History Of Childhood Sexual Abuse Research Articles

Differential Impact of Child Sexual Abuse and Family History of Suicidal Behavior in High-Risk Suicidal Patients

The current study aimed to compare suicide-related variables as a function of 1) family history of suicidal behavior and 2) child sexual abuse among patients hospitalized for a suicide attempt or active suicidal ideation. Family history of suicidal behavior and child sexual abuse were examined independently and in combination as a diathesis for a high-risk suicidal phenotype. A multicenter cross-sectional study was designed to compare data obtained from 292 patients hospitalized for suicidal behavior. Demographic and clinical variables were compared among Group 1 (patients who reported both family history of suicidal behavior and child sexual abuse), Group 2 (patients who reported only family history of suicidal behavior), Group 3 (patients who reported only child sexual abuse), and Group 4 (patients who did not report family history of suicidal behavior or childhood sexual abuse). A multinomial logistic regression was used to examine suicide-related variables associated with each group and to compare differences between groups. Group 1 and 3 endorsed a higher number of previous suicide attempts and were more likely to be younger at the first suicide attempt compared to Group 4. Group differences remained after adjustment in a multinomial regression model. The current findings suggest that child sexual abuse may be more strongly related to suicide risk among high risk patients than family history of suicidal behavior.

Re-traumatization Cycle: Sexual Abuse, Post-Traumatic Stress Disorder and Sexual Risk Behaviors among Club Drug Users

Background: Club drug users are high risk and vulnerable population for adverse drug-related consequences and sexual risk behaviors. Few investigations have addressed the possible interrelationship between early trauma and PTSD among young club drug using populations. Objective: Exposure to traumatic experiences – especially in childhood, has been linked to risk behaviors exposure and substance use disorder. This study aimed to assess and compare drug use patterns and the presence of childhood sexual abuse (CSA) experiences among ecstasy and LSD users with and without Posttraumatic Stress Disorder (PTSD). Method: This cross-sectional study employed targeted sampling and ethnographic mapping approaches via face-to-face interviews conducted at bars and electronic music festivals. The Global Appraisal of Individual Needs questionnaire was used as the primary assessment instrument. Participants were from 18 to 39 years of age, had used ecstasy and/or LSD in the 90 days prior to the interview, and were not in treatment for alcohol and other drug problems. Results: Out of the 240 participants, 123 (51.2%) presented PTSD symptoms. Those presenting PTSD were younger, less educated, with lower income, and presented higher drug use severity than those without PTSD symptoms. Moreover, a higher prevalence of sexual risk behavior was verified among those with PTSD. There was an association between PTSD symptoms and CSA history, where 64.2% of individuals with PTSD also presented CSA, compared to 47% among those without PTSD (p = .028). Individuals with co-occurring history of CSA and PTSD symptoms reported earlier use of ecstasy, LSD, and cocaine compared to individuals with a history of CSA but without PTSD. Conclusions: In the present study, participants with a history of PTSD demonstrate a history of CSA, as well as pronounced severity in several areas – precocity of use, severity of addiction, and greater exposure to situations of sexual risk. Thus, a cycle of traumatization may be established through early potential trauma, which can remain unprocessed and contribute to earlier and more severe substance use and sexual risk behaviors. Identification of PTSD symptoms and risk for HIV and other STIs among young club drug users is critical to address focused treatment approaches for this vulnerable population.

Cognitive Behavioral Therapy for Trauma and Self-Care (CBT-TSC) in Men Who have Sex with Men with a History of Childhood Sexual Abuse: A Randomized Controlled Trial.

To address childhood sexual abuse (CSA) related distress and HIV risk in men who have sex with men (MSM) using cognitive-behavioral therapy for trauma and self-care (CBT-TSC), which is a novel intervention integrating HIV risk reduction with modified cognitive and behavioral therapy strategies for post-traumatic stress. We compared CBT-TSC to HIV voluntary counseling and testing (VCT)-only in an initial 2-arm RCT in 43 HIV-negative MSM at with a history of CSA and HIV risk. Serodiscordant condomless anal/vaginal sex (CAS; CAS with HIV-postive or HIV unknown status partners) and posttraumatic stress disorder (PTSD) symptoms (Davidson Trauma Scale: total score and avoidance, intrusions, hyperarousal subscales) were outcomes immediately post-treatment, and at 6- and 9-month follow-up. At post-treatment, CBT-TSC had decreased odds (approximately 60%) of any CAS and greater reductions in CAS compared to VCT-only. Additionally, the CBT-TSC condition experienced greater reductions in total PTSD and avoidance symptoms. At the follow-up visits, CBT-TSC condition had significant reductions in the odds of any CAS and reductions in CAS. However, for PTSD symptoms, only the avoidance subscale remained significantly different compared to VCT-only. CBT-TSC is a potentially efficacious approach to address HIV risk in MSM with a CSA history, with replication and extension in a larger trial needed. This proof-of-concept trial is the first to integrate the treatment of a commonly occurring mental-health syndemic problem in MSM with a health psychology approach to self-care in MSM.Trial Registration Clinicaltrials.gov NCT01266122.

