(includes Suicide, Self-Injury)
The relationship between childhood physical and sexual abuse and the development of psychiatric symptomatology in adulthood is very well documented. Childhood abuse is a significant causal factor in suicide and self-injury.
Facts and Discussion Points:
1--Fifty to seventy percent of all women and a substantial number of men treated in psychiatric settings have histories of sexual or physical abuse, or both.1-3
2--Up to 81% of men and women in psychiatric hospitals who are diagnosed with a variety of major mental illnesses have experienced physical and/or sexual abuse. Sixty-seven percent of these men and women were abused as children.4
3--Seventy-four percent of Maine’s Augusta Mental Health Institute consumers, interviewed as class members, reported histories of sexual and physical abuse.5
4--The majority of adults diagnosed with Borderline Personality Disorder (81%) or dissociative identity disorder (90%) were sexually and/or physically abused as children.6-7
5--Women who were molested as children are at four times greater risk for Major Depression than those with no such history. They are significantly more likely to develop bulimia and chronic PTSD.8-11
6--Childhood abuse can result in adult experiences of shame, flashbacks, nightmares, severe anxiety, depression, alcohol and drug use, feelings of humiliation and unworthiness, ugliness, and profound terror.12-18
7--Adults who were abused during childhood are:
* more than twice as likely to have at least one lifetime psychiatric diagnosis;
* almost three times as likely to have an affective disorder;
* almost three times as likely to have an anxiety disorder;
* almost 2 1/2 times as likely to have phobias;
* more than 10 times as likely to have a panic disorder; and
* almost 4 times as likely to have an antisocial personality disorder.19
8--Ninety-seven percent of mentally ill homeless women have experienced severe physical and/or sexual abuse. Eighty-seven percent experienced this abuse both as children and as adults.20
9--Adults who were abused as children may be more prone to developing schizophrenia. A high rate of childhood physical and sexual abuse is evident among children later diagnosed as schizophrenic, with a strong link between childhood abuse and hearing voices. In addition, changes in the brain seen in abused children were similar to those found in adults with schizophrenia.21
10--There is a significant relationship between childhood sexual abuse and various forms of self-harm later in life, i.e. suicide attempts, cutting, and self-starving.22
11--For adults and adolescents with childhood abuse histories, the risk of suicide increases 4- to 12-fold.23
12--Most self-injurers have a history of childhood physical or sexual abuse. Forty percent of persons who self-injure are men.2426
13--Approximately 8% of individuals in the U.S.20 million peoplewill be diagnosed with full-blown PTSD in their lifetime. As many as 20 million more people may experience PTSD-related symptoms. In many cases, problems are not identified, or consumers do not receive appropriate treatment.27
Mental Illness References
1. Carmen, E., Rieker, P., & Mills, T. (March, 1984). Victims of violence and psychiatric illness. Am J Psychiatry, 141:3.
2. Bryer, J. B., Nelson, B., Miller, J. B., & Krol, P. (November 1987). Childhood sexual and physical abuse as factors in adult psychiatric illness. Am J Psychiatry, 144:1426-1430.
3. Craine, L. S., Henson, C. E., Colliver, J.A., et al. (1988). Prevalence of a history of sexual abuse among female psychiatric patients in a state hospital system. Hospital and Community Psychiatry, 39, 300-304.
4. Jacobson, A., & Richardson, B. (1987). Assault experiences of 100 psychiatric inpatients: Evidence of the need for routine inquiry. American Journal of Psychiatry, 144, 908-913.
5. Maine Department of Mental Health, Mental Retardation and Substance Abuse Services. (1998). Augusta Mental Health Institute consent decree class member assessment.
6. Herman, J., Perry, C., & van der Kolk, B. (April 1989). Childhood trauma in Borderline Personality Disorder. Am J Psychiatry, 164:4, 490-495.
7. Ross, C., Miller, S., Reagor, P., Bjornson, L., Fraser, G., & Anderson, G. (1990). Structured interview data on 102 cases of Multiple Personality Disorder from four centers. J Psychiatry, 147, 596-601.
