Childhood sexual abuse and pervasive problems across multiple life domains: Findings from a five-decade study
Open accessAbstract
The aim of this study was to use longitudinal population-based data to examine the associations between childhood sexual abuse (CSA) and risk for adverse outcomes in multiple life domains across adulthood. In 937 individuals followed from birth to age 45y, we assessed associations between CSA (retrospectively reported at age 26y) and the experience of 22 adverse outcomes in seven domains (physical, mental, sexual, interpersonal, economic, antisocial, multi-domain) from young adulthood to midlife (26 to 45y). Analyses controlled for sex, socioeconomic status, prospectively reported child harm and household dysfunction adverse childhood experiences, and adult sexual assault, and considered different definitions of CSA. After adjusting for confounders, CSA survivors were more likely than their peers to experience internalizing, externalizing, and thought disorders, suicide attempts, health risk behaviors, systemic inflammation, poor oral health, sexually transmitted diseases, high-conflict relationships, benefit use, financial difficulties, antisocial behavior, and cumulative problems across multiple domains in adulthood. In sum, CSA was associated with multiple persistent problems across adulthood, even after adjusting for confounding life stressors, and the risk for particular problems incremented with CSA severity. The higher risk for most specific problems was small to moderate, but the cumulative long-term effects across multiple domains reflect considerable individual and societal burden.
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Written from the paper’s full text.
TL;DR
In the Dunedin birth cohort followed to age 45, retrospectively reported childhood sexual abuse (CSA) was associated with persistent adverse outcomes across physical, mental, sexual, interpersonal, economic, antisocial, and multi-domain functioning after adjustment for confounders. Effects were generally small to moderate, but cumulative and severity-related, with the strongest association for lifetime suicide attempts.
Key findings
- CSA prevalence was 19% overall (30% of females, 9% of males); forced intercourse was reported by 6% overall (10% of females, 2% of males).
- After full adjustment, CSA was significantly associated with higher risk of health risk behaviors (RR 1.32, 95% CI 1.14–1.53), poor oral health (RR 1.54, 1.25–1.91), externalizing disorder (RR 1.44, 1.13–1.82), internalizing disorder (RR 1.40, 1.15–1.70), thought disorder (RR 2.55, 1.45–4.48), suicide attempt (RR 2.64, 1.81–3.86), sexually transmitted disease (RR 1.35, 1.02–1.80), high-conflict relationship (RR 1.43, 1.15–1.78), high benefit use (RR 1.37, 1.08–1.74), financial difficulties (RR 1.36, 1.07–1.74), high delinquency (RR 1.82, 1.43–2.32), and problems in ≥4 domains (RR 1.41, 1.20–1.65).
- After full adjustment, CSA was not significantly associated with low lung function, no formal qualifications, low socioeconomic status, or criminal conviction; sexual difficulties, risky sex, lack of intimate relationship, and parenting difficulties were not significant even before other controls.
- Findings were consistent across alternative CSA definitions and tended to increment with severity; for example, suicide attempt RRs ranged from 2.64 for any CSA versus no CSA to 4.22 for forced intercourse versus no CSA, and high delinquency RRs ranged from 1.82 to 2.32.
Methods
- Dunedin Study representative birth cohort born April 1972–March 1973 in Dunedin, New Zealand: n = 1,037 at birth, 937 with CSA data; followed to age 45, when 94% of living members participated. CSA was retrospectively assessed at age 26; outcomes were repeatedly assessed from ages 26 to 45 (with suicide attempt also queried from age 18).
- Poisson regression with robust standard errors estimated associations between CSA and 22 adverse outcomes across seven domains; models added covariates stepwise: sex, childhood socioeconomic status, child harm ACEs, household dysfunction ACEs, and adult sexual assault. Secondary analyses used alternative CSA definitions; sensitivity analyses tested linear and binary outcomes and separate assessment phases.
Limitations
- Stated by the paper: small exposed groups meant sex-specific effects could not be adequately tested and some potentially meaningful effects were not statistically significant; CSA was retrospectively reported at age 26, so recall or reporting bias cannot be ruled out; outcomes were limited to those repeatedly assessed from ages 26 to 45, and mechanisms were not elucidated.
- Evident from the text: the cohort was primarily New Zealand European/white (93%), which may limit generalizability; the observational design cannot establish causation, as the paper also notes.
Model-written summary. Check it against the paper before relying on it.
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Claims the paper makes
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- Findingcitation
Many associations between CSA and adverse long-term outcomes were not explained by other major childhood risk factors that often coincide with CSA, including socioeconomic adversity and other ACEs.
“Causation cannot be inferred from the current findings, but they nevertheless indicate that many associations between CSA and adverse long-term outcomes were not explained by other major childhood risk factors that often coincide with CSA, including socioeconomic adversity and other ACEs (Danese, 2020).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Danese, 2020
Not checked in the free run.
- Rests on an assumption: The control variables used (sex, childhood socioeconomic status, child harm and household dysfunction ACEs, and sexual assault in adulthood) adequately account for confounding of the CSA-outcome associations.
- Findingown data
The any-CSA group, compared with the no-CSA group, included a higher proportion of people who grew up in lower socioeconomic status families.
“The any CSA (compared to no CSA) group included higher proportions of people who were female, grew up in lower socioeconomic status families, had more child harm and household dysfunction ACEs, and had reported being sexually assaulted in adulthood (Table 2).”
Quote in the paperNot a substantial claim - Findingown data
CSA survivors were more likely than their peers to experience high-conflict relationships in adulthood after adjusting for confounders.
“After adjusting for confounders, CSA survivors were more likely than their peers to experience internalizing, externalizing, and thought disorders, suicide attempts, health risk behaviors, systemic inflammation, poor oral health, sexually transmitted diseases, high-conflict relationships, benefit use, financial difficulties, antisocial behavior, and cumulative problems across multiple domains in”
Quote in the paperSubstantial claim- Rests on an assumption: Retrospective self-reports of CSA at age 26 accurately measure childhood sexual abuse exposure.
- Rests on an assumption: The covariates included in the models (sex, childhood socioeconomic status, child harm ACEs, household dysfunction ACEs, and adult sexual assault) sufficiently control for confounding of the CSA-outcome associations.
