Gynecological Health Complaints Among College Women With Sexual Victimization Histories: Examination of Depression and Anxiety as Potential Mediators.

Abstract

The study's purpose was to examine the relation between sexual victimization history and gynecological health complaints among college women. A further aim was to explore whether anxiety and depression are mediators of this relation, as well as to examine the size of these indirect relations among individuals with different types of victimization histories (childhood sexual abuse, adolescent/adult sexual assault, combined childhood sexual abuse/adolescent/adult sexual assault). A sample of 1,759 undergraduate cisgender women attending a large Southeastern U.S. university completed online measures of lifetime sexual victimization history, current anxiety and depression, and current gynecological health complaints (dysmenorrhea, dyspareunia, vaginal discharge, pain during urination, and pelvic pain). Mediation analyses with bootstrapping were conducted to explore the relations among study variables. College women with a history of sexual victimization were significantly more likely to report experiencing the gynecological health complaints in the past month than women with no sexual victimization history (all ps<.05). There was a significant indirect path from sexual victimization to gynecological health complaints through both anxiety and depression for all three victimization types (βs=0.12-0.26). The indirect paths were stronger for women with combined childhood sexual abuse/adolescent/adult sexual assault histories as compared with the other two types of victimization history. Health care providers working with college women should implement a trauma-informed approach to addressing gynecological health complaints that recognizes that sexual victimization survivors are at an increased risk for these issues. Further, anxiety and depression represent possible mechanisms of risk for gynecological health complaints among survivors.