The Psychiatric Consequences of Child and Adolescent Sexual Abuse

Overview

Journal Noro Psikiyatr Ars

Date 2017 Apr 1

PMID 28360746

Citations 5

Authors

Murat Yuce

Koray Karabekiroglu

Zeynep Yildirim

Serkan Sahin

Dicle Sapmaz

Zehra Babadagi

Ahmet Turla

Berna Aydin

Affiliations

Soon will be listed here.

Abstract

Introduction: The purpose of this study was to investigate the psychiatric consequences of sexual abuse and its associated factors in children and adolescents referred to our child and adolescent psychiatry clinic from official medico-legal units.

Methods: All victims of sexual abuse (n=590) aged 1-18 (mean: 13.56±3.38) referred from forensic units to Ondokuz Mayis University Child and Adolescent Psychiatry Clinic over a period of 2 years [boys: 83 (14.1%); girls: 507 (85.9%)] were included. Child and adolescent psychiatry and forensic medicine specialists evaluated all the cases. The Wechsler Intelligence Scale for Children-Revised Form (WISC-R) and the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version-Turkish Version (K-SADS-PL-T) were applied.

Results: Abuse-related psychiatric diagnoses (of which 45.9% were major depressive disorder and 31.7% were post-traumatic stress disorder cases) were made in 75.2% of the cases. In 80.3% of the cases, the perpetrators were known to their victims [incest, n=91 (15.1%)], and intercourse took place in 48.8%. Although gender and age were not significantly associated with the appearance of any psychiatric disorders, severity of abuse (e.g., intercourse; p=.006), additional physical assault (p<.001), and incest (p<.001) had a significant correlation with psychiatric disorders. To explore the predictive value of multiple factors in the appearance of any sexual assault-related psychiatric disorder, a logistic regression model was used to determine the best linear combination of age, gender, abuse severity, incest, involvement of any other victim, additional physical assault, and length of time from first abuse to first psychiatric evaluation. This combination of variables (occurrence of incest, additional physical assault, and a long duration from first abuse to first psychiatric evaluation) significantly predicted the appearance of a psychiatric disorder of any kind (χ=55.42; df=7; n=522; p<.001).

Conclusion: Our findings reveal that the occurrence of incest, additional physical assault, and a long duration from first abuse to first psychiatric evaluation predict higher rates of sexual abuse-related psychiatric disorders.

Citing Articles

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Sexual Abuse of Children in Turkey: Psychiatric Evaluation of 1785 Cases.

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References

Paolucci E, Genuis M, Violato C . A meta-analysis of the published research on the effects of child sexual abuse. J Psychol. 2001; 135(1):17-36. DOI: 10.1080/00223980109603677. View

Duman R, Monteggia L . A neurotrophic model for stress-related mood disorders. Biol Psychiatry. 2006; 59(12):1116-27. DOI: 10.1016/j.biopsych.2006.02.013. View

Putnam F . Ten-year research update review: child sexual abuse. J Am Acad Child Adolesc Psychiatry. 2003; 42(3):269-78. DOI: 10.1097/00004583-200303000-00006. View

Walrath C, Ybarra M, Holden E, Liao Q, Santiago R, Leaf P . Children with reported histories of sexual abuse: utilizing multiple perspectives to understand clinical and psychosocial profiles. Child Abuse Negl. 2003; 27(5):509-24. DOI: 10.1016/s0145-2134(03)00035-8. View

Tyrka A, Price L, Gelernter J, Schepker C, Anderson G, Carpenter L . Interaction of childhood maltreatment with the corticotropin-releasing hormone receptor gene: effects on hypothalamic-pituitary-adrenal axis reactivity. Biol Psychiatry. 2009; 66(7):681-5. PMC: 2881567. DOI: 10.1016/j.biopsych.2009.05.012. View

McEwen B . Physiology and neurobiology of stress and adaptation: central role of the brain. Physiol Rev. 2007; 87(3):873-904. DOI: 10.1152/physrev.00041.2006. View

Dinwiddie S, Heath A, Dunne M, Bucholz K, Madden P, Slutske W . Early sexual abuse and lifetime psychopathology: a co-twin-control study. Psychol Med. 2000; 30(1):41-52. DOI: 10.1017/s0033291799001373. View

Gold S, Hyman S, Andres-Hyman R . Family of origin environments in two clinical samples of survivors of intra-familial, extra-familial, and both types of sexual abuse. Child Abuse Negl. 2004; 28(11):1199-212. DOI: 10.1016/j.chiabu.2004.07.001. View

Williams L, Finkelhor D . Impact of sexual abuse on children: a review and synthesis of recent empirical studies. Psychol Bull. 1993; 113(1):164-80. DOI: 10.1037/0033-2909.113.1.164. View

10.

Priebe G, Svedin C . Child sexual abuse is largely hidden from the adult society. An epidemiological study of adolescents' disclosures. Child Abuse Negl. 2008; 32(12):1095-108. DOI: 10.1016/j.chiabu.2008.04.001. View

11.

Dubowitz H . Preventing child neglect and physical abuse: a role for pediatricians. Pediatr Rev. 2002; 23(6):191-6. DOI: 10.1542/pir.23-6-191. View

12.

Ligezinska M, Firestone P, Manion I, McIntyre J, Ensom R, Wells G . Children's emotional and behavioral reactions following the disclosure of extrafamilial sexual abuse: initial effects. Child Abuse Negl. 1996; 20(2):111-25. DOI: 10.1016/0145-2134(95)00125-5. View

13.

Kogan S . Disclosing unwnated sexual experiences: results from a national sample of adolescent women. Child Abuse Negl. 2004; 28(2):147-65. DOI: 10.1016/j.chiabu.2003.09.014. View

14.

Sauzier M . Disclosure of child sexual abuse. For better or for worse. Psychiatr Clin North Am. 1989; 12(2):455-69. View

15.

Oates R, OToole B, Lynch D, Stern A, Cooney G . Stability and change in outcomes for sexually abused children. J Am Acad Child Adolesc Psychiatry. 1994; 33(7):945-53. DOI: 10.1097/00004583-199409000-00003. View

16.

Jumper S . A meta-analysis of the relationship of child sexual abuse to adult psychological adjustment. Child Abuse Negl. 1995; 19(6):715-28. DOI: 10.1016/0145-2134(95)00029-8. View

17.

Bandelow B, Krause J, Wedekind D, Broocks A, Hajak G, Ruther E . Early traumatic life events, parental attitudes, family history, and birth risk factors in patients with borderline personality disorder and healthy controls. Psychiatry Res. 2005; 134(2):169-79. DOI: 10.1016/j.psychres.2003.07.008. View

18.

Fergusson D, Horwood L . Prospective childhood predictors of deviant peer affiliations in adolescence. J Child Psychol Psychiatry. 1999; 40(4):581-92. View

19.

Bahali K, Akcan R, Tahiroglu A, Avci A . Child sexual abuse: seven years in practice. J Forensic Sci. 2010; 55(3):633-6. DOI: 10.1111/j.1556-4029.2010.01357.x. View

20.

Wozencraft T, Wagner W, Pellegrin A . Depression and suicidal ideation in sexually abused children. Child Abuse Negl. 1991; 15(4):505-11. DOI: 10.1016/0145-2134(91)90034-b. View