- Findingown data
Childhood sexual abuse (any vs no) was associated with increased risk of health risk behaviors in adulthood (RR=1.32, 95% CI 1.14-1.53).
“| Health risk behaviors | 1.32*** | 1.40*** | 1.44*** | 1.49*** |”
Quote in the paperSubstantial claim - Findingown data
CSA survivors were more likely than their peers to experience systemic inflammation in adulthood after adjusting for confounders.
“After adjusting for confounders, CSA survivors were more likely than their peers to experience internalizing, externalizing, and thought disorders, suicide attempts, health risk behaviors, systemic inflammation, poor oral health, sexually transmitted diseases, high-conflict relationships, benefit use, financial difficulties, antisocial behavior, and cumulative problems across multiple domains in”
Quote in the paperSubstantial claim- Rests on an assumption: Retrospective self-reports of CSA at age 26 accurately measure childhood sexual abuse exposure.
- Rests on an assumption: The covariates included in the models (sex, childhood socioeconomic status, child harm ACEs, household dysfunction ACEs, and adult sexual assault) sufficiently control for confounding of the CSA-outcome associations.
- Findingown data
The risk for particular problems incremented with CSA severity.
“In sum, CSA was associated with multiple persistent problems across adulthood, even after adjusting for confounding life stressors, and the risk for particular problems incremented with CSA severity.”
Quote in the paperSubstantial claim- Rests on an assumption: Retrospective self-reports of CSA at age 26 accurately measure childhood sexual abuse exposure.
- Rests on an assumption: The covariates included in the models (sex, childhood socioeconomic status, child harm ACEs, household dysfunction ACEs, and adult sexual assault) sufficiently control for confounding of the CSA-outcome associations.
- Findingown data
The unadjusted prevalence of every problem except sexual difficulties, risky sex, parenting difficulties, and criminal convictions was numerically higher among those who reported any CSA compared with no CSA.
“The unadjusted prevalence of every problem except sexual difficulties, risky sex, parenting difficulties, and criminal convictions was numerically higher among those who reported any compared with no CSA (Figure 1; Table S3).”
Quote in the paperNot a substantial claim - Findingown data
Those who reported CSA had problems across adulthood in more domains than those who did not.
“Those who reported CSA also had problems across adulthood in more domains (Figure S1).”
Quote in the paperSubstantial claim - Findingown data
In the Dunedin study birth cohort, 6% overall (10% of females, 2% of males) reported forced intercourse as the most severe type of childhood sexual abuse.
“One in five (19% overall; 30% of females; 9% of males) participants reported at least one type of CSA; one in twenty (6% overall; 10% of females; 2% of males) reported the most severe type: forced intercourse (Table 1).”
Quote in the paperNot a substantial claim - Findingown data
CSA survivors were more likely than their peers to experience cumulative problems across multiple domains in adulthood after adjusting for confounders.
“After adjusting for confounders, CSA survivors were more likely than their peers to experience internalizing, externalizing, and thought disorders, suicide attempts, health risk behaviors, systemic inflammation, poor oral health, sexually transmitted diseases, high-conflict relationships, benefit use, financial difficulties, antisocial behavior, and cumulative problems across multiple domains in”
Quote in the paperSubstantial claim- Rests on an assumption: Retrospective self-reports of CSA at age 26 accurately measure childhood sexual abuse exposure.
- Rests on an assumption: The covariates included in the models (sex, childhood socioeconomic status, child harm ACEs, household dysfunction ACEs, and adult sexual assault) sufficiently control for confounding of the CSA-outcome associations.
- Findingown data
Adding child harm ACEs to the model did not further change the pattern of results.
“The addition of child harm ACEs to the model (Model 3, Table 3) did not further change the pattern of results.”
Quote in the paperNot a substantial claim - Findingown data
CSA survivors were more likely than their peers to experience thought disorders in adulthood after adjusting for confounders.
“After adjusting for confounders, CSA survivors were more likely than their peers to experience internalizing, externalizing, and thought disorders, suicide attempts, health risk behaviors, systemic inflammation, poor oral health, sexually transmitted diseases, high-conflict relationships, benefit use, financial difficulties, antisocial behavior, and cumulative problems across multiple domains in”
Quote in the paperSubstantial claim- Rests on an assumption: Retrospective self-reports of CSA at age 26 accurately measure childhood sexual abuse exposure.
- Rests on an assumption: The covariates included in the models (sex, childhood socioeconomic status, child harm ACEs, household dysfunction ACEs, and adult sexual assault) sufficiently control for confounding of the CSA-outcome associations.
- Findingown data
CSA survivors were more likely than their peers to experience financial difficulties in adulthood after adjusting for confounders.
“After adjusting for confounders, CSA survivors were more likely than their peers to experience internalizing, externalizing, and thought disorders, suicide attempts, health risk behaviors, systemic inflammation, poor oral health, sexually transmitted diseases, high-conflict relationships, benefit use, financial difficulties, antisocial behavior, and cumulative problems across multiple domains in”
Quote in the paperSubstantial claim- Rests on an assumption: Retrospective self-reports of CSA at age 26 accurately measure childhood sexual abuse exposure.
- Rests on an assumption: The covariates included in the models (sex, childhood socioeconomic status, child harm ACEs, household dysfunction ACEs, and adult sexual assault) sufficiently control for confounding of the CSA-outcome associations.
- Findingown data
CSA survivors were more likely than their peers to experience sexually transmitted diseases in adulthood after adjusting for confounders.
“After adjusting for confounders, CSA survivors were more likely than their peers to experience internalizing, externalizing, and thought disorders, suicide attempts, health risk behaviors, systemic inflammation, poor oral health, sexually transmitted diseases, high-conflict relationships, benefit use, financial difficulties, antisocial behavior, and cumulative problems across multiple domains in”
Quote in the paperSubstantial claim- Rests on an assumption: Retrospective self-reports of CSA at age 26 accurately measure childhood sexual abuse exposure.
