Factors protecting against the development of adjustment difficulties in young adults exposed to childhood sexual abuse.
OBJECTIVE
The aims of this study were to identify the factors which discriminated young people exposed to childhood sexual abuse (CSA) who developed psychiatric disorder or adjustment difficulties in young adulthood from those young people exposed to CSA who did not develop psychiatric disorder or adjustment difficulties by age 18.


METHODS
Data were gathered on a birth cohort of 1,025 New Zealand children studied from birth to the age of 18 on (a) exposure to CSA; (b) patterns of psychiatric disorder and adjustment difficulties at age 18 years; (c) factors that may have influenced responses to CSA including characteristics of the abuse, parental bonding, parental characteristics, and adolescent peer affiliations.


RESULTS
Just over 10% of the cohort reported CSA. Those reporting CSA were at increased risks of a range of difficulties at age 18 (depression, anxiety, conduct disorder, alcohol abuse/dependence, other substance abuse/dependence, post sexual abuse trauma, attempted suicide). However, not all of those exposed to CSA developed difficulties and approximately a quarter of those exposed to CSA did not meet criteria for any adjustment difficulty. Further analysis suggested that the extent of adjustment difficulties in those exposed to CSA was influenced by two additional factors: (a) the extent of affiliations with delinquent or substance using peers in adolescence; and (b) the extent of paternal care or support in childhood.


CONCLUSIONS
The findings of this study suggest that while young people exposed to CSA are at increased risks of psychiatric disorder and adjustment difficulties in young adulthood, not all individuals exposed to CSA will develop adjustment difficulties. Important factors protecting against the development of adjustment difficulties in young people experiencing CSA appear to be the nature and quality of peer and family relationships.
Lynskey
M T
MT
Department of Psychological Medicine, Christchurch School of Medicine, New Zealand.
Fergusson
D M
DM
D000275:Adjustment Disorders / Q000209:etiology* / Q000517:prevention & control / Q000523:psychology; D000293:Adolescent; D002648:Child; D002650:Child Abuse, Sexual / Q000145:classification / Q000523:psychology*; D002675:Child, Preschool; D005190:Family; D006801:Humans; D008137:Longitudinal Studies; D012044:Regression Analysis