Abstract
Objectives: The current study’s objectives were to 1) determine if sexually abused youth in child protective agencies (CPA) were given more psychiatric diagnoses and exhibited more comorbidity than youth from the general population, 2) examine the comorbidity profiles of sexually abused youth over 10 years of medical consultations and hospitalizations. Method: Diagnoses of 882 youth with a substantiated sexual abuse report between 2001 and 2010 at a participating CPA were compared to those of 882 matched controls (n = 1764). Results: Results of generalized linear mixed models showed that sexually abused youth presented higher rates of all diagnostic categories and were up to four times more likely to present comorbid diagnoses. Latent class analyses among abused youth revealed four different comorbidity profiles; two more severe groups named complex trauma (11%) and dissociation (14%); and two less severe groups named depression (10%) and low or no comorbidity/resilience (65%). Youth with more cumulative maltreatment and greater number of years of data following CSA report were more at risk of presenting a comorbidity profile, while females were more likely to present a depression profile. Profiles of youth in the highest comorbidity class were similar to what is defined as complex trauma or complex post-traumatic stress disorder. Implications: Sexually abused youth's varied profiles warrant varied interventions. Integrated trauma informed interventions are needed to address the cumulative maltreatment experienced and the psychiatric comorbidity some youth exhibit.
Highlights
Child sexual abuse (CSA) is a major worldwide problem with social, public health and safety as well as economic impacts, it remains difficult to comprehend its full extent for two reasons: 1) a lack of consensus on how to define CSA and 2) important differences in how prevalence data is collected (Goldman & Padayachi, 2000; Johnson, 2008; Mathews & Collin-Vézina, 2019)
Results have revealed that abused youth have a greater risk of presenting mental health disorder diagnoses (Hypothesis 1) and higher comorbidity (Hypothesis 2)
They revealed four distinct classes of comorbidity in the abused group (Hypothesis 3), which were subsequently associated with gender, longer follow-up periods and cumulative substantiated reports of maltreatment (Hypothesis 4)
Summary
Child sexual abuse (CSA) is a major worldwide problem with social, public health and safety as well as economic impacts, it remains difficult to comprehend its full extent for two reasons: 1) a lack of consensus on how to define CSA and 2) important differences in how prevalence data is collected (Goldman & Padayachi, 2000; Johnson, 2008; Mathews & Collin-Vézina, 2019). When self-reported, CSA prevalence is much higher (35.8-38%) in children and adolescents within youth protection agencies (CPA) than in the general population (CollinVézina et al, 2011; Pauzé et al, 2000). Research has documented the short- and long-term consequences of CSA within CPA populations (Bourgeois et al, 2018), gaps remain in our understanding of the clustering of comorbid mental health outcomes. Previous research has mostly relied on self-report measures and cross-sectional or retrospective methods, which entail some biases and limit our understanding of how CSA consequences evolve over time (Belsky, 1993; Brewin et al, 1993; Brownell & Jutte, 2013; O'Donnell et al, 2010a, 2010b; Stanley, 2003; Straus, 1998). To overcome some of these limitations, the current study will attempt to better understand the consequences of CSA using a personcentered approach and administrative longitudinal data
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