The relative influence of childhood sexual abuse and other family background risk factors on adult adversities in female outpatients treated for anxiety disorders and depression

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.