This psychiatry weblog, authored by two Harvard University-trained psychiatrists and former lecturers at Harvard Medical School, offers you psychiatric news and commentary about brain disorders, mental dysfunction, psychological illness, and mental health wellness.
Mental health professionals have long wondered about the
relationship between childhood sexual abuse and adult mental health. An article
published in Medical News Today June 9, 2009, “'Strong Link' Between Childhood
Sexual Abuse And Suicide Attempts In Women,” examines this issue. The article
reports on the results of a study presented at the Annual Meeting of the Royal
College of Psychiatrists in Liverpool. The
researchers studied, “…..data from the 2000 National Psychiatric Morbidity
Survey.” The results of the study were concerning. “…sexual abuse was three
times more common in women than men - some 1.6 per cent of men report sexual
abuse, compared to 5.2 per cent of women….Women attempt to kill themselves more
often than men (3.5 per cent of women compared to 5.1 per cent of women) and the
number of suicide attempts attributable to sexual abuse was stronger in women
than men….sexual abuse in childhood made women far more likely than men to
attempt suicide…women react to trauma more strongly than men, perhaps
accounting for the strong link between sexual abuse and suicide.” There are a
number of important implications of this study. First, adult women with
childhood sexual abuse histories should consult a qualified mental health
professional to determine their current and future risk of suicidal thinking.
Second, mental health professionals who treat adult women with childhood sexual
abuse histories should routinely screen for suicidal thinking in these
patients. Third, spouses of adult women with childhood abuse histories should
educate themselves with the help of a qualified mental health professional to
understand the current and future risk of suicide in these women. Fourth, public
health professionals should educate the public about the link between childhood
sexual abuse and the risk of suicide in adult women. The researchers state,
“….[Women] who have been sexually abused have low self esteem, ironically blame
themselves for the abuse, and all their levels of confidence about all sorts of
things are reduced…Lowering your self esteem like that is associated with all
sorts of mood symptoms and these are the bed out of which arises suicidal
ideation. A proportion of those will then go on to attempt suicide and of those
some will be successful."
The researchers conclude, “…psychiatrists [must] deal with the issue of sexual
abuse in a more forceful way…finding out whether a patient had been sexually
abused opened up the possibility of treatment, as there were specific ways a
psychiatrist could intervene and help….The patient may have post-traumatic
stress disorder and you can treat that; they may have low self esteem and you
can address that too and you might make life better for that person and they
will be less inclined to think of suicide."
The Bottom Line:
The results of this study strongly suggest that childhood sexual abuse
increases the risk of suicide in adult women.
Sources: See blogposts in Psychiatric Disorders: General
Additional Resources:
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Outcomes of Abuse and Neglect Impose Significant Costs to Individual and Society
The
long-term impacts of childhood maltreatment include higher rates of
unemployment, poverty, and use of social services in adulthood,
according to a new study by David Zielinski, Ph.D., of the NIMH Office
of Science Policy, Planning, and Communications.1
The related losses in productivity and tax revenues, increased spending
on social services, and potential transmission of abusive behaviors
from one generation to the next, suggest major costs to society as
well. The results were published online ahead of print on October 8,
2009, in the journal Child Abuse and Neglect.
Background
Research has shown that negative early life experiences can adversely affect a person's physical and mental health in adulthood.2,3 However, few studies have focused on the association between childhood maltreatment and later socioeconomic well-being.
To
address this research gap, Zielinski evaluated data on childhood
maltreatment and socioeconomic well-being from the NIMH-funded National
Comorbidity Survey (NCS). The NCS was the first study to estimate the
prevalence of mental disorders (using modern psychiatric standards) in
a representative sample of the general U.S. population. Due to his
study's focus on socioeconomic factors, Zielinski examined data from
5,004 NCS participants who were age 18 or older and were not students
at the time of the survey.
Results from the Study
Adults
who were physically abused, sexually abused, or severely neglected as
children were significantly more likely to be unemployed, living below
the poverty line, and using social services than people without a
history of childhood maltreatment. Having experienced more than one
type of maltreatment increased these risks further.
Overall,
adults who had experienced any type of maltreatment in childhood were
twice as likely as non-victims to be unemployed. Childhood physical
abuse and a history of multiple types of maltreatment accounted for
this trend, increasing risk of unemployment by 140 percent and 190
percent, respectively. In contrast, survivors of sexual abuse or of
severe neglect did not show differences in unemployment rates when
compared with non-victims.
In terms of income, adults who had
been physically abused as children were 60 percent more likely than
non-victims to be living in poverty. The incidence rose to 180 percent
for those who had experienced more than one type of childhood
maltreatment.
Maltreatment was also linked to lower rates of
health care coverage and greater use of social services such as
Medicaid, especially among adults who had experienced childhood sexual
abuse. However, Medicaid usage varied by the type of maltreatment
experienced. For example, the study found that people who had been
severely neglected as children were about twice as likely as
non-maltreated adults to be living in poverty, thus eligible for
Medicaid, but were no more or less likely to use Medicaid.
Significance
In
the first comprehensive study of the long-term socioeconomic effects of
abuse and neglect, Zielinski shows that childhood maltreatment carries
significant costs to the individual and to society. Not only does the
public share the burden in supporting maltreatment-related social
services—such as child welfare services—but also those related to
unemployment insurance, poverty-based public assistance, and publicly
funded health insurance, such as Medicaid. Other societal impacts
include the loss in employment productivity and tax revenues, from
federal and state income taxes as well as state and local sales taxes.
