Implications of childhood trauma for depressed women: an analysis of pathways from childhood sexual abuse to deliberate self-harm and revictimization

Am J Psychiatry. 2004 Aug;161(8):1417-25. doi: 10.1176/appi.ajp.161.8.1417.

Abstract

Objective: Data from depressed women with and without a history of childhood sexual abuse were used to characterize clinical features that distinguished the two groups and to examine relationships of childhood sexual abuse to lifetime deliberate self-harm and recent interpersonal violence.

Method: One hundred twenty-five women with depressive disorders were interviewed and completed self-report questionnaires. Path analysis was used to examine relationships of several childhood and personality variables with deliberate self-harm in adulthood and recent interpersonal violence.

Results: Women with a childhood sexual abuse history reported more childhood physical abuse, childhood emotional abuse, and parental conflict in the home, compared to women without a childhood sexual abuse history. The two groups were similar in severity of depression, but the women with a childhood sexual abuse history were more likely to have attempted suicide and/or engaged in deliberate self-harm. The women with a history of childhood sexual abuse also became depressed earlier in life, were more likely to have panic disorder, and were more likely to report a recent assault. Path analysis confirmed the contributory role of childhood sexual abuse to deliberate self-harm and the significance of childhood physical abuse for recent interpersonal violence.

Conclusions: Childhood sexual abuse is an important risk factor to identify in women with depression. Depressed women with a childhood sexual abuse history constitute a subgroup of patients who may require tailored interventions to combat both depression recurrence and harmful and self-defeating coping strategies.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological
  • Adolescent
  • Adult
  • Aged
  • Child
  • Child Abuse / diagnosis
  • Child Abuse / statistics & numerical data
  • Child Abuse, Sexual / diagnosis*
  • Child Abuse, Sexual / statistics & numerical data
  • Comorbidity
  • Crime Victims / statistics & numerical data*
  • Depressive Disorder / diagnosis*
  • Depressive Disorder / epidemiology
  • Domestic Violence / statistics & numerical data
  • Female
  • Humans
  • Middle Aged
  • Models, Theoretical
  • New South Wales / epidemiology
  • Personality Inventory
  • Risk Factors
  • Secondary Prevention
  • Self-Injurious Behavior / diagnosis*
  • Self-Injurious Behavior / epidemiology
  • Suicide, Attempted / statistics & numerical data
  • Violence / statistics & numerical data*