Domestic Minor Sex Trafficking: Guidance for Communicating With Patients.

Domestic minor sex trafficking (DMST) is the “recruitment, harboring, transportation, provision, or obtaining of a person for the purpose of a commercial sex act” within domestic borders in which the person is a US citizen or lawful permanent resident <18 years of age.1 Over recent years, the perceived paradigm of youth involved in sex trafficking as mainly international criminals and prostitutes has shifted to domestic victims in need of services; this shift has been the result of increased knowledge and research. Potential indicators linked to DMST involvement are described in existing literature, such as runaway behaviors, substance use and/or abuse, dysfunctional home environments, and histories of child sexual abuse.1,2 Moreover, victimization is associated with health consequences, such as recurrent sexually transmitted infections (STIs), unwanted pregnancies, and untreated chronic medical conditions.1,2 In an effort to enhance prevention and identification, researchers have attempted to develop screening tools; however, there are limitations, such as small sample sizes, a lack of generalizability (eg, single geographic area), and no current valid and reliable tools.3 A separate …

Telomere length is associated with childhood trauma in patients with severe mental disorders

Reduced telomere length (TL) and structural brain abnormalities have been reported in patients with schizophrenia (SZ) and bipolar disorder (BD). Childhood traumatic events are more frequent in SZ and BD than in healthy individuals (HC), and based on recent findings in healthy individuals could represent one important factor for TL and brain aberrations in patients. The study comprised 1024 individuals (SZ [n = 373]; BD [n = 249] and HC [n = 402]). TL was measured by quantitative polymerase chain reaction (qPCR), and childhood trauma was assessed using the Childhood Trauma Questionnaire (CTQ). Diagnosis was obtained by the Structured Clinical Interview (SCID) for the diagnostic and statistical manual of mental disorders-IV (DSM-IV). FreeSurfer was used to obtain regional and global brain volumes from T1-weighted magnetic resonance imaging (MRI) brain scans. All analyses were adjusted for current age and sex. Patients had on average shorter TL (F = 7.87, p = 0.005, Cohen’s d = 0.17) and reported more childhood trauma experiences than HC (χ2 = 148.9, p < 0.001). Patients with a history of childhood sexual, physical or emotional abuse had shorter TL relative to HC and to patients without a history of childhood abuse (F = 6.93, p = 0.006, Cohen’s d = 0.16). After adjusting for childhood abuse, no difference in TL was observed between patients and HC (p = 0.12). There was no statistically significant difference in reported childhood abuse exposure or TL between SZ and BD. Our analyses revealed no significant associations between TL and clinical characteristics or brain morphometry. We demonstrate shorter TL in SZ and BD compared with HC and showed that TL is sensitive to childhood trauma experiences. Further studies are needed to identify the biological mechanisms of this relationship.

A Novel Screening Tool for Assessing Child Abuse: The Medical Somatic Dissociation Questionnaire–MSDQ

ABSTRACTSomatic dissociation is known to be associated with childhood abuse, particularly with childhood sexual abuse (CSA). Currently, the diagnosis of CSA is hampered by the lack of a validated questionnaire. While some questionnaires are excellent research tools, there is no suitable applied measure for the assessment of distress due to CSA. The current study’s objective was to validate a novel questionnaire, designated the Medical Somatic Dissociation Questionnaire–MSDQ, for evaluating somatic dissociation in the healthcare system setting. A total of 541 adults, 160 (30%) male and 381 (70%) female, of average age 35 years were recruited from the general population via the Internet. The Life Events Checklist for DSM-5 (LEC-5) was used for screening subjects for reporting a history of CSA. Our examination of the MSDQ indicated powerful internal consistency, reliability, and convergent validity of the instrument, with high correlations between the MSDQ and the SDQ-20 and also between the MSDQ and psychological symptomatology. In addition, there was known-groups validity when differences between adults who experienced CSA and those who did not were compared. Importantly, the MSDQ can be easily integrated into the evaluation process performed by medical professionals in the diagnosis of adult patients with apparently unexplained symptomatology.

