Depression In Victims of Childhood Sexual Abuse

Childhood sexual abuse (CSA) is considered an important public health concern that can derail the developmental course of children affecting both male and female (Ensink et al., 2019).

Studies have shown that there are differences between male and female survivors of child sexual abuse.  Male children are more likely to be sexually abused at a younger age, whereas female children are more vulnerable to being assaulted at all ages, particularly in adolescence. 

The mean age of onset of sexual abuse was found to be 6.71 years for both males and females, but the odds of experiencing the first sexual assault during childhood, as opposed to adolescence, were 4:1 for females and 9:1 for males. Studies have also indicated that male survivors of child sexual abuse are more likely to engage in risky behaviors, such as drug and alcohol use, unsafe sex, and criminal behavior, and may be more likely to experience anxiety, depression, and difficulty forming relationships than those who did not experience abuse (Al-Asadi, 2021; Wellman, 1993). 

Study finds that children with CSA are more likely to have insecure and disorganized attachment compared to non-abused children. Where insecure attachment is associated with higher self-reported depressive symptoms (Ensink et al., 2019).

Individuals with a history of childhood sexual abuse tend to have an earlier onset of depressive symptoms. Depressive symptoms in survivors of child sexual abuse can include chronic depressive symptoms. Such as, fear and anxiety, nightmares, disturbed sleeping and eating patterns, suicidal ideation and borderline depression. Survivors of sexual trauma may also experience guilt, shame, and self-blame. 

Research indicates that individuals who experienced sexual abuse in childhood are more likely to report a lifetime history of depression (Musliner & Singer, 2014). In addition to the direct impact on depression, childhood sexual abuse has been linked to an increased risk of other mental health problems, such as anxiety disorders. The effects of sexual abuse on victims can also extend to their relationships, school or employment, and physical health. (Radell et al., 2021)

Several risk factors for depression in survivors of child sexual abuse have been identified. These risk factors include:

1.Severity, frequency, and duration of abuse: Greater severity, frequency, and duration of child sexual abuse result in an increased likelihood of subsequently developing depression (Weiss et al., 1999).

2.Age at the time of abuse: Victims who experienced child sexual abuse before age 17 years were more likely to be diagnosed with adult-onset depression (Weiss et al., 1999).

3.Living environment: One study found that the living environment was a significant predictor of depression among survivors of child sexual abuse, with those living with others being 23 times more likely to be depressed compared to those living in other situations (Wahab et al., 2013).

4.Family dysfunction or poor parenting: The presence of family dysfunction or poor parenting has been linked to an increased risk of depression in survivors of child sexual abuse (Weiss et al., 1999).

5.Legal guardianship: A study found a significant association between legal guardianship and depression among sexually abused females, suggesting that those without legal guardianship might be at a higher risk of developing depression. (Wahab et al., 2013).

In conclusion, childhood sexual abuse is a significant issue that can lead to various mental health consequences, including depression in adulthood. The relationship between childhood sexual abuse and depression is complex and can be influenced by factors such as the severity of the abuse, the child's age, and the presence of other risk factors. 

It is essential for healthcare providers to be aware of the potential consequences of childhood sexual abuse and to be prepared to address any concerns or disclosures related to such abuse. Early identification and intervention can help ameliorate the adverse impact of childhood sexual abuse on mental health and overall well-being

References

Ensink, K., Borelli, J. L., Normandin, L., Target, M., & Fonagy, P. (2019). Childhood Sexual Abuse and Attachment Insecurity: Associations With Child Psychological Difficulties. American Journal of Orthopsychiatry, 90(1), 115-124. DOI: http://dx.doi.org/10.1037/ort0000407

AL-Asadi A. (2021). Comparison Between Male and Female Survivors of Sexual Abuse and Assault in Relation to Age at Admission to Therapy, Age of Onset, and Age at Last Sexual Assault: Retrospective Observational Study. DOI: 10.2196/23713

Musliner, Katherine L. & Singer, Jonathan B. (2014). Emotional support and adult depression in survivors of childhood sexual abuse. Child Abuse & Neglect, 38 (8), 1431-1340 DOI: https://doi.org/10.1016/j.chiabu.2014.01.016

Radell, Milen L., Hamza, Eid G. A., Daghustani, Wid H., Perveen, Asma, & Moustafa, Ahmed A. (2021). The Impact of Different Types of Abuse on Depression. Depression Research and Treatment. DOI: https://doi.org/10.1155/2021/6654503

Wahab, S., Tan, S. M., Marimuthu, S., Razali, R., & Muhamad, N. A. (2013). Young female survivors of sexual abuse in Malaysia and depression: what factors are associated with better outcome?. Asia-Pacific psychiatry : official journal of the Pacific Rim College of Psychiatrists, 5 Suppl 1, 95--102. DOI: https://doi.org/10.1111/appy.12051

Wellman M. M. (1993). Child sexual abuse and gender differences: attitudes and prevalence. Child abuse & neglect, 17(4), 539--547. DOI: https://doi.org/10.1016/0145-2134(93)90028-4

Weiss, Erica L., Longhurst, James G., D. M., & Mazure, Carolyn M. (1999). Childhood Sexual Abuse as a Risk Factor for Depression in Women: Psychosocial and Neurobiological Correlates. DOI: https://doi.org/10.1176/ajp.156.6.816