RELATIONSHIP BETWEEN DISSOCIATION, CHILDHOOD SEXUAL ABUSE, CHILDHOOD PHYSICAL ABUSE, AND MENTAL-ILLNESS IN A GENERAL-POPULATION SAMPLE

Objective: The aim of this study was to examine the relationship betwe en childhood sexual abuse, childhood physical abuse, current psychiatr ic illness, and measures of dissociation in an adult population. Metho d: The authors used a randomly selected sample of 1,028 individuals. E ach subject completed a semistructured face-to-face interview that inc luded measures of childhood sexual abuse, childhood physical abuse, DS M-III-R psychiatric diagnoses, and selected items from the Dissociativ e Experiences Scale. Results: Many individuals experienced occasional dissociative symptoms, and 6.3% of the population suffered from three or more frequently occurring dissociative symptoms. Among these indivi duals, the rate of childhood sexual abuse was two and one-half times a s high, the rate of physical abuse was five times as high, and the rat e of current psychiatric disorder was four times as high as the respec tive rates for the other subjects. Logistic regression modeling showed that physical abuse and current psychiatric illness were directly rel ated to a high rate of dissociative symptoms but sexual abuse was not. The influence of sexual abuse was due to its associations with curren t psychiatric illness and with childhood physical abuse. Childhood phy sical abuse was not directly related to current psychiatric illness. I ts association appeared to be mediated by its link to childhood sexual abuse. Conclusions: This study confirms that a small proportion (appr oximately 6%) of the general population suffer from high levels of dis sociative symptoms. It calls into question the hypothesized direct rel ationship between childhood sexual abuse and adult associative symptom s.