"Time Does Not Heal All Wounds": Sexual Victimisation Is Associated with Depression, Anxiety, and PTSD in Old Age.

Ines Keygnaert,Christophe Vandeviver,Marie Beaulieu,Anne Nobels,Lisa Thibau,Gilbert Lemmens

doi:10.3390/ijerph19052803

Abstract

Sexual violence (SV) has an important impact on mental health. Childhood sexual abuse is linked to internalising disorders in later life. In older adults, SV occurs more often than previously believed. Moreover, health care workers lack the skills to address SV in later life. Studies researching the mental health impact of lifetime SV, i.e., SV during childhood, adulthood, and old age, are lacking. Between July 2019 and March 2020, 513 older adults living in Belgium participated in structured face-to-face-interviews. Selection occurred via a cluster random probability sampling with a random walk finding approach. Depression, anxiety, and posttraumatic stress syndrome (PTSD) were measured using validated scales. Participants were asked about suicide attempts and self-harm during their lifetime and in the past 12 months. SV was measured using behaviourally specific questions based on a broad SV definition. We found rates for depression, anxiety, and PTSD of 27%, 26%, and 6% respectively, while 2% had attempted suicide, and 1% reported self-harm in the past 12 months. Over 44% experienced lifetime SV and 8% in the past 12 months. Lifetime SV was linked to depression (p = 0.001), anxiety (p = 0.001), and PTSD in participants with a chronic illness/disability (p = 0.002) or no/lower education (p < 0.001). We found no link between lifetime SV and suicide attempts or self-harm in the past 12 months. In conclusion, lifetime SV is linked to mental health problems in late life. Tailored mental health care for older SV victims is necessary. Therefore, capacity building of professionals and development of clinical guidelines and care procedures are important.

Highlights

Sexual violence (SV) [1] is increasingly considered an important public health problem of major societal concern [2]
The objectives of this paper are three-fold: (1) to establish the prevalence of depression, anxiety, posttraumatic stress syndrome (PTSD), suicide attempts, and self-harm and its moderators in older adults in Belgium; (2) to research whether lifetime sexual victimisation is associated with depression, anxiety, PTSD, suicide attempts, and self-harm in older adults; (3) to test the moderating effect of the previous identified moderators of elder abuse and neglect, SV, and mental health problems
We present the results of a study on the mental health impact of sexual victimisation in a representative sample of 513 older adults living in Belgium

Summary

Introduction

Sexual violence (SV) [1] is increasingly considered an important public health problem of major societal concern [2]. SV has been studied in the broader context of elder abuse and neglect for many years. Most studies only included hands-on SV (e.g., unwanted kissing, rape), whereas hands-off SV (sexual harassment without physical contact) was not studied. A recent study, which assessed SV independently from other forms of violence and used a broad definition of SV encompassing both hands-off and hands-on SV, showed that SV in older adults occurs more frequently than previously believed [4]. Mental health problems are common and lead to impaired functioning in daily life [5]. Research has shown that up to one in three older adults reports depressive symptoms [6], and up to 14% suffers from an anxiety disorder [7] and 3% from PTSD [8]

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