Department of Psychiatry, New York State Psychiatric Institute, NY 10032, USA.
Psychiatry. 2013 Fall;76(3):223-40. doi: 10.1521/psyc.2013.76.3.223.
Sexual violence can cause acute and persistent negative psychological outcomes among children and adults in a community. Previous studies have frequently reported high prevalence of prior child and adolescent sexual abuse among adult victims of sexual violence. This raises uncertainty over the specific contribution of sexual victimization in adulthood to the adverse psychological outcomes. The present study draws on a large nationally representative sample of adults without history of childhood sexual abuse, and applies diagnostic criteria of DSM-IV, in order to investigate the risk factors and psychiatric comorbidities correlated with sexual victimization in adulthood. In a large representative sample of U.S. adults without history of childhood sexual abuse, 2.5% reported sexual victimization in adulthood. Female gender, living alone, economic disadvantage, and a history of childhood adversities and parental psychopathology were identified as risk factors. Adult sexual victimization increased the risk of developing a variety of psychiatric disorders, especially PTSD (HR = 3.43, 95% CI [2.67, 4.41]) and drug abuse (HR = 3.38, 95% CI [2.49, 4.58]). Conversely, pre-existing psychiatric psychopathology, particularly PTSD (HR = 3.99, 95% CI [2.68, 5.94]) and dysthymia (HR = 2.26, 95% CI [1.42, 3.59]), increased the likelihood of sexual victimization in adulthood. Childhood experience and adulthood sociodemographic characteristics are important in affecting the risk of being sexually victimized in adulthood. Psychiatric disorders can act as both risk factors and outcomes of adult sexual victimization.
性暴力会给社区中的儿童和成年人带来急性和持久的负面心理后果。先前的研究经常报告，性暴力的成年受害者中有很高比例的儿童和青少年时期曾遭受性虐待。这让人对性侵害在成年期对不良心理后果的具体贡献产生了不确定性。本研究利用了一个没有儿童期性虐待史的大型全国代表性成年人样本，并应用 DSM-IV 的诊断标准，以调查与成年期性侵害相关的风险因素和精神共病。在一个没有儿童期性虐待史的美国成年人的大型代表性样本中，有 2.5%的人报告在成年期遭受过性侵害。女性、独居、经济劣势以及童年逆境和父母精神病理学史被确定为风险因素。成年期性侵害增加了多种精神障碍的发病风险，尤其是 PTSD（HR=3.43，95%CI[2.67,4.41]）和药物滥用（HR=3.38，95%CI[2.49,4.58]）。相反，预先存在的精神病理学，特别是 PTSD（HR=3.99，95%CI[2.68,5.94]）和心境恶劣（HR=2.26，95%CI[1.42,3.59]），增加了成年期遭受性侵害的可能性。童年经历和成年社会人口统计学特征对成年期遭受性侵害的风险有重要影响。精神障碍既可以作为成年期性侵害的风险因素，也可以作为其结果。