- Rests on an assumption: The covariates included in the models (sex, childhood socioeconomic status, child harm ACEs, household dysfunction ACEs, and adult sexual assault) sufficiently control for confounding of the CSA-outcome associations.
- Findingown data
After adjusting for household dysfunction ACEs, CSA was no longer significantly associated with criminal convictions.
“After adjusting for household dysfunction ACEs, CSA was no longer significantly associated with criminal convictions.”
Quote in the paperSubstantial claim - Findingown data
In the current study, CSA-related differences in sexual difficulties were seen at age 45 years only.
“Consistent with this idea, previous Dunedin Study research showed stronger CSA-related differences in sexual health at age 18 to 21 years than 26 to 32 years (van Roode et al., 2009), and in the current study we saw CSA-related differences in sexual difficulties at age 45 years only.”
Quote in the paperSubstantial claim - Findingown data
CSA survivors were more likely than their peers to experience health risk behaviors in adulthood after adjusting for confounders.
“After adjusting for confounders, CSA survivors were more likely than their peers to experience internalizing, externalizing, and thought disorders, suicide attempts, health risk behaviors, systemic inflammation, poor oral health, sexually transmitted diseases, high-conflict relationships, benefit use, financial difficulties, antisocial behavior, and cumulative problems across multiple domains in”
Quote in the paperSubstantial claim- Rests on an assumption: Retrospective self-reports of CSA at age 26 accurately measure childhood sexual abuse exposure.
- Rests on an assumption: The covariates included in the models (sex, childhood socioeconomic status, child harm ACEs, household dysfunction ACEs, and adult sexual assault) sufficiently control for confounding of the CSA-outcome associations.
- Findingown data
The any-CSA group, compared with the no-CSA group, had more child harm and household dysfunction adverse childhood experiences.
“The any CSA (compared to no CSA) group included higher proportions of people who were female, grew up in lower socioeconomic status families, had more child harm and household dysfunction ACEs, and had reported being sexually assaulted in adulthood (Table 2).”
Quote in the paperNot a substantial claim - Findingown data
CSA survivors were more likely than their peers to experience benefit use in adulthood after adjusting for confounders.
“After adjusting for confounders, CSA survivors were more likely than their peers to experience internalizing, externalizing, and thought disorders, suicide attempts, health risk behaviors, systemic inflammation, poor oral health, sexually transmitted diseases, high-conflict relationships, benefit use, financial difficulties, antisocial behavior, and cumulative problems across multiple domains in”
Quote in the paperSubstantial claim- Rests on an assumption: Retrospective self-reports of CSA at age 26 accurately measure childhood sexual abuse exposure.
- Rests on an assumption: The covariates included in the models (sex, childhood socioeconomic status, child harm ACEs, household dysfunction ACEs, and adult sexual assault) sufficiently control for confounding of the CSA-outcome associations.
- Findingown data
In the Dunedin study birth cohort, 19% overall (30% of females, 9% of males) reported at least one type of childhood sexual abuse.
“One in five (19% overall; 30% of females; 9% of males) participants reported at least one type of CSA; one in twenty (6% overall; 10% of females; 2% of males) reported the most severe type: forced intercourse (Table 1).”
Quote in the paperNot a substantial claim - Findingown data
CSA survivors were more likely than their peers to experience externalizing disorders in adulthood after adjusting for confounders.
“After adjusting for confounders, CSA survivors were more likely than their peers to experience internalizing, externalizing, and thought disorders, suicide attempts, health risk behaviors, systemic inflammation, poor oral health, sexually transmitted diseases, high-conflict relationships, benefit use, financial difficulties, antisocial behavior, and cumulative problems across multiple domains in”
Quote in the paperSubstantial claim- Rests on an assumption: Retrospective self-reports of CSA at age 26 accurately measure childhood sexual abuse exposure.
- Rests on an assumption: The covariates included in the models (sex, childhood socioeconomic status, child harm ACEs, household dysfunction ACEs, and adult sexual assault) sufficiently control for confounding of the CSA-outcome associations.
- Findingown data
CSA was associated with multiple persistent problems across adulthood, even after adjusting for confounding life stressors.
“In sum, CSA was associated with multiple persistent problems across adulthood, even after adjusting for confounding life stressors, and the risk for particular problems incremented with CSA severity.”
Quote in the paperSubstantial claim- Rests on an assumption: Retrospective self-reports of CSA at age 26 accurately measure childhood sexual abuse exposure.
- Rests on an assumption: The covariates included in the models (sex, childhood socioeconomic status, child harm ACEs, household dysfunction ACEs, and adult sexual assault) sufficiently control for confounding of the CSA-outcome associations.
- Findingown data
After adding childhood socioeconomic status, the associations between CSA and high systemic inflammation, low lung function, lack of formal qualifications, and low socioeconomic status were no longer statistically significant.
“The associations observed in Model 1 between CSA and high systemic inflammation, low lung function, lack of formal qualifications, and low socioeconomic status in adulthood were no longer statistically significant; associations with metabolic syndrome, sexual difficulties, risky sex, lack of intimate relationships, and parenting difficulties remained nonsignificant.”
Quote in the paperNot a substantial claim - Findingown data
CSA survivors were more likely than their peers to experience antisocial behavior in adulthood after adjusting for confounders.
“After adjusting for confounders, CSA survivors were more likely than their peers to experience internalizing, externalizing, and thought disorders, suicide attempts, health risk behaviors, systemic inflammation, poor oral health, sexually transmitted diseases, high-conflict relationships, benefit use, financial difficulties, antisocial behavior, and cumulative problems across multiple domains in”
Quote in the paperSubstantial claim- Rests on an assumption: Retrospective self-reports of CSA at age 26 accurately measure childhood sexual abuse exposure.
- Rests on an assumption: The covariates included in the models (sex, childhood socioeconomic status, child harm ACEs, household dysfunction ACEs, and adult sexual assault) sufficiently control for confounding of the CSA-outcome associations.
- Findingown data
The study did not find statistically significant associations between CSA and sexual difficulties, risky sex, lack of intimate relationships, and parenting difficulties, even before other control variables were taken into account.
“We also did not find statistically significant associations between CSA and sexual difficulties, risky sex, lack of intimate relationships, and parenting difficulties, even before other control variables were taken into account.”
