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The British Journal of Psychiatry (2003) 183: 451-456
© 2003 The Royal College of Psychiatrists

Psychological disturbance associated with sexual abuse in people with learning disabilities

Case–control study

HEATHER SEQUEIRA, CPsychol, AFBPsS

St George’s Hospital Medical School, London, and UK & Coventry Primary Care Trust, Coventry

PATRICIA HOWLIN, CPsychol, FBPsS and SHIELA HOLLINS, FRCPsych

St George’s Hospital Medical School, London, UK

Correspondence: Ms Heather Sequeira, Department of Psychiatry of Disability, Jenner Wing, Cranmer Terrace, London SW17 0RE, UK. E-mail: heathersequeira{at}onetel.net.uk

Declaration of interest None.

Background The association between sexual abuse, mental health and behavioural problems in people with learning disabilities has not previously been examined in a controlled study.

Aims To identify symptoms of psychological disturbance in adults with and without a confirmed history of sexual abuse.

Method The study used a matched (1:1) case–control design comparing 54 adults who had experienced sexual abuse with 54 adults with no reported history of abuse. The two groups were selected from a community population of adults with learning disabilities living in residential care, and compared for selected psychiatric diagnoses and for scores on measures of disturbed behaviour.

Results Sexual abuse was associated with increased rates of mental illness and behavioural problems, and with symptoms of post-traumatic stress. Psychological reactions to abuse were similar to those observed in the general population, but with the addition of stereotypical behaviour.The more serious the abuse, the more severe the symptoms that were reported.

Conclusions The study provides the first evidence from a controlled study that sexual abuse is associated with a higher incidence of psychiatric and behavioural disorder in people with learning disabilities.


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