal of Consulting and Clinical Psychology, 56, 843850.Google Scholar
Bushnell, J. A., Wells, J. E. & Oakley-Browne, M. (1993) Long term effects of intrafamilial sexual abuse in childhood. Acta Psychiatrica Scandinavica, 85, 136142.Google Scholar
Calam, R. & Slade, P. (1987) Eating problems and sexual experience: some relationships. British Review of Bulimia and Anorexia Nervosa, 2, 3743.Google Scholar
Carmen (Hilberman), E., Richer, P. E. & Mills, T. (1984) Victims of violence and psychiatric illness. American Journal of Psychiatry, 141, 378383.Google Scholar
Conte, J. R. & Schuerman, J. R. (1987) Factors associated with an increased impact of child sexual abuse. Child Abuse and Neglect, 11, 201211.Google Scholar
Coons, P. E. & Milstein, V. (1986) Psychosexual disturbances in multiple personality characteristics, etiology and treatment. Journal of Clinical Psychiatry, 47, 106110.Google ScholarPubMed
Craine, L. S., Henson, C. E., Colliver, J. A., et al (1988) Prevalence of a history of sexual abuse among female psychiatric patients in a state mental hospital. Hospital and Community Psychiatry, 39, 300304.Google Scholar
Finkelhor, D. (1984) Child Sexual Abuse: New Theory and Research. New York: Free Press.Google Scholar
Finkelhor, D. (1986) A Sourcebook on Child Sexual Abuse. Beverley Hills, California: Sage.Google Scholar
Finkelhor, D. & Baron, L. (1986) Risk factors for child sexual abuse. Journal of Interpersonal Violence, 1, 4371.Google Scholar
Fromuth, M. E. (1986) The relationship of childhood sexual abuse with later psychological and sexual adjustment in a sample of college women. Child Abuse and Neglect, 10, 515.Google Scholar
Goldberg, D. (1978) Manual of the General Health Questionnaire. Windsor: National Foundation for Educational Research.Google Scholar
Goodchild, M. E. & Duncan-Jones, P. (1985) Chronicity and the General Health Questionnaire. British Journal of Psychiatry, 146, 5561.Google Scholar
Herman, J. (1981) Father Daughter Incest. Cambridge, Massachusetts: Harvard University Press.Google Scholar
Herman, J. Russell, D. & Trochi, K. (1986) Long term effects of incestuous abuse in childhood. American Journal of Psychiatry, 143, 12931296.Google Scholar
Jacobsen, A. & Richardson, B. (1987) Assault experiences of 100 psychiatric inpatients: evidence of the need for routine enquiry. American Journal of Psychiatry, 144, 909913.Google Scholar
Jones, D. R. & Rushton, L. (1982) Simultaneous inference in epidemiological studies. International Journal of Epidemiology, 11, 276282.Google Scholar
McGuffin, P., Katz, R. & Aldrich, J. (1986) Past and present state examination: the assessment of ‘lifetime ever’ psychopathology. Psychological Medicine, 16, 461465.Google Scholar
Martin, J., Anderson, J. C., Romans-Clarkson, S. E., et al (1993) Asking about child sexual abuse: methodological implications of a two stage survey. Child Abuse and Neglect, 17, 383392.Google Scholar
Mezey, G. & Taylor, P. (1988) Psychological reactions of women who have been raped: a descriptive and comparative study. British Journal of Psychiatry, 152, 330339.Google Scholar
Morrison, J. (1989) Childhood sexual histories of women with somatization disorder. American Journal of Psychiatry, 146, 239241.Google ScholarPubMed
Mullen, P. E. (1990) The long term influence of sexual assault on the mental health of victims. Journal of Forensic Psychiatry, 1, 1334.CrossRefGoogle Scholar
Mullen, P. E., Romans-Clarkson, S. E., Walton, V. A., et al (1988) Impact of sexual and physical abuse on women's mental health. Lancet, i, 841845.Google Scholar
Oates, R. K. & Tong, L. (1987) Child sexual abuse: an area with room for professional reforms. Medical Journal of Australia, 147, 544548.Google Scholar