Quote in the paperSubstantial claim - Findingown data
CSA survivors were more likely than their peers to experience internalizing disorders in adulthood after adjusting for confounders.
“After adjusting for confounders, CSA survivors were more likely than their peers to experience internalizing, externalizing, and thought disorders, suicide attempts, health risk behaviors, systemic inflammation, poor oral health, sexually transmitted diseases, high-conflict relationships, benefit use, financial difficulties, antisocial behavior, and cumulative problems across multiple domains in”
Quote in the paperSubstantial claim- Rests on an assumption: Retrospective self-reports of CSA at age 26 accurately measure childhood sexual abuse exposure.
- Rests on an assumption: The covariates included in the models (sex, childhood socioeconomic status, child harm ACEs, household dysfunction ACEs, and adult sexual assault) sufficiently control for confounding of the CSA-outcome associations.
- Findingown data
In this longitudinal study, CSA was associated with problems across multiple domains of functioning from young adulthood to midlife.
“In this longitudinal study, CSA was associated with problems across multiple domains of functioning from young adulthood to midlife.”
Quote in the paperSubstantial claim - Findingown data
The any-CSA group, compared with the no-CSA group, included a higher proportion of people who had reported being sexually assaulted in adulthood.
“The any CSA (compared to no CSA) group included higher proportions of people who were female, grew up in lower socioeconomic status families, had more child harm and household dysfunction ACEs, and had reported being sexually assaulted in adulthood (Table 2).”
Quote in the paperNot a substantial claim - Findingown data
CSA survivors were more likely than their peers to experience suicide attempts in adulthood after adjusting for confounders.
“After adjusting for confounders, CSA survivors were more likely than their peers to experience internalizing, externalizing, and thought disorders, suicide attempts, health risk behaviors, systemic inflammation, poor oral health, sexually transmitted diseases, high-conflict relationships, benefit use, financial difficulties, antisocial behavior, and cumulative problems across multiple domains in”
Quote in the paperSubstantial claim- Rests on an assumption: Retrospective self-reports of CSA at age 26 accurately measure childhood sexual abuse exposure.
- Rests on an assumption: The covariates included in the models (sex, childhood socioeconomic status, child harm ACEs, household dysfunction ACEs, and adult sexual assault) sufficiently control for confounding of the CSA-outcome associations.
- Findingown data
After adjusting for prospectively measured confounding factors, participants who reported CSA were more likely than their peers to have problems across adulthood in physical, mental, sexual, interpersonal, economic, antisocial, and cumulative domains.
“After adjusting for prospectively measured confounding factors, participants who reported CSA were more likely than their peers to have problems across adulthood in the following domains: physical (health risk behaviors, high systemic inflammation, and poor oral health), mental (internalizing disorder, externalizing disorder, thought disorder, and suicide attempts), sexual (sexually transmitted”
Quote in the paperSubstantial claim- Rests on an assumption: The control variables used (sex, childhood socioeconomic status, child harm and household dysfunction ACEs, and sexual assault in adulthood) adequately account for confounding of the CSA-outcome associations.
- Findingown data
CSA survivors were more likely than their peers to experience poor oral health in adulthood after adjusting for confounders.
“After adjusting for confounders, CSA survivors were more likely than their peers to experience internalizing, externalizing, and thought disorders, suicide attempts, health risk behaviors, systemic inflammation, poor oral health, sexually transmitted diseases, high-conflict relationships, benefit use, financial difficulties, antisocial behavior, and cumulative problems across multiple domains in”
Quote in the paperSubstantial claim- Rests on an assumption: Retrospective self-reports of CSA at age 26 accurately measure childhood sexual abuse exposure.
- Rests on an assumption: The covariates included in the models (sex, childhood socioeconomic status, child harm ACEs, household dysfunction ACEs, and adult sexual assault) sufficiently control for confounding of the CSA-outcome associations.
- Findingown data
The any-CSA group, compared with the no-CSA group, included a higher proportion of people who were female.
“The any CSA (compared to no CSA) group included higher proportions of people who were female, grew up in lower socioeconomic status families, had more child harm and household dysfunction ACEs, and had reported being sexually assaulted in adulthood (Table 2).”
Quote in the paperNot a substantial claim - Findingown data
Childhood sexual abuse (any vs no) was associated with increased risk of internalizing disorder in adulthood (RR=1.40, 95% CI 1.15-1.70).
“| Internalizing disorder | 1.40*** | 1.47*** | 1.61*** | 1.68*** |”
Quote in the paperSubstantial claim - Findingcitation
The higher risk for most specific problems associated with childhood sexual abuse was small to moderate.
“the higher risk for most specific problems was small to moderate”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Fergusson et al., 2013
Not checked in the free run.
- cites Hailes et al., 2019
Not checked in the free run.
- Findingown data
Childhood sexual abuse (any vs no) was associated with increased risk of high benefit use in adulthood (RR=1.37, 95% CI 1.08-1.74).
“| High benefit use | 1.37** | 1.40* | 1.45* | 1.53* |”
Quote in the paperSubstantial claim - Findingown data
Childhood sexual abuse (any vs no) was associated with increased risk of high-conflict relationship in adulthood (RR=1.43, 95% CI 1.15-1.78).
“| High-conflict relationship | 1.43** | 1.55*** | 1.60** | 1.70*** |”
Quote in the paperSubstantial claim - Findingown data
Childhood sexual abuse (any vs no) was associated with increased risk of problems in four or more life domains in adulthood (RR=1.41, 95% CI 1.20-1.65).
“| Problems in ≥4 domains | 1.41*** | 1.47*** | 1.45*** | 1.52*** |”
Quote in the paperSubstantial claim - Findingown data
Childhood sexual abuse (any vs no) was associated with increased risk of financial difficulties in adulthood (RR=1.36, 95% CI 1.07-1.74).
“| Financial difficulties | 1.36* | 1.49** | 1.59** | 1.60** |”
Quote in the paperSubstantial claim - Findingown data
Childhood sexual abuse (any vs no) was associated with increased risk of thought disorder in adulthood (RR=2.55, 95% CI 1.45-4.48).