Previous
research has shown low socioeconomic status to be a risk factor for the
perpetration of child abuse and neglect. Additional research has found
that parents who were maltreated as children are more likely to abuse
and neglect their own children than those without a history of
maltreatment. Zielinski's finding that child abuse and neglect appears
to contribute to low socioeconomic status in adulthood may help to
explain a key factor in this "intergenerational cycle of violence."
Targeted assistance for maltreatment victims may help break this cycle.
For example, Zielinski suggests that enhanced access to job training
and job counseling programs may be especially helpful for victims of
physical abuse or multiple types of maltreatment, who were most likely
to be unemployed among those who had experienced maltreatment.
What's Next
Studies
that follow maltreated children over time and examine long-term
socioeconomic outcomes are needed to confirm these findings. Future
studies may also reveal why these associations occur, for example, why
some maltreatment survivors suffer from greater unemployment rates than
others or what factors influence the decision to enroll in social
services. Such research may help scientists to better understand the
mechanisms behind socioeconomic hardships following negative early life
events and to develop treatments targeting these mechanisms.
Sources: See blogposts in Psychiatric Disorders: General
Additional Resources:
For related articles on the
Web, click on: “Sphere: Related Content” located at the bottom of this
blog post.
For related books or blog
posts with related content in Dr. Jeff’s and Dr. Tanya’s Blog type in the
keywords into “Google Search” located in
the sidebar.
For more books with related
content, type in the keywords into “Amazon
Search” on the Amazon banner located in the side bar.
The National Institute of Mental Health conducts and supports
research not only on a wide range of mental health disorders, but also
on reactions to national crises and traumatic events. This research
includes the reactions of people following the September 11, 2001
terrorist attack on the Twin Towers; the Oklahoma City bombing; wars
and violence in the Middle East; and disasters such as earthquakes,
tornados, fires, floods, and hurricanes, including the 2005 Gulf Coast
storms.
There are many different responses to crisis. Most
survivors have intense feelings after a traumatic event but recover
from the trauma; others have more difficulty recovering — especially
those who have had previous traumatic experiences, who are faced with
ongoing stress, or who lack support from friends and family — and will
need additional help.
The NIMH provides information based on
scientific research and evidence-based practice. We have compiled this
information to assist you, your family, and friends. We have special
information for helping children that many parents and organizations
have found useful.
Mental Disorders That May Be Related to or Affected by Exposure to Violence or Traumatic Events
Courage to Care,
a USUHS health promotion campaign for the military and civilians that
are part of the military community, has developed several fact sheets
on health topics relevant to military life.
Mental health professionals have long been interested in the link between
childhood abuse and obesity. An article titled, “Obesity in Middle-Aged Adults
Linked to Childhood Abuse, “ recently published in Psychiatric News
(8/15/08), examines this issue. The article describes a recent Pediatrics study
in which researchers studied 9400 individuals at ages 7, 11, 16, and 45. The
findings were disturbing. “Even when possibly confounding factors
were considered, a highly significant link was found between physical
abuse and midlife obesity, and statistically significant links were
found between verbal abuse, a strict upbringing, and a mother having
little interest in her child's education and midlife obesity.
The Bottom Line: This study
strongly suggests that physical abuse in childhood is associated with an
increased risk of midlife obesity.
For related articles on PTSD
on the Web, click on: “Sphere: Related Content” located at the bottom of
this blog post.
For related books or blog
posts with related content in Dr. Jeff’s and Dr. Tanya’s Blog, click on
the “Psychiatric Disorders: PTSD” category at the bottom of the post or
type in keywords “PTSD” into “Google Search” located in the sidebar.
For related articles from
Psychology Today, click on the “Psychology Today” banner in the side bar
and type in Key words, “PTSD” into the Psychology Today “Search”.
For more books with related
content, click any hyperlinked key word in the blog or type in key words,
“PTSD“ into “Amazon Search” on the Amazon banner located in the side bar.
Mental health professionals have long been concerned about the impact of
stressful early life events on children. An article in MedWire News (7/31/08),
titled “Psychiatric diagnosis and
symptom severity increased by early stress events”, examines this issue. The
article reports on a recent study published in BMC Psychiatry. The researchers studied the trauma histories of
individuals with psychiatric disorders, and compared them to individuals
without a psychiatric diagnosis. The results were disturbing. “Patients had
significantly higher scores than controls for early life stress events,
pre-pubertal stress events, overall traumatic experiences, and prenatal
stress…[including] emotional neglect, violence in families during childhood and
adolescence, and separation from their biologic mother for at least 3 months before
puberty than controls…A high stress load was associated with major depressive
disorder and personality disorder, while patients with schizophrenia and drug
abuse tended to have a lower stress load.” This study suggests that stressful
early life events in children significantly increase the risk of developing
psychiatric disorders later in life, particularly major depression and
personality disorders.
The Bottom Line: This study
strongly suggests that children who experience stressful early life events may
be at increased risk for developing psychiatric disorders later in life including major depressive disorder.
For related articles on depression on the Web, click on: “Sphere: Related Content” located at the bottom of this blog post.
For related books or blog posts with related content in Dr. Jeff’s and Dr. Tanya’s Blog, go to “Psychiatric Disorders: Depression” or type in the keyword “depression” into “Google Search” located in the sidebar.
For related articles from Psychology Today,
click on the “Psychology Today” banner in the side bar and type in the
keyword, “depression” into the Psychology Today “Search”.
For more books with related content, click any hyperlinked keyword in
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