Background
Childhood sexual abuse (CSA) is a worldwide problem. Although most studies on the
long-term consequences of CSA have focused on women, sexual abuse of both boys and
girls is common. Thus, a comparison of the long-term effects of CSA by gender of the
victim will provide perspective on the need for future research, prevention activities,
and treatment of survivors.
Methods
A retrospective cohort study was conducted from 1995 to 1997 among 17,337 adult HMO
members in San Diego, California. Participants completed a survey about abuse or household
dysfunction during childhood, and multiple other health-related issues. Multivariate
logistic regression was used to examine the relationships between severity of CSA
(intercourse vs no intercourse) and long-term health and social problems (substance
use and abuse, mental illness, and current problems with marriage and family) by gender
of victim. Models controlled for exposure to other forms of adverse childhood experiences
that co-occur with CSA. Among men, the relationship between the gender of the CSA
perpetrator to the outcomes was also examined.
Results
Contact CSA was reported by 16% of males and 25% of females. Men reported female perpetration
of CSA nearly 40% of the time, and women reported female perpetration of CSA 6% of
the time. CSA significantly increased the risk of the outcomes. The magnitude of the
increase was similar for men and women. For example, compared to reporting no sexual
abuse, a history of suicide attempt was more than twice as likely among both men and
women who experienced CSA (p<0.05). Compared with those who did not report CSA, men and women exposed to CSA were
at a 40% increased risk of marrying an alcoholic, and a 40% to 50% increased risk
of reporting current problems with their marriage (p<0.05).
Conclusions
In this cohort of adult HMO members, experiencing CSA was common among both men and
women. The long-term impact of CSA on multiple health and social problems was similar
for both men and women. These findings strongly indicate that boys and girls are vulnerable to this form of childhood maltreatment; the similarity in the
likelihood for multiple behavioral, mental, and social outcomes among men and women
suggests the need to identify and treat all adults affected by CSA.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of Preventive MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Childhood trauma as a correlate of lifetime opiate use in psychiatric patients.Addict Behav. 2000; 25: 797-803
- Impact of sexual abuse on children.Psychol Bull. 1993; 113: 164-180
- Risk factors for suicide attempts among low-income women with a history of alcohol problems.Addict Behav. 1991; 24: 583-587
- Childhood sexual abuse and mental health in adult life.Br J Psychiatry. 1993; 163: 721-732
- The impact of violence on children.Future Child. 1999; 9: 33-49
- Childhood origins of self-destructive behavior.Am J Psychiatry. 1991; 148: 1665-1671
- The relationship of childhood sexual abuse with later psychological and sexual adjustment in a sample of college women.Child Abuse Neglect. 1986; 10: 5-15
- Symptomology associated with childhood sexual victimization in a nonclinical adult sample.Child Abuse Neglect. 1988; 12: 51-99
- Long-term effects of incestuous child abuse in college women.J Consult Clin Psychol. 1988; 56: 5-8
- Post sexual abuse trauma.J Interpersonal Violence. 1987; 2: 367-379
- Prevalence, case characteristics, and long-term psychological correlates of child rape among women.Child Maltreatment. 1999; 4: 187-200
- Current information on the scope and nature of child sexual abuse.Future Child. 1994; 4: 31-53
- Sexual abuse of boys.JAMA. 1998; 280: 1855-1862
- Risk factors for child sexual abuse.J Interpersonal Violence. 1986; 1: 43-71
- A review of the long-term effects of child sexual abuse.Child Abuse Neglect. 1992; 16: 101-118
- Forensic sexual abuse evaluations of older children.Behav Sci Law. 1994; 12: 261-277
- Female perpetration of child sexual abuse.Aggressive Violent Behav. 1999; 4: 93-106
- Self-reported childhood sexual and physical abuse and adult HIV-risk behaviors and heavy drinking.Am J Prev Med. 2000; 18: 151-158
- Childhood sexual experiences reported by male psychiatric patients.Psychol Med. 1990; 20: 925-929
