Psychopathology in a large cohort of sexually abused children followed up to 43 years
Abstract
Objective To determine the rate and risk of clinical and personality disorders diagnosed in childhood and adulthood in those known to have been sexually abused during childhood.Methods Forensic medical records of 2,759 sexually abused children assessed between 1964 and 1995 were linked with a public psychiatric database between 12 and 43 years later. Cases were compared to control subjects matched on gender and age groupings drawn from the general population through a random sample of the national electoral database.Results A lifetime record of contact with public mental health services was found in 23.3% of cases compared to 7.7% of controls. The rate of contact among child sexual abuse victims was 3.65 times higher (95% CI, 3.09-4.32, p<0.001). It was estimated that child sexual abuse accounted for approximately 7.83% of mental health contact. Exposure to sexual abuse increased risks for the majority of outcomes including psychosis, affective, anxiety, substance abuse, and personality disorders. Rates of clinical disorders diagnosed in adulthood and childhood remained significantly higher among child sexual abuse cases. Older age at sexual abuse and those exposed to severe abuse involving penetration or multiple offenders were associated with greater risk for psychopathology.Conclusions This study confirms that child sexual abuse is a substantial risk factor for a range of mental disorders in both childhood and adulthood.Practice implications Those treating victims of sexual abuse must assess not only disorders commonly associated with trauma, but also low prevalence disorders such as psychosis.
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In a large cohort followed for over four decades, the odds ratio for the development of CD following childhood sexual abuse was 6.32.
“In a large cohort study of individuals followed for over four decades of childhood sexual abuse, the odds ratio for the development of CD was 6.32 (Cutajar et al, 2010).”
From Deviations from the expectable environment in early childhood and emerging psychopathology (2015) · cites this paper as Cutajar et al, 2010
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- Authors
- Cutajar, M. C., Mullen, P. E., Ogloff, J. R. P., Thomas, S. D., Wells, D. L., & Spataro, J.
- Affiliations
- Monash University (AU)
- Victorian Institute of Forensic Medicine (AU)
- Corresponding author
- Cutajar, Margaret C.
- Venue
- Child Abuse & Neglect
- Publisher
- Elsevier BV
- Published
- 2010-11
- Volume
- 34
- Issue
- 11
- Pages
- 813-822
- ISSN
- 0145-2134 (ISSN-L)
- OpenAlex
- W2163025547
- Cited by
- 472
- References
- 63
- Citations by year
- 2026: 19 · 2025: 15 · 2024: 21 · 2023: 22 · 2022: 28 · 2021: 31 · 2020: 40 · 2019: 32 · 2018: 40 · 2017: 41 · 2016: 46 · 2015: 33 · 2014: 41 · 2013: 35 · 2012: 14
- FWCI
- 22.90
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Child Abuse & Neglect (publishedVersion)
- PubMed (publishedVersion)
- Research Online (University of Wollongong) (submittedVersion)
- Swinburne figshare (Swinburne University of Technology) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
- Social Sciences › Sociology and Political Science › Military, Security, and Education Studies
- Keywords
- child sexual abuse, psychopathology, personality disorders, psychosis, mood disorders, anxiety disorders, substance abuse, mental health service contact, long-term follow-up, abuse severity, multiple offenders, trauma
- MeSH terms
- Adolescent, Mental Disorders, Child, Child Abuse, Sexual, Child, Preschool, Female, Follow-Up Studies, Humans, Infant, Infant, Newborn, Male, Medical Record Linkage, Mental Health Services, Psychopathology, Risk Factors, Sexual Partners, Victoria, Proportional Hazards Models, Case-Control Studies, Sex Distribution
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