“| Thought disorder | 2.55** | 2.31* | 2.08 | 2.85* |”
Quote in the paperSubstantial claim - Findingown data
Childhood sexual abuse (any vs no) was associated with increased risk of sexually transmitted disease in adulthood (RR=1.35, 95% CI 1.02-1.80).
“| Sexually transmitted disease | 1.35* | 1.32 | 1.18 | 1.18 |”
Quote in the paperSubstantial claim - Interpretationcitation
The findings are consistent with the idea that childhood maltreatment is likely to contribute to poor biopsychosocial outcomes via the downstream effects of chronic stress and maladaptive coping behaviors.
“Our findings are also consistent with the idea that childhood maltreatment is likely to contribute to poor biopsychosocial outcomes via the downstream effects of chronic stress and maladaptive coping behaviors (Cicchetti & Toth, 2004;Danese, 2020).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Cicchetti & Toth, 2004
Not checked in the free run.
- cites Danese, 2020
Not checked in the free run.
- Premisenone given
No currently available measure of CSA in a population research setting, whether prospective or retrospective, can provide precise and correct identification of all cases and exclusion of all inaccurate reports.
“Nonetheless, no currently available measure of CSA in a population research setting (whether prospective or retrospective) can provide precise and correct identification of all cases and exclusion of all inaccurate reports.”
Quote in the paperNot a substantial claim - Premisecitation
Previous Dunedin Study research showed stronger CSA-related differences in sexual health at age 18 to 21 years than at 26 to 32 years.
“Consistent with this idea, previous Dunedin Study research showed stronger CSA-related differences in sexual health at age 18 to 21 years than 26 to 32 years (van Roode et al., 2009), and in the current study we saw CSA-related differences in sexual difficulties at age 45 years only.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites van Roode et al., 2009
Not checked in the free run.
- Interpretationown data
Where differences between CSA definitions in observed effect sizes were evident, they tended to reflect differences in the relative severity of CSA between the exposed and comparison groups.
“The second point to note is that where differences between definitions of CSA in the observed effect sizes were evident, they tended to reflect differences in the relative severity of CSA between the exposed and comparison groups.”
Quote in the paperNot a substantial claim - Premisenone given
Good quality evidence relating to the long-term outcomes associated with CSA in the general population comes from prospective longitudinal studies in which a population-based cohort is followed over their life course, and adjustments made for prospectively measured covariates.
“Good quality evidence relating to the long-term outcomes associated with CSA in the general population comes from prospective longitudinal studies in which a population-based (rather than selected) cohort of individuals is followed over their life course, and adjustments made for prospectively measured covariates.”
Quote in the paperSubstantial claim - Interpretationown data
The results are best described as providing evidence that CSA retrospectively reported in young adulthood is associated with multiple problems across life domains and across adulthood.
“Thus, the results here are best described as providing evidence that CSA retrospectively reported in young adulthood is associated with multiple problems across life domains and across adulthood.”
Quote in the paperSubstantial claim - Interpretationcitation
Alongside previous research, the current findings support the hypothesis that CSA is likely to contribute, whether directly or indirectly, to a range of adverse outcomes in adulthood.
“Alongside previous research, the current findings support the hypothesis that CSA is likely to contribute, whether directly or indirectly, to a range of adverse outcomes in adulthood (Chartier et al., 2009;Nelson et al., 2002;Power et al., 2020).”
Quote in the paperSubstantial claim0 of 3 sources checked- cites Chartier et al., 2009
Not checked in the free run.
- cites Nelson et al., 2002
Not checked in the free run.
- cites Power et al., 2020
Not checked in the free run.
- Interpretationown data
Using population-based longitudinal data and a comprehensive set of outcomes repeatedly assessed from young adulthood to midlife, the study indicates that retrospectively reported CSA is a risk factor for problems across multiple life domains.
“Using population-based longitudinal data and a comprehensive set of outcomes repeatedly assessed from young adulthood to midlife, this study indicates that retrospectively reported CSA is a risk factor for problems across multiple life domains”
Quote in the paperSubstantial claim- Rests on an assumption: The Dunedin Study birth cohort is representative of the general population of New Zealanders born in 1972-73.
- Study design and conductreasoning
In this study of retrospectively reported CSA, the authors cannot rule out the possibility that recall or reporting biases influenced the results.
“In this study of retrospectively reported CSA, we cannot not rule out the possibility that recall or reporting biases influenced the results.”
Quote in the paperNot a substantial claim - Premisereasoning
Findings from selected-sample studies may not generalize to the wider population.
“findings from such selected-sample studies may not generalize to the wider population”
Quote in the paperSubstantial claim - Study design and conductown data
Causation cannot be inferred from the current findings.
“Causation cannot be inferred from the current findings, but they nevertheless indicate that many associations between CSA and adverse long-term outcomes were not explained by other major childhood risk factors that often coincide with CSA, including socioeconomic adversity and other ACEs (Danese, 2020).”
Quote in the paperSubstantial claim - Premisereasoning
To date none have taken a wider view and systematically assessed associations between CSA and the persistence across adulthood of problems in multiple domains of functioning.
“to date none have taken a wider view and systematically assessed associations between CSA and the persistence across adulthood of problems in multiple domains of functioning.”
Quote in the paperSubstantial claim - Study design and conductown data
Outcomes were largely limited to those that were consistently and repeatedly assessed from age 26 to 45 years.
“The fourth limitation is that while this omnibus study provides an overview of a range of problems in adulthood, outcomes were largely limited to those that were consistently and repeatedly assessed from age 26 to 45 years.”
Quote in the paperNot a substantial claim - Study design and conductreasoning
The high retention rate (94% of living study members participated at age 45) and study design features help rule out some alternative explanations for the findings.
“First, the high retention rate (94% of living study members participated at age 45) and study design features (e.g., population-based birth cohort, predominantly prospective data, regular follow-ups over the life course, consistent high quality biopsychosocial measures, controls for other stressors) help to rule out some of the alternative explanations for the findings.”
