University of Alabama at Birmingham, United States.
University of Alabama at Birmingham, United States.
Child Abuse Negl. 2018 Dec;86:167-177. doi: 10.1016/j.chiabu.2018.09.019. Epub 2018 Oct 8.
Childhood physical and sexual abuse victims are at increased risk for developing depression, anxiety, and post-traumatic stress disorder (PTSD) in adulthood. Prior findings suggest abuse onset, duration, and severity moderate relationships between victimization and psychopathology. However, because these abuse characteristics are highly intercorrelated, their unique, individual effects on mental health outcomes remain unclear. To address this gap, the present study examined relationships between physical and sexual abuse characteristics and mental health outcomes and whether these relationships differed by sex. A diverse community sample of late adolescents and emerging adults (N = 1270; mean age = 19.68; 51% female) self-reported the onset, duration, and severity of physical and sexual abuse, as well as their depressive, anxiety, and PTSD symptoms. Results of a multivariate regression model (simultaneously evaluating all physical and sexual abuse characteristics) indicated that physical abuse onset in middle childhood and sexual abuse onset in middle childhood or adolescence were associated with all forms of psychopathology; and physical abuse onset at any time was uniquely linked with PTSD. Duration and severity of physical or sexual abuse did not predict psychopathology after accounting for time of onset. Multigroup analyses indicated that adolescence-onset and duration of sexual abuse respectively predicted anxiety and PTSD in females but not males, whereas sexual abuse severity predicted fewer PTSD symptoms in males but not females. Overall, results suggested that abuse occurring after age 5 may have the most deleterious impact on mental health.
童年期身体和性虐待受害者在成年后患抑郁症、焦虑症和创伤后应激障碍（PTSD）的风险增加。先前的研究结果表明，虐待的开始、持续时间和严重程度会调节受害者和精神病理学之间的关系。然而，由于这些虐待特征高度相关，它们对心理健康结果的独特、个体影响仍不清楚。为了解决这一差距，本研究考察了身体和性虐待特征与心理健康结果之间的关系，以及这些关系是否因性别而异。一个由晚青春期和新兴成年人组成的多样化社区样本（N=1270；平均年龄=19.68；51%为女性）自我报告了身体和性虐待的开始、持续时间和严重程度，以及他们的抑郁、焦虑和 PTSD 症状。多变量回归模型的结果（同时评估所有身体和性虐待特征）表明，儿童中期的身体虐待开始和儿童中期或青春期的性虐待开始与所有形式的精神病理学有关；任何时候的身体虐待开始都与 PTSD 有关。在考虑到开始时间后，身体或性虐待的持续时间和严重程度与精神病理学无关。多组分析表明，青春期开始的性虐待和性虐待的持续时间分别预测女性的焦虑和 PTSD，但不预测男性；而性虐待的严重程度预测男性 PTSD 症状较少，但不预测女性。总体而言，结果表明，5 岁以后发生的虐待可能对心理健康有最严重的影响。
