title: Mental health problems and medically unexplained physical symptoms in adult survivors of childhood sexual abuse: an integrative literature review.
abstract: People sexually abused in childhood are at higher risk than non-abused people of medically unexplained symptoms such as irritable bowel syndrome or chronic pain, with mental ill health and high healthcare use. Friction and frustration, with high, unproductive healthcare costs, can often develop between these patients and health-care professionals such as general practitioners and nursing staff. The aim of this integrative literature review was to seek a sound evidence base from which to develop helpful interventions, improve relationships and identify gaps in knowledge. It found some theories about interconnections among childhood sexual abuse mental health and medically unexplained symptoms, such as 'somatization' or 'secondary gain', were used prejudicially, stigmatizing survivors. Conflicting theories make more difficult the search for effective interventions. Researchers rarely collaborated with sexual abuse specialists. Emphasis on identifying key risk factors, rather than providing support or alleviating distress, and lack of studies where survivors voiced their own experiences, meant very few targeted interventions for this group were proposed. Recommendations to enable effective interventions include making abuse survivors the prime study focus; qualitative research with survivors, to assist doctors and nursing staff with sensitive care; case histories using medical records; prospective studies with sexually abused children; support for the growing field of neurobiological research.
authors: Centre for Research on Families and Relationships, University of Edinburgh, Edinburgh, Scotland, UK. sarah.nelson@ed.ac.uk
authors: S
authors: S
authors: Nelson
authors: N
authors: N
authors: Baldwin
authors: J
authors: J
authors: Taylor
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology*; D006801:Humans; D001523:Mental Disorders / Q000209:etiology* / Q000523:psychology*