Quote in the paperSubstantial claim- Rests on an assumption: The Dunedin Study birth cohort is representative of the general population of New Zealanders born in 1972-73.
- Premisereasoning
A definitive causal link between CSA and outcomes in adulthood cannot be ethically determined because it would require random assignment to CSA.
“A definitive causal link between CSA and outcomes in adulthood cannot be ethically determined because it would require random assignment to CSA”
Quote in the paperNot a substantial claim - Interpretationown data
Problems associated with childhood sexual abuse can persist across the 20s, 30s, and well into the 40s.
“problems can persist across the 20s, 30s, and well into the 40s.”
Quote in the paperSubstantial claim - Interpretationreasoning
Taken together, the cumulative risk over a long period and across multiple domains reflects considerable individual and societal burden.
“the cumulative risk over a long period and across multiple domains reflect considerable individual and societal burden”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Fergusson et al., 2013
Not checked in the free run.
- cites Hailes et al., 2019
Not checked in the free run.
- May combine two claims. 24
- The quote only partly states this claim. 5
- Classified as probably not a substantial claim. 8
May combine two claims.
Findingown dataAfter adding childhood socioeconomic status to the model, CSA remained significantly associated with physical (health risk behaviors and poor oral health), mental (externalizing, internalizing, thought disorder, suicide attempts), sexual (sexually transmitted diseases), interpersonal (high-conflict relationships), economic (high benefit use and financial difficulties), antisocial (high delinquency
“After adding childhood socioeconomic status to the model (Model 2, Table 3), CSA remained significantly associated with the following problems across the assessed domains: physical (health risk behaviors and poor oral health); mental (externalizing disorder, internalizing disorder, thought disorder, and suicide attempts); sexual (sexually transmitted diseases); interpersonal (high-conflict”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataThe overall pattern of findings was consistent across the different CSA definitions, with differences in statistical significance due to severity-related differences in effect size and sample size in the exposed group.
“The first point to note is that the overall pattern of findings was consistent across the different definitions, albeit with some differences in statistical significance due to severity-related differences in effect size (i.e., smaller effect sizes for comparisons with less severe CSA types) and sample size in the exposed group (i.e., smaller sample size and less certain estimates in the”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataAfter including household dysfunction ACEs, CSA was no longer significantly associated with criminal convictions, but all other patterns remained the same.
“After including household dysfunction ACEs (Model 4, Table 3), CSA was no longer significantly associated with criminal convictions, but all other patterns remained the same.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataThe pattern of findings was consistent across different CSA definitions, with small to moderate effect sizes (large for lifetime suicide attempts) that incremented with CSA severity.
“The pattern of findings was consistent across different CSA definitions, with small to moderate effect sizes (albeit large for lifetime suicide attempts) that incremented with CSA severity.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataParticipants who reported CSA were not significantly more likely than their peers to have low lung function, lack of formal qualifications, low socioeconomic status, and criminal convictions in adulthood after adjusting for all control variables.
“Against the overall picture of higher risk for problems in multiple domains across adulthood, participants who reported CSA were not significantly more likely than their peers to have low lung function, lack of formal qualifications, low socioeconomic status, and criminal convictions in adulthood after adjusting for all control variables (sex, childhood socioeconomic status, child harm and”
Quote in the paperSubstantial claim- Rests on an assumption: The control variables used (sex, childhood socioeconomic status, child harm and household dysfunction ACEs, and sexual assault in adulthood) adequately account for confounding of the CSA-outcome associations.
May combine two claims. The quote only partly states this claim.
Findingown dataFor all four CSA definitions, participants in the exposed group had significantly higher risk of problems across the assessed domains, including health risk behaviors, poor oral health, externalizing, internalizing, suicide attempts, sexually transmitted diseases, high-conflict relationships, high benefit use, financial difficulties, high delinquency, and multi-domain problems.
“For all four definitions, participants in the exposed group had significantly higher risk of the following problems across the assessed domains: physical (health risk behaviors 82-2.32]); and multi-domain (RRs 1.41-1.52).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataAfter adjusting for sex only, CSA was associated with low lung function, lack of formal qualifications, low socioeconomic status, and criminal convictions, but after further adjusting for childhood socioeconomic status, CSA was no longer significantly associated with low lung function, lack of formal qualifications, or low socioeconomic status.
“After adjusting for sex only, CSA was associated with those four outcomes, but after further adjusting for childhood socioeconomic status, CSA was no longer significantly associated with low lung function, lack of formal qualifications, or low socioeconomic status.”
Quote in the paperSubstantial claimMay combine two claims.
FindingreasoningObserved relative risks tended to be larger for analyses focused on forced intercourse than for those focused on any CSA, and larger for forced intercourse versus no CSA than for forced intercourse versus all other participants.
“For example, the observed relative risks tended to be larger for the analyses that focused on forced intercourse than those that focused on any CSA, and larger for the forced intercourse versus no CSA analyses than the more conservative analyses that compared those who reported forced intercourse to all other participants”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataAfter adjusting for sex, CSA was significantly associated with higher risk of problems in physical, mental, sexual, interpersonal, economic, antisocial, and multidomain domains.
“After adjusting for sex (Model 1, Table 3), CSA was significantly associated with higher risk of the following problems across the assessed domains: physical (health risk behaviors, high systemic inflammation, low lung function, poor oral health); mental (externalizing disorder, internalizing disorder, thought disorder, suicide attempts); sexual (sexually transmitted diseases); interpersonal (high”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataAfter adjusting for sex, CSA was not significantly associated with metabolic syndrome, sexual difficulties, risky sex, lack of intimate relationships, or parenting difficulties.
“We did not observe statistically significant associations between CSA and metabolic syndrome, sexual difficulties, risky sex, lack of intimate relationships, and parenting difficulties.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataAcross CSA definitions, female sex, lower childhood socioeconomic status, and more household dysfunction ACEs were consistently and significantly linked to all four measures of CSA.
“Regarding participant characteristics, a consistent picture emerged, with female sex, lower childhood socioeconomic status, and more household dysfunction ACEs consistently and significantly linked to all four measures of CSA.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataFor all four CSA definitions, participants in the exposed groups were not significantly more likely to have low lung function, sexual difficulties, risky sex, lack of intimate partner relationships, parenting difficulties, lack of formal qualifications, low socioeconomic status, or a criminal conviction.
