History of Childhood Sexual Abuse Increases Risk of Schizophrenia in Adulthood
Child abuse is known to contribute to future behavioral health consequences, such as anxiety, depression, and suicide—illnesses that can create lifelong disability or increase risk for death. These types of disorders have clinically and historically been accepted by the mental health field to be rooted in child abuse, yet the same association has not been made among psychotic disorders. Although psychotic disorders, including schizophrenias, are commonly believed to be linked with abuse during childhood or adolescence, scientific research on this relationship has been largely under-studied.
Now, researchers from Monash University, Clifton Hill in Australia are saying that sexual abuse during childhood increases an individual’s risk of psychotic disorders during adulthood. A new study released by Dr. Margaret Cutajar from Monash’s Centre for Forensic Behavioural Science and her colleagues has found that experiencing sexual abuse as a child is a risk factor for developing later psychotic disorders—a risk that is double or more what the general population experiences, depending on the level of abuse. The study was published in the November issue of Archives of General Psychiatry.
For the study, researchers traced 30 years worth of police and hospital records from the Victorian state that included episodes of sexual assault upon minors younger than 16 years of age. The cases selected for the study, a total of 2,759 individual cases, included individuals who had made contact with mental health services in the area after their assault. Then, the researchers compared the rate of psychotic illnesses among assault victims to the rate of psychotic illnesses among a control group of individuals drawn from the voting records of the Victorian region who were of the same gender and age. For both groups, the researchers identified cases of psychotic illnesses using the same method of diagnosis; this design was intended to produce more concrete evidence of any existing links between childhood sexual assault and adulthood psychotic disorders. Typically, studies that involve investigating childhood sexual assault are dependent upon recall, which is not always a reliable way to establish facts. This cohort, control-case study, however, found a more trustworthy method for comparison by relying on evidentiary documentation of assault and diagnosis within a large time frame.
In general, individuals who had a history of childhood sexual abuse had a significantly higher risk for later psychoses: compared to the general population, these individuals were twice more likely to develop a psychotic disorder (2.8% vs. 1.4%), and 2.7 times more likely to develop a schizophrenic disorder (1.9% vs. 0.7%). Those assault victims who had experienced penetration were at an even greater risk for a psychotic disorder (3.4%) and schizophrenia (2.4%). Those at the highest risk included assault victims who had experienced penetration, were over the age of 12 years at the time of their attack, or were attacked by more than one perpetrator. In total, these combined risk factors resulted in a rate of 8.6% for a later schizophrenic disorder, and a rate of 17.2% for a later psychotic disorder.
The research does point to the presence of serious risk factors for these psychotic disorders; however, the researchers caution that their study does not suggest that childhood sexual assault is necessarily a precursor to adulthood psychotic disorders. What the study does reveal, most importantly, are those individuals who may be highly in need of professional psychological intervention in order to prevent or treat their symptoms of psychosis. Furthermore, the findings could also indicate the presence of other variable factors related to childhood assault that may influence the rate of later psychosis, such as difficult family life or poverty. Having an abusive parent, for example, may condition a young child to perceive the world as a threatening place, and subsequently induce anxiety and paranoid thoughts—symptoms that could help explain later schizophrenic characteristics. Because of these findings, the study suggests that investigating schizophrenic patients’ history of childhood trauma should be made a pivotal part of clinicians’ cognitive treatment methods for these patients.
Source: Reuters Health, Sexual abuse in childhood tied to schizophrenia. November 2, 2010