Oppenheimer, R., Howells, K., Palmer, R. L., et al (1985) Adverse sexual experience in childhood and clinical eating disorders: a preliminary description. Journal of Psychiatric Research, 19, 357361.Google Scholar
Palmer, R. L., Oppenheimer, R., Dignon, A., et al (1990) Childhood sexual experience with adults reported by women with eating disorders: an extended series. British Journal of Psychiatry, 156, 699703.Google Scholar
Palmer, R. L., Chaloner, D. A. & Oppenheimer, R. (1992) Childhood sexual experiences with adults reported by female psychiatric patients. British Journal of Psychiatry, 160, 261265.Google Scholar
Parker, G. (1983) Parental Overprotection: A Risk Factor in Psychosocial Development. New York: Grune and Stratton.Google Scholar
Parker, G., Tupling, H. & Brown, L. B. (1979) A parental bonding instrument. British Journal of Medical Psychology, 52, 110.CrossRefGoogle Scholar
Peters, S. D. (1984) The Relationship Between Childhood Sexual Victimisation and Adult Depression Among Afro American and White Women. Doctoral Dissertation, University of California, Los Angeles, California.Google Scholar
Peters, S. D. (1988) Child sexual abuse and later psychological problems. In Lasting Effects of Child Sexual Abuse (eds Wyatt, G. & Powell, G.), pp. 101117. Beverley Hills, California: Sage.Google Scholar
Putnam, F. W., Saroff, J. J., Silberman, E. K., et al (1986) The clinical phenomenology of multiple personality disorder: review of 100 recent cases. Journal of Clinical Psychiatry, 47, 285293.Google ScholarPubMed
Robson, P. (1989) Development of a new self-report questionnaire to measure self-esteem. Psychological Medicine, 19, 513518.Google Scholar
Root, M., Fallon, P. (1988) The incidence of victimisation experiences in a bulimic sample. Journal of Interpersonal Violence, 3, 161173.Google Scholar
Russell, D. E. H. (1984) The prevalence and seriousness of incestuous abuse; stepfathers versus biological fathers. Child Abuse and Neglect, 8, 1522.Google Scholar
Russell, D. E. H. (1986) The Secret Trauma: Incest in the lives of Girls and Women. New York: Basic Books.Google Scholar
Saunders, J. B., Aasland, O. G. & Grant, M. (1987) The World Health Organization Screening Instrument for Harmful and Hazardous Alcohol Consumption. Geneva: World Health Organization.Google Scholar
Sedney, M. A. & Brooks, B. (1984) Factors associated with a history of childhood sexual experience in a non-clinical female population. Journal of the American Academy of Child Psychiatry, 23, 215218.Google Scholar
Stein, J. A., Golding, J. M., Siegel, J. M., et al (1988) Long term psychological sequelae of child sexual abuse. In Lasting Effects of Child Sexual Abuse (eds Wyatt, G. & Powell, G.), pp. 135154. Beverley Hills, California: Sage.Google Scholar
Tong, L. & Oates, R. K. (1990) Long term effects of child sexual abuse. In Understanding and Managing Child Sexual Abuse (ed. Oates, R. K.), pp. 354369. London: W. B. Saunders.Google Scholar
Westen, D. (1990) Physical and sexual abuse in adolescent girls with borderline personality disorder. American Journal of Orthopsychiatry, 60, 5566.CrossRefGoogle ScholarPubMed
Winfield, I., George, L. K., Swartz, M., et al (1990) Sexual assault and psychiatric disorders among a community sample of women. American Journal of Psychiatry, 147, 335341.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Measurement and Classification of Psychiatric Symptoms. London: Cambridge University Press.Google Scholar
Wing, J. K., Nixon, J. M., Mann, S. A., et al (1977) Reliability of the PSE used in a population study. Psychological Medicine, 7, 505516.Google Scholar
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