ALLAN SISON
New York Times Syndicate - November 28, 1999
Abuse or neglect during childhood has lasting, harmful effects. Sexual abuse
is even more harmful than physical abuse.
Adolescents and young adults who were abused
or neglected during childhood are more than three times as likely to become
depressed or suicidal, according to a new study.
Researchers also found that children who are
sexually abused are more likely to become depressed or suicidal. Victims of
sexual abuse were about six times more likely to attempt suicide; additionally,
the risk of repeated suicide attempts was eight times higher than in children
who were not sexually abused.
Further, 36 percent of those subjected to
sexual abuse were diagnosed with a depressive disorder, compared to a 25 percent
rate in victims of all types of child abuse or neglect.
``Sexual abuse carries the greatest risk of
depression and suicide,'' the researchers said. More than a third, 36 percent,
of sexually abused youths attempted suicide, compared to 16 percent of
physically abused youths. Six percent of children without a history of abuse
reported attempting suicide.
Researchers led by Dr. Jocelyn Brown,
associate professor in the department of pediatrics at Columbia University, New
York, studied 639 youths from the state of New York, 81 of whom had histories of
childhood abuse or neglect. Follow-up evaluations from childhood through young
adulthood were performed between 1975 and 1992.
The study is published in the December issue
of the Journal of the American Academy of Child and Adolescent Psychiatry http://www.aacap.org/publications/journal/index.htm.
Past studies have demonstrated a connection
between childhood abuse and an increased risk for mental disorders. Several
other studies have also shown an association between physical childhood abuse
and depression.
Researchers also found that the incidence of
suicide attempts was higher during adolescence. ``Adolescence is the most
vulnerable time for sexually abused youths, who are more prone to make repeated
suicide attempts,'' the researchers said.
``Contextual factors such as family conflict,
parental substance abuse and illegal activities should be addressed and dealt
with in the treatment of depressed and suicidal adolescents who have been
neglected in childhood,'' the researchers added.
Familial, parental and environmental factors
were cited as possible contributors to depression. Familial factors include a
poor marriage; parental factors include a low parental involvement; and
environmental factors include welfare dependence and other socioeconomic issues.
Because researchers used both official and
self-reported reports of abuse, the researchers noted that depressed individuals
may have been more apt to report cases of physical or sexual abuse. They also
noted that their inquiries may have also missed some cases of neglect, due to
the nature of their questioning.
The scientists suggested that future studies
should address specific characteristics of the abuse, including the relationship
of the abuser and the duration, frequency and severity of the abuse.
``Clinicians evaluating depressed and suicidal
youths should screen specifically for the presence of different types of
abuse,'' the researchers concluded.
-----
American Academy of Child and Adolescent
Psychiatry (1999;38:1490-1496)
(The Medical Tribune Web site is at http://www.medtrib.com)
c.1999 Medical PressCorps News Service
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