OBJECTIVE: This study from Norway examines the relative influence of child sexual abuse (CSA) and family background risk factors (FBRF) on the risk for current mental disorders and the quality of current intimate relationships in women with CSA treated for anxiety disorders and/or depression. Women with these disorders frequently seek treatment, and the place of CSA in therapy is still under debate. METHOD: 112 women, who were treated with outpatient psychotherapy by female therapists for anxiety disorders and/or depression were included. CSA had been admitted at the start of treatment start in 56 women, while no CSA was admitted among the 56 women of the comparison group. Systematic and detailed retrospective information about childhood as well as data on current functioning and current mental disorders were collected by questionnaires and structured interviews done by an independent female psychiatrist. RESULTS: The women of the CSA group reported significantly more FBRF than the comparisons. CSA increased the risk for posttraumatic stress disorder (PTSD), non-suicidal self-inflicted harm, and rape after 16 years. Major depression, dysthymia, and their comorbidity were not associated with CSA. The five indicators of quality of current intimate relationship were not associated with CSA. CONCLUSIONS: Women with CSA who have been treated for anxiety disorders and/or depression, also frequently have been exposed to FBRF. Increased risk for PTSD, self-inflicted harm before therapy, and rape after 16 years of age was influenced by CSA, while mood disorders and the quality of current attachment are not associated with CSA, but with FBRF or other factors not examined in this study.
PURPOSE: This study from Norway examines mental health status of women with child sexual abuse (CSA) who formerly had outpatient psychotherapy for anxiety disorders and/or depression. The relative contributions of CSA and other family background risk factors (FBRF) to aspects of mental health status are also explored. SUBJECTS: At a mean of 5.1 years after outpatient psychotherapy, 56 female outpatients with CSA and 56 without CSA were personally examined by an independent female psychiatrist. Systematic information about current mental health and functioning was collected by structured interview and questionnaires. RESULTS: Among women with CSA 95% had a mental disorder, 50% had PTSD, and mean global assessment of functioning (GAF) score was 61.8+/-10.6. In contrast, 70% of women without CSA had a mental disorder, 14% had PTSD, and mean GAF 71.2 + 8.5. GAF and trauma scale scores were mainly determined by CSA, while FBRF mainly influenced the global psychopathology and dissociation scores. DISCUSSION: We have little knowledge on the mental health status at long-term in women with CSA who had psychotherapy. This study found their mental status to be rather poor, and worse than that of women without CSA who had psychotherapy for the same disorders. From the broad spectrum of mental disorders associated with CSA, this study concerns only women treated as outpatients for anxiety disorders and/or non-psychotic depressions. CONCLUSION: Women with CSA showed poor mental health at long-term follow-up after treatment. The fitness of the psychodynamic individual psychotherapy given, or to what extent treatment can remedy the consequences of such childhood adversities, is discussed.
The aim of this paper was twofold: namely to examine current intimate relationships and social status of women with childhood sexual abuse (CSA) in the long term after outpatient psychotherapy, and to investigate the relative influence of CSA and family background risk factors (FBRF) on the indicators of this status. Fifty-six women with reported CSA and 56 without CSA, who had outpatient psychotherapy for anxiety disorders and/or depression, were personally examined 5 years after termination. Women with CSA had considerably greater sexual and mental health problems, but the same prevalence of partnerships, children and friends as the contrast. No differences were observed as to self-esteem, intimate bonds and physical quality of life. Sexual problems and low education were mainly explained by CSA, other measures by FBRF. Women treated with outpatient psychotherapy for anxiety disorders and depression had moderate problems at long-term follow-up, but more so for those women who had been exposed to CSA.