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The British Journal of Psychiatry (2001) 179: 444-449
© 2001 The Royal College of Psychiatrists

Features of childhood sexual abuse and the development of psychiatric and substance use disorders

CYNTHIA M. BULIK, PhD

CAROL A. PRESCOTT, PhD and KENNETH S. KENDLER, MD

Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, Virginia, USA

Correspondence: Dr. C. M. Bulik, Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, PO Box 980126, Richmond, VA, 23298-0126, USA. Tel: 001 804 828 8129; fax: 001 804 828 1471; e-mail: cbulik{at}hsc.vcu.edu

Declaration of interest None. Funding detailed in Acknowledgements.

Background Childhood sexual abuse (CSA) is associated with an increased risk of subsequent psychiatric disorders.

Aims To explore the risk associated with features of CSA and examine whether specific associations exist between particular profiles of CSA and the development of specific syndromes.

Method In a population-based sample of adult female twins, we used logistic regression to explore the association between features of CSA (reported by the twin and her co-twin) and lifetime major depression, generalised anxiety disorder, bulimia nervosa, panic disorder and alcohol and drug dependence.

Results In univariate and stepwise multiple regressions, patterns of predictors differed, although not significantly, across diagnoses. Greater risk was associated with attempted or completed intercourse, the use of force or threats, abuse by a relative, and a negative response by someone who was told about the abuse. Similar patterns were observed with co-twin reports.

Conclusions Specific features of CSA differentially increase risk of later psychopathology; however, there do not appear to be unique predictive relationships between features of CSA and the emergence of specific psychiatric disorders.


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