Sexual abuse may affect health for a lifetime

November 20, 2000

Far from being a static experience, sexual abuse during youth may affect health even in old age, suggest the results of a study.

Two University of California researchers noted associations between early abuse and several health conditions in the elderly. "These associations are impressive in that they were still present in an older population," said co-author Murray B. Stein, MD, of the University of California, San Diego's Anxiety and Traumatic Stress Disorders Program.

Stein and co-author Elizabeth Barrett-Connor, MD, analyzed health data on more than 1,300 elderly white, middle class study participants from a Southern California community. Study participants took a sexual assault questionnaire in which they were asked if they ever experienced unwanted sexual contact.

More than 12 percent of the women and 5 percent of the men reported early sexual abuse. On average, the first experience of abuse occurred when the women were 16 years old and the men were 13.5 years old. Most of the respondents never received counseling for their experience.

Past sexual assault was associated with an increased risk of breast cancer, arthritis and thyroid disease, Stein and Barrett-Connor found. The study results appear in the November/December issue of Psychosomatic Medicine.

The findings varied by gender. In women, early sexual assault appeared to increase the risk of arthritis and breast cancer, with multiple abuse episodes increasing disease risk by two- to three-fold compared with a single episode. In men, early sexual assault appeared to increase the risk of thyroid disease.

Although this study resembles others that found adverse health effects of sexual abuse, Stein and Barrett-Connor did not find the associations between sexual abuse and obesity or headaches observed in other studies.

Their finding of an association between breast cancer and early sexual abuse was somewhat unexpected. Stein and Barrett-Connor were also surprised to find an association between early sexual abuse and a reduced risk of hypertension. This finding may reflect "a survivor bias," meaning that individuals with conditions associated with hypertension -- such as cardiac disease and diabetes -- may have died before the study was conducted.

Exactly how sexual abuse may contribute to health problems can't be determined from this study. The effects of stress-related hormonal alterations may play a role, but further research is needed, noted the researchers.

"It remains to be established from future research to what extent, and through what mechanisms, sexual assault is associated with adverse effects on health," said Stein.

The researchers also suggested an evaluation of the extent to which counseling may improve the health of those who experienced early sexual abuse.
This research was supported in part by the National Institute of Diabetes, Digestive and Kidney Diseases and the National Institute of Aging.

Psychosomatic Medicine is the official bimonthly peer-reviewed journal of the American Psychosomatic Society. For information about the journal, contact Joel E. Dimsdale, MD, at (619) 543-5468.

Posted by the Center for the Advancement of Health . For more research news and information, go to our special section devoted to health and behavior in the "Peer-Reviewed Journals" area of Eurekalert!, For information about the Center, call Petrina Chong,, (202) 387-2829.

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