The relationship between childhood sexual abuse and mental health
in adult life was investigated in a random community sample of
women. There was a positive correlation between reporting abuse and
greater levels of psychopathology on a range of measures. Substance
abuse and suicidal behaviour were also more commonly reported by the
abused group. Childhood sexual abuse was more frequent in women from
disrupted homes as well as in those who had been exposed to inadequate
parenting or physical abuse. While elements in the individual's
childhood which increased the risks of sexual abuse were also directly
associated to higher rates of adult psychopathology, abuse emerged
from logistic regression as a direct contributor to adult
psychopathology. Severity of abuse reported was related to the degree
of adult psychopathology. The overlap between the possible effects of
sexual abuse and the effects of the matrix of disadvantage from which
it so often emerges were, however, so considerable as to raise doubts
about how often, in practice, it operates as an independent causal
element. Further, many of those reporting childhood sexual abuse did
not show a measurable long-term impairment of their mental
health. Abuse correlated with an increased risk for a range of mental
health problems, but in most cases its effects could only be
understood in relationship to the context from which it emerged.