title: Sexual abuse history: prevalence, health effects, mediators, and psychological treatment.
abstract: OBJECTIVE
  Lifetime history of sexual abuse is estimated to range between 15% and 25% in the general female population. People who are sexually abused are at greater risk for a whole host of physical health disorders that may occur many years after the abusive incident(s). Despite the high prevalence of this trauma and its association with poor health status, abuse history often remains hidden within the context of medical care. The aims of this review are to determine which specific health disorders have been associated with sexual abuse in both women and men, to outline the types of sexual abuse associated with the worst health outcome, to discuss some possible explanations and mediators of the abuse/health relationship, to discuss when and how to talk about abuse within a clinical setting, and to present evidence for which psychological treatments have been shown to improve the mental health of patients with past sexual abuse.
  
  
  METHODS
  To meet these objectives, we have reviewed a wide literature on the topic of sexual abuse.
  
  
  RESULTS
  We demonstrate that abuse appears to be related to greater likelihood of headache and gastrointestinal, gynecologic, and panic-related symptoms; that the poor health effects associated with abuse are also seen in men; that abuse involving penetration and multiple incidents appears to be the most harmful, and that exposure-type therapies with and without cognitive behavioral therapy hold promise for those with abuse history.
  
  
  CONCLUSIONS
  We need more research examining psychological treatments that might be efficacious in treating the physical health problems associated with sexual abuse history.
authors.affiliation: Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7160, USA. JLes@med.unc.edu
authors.forename: Jane
authors.initials: J
authors.lastname: Leserman
mesh_terms: D000328:Adult; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology / Q000706:statistics & numerical data; D015928:Cognitive Behavioral Therapy; D005260:Female; D006304:Health Status; D006801:Humans; D007171:Implosive Therapy; D008016:Life Change Events; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D009017:Morbidity; D015995:Prevalence; D011613:Psychotherapy; D012742:Sex Offenses / Q000523:psychology / Q000706:statistics & numerical data*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000523:psychology / Q000628:therapy