8. Stein, J. A., Golding, J. M., Siegel, J. M., Burnam, M. A., Sorenson, S. B. (1988). Long-term psychological sequelae of child sexual abuse: The Los Angeles Epidemiologic Catchment Area Study. In G. E. Wyatt, & G. J. Powell (Eds.), Lasting effects of child sexual abuse. Sage Focus Editions, Vol. 100 (pp. 135-154). Newbury Park, CA: Sage Publications.
9. Root, M., & Fallon. (1989). The incidence of victimization experiences in a bulimic sample. J. of Interpersonal Violence, 4, 90-100.
10. Sloane, G., & Leichner, P. (1986). Is there a relationship between sexual abuse or incest and eating disorders? Canadian J. of Psychiatry, 31, 656-660.
11. Craine, P. (1990). Cited by Gondolf, E. W. Psychiatric responses to family violence: Identifying and confronting neglected danger. Lexington, MA: Lexington Books.
12. M. Harris, & Landis (Eds.), (1997). Sexual abuse in the lives of women diagnosed with serious mental illness. Netherlands: Harwood Academic Publishers.
13. Rieker, P. P., & Carmen, E. H. (July 1986). The victim-to-patient process: The disconfirmation and transformation of abuse. American Journal of Orthopsychiatry, Vol. 56(3).
14. Herman, J. (1992). Trauma and recovery: The aftermath of violence from domestic abuse to political terror. New York, NY: Basic Books.
15. Janoff-Bulman, R., & Frieze, I. H. (Summer 1983). A theoretical perspective for understanding reactions to victimization. Journal of Social Issues, Vol. 39(2): 1-17.
16. B. A. van der Kolk (Ed.), (1987). Psychological trauma. Washington, DC: American Psychiatric Press.
17. Brown, A., & Finkeihor, D. (1986). Impact of child sexual abuse: A review of the literature. Psychological Bulletin, 99:66-77.
18. Rimsza, M. E., Berg, R. A., & Locke, C. (1988). Sexual abuse: Somatic and emotional reactions. Child Abuse and Neglect, 12(2):201-8.
19. Stein, J. A., Golding, J. M., Siegel, J. M., Burnam, M. A., Sorenson, S. B. (1988). Long-term psychological sequelae of child sexual abuse: The Los Angeles Epidemiologic Catchment Area Study. In G. E. Wyatt, & G. J. Powell (Eds.), Lasting effects of child sexual abuse. Sage Focus Editions, Vol. 100 (pp.135-154). Newbury Park, CA: Sage Publications.
20. Goodman, L., Johnson, M., Dutton, M. A., & Harris, M. (1997). Prevalence and impact of sexual and physical abuse. In M. Harris, & C. L. Landis (Eds.), Sexual abuse in the lives of women diagnosed with serious mental illness (pp.277-299). Netherlands: Harwood Academic Publishers.
21. Read, J. (2002). Interpersonal and biological processes. Journal Psychiatry.
22. van der Kolk, B. A., Perry, J. C., & Herman, J. L. (1991). Childhood origins of self-destructive behavior. American Journal of Psychiatry, 148:1665-1671.
23. Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. Am J Prev Med, 14:245-258.
24. Graff, H., & Mallin, R. (1967). The syndrome of the wrist cutter. American Journal of Psychiatry. 12A(1):36-42.
25. Pattison, E. M., & Kahan, J. (July, 1983). The deliberate self-harm syndrome. Am J of Psychiatry, Vol. 140(7): 867-872.
26. Briere, J., & Runtz, M. (1988). Post sexual abuse trauma. In G. E. Wyatt, G. J. Powell (Eds.), Lasting Effects of Child Sexual Abuse. CA: Sage Publications.
27. Marshall, R. (May 9, 2002). The prevalence of problems related to PTSD. Study presented at the 154th Annual Meeting of the American Psychiatric Associatio