Relationship between Child Sexual Abuse, Psychiatric Disorders and Infectious Diseases: A Matched-Cohort Study

ABSTRACT

Child sexual abuse (CSA) has been strongly associated with a range of psychological and physical problems in childhood and adulthood, such as anxiety, post-traumatic stress disorder (PTSD), and infectious diseases. Despite the strength of these associations, no studies to date have investigated psychobiological processes that might underlie the relationship between CSA and physical health problems occurring during childhood, such as infectious diseases. The goal of the current study is to evaluate PTSD as a potential mediator between CSA and the occurrence of infectious diseases among children and adolescents. Furthermore, we postulate that PTSD plays a specific role as an indicator of chronic stress during childhood, in comparison to other mental disorders, such as anxious and non-anxious disorders (e.g., depression). Via a prospective matched-cohort design, administrative data were used to document PTSD, anxious and non-anxious disorders, and infectious diseases. The sample size was 882 persons with a substantiated report of sexual abuse and 882 matched controls. Negative binomial regressions revealed that CSA is associated with a greater number of anxious diseases diagnoses that, in turn, predict more infectious diseases diagnoses. These findings highlight the importance of preventing and intervening among sexually abused youth with anxious disorder symptoms to limit negative outcomes on physical health.

KEYWORDS:

• Child sexual abuse
• infectious diseases
• post-traumatic stress disorders
• anxious disorders

Disclosure of Interest

No conflict to report.

Ethical Standards and Informed Consent

All procedures followed were in accordance with the ethical standards of the fist author’s institutional review board, the Commission of access to information and the participating child protection agency (CPA). Informed consent was lifted by the Comission of access to information and the participating CPA.

Additional information

Funding

This study was funded by a grant to Dr. Daigneault from Quebec’s Department of Justice (no. 126489). The opinions expressed are those of the authors and do not necessarily represent those of Quebec’s Department of Justice.

Notes on contributors

Oulma Maalouf

Oulma Maalouf, B.A., began her Psy.D. in Clinical Psychology at the University of Montreal in September 2016. Her research interests focus on the psychological and physical impact of sexual abuse among children and adolescents. She is now completing her doctoral essay, which aims to document the links between sexual abuse, mental and physical health among children and adolescents.

Isabelle Daigneault

Isabelle Daigneault, Ph.D., is a professor of clinical psychology at the University of Montreal. She received a PhD in Clinical Psychology at University of Montreal. Her research interests focus on sexual abuse of children and adolescents. She is a member of the Research Center of Interdisciplinary Research on Marital Problems and Sexual Assault (CRIPCAS); she also leads the Research Laboratory on the trajectories of health and resilience of sexually abused young people (TRAJETS).

Sonia Dargan

Sonia Dargan, B.Sc., began her Psy.D. in Clinical Psychology at the University of Montreal in September 2015. Her research interests include the impact on physical and psychological health of children and adolescents who have been sexually abused. Her doctoral essay aims to document the prevalence of non-sexually transmitted infectious diseases in children and adolescents who are victims of sexual abuse.

Pierre McDuff

Pierre McDuff is a research associate at University of Montreal. He is a member of the CRIPCAS and his primary research interests include the impact of child sexual abuse disclosure, psychological distress in adolescents, and borderline impulsive behaviors.

Jean-Yves Frappier

Jean-Yves Frappier, MD, FRCPC, MSc, is a pediatrician specialized in adolescent medicine. He is the head of the Adolescent Medicine and of the Social Pediatric divisions of Montreal CHU Sainte-Justine and professor of Paediatrics, Faculty of Medicine, University of Montreal. His research interests focus on sexual abuse, sexually transmitted infections and physical and mental health among adolescents.