Study shows link between severity of Child Sexual Abuse and mental health, HRQoL

In an investigation published in the current issue of Psychotherapy and Psychosomatics the harm of sexual abuse in Swiss adolescents is analyzed. Child Sexual Abuse (CSA) comprises activities with actual physical contact (e.g. rape, unwanted touching) and without physical contact (e.g. exhibitionism, exposure to pornography, verbal sexual harassment, distribution of intimate pictures against one's will). Research has shown that CSA is a persistent public health problem across all countries and cultures. However, there is almost no research on the differential effects of the type of CSA on outcome. To bridge these research gaps, the aim of the study was to assess health-related quality of life (HRQoL) and mental health across contact and non-contact types of CSA in a population sample of adolescents.

Authors assessed a nationally representative sample of 6,751 Swiss 9th grade students (mean age 15.5 years) attending public schools. Results found that roughly 40% of females and 17% of males reported experience of some type of CSA in their lifetimes, with 'non-contact CSA only' considerably more prevalent in both genders (24.7 and 12.1%, respectively) than 'contact CSA only' (5.1 and 2.3%) and both types of CSA (10.5 and 2.8%). The risk of females experiencing all categories of CSA was considerably higher than for males (OR = 2.37, 2.28, and 4.12, respectively). In addition, participants who had experienced both types of CSA had the lowest HRQoL and poorest mental health, whereas participants with no history of CSA had the highest scores for HRQoL as well as the best mental health. Notably, in almost all measures, participants with non-contact CSA only were significantly more impaired than participants with no history of CSA. Males had better mental HRQoL as well as less mental health problems than females across all four groups.

Taken together, these results indicate that there is a gradient association between the severity of CSA and HRQoL and mental health. Furthermore, females reported lower scores than males in most dimensions of HRQoL and mental health. However, this was not specific for victims of CSA, confirming epidemiological findings on mental health in adolescence that show a higher prevalence of many mental disorders in girls.