- Psychiatric morbidity in adult inpatients with childhood histories of sexual and physical abuse.Am J Psychiatry. 1991; 148: 55-61
- Childhood sexual abuse and adult psychiatric and substance use disorders in women.Arch Gen Psychiatry. 2000; 57: 953-959
- Molested as children.J Substance Abuse Treatment. 1988; 5: 13-18
- Risk factors for suicide attempts among low-income women with a history of alcohol problems.Addict Behav. 1999; 24: 583-587
- Shattered childhood.Addiction. 2001; 96: 227-240
- Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults.Am J Prev Med. 1998; 14: 245-258
- Adverse childhood experiences and smoking during adolescence and adulthood.JAMA. 1999; 282: 1652-1658
- Adverse childhood experiences and sexually transmitted diseases in men and women.Pediatrics. 2000; 106: 1-6
- Unintended pregnancy among adult women exposed to abuse or household dysfunction during their childhood.JAMA. 1999; 282: 1359-1364
- Abused boys, battered mothers, and male involvement in teen pregnancy.Pediatrics. 2001; 107: 1-8
- Adverse childhood experiences and personal alcohol abuse as an adult.Addict Behav. 2002; 27: 713-725
- Adverse childhood experiences, alcoholic parents, and later risk of alcoholism and depression.Psychiatric Services. 2002; 53: 1001-1009
- Childhood abuse, neglect and household dysfunction and the risk of illicit drug use.Pediatrics. 2003; 111: 564-572
- Adverse childhood experiences and self-reported liver disease.Arch Intern Med. 2003; 163: 1949-1956
Dube SR, Anda RF, Felitti VJ, Chapman D, Williamson DF, Giles WH. Childhood abuse, household dysfunction and the risk of attempted suicide throughout the life span: findings from Adverse Childhood Experiences Study. JAMA 200;286:3089–96.
- Bias assessment for child abuse survey; factors affecting probability of response to a survey about childhood abuse.Child Abuse Neglect. 2001; 25: 307-312
- The sexual abuse of Afro-American and white American women in childhood.Child Abuse Neglect. 1985; 9: 507-519
- Physical violence in American families. Transaction Press, New Brunswick NJ1990
- Assessing the reliability of retrospective reports of adverse childhood experiences among adult HMO members attending a primary care clinic.Child Abuse Neglect. 2004; 28: 729-737
- Exposure to alcoholism in the family.Vital Health Stat. 1998; 16
- Ninth special report to the US Congress on alcohol and health. U.S. Department of Health and Human Services, Rockville MD1997
- Depression as a tracer condition for the national study of medical care outcomes. Rand Corporation, Santa Monica CA1985
- Development of a brief screening instrument for detecting depressive disorders.Med Care. 1988; 26: 775-789
- Six-month prevalence of specific psychiatric disorders among Mexican-Americans and non-Hispanic whites in Los Angeles.Arch Gen Psychiatry. 1987; 44: 687-694
Dong M, Anda RF, Felitti VJ, et al. The interrelatedness of multiple forms of childhood abuse, neglect, and household dysfunction. Child Abuse Neglect 28:771–84.
- Female sexual abuse of children. Guilford Press, New York1994
- Childhood sexual abuse.Child Maltreatment. 2004; 9: 223-238
- Sexual abuse of children.in: Meyers J.E.B. Berliner L. Briere J. Hendrix C.T. Jenny C. Reid T.A. The APSAC handbook on child maltreatment. Sage Publications, Thousand Oaks CA2002: 55-78
- Ten-year research update review.J Am Acad Child Adolesc Psychol. 2003; 42: 269-278
- Gender-specific outcomes for sexually abuse adolescents.Child Abuse Neglect. 1996; 20: 1219-1231
- Child abuse.Child Abuse Neglect. 1990; 14: 227-231
- Recovered memories of abuse in women with documented child sexual victimization histories.J Trauma Stress. 1995; 8: 649-673
- Sexual abuse in a national survey of adult men and women.Child Abuse Neglect. 1990; 14: 19-28
- The long-term effects of contact and noncontact forms of child sexual abuse in a sample of university men.Child Abuse Neglect. 1995; 19: 1-6
- The effects of child sexual abuse in later family life; mental health, parenting and adjustment of offspring.Child Abuse Neglect. 2004; 28: 525-545
- Child sexual abuse.Lancet. 2004; 364: 462-470
Article Info
Identification
Copyright
© 2005 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