“The Power of Me”: The Role of Agency in the Resilience Processes of Adolescent African Girls Who Have Been Sexually Abused

In this article we explore how individual expressions of agency are shaped by structural factors and exercised by Black African girls with child sexual abuse (CSA) histories as they navigate resilience pathways. We employed a qualitative multiple instrumental case study design and purposefully recruited seven Black African girls, between the ages of 15 and 18 years, with a history of CSA. Participants were engaged in a range of participatory methods that included participatory diagramming (time lines), digital stories, and participatory videos. Data were analyzed using inductive thematic analysis. Findings highlight how agency, as a process of resilience, manifested as well as how these agentic expressions were activated, bound, and later reciprocated and sustained by the surrounding social structures.

Self esteem levels vs global scores on the Rosenberg self-esteem scale

BackgroundThe Rosenberg Self-esteem Scale (RSS) is the most widely used instrument to measure this trait. Although the test offers results by levels (low, medium & high), the mean of global scores it is the indicator mostly used in scientific studies. The purpose of this study is to compare self-esteem levels with the global scores as criteria for contrasting self-esteem in subjects with and without a History of Childhood Sexual Abuse (HCSA). MethodRSS was administered to 74 subjects between 17 and 60 years, half of them with a HCSA, 20 men and 54 women; subjects without a HCSA were used as a comparison group. ResultsUsing the mean of the global scores as a criterion to compare the two groups, no significant differences were observed. However, when using self-esteem levels as a criterion, the findings indicate significant differences between subjects with and without HCSA. ConclusionsThe study shows that self-esteem levels are more accurate than global scores to describe this trait and to make comparisons between groups of subjects.

Childhood Sexual Abuse and Depression among American Indians in Adulthood.

The present study investigated distal and proximal factors associated with depression among a sample of 479 American Indian (AI) adults in the Midwest. Distal factors included histories of childhood sexual abuse (CSA) and other childhood adversities. Proximal factors included levels of health self-efficacy and treatment for alcohol problems. The study also examined the moderating effect of treatment for alcohol problems on the relationship between CSA and depression. In model 1, results indicate that CSA was positively related to depression after controlling for demographic and background variables. In model 2, childhood adversities and treatment for alcohol problems were associated with increased depression in AI adults; CSA became nonsignificant. As a protective factor, level of health self-efficacy was negatively associated with depression. In model 3, treatment for alcohol problems magnified the effect of CSA on depression. These findings suggest that early traumatic experiences may have persistent, harmful effects on depression among AIs; one mechanism exacerbating the impact of CSA on depression is treatment for alcohol problems. Targeted interventions are needed to mitigate the long-term negative health effects of childhood trauma in this population and to strengthen proximal protective factors, such as health self-efficacy.

Men with childhood sexual abuse histories: Disclosure experiences and links with mental health.

There is limited research on the disclosure experiences of men who have experienced childhood sexual abuse and on how such experiences might impact mental health outcomes. The current study described men's disclosure experiences and examined the role of disclosure characteristics on mental well-being (internalizing and externalizing behaviors, substance use, resilience). Men (N = 253) from across Canada and the U.S. were recruited through websites for males with sexual abuse histories. Men aged 18-59 years anonymously completed an online study on their sexual abuse, disclosure experiences, and mental health outcomes. Findings indicated that 77.9% of men disclosed their sexual abuse, although they waited an average of 15.4 years before sharing their experience. Once disclosed, 64.4% of the men reported a positive response (e.g., support), while 35.6% reported a negative response (e.g., blame). Regression analyses indicated that a greater delay in disclosure predicted greater externalizing behaviors (B = .49, p < .05), although this was a small effect (Cohen's f2 = 0.02). Additional disclosure variables were associated with components of externalizing (aggressive and rule-breaking behaviors) and internalizing (somatic complaints) behaviors. These results require replication in future studies. However, they do suggest that efforts need to be undertaken to address the barriers that hinder men from disclosing their sexual abuse and to ensure that men are supported once they disclose.

Emotional reactivity, trauma-related distress, and suicidal ideation among adolescent inpatient survivors of sexual abuse.

