Childhood sexual abuse and affective symptoms in women: a general population study

Background. Child sexual abuse (CSA) is associated, after controlling for o ther adversities, with a range of non-psychotic disorders in adult life. Th ere is a need to clarify whether CSA contributes to risk of disorder in the absence of such adversities, and given that associations may be accounted for by genetic mechanisms, whether they are seen where the perpetrator of C SA is not a biological relative, and where there has been only one incident . Methods. A questionnaire-based study of a socio-economically representative sample of women age 25-36 (N = 862) was carried out. Parental care and con trol were assessed using the Parental Bonding Instrument, and CSA using a p reviously validated questionnaire. Current affective symptoms were assessed from the depression scale of the GHQ-28. Results. Low maternal and paternal care were associated with risk of abuse by a biologically unrelated perpetrator before the age of 11, but not durin g early adolescence. Low maternal care and CSA each made independent contri butions to the prediction of affective symptoms. CSA by a non-relative was strongly associated with GHQ depression, as was CSA by a non-relative that had occurred only once. Conclusions. Quality of parental care probably influences risk of CSA by un related abusers in younger children, while there may be a combination of ge netic and parental influences on the risk of abuse by a relative. The stron g association of affective symptoms in adult life with CSA by a non-relativ e suggests an environmental effect. Studies, utilizing genetic designs, of the role of childhood trauma in relation to adult affective symptoms are ne eded.