“Similarly, for all four definitions of CSA, participants in the exposed groups were not significantly more likely to have: low lung function, sexual difficulties, risky sex, lack of intimate partner relationships, parenting difficulties, lack of formal qualifications, low socioeconomic status, or a criminal conviction.”
Quote in the paperNot a substantial claimThe quote only partly states this claim.
Findingown dataChildhood sexual abuse (any vs no) was associated with increased risk of high delinquency in adulthood (RR=1.82, 95% CI 1.43-2.32).
“| High delinquency | 1.82*** | 2.01*** | 2.07*** | 2.32*** |”
Quote in the paperSubstantial claimThe quote only partly states this claim.
Findingown dataChildhood sexual abuse (any vs no) was associated with increased risk of suicide attempt in adulthood (RR=2.64, 95% CI 1.81-3.86).
“| Suicide attempt | 2.64*** | 3.10*** | 3.75*** | 4.22*** |”
Quote in the paperSubstantial claimThe quote only partly states this claim.
Findingown dataChildhood sexual abuse (any vs no) was associated with increased risk of externalizing disorder in adulthood (RR=1.44, 95% CI 1.13-1.82).
“| Externalizing disorder | 1.44** | 1.51** | 1.56** | 1.59** |”
Quote in the paperSubstantial claimThe quote only partly states this claim.
Findingown dataChildhood sexual abuse (any vs no) was associated with increased risk of poor oral health in adulthood (RR=1.54, 95% CI 1.25-1.91).
“| Poor oral health | 1.54*** | 1.61*** | 1.50** | 1.67*** |”
Quote in the paperSubstantial claimMay combine two claims.
Study design and conductown dataRelatively small numbers in the exposed groups meant the study could not adequately test whether CSA effects differed for males and females, and some potentially meaningful effects were not statistically significant.
“First, the relatively small numbers in the exposed groups meant that we could not adequately test whether CSA effects were different for males and females, and that some potentially meaningful effects (see Figure 2) were not statistically significant.”
Quote in the paperNot a substantial claimMay combine two claims.
Study design and conductown dataThe study observed relationships between CSA and objectively measured outcomes as well as self-reported ones, helping to avoid issues with common method variance.
“For example, we observed relationships between CSA and objectively measured outcomes as well as self-reported ones, helping to avoid issues with common method variance.”
Quote in the paperSubstantial claimMay combine two claims.
Study design and conductown dataRepeating analyses using different definitions of CSA showed consistent patterns of effects that varied according to severity in expected ways.
“Second, we repeated our analyses using different definitions of CSA and showed consistent patterns of effects that varied according to severity in expected ways: a pattern that is consistent with other similar studies, including the Christchurch Health and Development Study (Fergusson et al., 2013).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Fergusson et al., 2013
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductnone givenAll analyses were conducted using Stata/IC 16 and checked via independent replication by a second analyst.
“All analyses were conducted using Stata/IC 16 (HG) and checked via independent replication by a second analyst (JK).”
Quote in the paperNot a substantial claimMay combine two claims.
Study design and conductown dataSupplementary analyses showed that the overall pattern of findings was consistent across linear as well as binary outcome measures, and four separate ages in adulthood.
“Third, our supplementary analyses showed that the overall pattern of findings was consistent across linear as well as binary outcome measures, and four separate ages in adulthood.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationPrevious literature on the relationships between CSA and sexual outcomes, and between CSA and parenting, is mixed and often depends on how the sample was selected.
“Guidance from the previous literature is limited as findings on the relationships between CSA and sexual outcomes, and between CSA and parenting, are mixed and often depend on how the sample was selected (Bigras et al., 2020;Greene et al., 2020).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Bigras et al., 2020
Not checked in the free run.
- cites Greene et al., 2020
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe study considered different definitions of CSA in secondary analyses.
“Analyses controlled for sex, socioeconomic status, prospectively reported child harm and household dysfunction adverse childhood experiences, and adult sexual assault, and considered different definitions of CSA.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductnone givenThe New Zealand Health and Disability Ethics Committee approved the study, and informed written consent was obtained from all participants.
“The New Zealand Health and Disability Ethics Committee approved the study, and informed written consent was obtained from all participants.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataAt age 45, 94% (n = 938) of the 997 participants still alive took part.
“when 94% (n = 938) of the 997 participants still alive took part.”
Quote in the paperNot a substantial claimMay combine two claims.
Study design and conductcitationThe cohort represented the full range of socioeconomic status in the general population of New Zealand's South Island and as adults matched the New Zealand National Health and Nutrition Survey on key adult health indicators and the New Zealand Census of citizens of the same age on educational attainment.
“The cohort represented the full range of socioeconomic status in the general population of New Zealand's South Island and as adults matched the New Zealand National Health and Nutrition Survey on key adult health indicators and the New Zealand Census of citizens of the same age on educational attainment (Poulton et al., 2006;Richmond-Rakerd et al., 2020).”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites Poulton et al., 2006
Not checked in the free run.
- cites Richmond-Rakerd et al., 2020
Not checked in the free run.
May combine two claims.
Study design and conductown dataSensitivity analyses confirmed a consistent pattern of effects across linear and binary outcome measures and four separate ages in adulthood, although some problems were more evident earlier or later in adulthood.
“Sensitivity analyses confirmed a consistent pattern of effects across linear and binary outcome measures (Supplement section 4.1), and four separate ages in adulthood, although some problems were more evident earlier or later in adulthood (Supplement section 4.2).”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim. May combine two claims.
Study design and conductnone givenAlthough all other measures were collected prospectively, exposure to CSA was recorded retrospectively at age 26 years.
“Third, although all other measures were collected prospectively, exposure to CSA was recorded retrospectively at age 26 years.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThe current findings do not elucidate the likely complex mechanisms by which CSA could lead to problems in multiple domains across adulthood.