Adolescent psychiatric inpatients suffer high rates of childhood sexual abuse, trauma-related distress, and suicidality. This study evaluated the hypothesis that three domains of resiliency (i.e., Sense of Mastery, Sense of Relatedness, and Emotional Reactivity) would mediate the effect of trauma-related distress upon suicidal ideation, while accounting for symptoms of depression, and that the indirect effect of trauma-related distress upon suicidal ideation would be greater among survivors of childhood sexual abuse. Chart review patients included 550 adolescents admitted to a public psychiatric hospital in a Northwestern US State from 2010 to 2015. Adolescents completed self-report measures of trauma-related distress, depression, resiliency, and suicidal ideation. Half of the adolescents in this study reported past history of childhood sexual abuse, and more than half disclosed history of attempted suicide. There was a group noninvariant indirect effect of trauma-related distress upon suicidal ideation via emotional reactivity among survivors of childhood sexual abuse (β = 0.10, 95% ACI: 0.04 to .17), as well as a group invariant direct effect of depression symptoms (β = 0.88, p < .001). The other two domains of resiliency, sense of mastery and sense of relatedness did not mediate the association between trauma-related distress and suicidal ideation. These findings demonstrate the importance of emotional reactivity with regard to suicidal ideation, as well as the association between depression symptoms and suicidal ideation in this clinical population, and suggest the potential utility of skills-based interventions, and the need for trauma-informed policy and procedures in adolescent psychiatric inpatient settings.

Familial support following childhood sexual abuse is associated with longer telomere length in adult females.

Robust associations between adverse childhood experiences and shortened telomere length exist, but few studies have examined factors that may moderate this association, particularly with a resilience framework. The present study examined the association between exposure to childhood sexual abuse (and abuse severity) and mean telomere length, and whether social support and optimism moderated this association. The sample included 99 White monozygotic female twins, ranging in age from 35 to 70 (Mage = 52.74, SD = 8.55years), who provided a blood sample for telomere assay, and data on their childhood sexual abuse history, trait optimism, and current social support. Linear mixed effects models were employed to test study hypotheses. There were no effects of exposure to abuse or abuse severity on mean telomere length, nor were there main or moderating effects of optimism, in analyses of the full sample. However, in analyses that only included women exposed to abuse, there was an abuse type × support interaction: among women who experienced abuse in forms other than intercourse, higher levels of social support were associated with longer mean telomere length. Findings from the current study clarify the role of childhood sexual abuse in telomere attrition, and identify one factor that may protect against the negative biological effects of childhood sexual abuse.

The impact of gender and childhood abuse on age of psychosis onset, psychopathology and needs for care in psychosis patients

Gender is associated with several features of psychotic disorders, including age of illness onset, symptomatology, a higher prevalence of history of childhood sexual abuse (CSA) and needs for care. Childhood sexual abuse is associated with adverse mental health consequences but as there is a gender difference in stress reactivity, there may be a differential impact of CSA on psychopathology, age of psychosis onset and needs for care in First Episode Psychosis (FEP) patients. We hypothesized that a history of abuse would be associated with lowering of age of onset, increased symptomatology and more unmet needs in women but not men. A total of 444 FEP patients have been recruited within the context of the GET UP trial. Symptomatology has been assessed using the PANSS scale, needs for care with the CAN scale and childhood abuse with the CECA-Q scale. Childhood sexual abuse was more frequent among female patients [22.6% in women vs 11.6% in men (OR = 0.45, p < 0.01)], whereas there was no gender difference in the prevalence of childhood physical abuse (29.0% in women vs 31.7% in men). Childhood abuse was associated with higher levels of negative symptoms in both men and women, with a reduced age of onset in women only and little increase in needs for care in both men and women. Our results seem to suggest that childhood sexual abuse in female FEP patients may be linked to a more severe form of psychosis whose presentation is characterized by earlier age of onset and higher levels of negative symptoms and we can also speculate that gender-specific protective factors in women, but not in men, may be outweighed by the consequences of childhood abuse.

