The British Journal of Psychiatry · 1993 · 648 citations · 51 references
Mental HealthSocial SciencesPsychologySexual OffendingChildhood Sexual AbuseSexual And Reproductive HealthHealth SciencesPsychiatrySexual ViolenceChild AbuseSexual AssaultSubstance AbuseSexual AbuseAbuse StudiesLogistic RegressionAdult Mental HealthChild Sexual AbusePsychological AbusePsychopathology
The overlap between sexual abuse effects and broader disadvantage makes it unclear whether abuse independently causes adult mental health problems. The study examined the association between childhood sexual abuse and adult mental health in a random community sample of women. The authors investigated this relationship in that sample. Abuse was positively correlated with higher psychopathology, substance abuse, and suicide risk, and logistic regression identified it as a direct contributor, yet many abused women showed no long-term impairment, indicating that abuse effects are context‑dependent.
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.
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