Childhood sexual abuse and adult psychiatric and substance use disorders in women -: An epidemiological and Cotwin control analysis
Childhood sexual abuse and adult psychiatric and substance use disorders in women -: An epidemiological and Cotwin control analysis
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DOI：
10.1001/archpsyc.57.10.953
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发表时间：
2000-10-01
影响因子：
--
通讯作者：
Prescott, CA
中科院分区：
文献类型：
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作者：
Kendler, KS;Bulik, CM;Prescott, CA
背景：报告儿童期性虐待（CSA）的妇女在成年后患精神疾病的风险增加。这种关联的诊断特异性和原因是什么？研究方法：在一个基于人口的样本1411女性成年双胞胎，3个水平的CSA进行了评估，自我报告和cotwin报告：非生殖器，生殖器，和性交。访谈双胞胎和父母评估家庭背景和精神和物质依赖性障碍的诊断。结果：通过自我报告，30.4%的人报告了任何CSA，8.4%的人报告了性交。自我报告的CSA与所有疾病呈正相关，最高的OR与贪食症、酒精和其他药物依赖有关。非生殖器CSA的OR值适中，通常不显著，生殖器CSA尤其是性交的OR值增加，大多数OR值超过3.0。与cotwin报告的CSA结果相似，尽管许多OR较小。控制家庭背景因素和父母的精神病理学产生了一个小到适度的减少OR。在双胞胎对不一致的CSA，暴露的双胞胎是在一贯较高的患病风险。结论：CSA的妇女有一个显着增加的风险，发展范围广泛的精神病理学。大多数这种关联是由于更严重的CSA形式，不能用背景家族因素来解释。虽然不能排除其他偏见，但这些结果与CSA与精神病和药物滥用障碍风险增加有因果关系的假设一致。
Background: Women who report childhood sexual abuse (CSA) are at increased risk for developing psychiatric disorders in adulthood. What is the diagnostic specificity and cause of this association!Methods: In a population-based sample of 1411 female adult twins, 3 levels of CSA were assessed by self-report and cotwin report: nongenital, genital, and intercourse. Interviews with twins and parents assessed family background and diagnoses of psychiatric and substance dependence disorders. Odds ratios (ORs) were calculated by logistic regression.Results: By self-report, 30.4% reported any CSA and 8.4% reported intercourse. Self-reported CSA was positively associated with all disorders, the highest ORs being seen with bulimia and alcohol and other drug dependence. The ORs were modest and often nonsignificant with nongenital CSA and increased with genital CSA and especially intercourse, where most ORs exceeded 3.0. A similar pattern of findings was seen with CSA as reported by the cotwin, although many ORs were smaller. Controlling for family background factors and parental psychopathology produced a small to modest reduction in ORs. In twin pairs discordant for CSA, the exposed twin was at consistently higher risk of illness.Conclusions: Women with CSA have a substantially increased risk for developing a wide range of psychopathology. Most of this association is due to more severe forms of CSA and cannot be explained by background familial factors. Although other biases cannot be ruled out, these results are consistent with the hypothesis that CSA is causally related to an increased risk for psychiatric and substance abuse disorders.