Childhood Adversity, Trauma and Abuse: Context and Consequences

Abstract

Child sexual abuse is a well-established risk factor for a range of psychiatric disorders and other health problems. Ever since Mullen et al reported that there were signifi cantly higher rates of psychiatric disorder among women who had been exposed to abuse compared to women that hadn ’ t [1], there have been numerous epidemiological studies examining the rates of abuse and the poor health outcomes associated with it. What these studies have clearly demonstrated is that the rate of child sexual abuse (CSA) is disturbingly high and that it increases the risk for psychotic and non-psychotic disorders [2‐4]. The origins of child sexual abuse are less clear. In this issue of the journal, Martin et al, [5] in a carefully designed longitudinal study examine the maternal factors (assessed at the time of the child ’ s birth) associated with subsequent child sexual abuse when the children were 21 years old. The rates of sexual abuse in this study, as in many studies, are disturbingly high with 20.2% of females and 11.4% of males reporting non-penetrative abuse, and 10.2% of females and 8.1% of males penetrative abuse. Maternal characteristics associated with abuse fall broadly in the domain of social disadvantage, with some variance