An Exploratory Investigation of Childhood Sexual Abuse and Other Theory-Driven Predictors of Sex Work Among Women with and without Childhood ADHD.

Abstract

Participants were a racially and socioeconomically diverse sample of 140 girls with rigorously diagnosed ADHD (47 Inattentive [ADHD-I], 93 Combined [ADHD-C]), and 88 age- and ethnicity-matched comparison girls, all followed longitudinally into adulthood. Self-report data on young-adult occupations revealed a subsample of 7 participants reporting engagement in "sex work" or "prostitution." Logistic regressions tested whether CSA, measured both dichotomously and by discrete age ranges, predicted later sex work, accounting for other risk factors. A lifetime history of CSA was positively associated with sex work in initial analyses (β = 1.51, p = .045), but not after adjusting for additional risk factors. When examined by age ranges, only CSA occurring between ages 9-15 significantly predicted sex work (β = 2.84, p = .043), even after adjusting for additional risk factors. Childhood ADHD-C also emerged as a significant predictor (β = 4.94, p = .015). ADHD-related medication and years of education were protective factors only when CSA was considered dichotomously. Findings from this exploratory study underscore the need for longitudinal research that (a) considers the developmental timing of CSA and (b) accounts for impulsivity and inattention as risk factors for sex work among young-adult women. Implications for clinical practice are briefly discussed.