Childhood sexual abuse and adult developmental outcomes: Findings from a 30-year longitudinal study in New Zealand

• Published in: Child abuse & neglect Vol. 37; no. 9; pp. 664 - 674
• Main Authors: Fergusson, David M, McLeod, Geraldine F.H, Horwood, L. John
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.09.2013; Elsevier; Elsevier Science Ltd
• Subjects: Adolescent; Adult; Adult Survivors of Child Abuse - psychology; Adults; Alcoholism - epidemiology; Alcoholism - psychology; Anxiety Disorders; Biological and medical sciences; Child; Child abuse & neglect; Child Abuse, Sexual - psychology; Child sexual abuse; Child, Preschool; Cohort Studies; Correlation analysis; Effect Size; Female; Health Status; Humans; Infant; Infant, Newborn; Life Change Events; Life Satisfaction; Longitudinal; Longitudinal Studies; Male; Medical sciences; Mental Disorders; Mental Disorders - diagnosis; Mental Disorders - psychology; Mental health; New Zealand - epidemiology; Pediatrics; Personal health; Physical Health; Posttraumatic Stress Disorder; Psychiatry; Psychological problems; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Risk-Taking; Sex crimes; Sexual Abuse; Sexual Behavior; Sexual risk-taking; Social Class; Socioeconomic; Socioeconomic factors; Substance-Related Disorders - epidemiology; Substance-Related Disorders - psychology; Suicide; Suicide, Attempted - psychology; Suicide, Attempted - statistics & numerical data; Victimology; Young Adult; New Zealand; Oceania; Socioeconomic; Child sexual abuse; Longitudinal; Psychological problems; Physical health; Sexual risk-taking; Human; Socioeconomic status; Sexual behavior; Risk taking; Victimology; Child abuse; Health status; Sociodemographic factor; Correlation analysis; Follow up study; Early traumatism; Adult; Sexual abuse; Psychological well-being; Antecedent
• ISSN: 0145-2134; 1873-7757
• DOI: 10.1016/j.chiabu.2013.03.013

Abstract Objectives 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.