Child sexual abuse and subsequent psychopathology: results from the National Comorbidity Survey.
OBJECTIVE
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.
Molnar
B E
BE
Department of Maternal and Child Health, Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA. bmolnar@post.harvard.edu
Buka
S L
SL
Kessler
R C
RC
D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology* / Q000706:statistics & numerical data; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology; D015999:Multivariate Analysis; D016017:Odds Ratio; D012306:Risk; D019966:Substance-Related Disorders / Q000453:epidemiology; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology