Mental and Physical After-Effects of Childhood Sexual Abuse

Psychological and physical effects of childhood sexual abuse are closely tied, according to a Canadian study. The study can help improve the mental and physical health of childhood abuse survivors by developing more effective interventions. // The study is published in Health Psychology.

Twice as Many Diagnoses
A recent study on childhood sexual abuse found that girls who survived sexual abuse received 2.1 times as many diagnoses of urinary health issues and 1.4 times as many diagnoses of genital issues than normal girls.

This study was followed by another study which aimed to determine the reason behind the more often genito-urinary problems in sexual-abuse survivors.

The second study tested the theory that increased psychological distress is partly responsible for the higher incidence of genitourinary issues - such as urinary tract infections, vaginitis and pain during sex or menstruation - among childhood sexual abuse survivors.

Combined Approach to Treatment

A combined treatment approach that addresses psychological after-effects and physical trauma is needed.

An interdisciplinary approach to care with general practitioners, urologists, pediatricians, psychologists, gynecologists, and psychiatrists are needed to help children recover as much as possible.

The current study is the first study to look at the relationship between genitourinary and psychological issues over such a long period in such a large sample of child survivors of substantiated sexual abuse with a comparison group.

Study Details

The study involved 661 girls between the ages of 1 and 17 who survived one or more instances of substantiated sexual abuse. The comparison group had 661 girls from the general population.

The researchers used medical data provided by different agencies. They had access to genitourinary and mental health diagnoses data, and medical consultations or hospital stays from 1996 to 2013.

Socioeconomic status, the number of years of access to medical data, and individual predispositions to genitourinary health problems were taken into account before the sexual abuse occurred.

Childhood sexual abuse included petting and fondling, oral sex, actual penetration or attempted penetration, voyeurism, indecent exposure, inducement to engage in sexual activity and sexual exploitation (prostitution).

A wider range of psychiatric issues

The researchers found that girls who were sexually abused were more likely to consult a health professional for a wider range of psychological issues.

The psychological issues were anxiety, schizophrenia, mood disorders or substance abuse.

Psychiatric issues were associated with frequent medical appointments or hospitalizations for genital health issues (62%) and urinary health issues (23%) years after the girls experienced sexual abuse.

Additional studies are needed to understand why there are differences between genital and urinary health. Additional factors like severity, length and frequency of the abuse may play a role in this difference.

Two hypotheses

Two hypotheses can be formulated to explain the association between psychological and physical effects in children who have experienced sexual abuse.

1. The association could be due to a hypervigilant response. Sexual-abuse survivors with mental health issues may become hypervigilant and notice symptoms related to their genitals or urinary health
2. The association could be due to avoidant behavior because survivors may avoid seeing a doctor which would increase the risk of getting issues

"In light of these findings, healthcare practitioners should assess the level of psychological distress experienced by survivors of childhood sexual abuse who report genitourinary issues and direct them to the right mental health resources," Vézina-Gagnon said.

Early and targeted intervention to reduce psychological distress may help prevent genitourinary issues from turning into chronic conditions.



Source-Medindia