OBJECTIVE: Data from depressed women with and without a history of childhood sexual abuse were used to characterize clinical features that distinguished the two groups and to examine relationships of childhood sexual abuse to lifetime deliberate self-harm and recent interpersonal violence.
METHOD: One hundred twenty-five women with depressive disorders were interviewed and completed self-report questionnaires. Path analysis was used to examine relationships of several childhood and personality variables with deliberate self-harm in adulthood and recent interpersonal violence.
RESULTS: Women with a childhood sexual abuse history reported more childhood physical abuse, childhood emotional abuse, and parental conflict in the home, compared to women without a childhood sexual abuse history. The two groups were similar in severity of depression, but the women with a childhood sexual abuse history were more likely to have attempted suicide and/or engaged in deliberate self-harm. The women with a history of childhood sexual abuse also became depressed earlier in life, were more likely to have panic disorder, and were more likely to report a recent assault. Path analysis confirmed the contributory role of childhood sexual abuse to deliberate self-harm and the significance of childhood physical abuse for recent interpersonal violence.
CONCLUSIONS: Childhood sexual abuse is an important risk factor to identify in women with depression. Depressed women with a childhood sexual abuse history constitute a subgroup of patients who may require tailored interventions to combat both depression recurrence and harmful and self-defeating coping strategies.
"...Women with depression who report a history of childhood sexual abuse develop depression at a younger age, are more likely to engage in deliberate self-harm behaviors and/or suicide attempts, and are more likely to experience physical or sexual assault in adulthood, compared to depressed women without childhood sexual abuse. Depressed women with a history of childhood sexual abuse constitute a unique subgroup that requires tailored treatment. One integrative approach includes group work programs (27) that facilitate the resolution of themes of guilt, isolation, and secrecy. The positive outcomes of such intervention programs reported in the literature (28) should encourage wider scale application of such methods.
The identification of childhood sexual abuse in patients who present with depression is important because a history of childhood sexual abuse is likely to play a key role in lowering the threshold to both onset and recurrence of depression. Early trauma that remains unresolved may further complicate recovery from a depression for which a different etiology has been ascribed and, as such, is a crucial determinant to characterize."Click
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