Child sexual abuse and subsequent psychopathology: results from the National Comorbidity Survey

TLDR

The study examined how child sexual abuse predicts later psychiatric disorders, controlling for other childhood adversities, abuse type, and chronicity. Using retrospective data from the nationally representative National Comorbidity Survey (n = 5,877), the authors applied multivariate analyses to examine CSA and other adversities. Child sexual abuse, reported by 13.5% of women and 2.5% of men, was linked to a markedly higher risk of mood, anxiety, and substance‑use disorders—especially among women—and even in the absence of other adversities, with rape, known perpetrators, and chronic abuse further elevating risk.

Abstract

OBJECTIVES: This study examined the relationship between child sexual abuse (CSA) and subsequent onset of psychiatric disorders, accounting for other childhood adversities, CSA type, and chronicity of the abuse. METHODS: Retrospective reports of CSA, other adversities, and psychiatric disorders were obtained by the National Comorbidity Survey, a nationally representative survey of the United States (n = 5877). Reports were analyzed by multivariate methods. RESULTS: CSA was reported by 13.5% of women and 2.5% of men. When other childhood adversities were controlled for, significant associations were found between CSA and subsequent onset of 14 mood, anxiety, and substance use disorders among women and 5 among men. In a subsample of respondents reporting no other adversities, odds of depression and substance problems associated with CSA were higher. Among women, rape (vs molestation), knowing the perpetrator (vs strangers), and chronicity of CSA (vs isolated incidents) were associated with higher odds of some disorders. CONCLUSIONS: CSA usually occurs as part of a larger syndrome of childhood adversities. Nonetheless, CSA, whether alone or in a larger adversity cluster, is associated with substantial increased risk of subsequent psychopathology.