Childless

This paper explores the complex interplay that unfolded between analyst and patient around their respective childlessness and aims to draw attention to the larger societal issues of imperative parenthood and the stigma of childlessness. As the analyst confronted her own internal conflicts about motherhood, children, and procreation as a woman living in a pronatalist society (one that encourages increasing birth-rates), she was treating a lesbian patient with a history of childhood relational trauma and sexual abuse who was undergoing fertility treatments. The patient’s experience with assisted reproductive technologies raised complicated questions and concerns within the analyst regarding their emotional impact on her patient and, more broadly, how they might reflect societal dissociation. Themes of trauma, loss, dissociation, and shifting self-states, which emerged during the fertility treatments and wove their way throughout the analysis, are discussed. In addition, the author describes the nature of the therapeutic action in this case.

Hyperbaric Oxygen Therapy Can Induce Neuroplasticity and Significant Clinical Improvement in Patients Suffering From Fibromyalgia With a History of Childhood Sexual Abuse-Randomized Controlled Trial.

Background: Fibromyalgia syndrome (FMS), a condition considered to represent a prototype of central sensitization syndrome, can be induced by different triggers including childhood sexual abuse (CSA). Recent studies have demonstrated hyperbaric oxygen therapy (HBOT) can induce neuroplasticity and improve clinical outcome of FMS. The aim of the current study was to evaluate the effect of HBOT on patients suffering from FMS with a history of CSA.Materials and methods: A prospective randomized clinical trial conducted between July 2015 and November 2017 included women with a history of CSA who fulfilled fibromyalgia diagnosis criteria for at least 5 years prior to inclusion. Included participants (N = 30) were randomly assigned to treatment group, treated with 60 HBOT sessions and a control/crossover group received psychotherapy. After the control period, the control/crossover group was crossed to HBOT. Clinical outcomes were assessed using FMS questioners, post-traumatic stress disorder (PTSD) questioners and quality of life questioners. Objective outcome were assessed using brain function and structure imaging.Findings: Following HBOT, there was a significant improvement in all FMS questionnaires (widespread pain index, Fibromyalgia symptoms severity scale, Fibromyalgia functional impairment), most domains of quality of life, PTSD symptoms and psychological distress. The same significant improvements were demonstrated in the control following crossover to HBOT. Following HBOT, brain SPECT imaging demonstrated significant increase in brain activity in the prefrontal cortex, orbital frontal cortex, and subgenual area (p < 0.05). Brain microstructure improvement was seen by MRI-DTI in the anterior thalamic radiation (p = 0.0001), left Insula (p = 0.001), and the right Thalamus (p = 0.001).Conclusion: HBOT induced significant clinical improvement that correlates with improved brain functionality and brain microstructure in CSA related FMS patients.Trial Registration: www.Clinicaltrials.gov, identifier: NCT03376269. url: https://clinicaltrials.gov/show/NCT03376269

Visual methods in resilience research: reflections on its utility

ABSTRACT The potential of the visual image to foster reflection and to mobilise individuals and communities into action coupled with its capacity to bridge language and cultural divides has made the inclusion of visual methods (VMs) increasingly popular in resilience research as well as in research on sexual violence. In spite of this popularity, VMs are not beyond criticism and there have been calls to scrutinise the efficacy of VMs in research. Our aim, in this article, is to reflect critically on the usefulness of VMs to increase understandings of resilience processes in girls with child sexual abuse histories. We also consider the effectiveness of VMs in initiating social change by following up on audience members who viewed a screening of digital stories that dealt with the CSA experiences of adolescent girls. Our findings suggest that VMs are effective in creating greater awareness of resilience processes but in terms of initiating social change, dissemination of outputs produced through VMs requires greater consideration and clearer guidelines.

Resilience enabling processes and posttraumatic growth outcomes in a group of women survivors of childhood sexual abuse.

BackgroundThis study forms part of a pilot project, aiming to evaluate the benefits of a programme entitled S2T denoting from Survivor to Thriver, which is a collaborative strengths-based group intervention programme for women survivors of childhood sexual abuse. The objective of the S2T is to enable resilience processes and facilitate posttraumatic growth outcomes. A theory of change was developed to explain how these objectives are met, it outlines the theoretical approach, mediators, primary and secondary outcomes.AimTo explore emerging resilience processes and posttraumatic growth outcomes in women survivors of childhood sexual abuse after attending the S2T.SettingData was collected during group treatment sessions of the S2T group intervention programme with women survivors of childhood sexual abuse.MethodsA quasi-experimental, one group, pretest, posttest, time-delay design was used with eight purposively selected women with a history of childhood sexual abuse, using qualitative methods to evaluate the benefit of this intervention. Nine group treatment sessions and a delayed follow-up session were conducted. A visual participatory technique and transcriptions of group sessions were used to collect qualitative data.ResultsQualitative thematic analysis revealed the following enabling resilience processes: group as healing vehicle of change; changing destructive to constructive rumination; coping strengths and meaning-making. Posttraumatic growth outcomes which evolved were: transforming wounded to healer; a changed life philosophy; excavated spirituality and re-briefing strengths through a posttrauma thriver identity.ConclusionsThe themes suggest resilience processes and posttraumatic growth outcomes; a longitudinal study is recommended to establish effectiveness and inform treatment practice.

