title: Childhood sexual abuse and adult developmental outcomes: findings from a 30-year longitudinal study in New Zealand.
abstract: OBJECTIVE
  Childhood sexual abuse (CSA) has been associated with many adverse medical, psychological, behavioral and socioeconomic outcomes in adulthood. This study aims to examine the linkages between CSA and a wide range of developmental outcomes over a protracted time period to age 30.
  
  
  METHODS
  Data from over 900 members of the New Zealand birth cohort the Christchurch Health and Development Study were examined. CSA prior to age 16 was assessed at ages 18 and 21 years, in addition to: mental health, psychological wellbeing, sexual risk-taking behaviors, physical health and socioeconomic outcomes to age 30.
  
  
  RESULTS
  After statistical adjustment for confounding by 10 covariates spanning socio-demographic, family functioning and child factors, extent of exposure to CSA was associated with increased rates of (B, SE, p): major depression (0.426, 0.094, <.001); anxiety disorder (0.364, 0.089, <.001); suicidal ideation (0.395, 0.089, <.001); suicide attempt (1.863, 0.403, <.001); alcohol dependence (0.374, 0.118, <.002); and illicit drug dependence (0.425, 0.113, <.001). In addition, at age 30 CSA was associated with higher rates of PTSD symptoms (0.120, 0.051, .017); decreased self-esteem (-0.371, 0.181, .041); and decreased life satisfaction (-0.510, 0.189, .007). Childhood sexual abuse was also associated with decreased age of onset of sexual activity (-0.381, 0.091, <.001), increased number of sexual partners (0.175, 0.035, <.001); increased medical contacts for physical health problems (0.105, 0.023, <.001); and welfare dependence (0.310, 0.099, .002). Effect sizes (Cohen's d) for the significant outcomes from all domains ranged from .14 to .53, while the attributable risks for the mental health outcomes ranged from 5.7% to 16.6%.
  
  
  CONCLUSIONS
  CSA is a traumatic childhood life event in which the negative consequences increase with increasing severity of abuse. CSA adversely influences a number of adult developmental outcomes that span: mental disorders, psychological wellbeing, sexual risk-taking, physical health and socioeconomic wellbeing. While the individual effect sizes for CSA typically range from small to moderate, it is clear that accumulative adverse effects on adult developmental outcomes are substantial.
authors.affiliation: Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Christchurch, PO Box 4345, Christchurch 8140, New Zealand.
authors.forename: David M
authors.initials: DM
authors.lastname: Fergusson
authors.forename: Geraldine F H
authors.initials: GF
authors.lastname: McLeod
authors.forename: L John
authors.initials: LJ
authors.lastname: Horwood
mesh_terms: D000293:Adolescent; D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology*; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006304:Health Status; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008016:Life Change Events; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology; D009520:New Zealand / Q000453:epidemiology; D012309:Risk-Taking; D012725:Sexual Behavior; D012923:Social Class; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Child sexual abuse; Longitudinal; Physical health; Psychological problems; Sexual risk-taking; Socioeconomic