Survivors of Childhood Sexual Abuse at Increased Risk for Depression, Substance Abuse, Suicide

By Hugh C. McBride

Considering the countless instances of physical abuse, acts of war, natural disasters and the myriad other types of terrifying experiences that occur across the globe, trauma is a tragically prevalent reality for millions of adults, teens, adolescents and children.

And while many people involved in traumatic events are able to overcome the damage associated with these experiences, other trauma survivors carry physical and psychological scars for the remainder of their days.

For the survivors of one particularly horrifying type of trauma, the emotional aftereffects can range from debilitating to devastating. Unless they receive effective professional treatment, individuals who were sexually abused during childhood are at significantly increased risk for depression, substance abuse and suicide.

Shocking Statistics

Among the most disturbing issues related to childhood sexual abuse are the prevalence with which these traumatic events occur and the degree to which very young children are victimized:

• According to the U.S. Centers for Disease Control and Prevention, about 25 percent of girls and 16 percent of boys are sexually abused in the United States.
• An article in the Journal of Interpersonal Violence indicates that the United States is currently home to 39 million survivors of childhood sexual abuse.
• Darkness to Light, a nonprofit organization dedicated to the eradication of childhood sexual abuse and the support of sexual abuse survivors, reports that 90 percent of childhood sexual abuse cases involve family members, family friends or older children who are known to the victim.
• A 2003 article in the Journal of the American Academy of Child and Adolescent Psychiatry reported that 9 is the median age for reported cases of childhood sexual abuse.
• A 2000 report by the National Center for Juvenile Justice reported that one in five cases of childhood sexual abuse involves a victim under the age of 8.

With so many adolescents, teenagers and adults living with the trauma of having been sexually assaulted during childhood -- and with so many of these survivors attempting to deal with the aftermath of their victimization without accessing professional mental heath treatment -- it is hardly surprising that issues such as depression, substance abuse and suicide (both ideation and actual attempts) are so common among this population.

Sexual Assault and Substance Abuse

Darkness to Light reports that between 70 and 80 percent of childhood sexual abuse survivors have abused alcohol or other drugs.

Viewing the relationship between childhood abuse and substance abuse from the treatment professionals' perspective yields similar data. A July 1999 report from the National Institute on Drug Abuse (NIDA) notes that about 67 percent of individuals who enter treatment for drug abuse disorders report having been physically, emotionally or sexually abused during their childhood years.

With the vast majority of childhood sexual assault cases involving adults or older children with whom the victims are familiar, survivors are apt to suffer from problems related to their ability to trust, form healthy attachments and participate in healthy positive interpersonal relationships. Many are also likely to suffer from Post Traumatic Stress Disorder (PTSD).

The National Institute of Mental Health (NIMH) defines PTSD as "an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened." The nonprofit online resource HelpGuide describes PTSD as "a response by normal people to an abnormal situation," and notes that many individuals who are struggling with traumatic memories may be tempted to self-medicate with alcohol or other drugs.

Because so many cases of alcoholism, drug addiction and substance abuse have their origins in instances of childhood sexual assault, it is essential that treatment providers identify and address both the trauma and the substance abuse disorders.

Sexual Assault and Suicide

While the abuse of alcohol and other drugs can have fatal consequences, these are not the only potentially deadly aftereffects of childhood sexual assault.

According to an Aug. 4 article by PsychCentral Senior News Editor Rick Nauert, Ph.D., British researchers have determined that victims of child abuse are at increased risk for suicide later in life:

This latest study, published in the August issue of the British Journal of Psychiatry, sheds new light on the indicators of risk for suicide attempts.

Between 1986 and 1988, researchers recruited families of children attending French-speaking nursery schools in Quebec, Canada, to take part in the study. A total of 3,388 children participated.

Repeated abuse was generally more strongly associated with suicide attempts than a single occurrence of abuse. Furthermore, sexual abuse by an immediate family member (such as a father, stepfather or brother) carried the greatest risk.

Abuse perpetrated by an extended family member (uncle or cousin) carried an intermediate risk, while abuse by an unrelated individual (an acquaintance, romantic partner or stranger) carried a weaker risk.

Five years before Nauert's article, another study of the relationship between adult suicide and childhood abuse yielded similar results. 

Writing in the Nov. 5, 2004, edition of Psychiatric News, Marc Moran reported that "sexual abuse may amplify the desire for escape and cessation of psychic pain well into middle age and older adulthood." Moran's article focused on a study by Nancy Talbot, Ph.D.:

• In the study, Talbot and colleagues evaluated 127 women over the age of 50 who were admitted to a psychiatric unit with a diagnosis of major depression.
• Of those, 18 women reported having experienced sexual abuse in their youth, defined as "unwanted sexual contact before age 18."
• Of the 18, 15 (83 percent) had attempted suicide in their lifetime, and 12 (67 percent) had made multiple attempts.
• By comparison, 58 percent of women with major depression who had not experienced childhood sexual abuse reported at least one suicide attempt in their lifetime, and 27 percent reported multiple attempts.

"Perhaps sexual abuse amplifies the risk for a persistent desire for escape and cessation of  psychic pain proceeding well into middle-age and older adulthood, marked by a history of chronic suicide ideation and multiple suicide attempts," Talbot wrote in the October 2004 issue of the American Journal of Geriatric Psychiatry, which published the results of her study.

Treatment

Treating addiction and substance abuse disorders in adults, teenagers and adolescents is far from a simple process -- and this effort can become decidedly more complex in cases that involve PTSD and a history of childhood sexual abuse.

However, this does not mean that treatment for these concerns is unlikely to be effective; rather, it simply underscores the importance of designing a personalized treatment plan that addresses all of the challenges that the client is facing.

For example, at the Life Healing Center, a residential program for emotional trauma, mental heath disorders and substance abuse problems, men and women are able to receive comprehensive professional treatment in a nurturing, supportive and highly professional environment.

With specialized treatment tracks and specific therapy groups designed to address issues including (but not limited to) trauma recovery, grief and loss, co-dependency, sex/love addiction, anger, chemical dependency and body image, the Life Healing Center offers a holistic healing experience that features both time-tested techniques and emerging methodologies.

Childhood sexual abuse is a devastating experience with aftereffects that can continue to wreak personal, social and professional destruction for decades. No one should have to endure the trauma of childhood sexual abuse -- but for those who have, hope remains, help is available and recovery is possible.