OBJECTIVE: There were two objectives; first, to investigate the
prevalence and characteristics of child sexual abuse in an American
Indian community, and second, to determine whether persons with
histories of child sexual abuse are at greater risk to develop
psychiatric disorders and behavioral problems than persons who report
no such history. METHOD: A sample of 582 Southwestern American Indian
tribal members was collected for a genetic and linkage study on
alcoholism and psychiatric disorders in three large and interrelated
pedigrees. Subjects were recruited from the community without
knowledge of their clinical histories or those of their
relatives. Child sexual abuse and psychiatric disorders were assessed
using a semi-structured psychiatric interview. RESULTS: Females were
more likely to be sexually abused as children (49%) than were males
(14%). Intrafamilial members accounted for 78% of the reported child
sexual abuse. Sexually abused males and females were more likely to
report childhood and adult behavioral problems than were nonabused
subjects. There was a strong relationship between multiple psychiatric
disorders and child sexual abuse, with sexually abused males and
females more likely to be diagnosed with > or = 3 psychiatric
disorders, both including and excluding alcohol dependence or abuse,
than were nonabused subjects. CONCLUSION: Child sexual abuse in this
population is both an index of family dysfunction and community
disorganization as well as a predictor of later behavioral patterns
and psychopathology.