“Finally, the current findings do not elucidate the likely complex mechanisms by which CSA could lead to problems in multiple domains across adulthood.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown dataSome CSA-outcome links might be better explained by other coinciding adversities, underscoring the importance of adjusting for prospectively measured covariates in CSA outcomes research.
“These findings indicate that some CSA-outcome links might be better explained by other coinciding adversities, and underscore the importance of adjusting for prospectively measured covariates in CSA outcomes research.”
Quote in the paperSubstantial claimMay combine two claims.
PremisereasoningMethodological limitations and a narrow focus on mental health outcomes in much of the existing literature mean that we do not yet have good quality population-based evidence about the links between CSA and adverse outcomes across multiple life domains, how strong those links are, and whether they persist across adulthood.
“However, methodological limitations and a narrow focus on mental health outcomes in much of the existing literature mean that we do not yet have good quality population-based evidence about the links between CSA and adverse outcomes across multiple life domains, how strong those links are, and whether they persist across adulthood.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
Study design and conductown dataAnalyses controlled for sex, socioeconomic status, prospectively reported child harm and household dysfunction adverse childhood experiences, and adult sexual assault.
“Analyses controlled for sex, socioeconomic status, prospectively reported child harm and household dysfunction adverse childhood experiences, and adult sexual assault, and considered different definitions of CSA.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S2 (checkable).
PremisereasoningGood quality longitudinal studies that adjust for potential confounding factors can help researchers get closer to understanding the relationship.
“good quality longitudinal studies that adjust for potential confounding factors can help researchers get closer to understanding the relationship.”
Quote in the paperNot a substantial claim
The paper relies on this without support.
Retrospective self-reports of CSA at age 26 accurately measure childhood sexual abuse exposure.
“we focused on retrospective reports of CSA provided by participants at the age 26 assessment.”
The paper relies on this without support.
The covariates included in the models (sex, childhood socioeconomic status, child harm ACEs, household dysfunction ACEs, and adult sexual assault) sufficiently control for confounding of the CSA-outcome associations.
“To understand the influence of potential confounding factors, sex, childhood socioeconomic status, child harm ACEs, household dysfunction ACEs, and sexual assault in adulthood were entered into the regression models in a stepwise fashion”
The paper relies on this without support.
The Dunedin Study birth cohort is representative of the general population of New Zealanders born in 1972-73.
“population-based birth cohort”
The paper relies on this without support.
The control variables used (sex, childhood socioeconomic status, child harm and household dysfunction ACEs, and sexual assault in adulthood) adequately account for confounding of the CSA-outcome associations.
“After adjusting for all control variables in the final model (Model 5, Table 3), CSA was significantly associated with the following problems across the assessed domains”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Since negative affective states are a characteristic of PTSD and are more common among individuals with a history of childhood trauma, a meditation-related amplification of such states could result in a relationship between trauma history and meditation-related hyperarousal.
“Since negative affective states are a characteristic of PTSD and are more common among individuals with a history of childhood trauma [64], a meditation-related amplification of such states could result in a relationship between trauma history and meditation-related hyperarousal.”
From Childhood trauma and subclinical PTSD symptoms predict adverse effects and worse outcomes across two mindfulness-based programs for active depression (2025) · cites this paper as [64]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Discussion lists systemic inflammation among adjusted findings despite nonsignificant primary result
MinorThe discussion includes high systemic inflammation among problems associated with CSA after adjustment. In the primary analysis's fully adjusted Model 5, however, its relative risk is 1.32 with a 95% confidence interval of 0.97-1.79, which includes 1; the results section also omits it from the significant Model 5 outcomes.
“After adjusting for prospectively measured confounding factors, participants who reported CSA were more likely than their peers to have problems across adulthood in the following domains: physical (health risk behaviors, high systemic inflammation, and poor oral health)”
“| High systemic | 1.40* | 1.34 | 1.32 | 1.32 | 1.32 | | inflammation | | | | | | | | (1.03-1.91) | (0.99-1.81) | (0.97-1.80) | (0.97-1.80) | (0.97-1.79) |”
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- Authors
- Guiney, H., Caspi, A., Ambler, A., Belsky, J., Kokaua, J., Broadbent, J., Cheyne, K., Dickson, N., Hancox, R. J., Harrington, H., Hogan, S., Ramrakha, S., Righarts, A., Thomson, W. M., Moffitt, T. E., & Poulton, R.
- Affiliations
- University of Otago (NZ)
- Duke University (US)
- King's College London (GB)
- University of California, Davis (US)
- Corresponding author
- Guiney, Hayley
- ORCID
- Venue
- Development and Psychopathology
- Publisher
- Cambridge University Press (CUP)
- Published
- 2022-12-23
- Volume
- 36
- Issue
- 1
- Pages
- 219-235
- ISSN
- 0954-5794 (ISSN-L)
- 1469-2198
- PMC
- PMC10287838
- OpenAlex
- W4312155742
- Semantic Scholar
- 9836bad4cd4435b00bdfe7794cbaeb1b0edccd90
- Cited by
- 64
- References
- 94
- Citations by year
- 2026: 27 · 2025: 21 · 2024: 10 · 2023: 6
- FWCI
- 8.45
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Development and Psychopathology (publishedVersion, cc-by)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Research Portal (King's College London) (submittedVersion, cc-by)
- Funders
- University of Otago
- Ministry of Business, Innovation and Employment (MR/P005918/1)
- Medical Research Council (MR/P005918, P005918, R01AG032282, MR/P005918/1, P005918/1)
- National Institute on Aging (MR/P005918/1, R01AG032282, R01AG049789)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Sociology and Political Science › Military, Security, and Education Studies
- Social Sciences › Gender Studies › Sexual Assault and Victimization Studies
- Keywords
- child sexual abuse, long-term outcomes, cumulative adversity, internalizing disorders, externalizing disorders, thought disorder, suicide attempts, health risk behaviors, systemic inflammation, oral health, sexually transmitted infections, financial hardship, antisocial behavior, adverse childhood experiences, abuse severity
- MeSH terms
- Adolescent, Adult, Child, Child Abuse, Sexual, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Male, Middle Aged, Retrospective Studies, Sexual Behavior, Social Class, Suicide, Attempted, Young Adult
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