Resilience enabling processes and posttraumatic growth outcomes in a group of women survivors of childhood sexual abuse

Background: This study forms part of a pilot project, aiming to evaluate the benefits of a programme entitled S2T denoting from Survivor to Thriver, which is a collaborative strengths-based group intervention programme for women survivors of childhood sexual abuse. The objective of the S2T is to enable resilience processes and facilitate posttraumatic growth outcomes. A theory of change was developed to explain how these objectives are met, it outlines the theoretical approach, mediators, primary and secondary outcomes.Aim: To explore emerging resilience processes and posttraumatic growth outcomes in women survivors of childhood sexual abuse after attending the S2T.Setting: Data was collected during group treatment sessions of the S2T group intervention programme with women survivors of childhood sexual abuse.Methods: A quasi-experimental, one group, pretest, posttest, time-delay design was used with eight purposively selected women with a history of childhood sexual abuse, using qualitative methods to evaluate the benefit of this intervention. Nine group treatment sessions and a delayed follow-up session were conducted. A visual participatory technique and transcriptions of group sessions were used to collect qualitative data.Results: Qualitative thematic analysis revealed the following enabling resilience processes: group as healing vehicle of change; changing destructive to constructive rumination; coping strengths and meaning-making. Posttraumatic growth outcomes which evolved were: transforming wounded to healer; a changed life philosophy; excavated spirituality and re-briefing strengths through a posttrauma thriver identity.Conclusions: The themes suggest resilience processes and posttraumatic growth outcomes; a longitudinal study is recommended to establish effectiveness and inform treatment practice.

Attributions of Blame among Victims of Child Sexual Abuse: Findings from a Community Sample

ABSTRACTAccording to the attribution theory, negative outcomes of child sexual abuse (CSA) are thought to vary depending on whether CSA victims attribute the abuse to internal or external factors, respectively, self-blame and perpetrator-blame. Therefore, the purpose of this study was to identify abuse characteristics and attitudes that influence blame attributions among CSA victims from a community sample. Data from respondents with a history of CSA (N = 1,496) have been used in predicting blame attributions; perpetrator-blame, self-blame, or both. Results from a multinomial logistic regression analysis showed that attitudes toward gender roles had a significant effect on blame: victims were more likely to blame themselves when they endorsed more conservative gender attitudes than victims with more liberal attitudes. Implications for this finding are discussed.

Predictors of change in depressive symptoms over time: Results from the Australian Longitudinal Study on Women's Health

BackgroundDepressive symptoms fluctuate over time, and are most common amongst women in early adulthood. Understanding predictors of changes in depressive symptoms among young women may inform health promotion and early intervention. MethodsData were collected at three-yearly intervals from 2000 (Survey 2) to 2012 (Survey 6) from the Australian Longitudinal Study on Women's Health. The sample comprised 7663 women, aged 22–27 in 2000, who reported any indicator of poor mental health at any wave. Generalised linear mixed models identified predictors of change in depressive symptoms (CESD-10) over each three-year period. ResultsDepressive symptoms reduced over time. In a fully adjusted model, greater reduction in symptoms was predicted by higher initial symptoms, time, higher social support, and higher self-rated general health. Slower reduction was predicted by lower education, difficulty managing on income, high or zero alcohol consumption, stress, and history of childhood sexual assault or partner violence. Motherhood predicted an increase in depressive symptoms at Survey 2 (2000), but a decrease at Survey 5 (2009). LimitationsAlthough sampling was nationally representative, there is a slight bias towards Australian-born and more educated women. Further, although validated measures are used, all data are self-report. ConclusionsFluctuations in depressive symptoms among young women are related to fixed and time-varying factors spanning multiple health and social domains. A range of factors, including education and financial resources, promotion of positive social support systems, and encouragement of health promoting lifestyles, might serve to promote young women's mental health and thus to reduce pressure on clinical services.