Sexual Abuse

Introduction

Research into the psychosocial consequences of sexual abuse in childhood has focused mainly on disturbances that arise shortly after the abusive experience. Long term effects have proved more difficult to investigate. The relevant literature mainly comprises case reports and studies of special populations,[1] most of which failed to use standardised instruments to measure psychopathology. Two recent community based studies, however, found an association between adult depression and sexual abuse in childhood,[2 3] and studies of psychiatric patients also report higher than expected rates of past abuse.[4 5]

We used screening questionnaires and semistructured interviews to examine the association between depression and sexual abuse in childhood among women in a general practice setting. No similar study in the whole of Ireland has involved personal interview.

Method

We recruited subjects from three general practices--in a middle class suburb of Dublin, an underprivileged area of Dublin, and a small town in the middle of the Republic of Ireland. All women aged over 18 years attending one morning and one evening surgery per general practice per week were included in the study. Each woman was recruited and screened only once.

The study followed a standard, two stage design for case detection and case identification. For the screening stage, we used the 30-item general health questionnaire,[6] with a cut off score of 6, and the Beck depression inventory[7] with a cut off score of 12. In all, 1213 women were asked to complete these questionnaires.

Women who were classed as depressed on both of these screening questionnaires were invited to participate in the second stage. As well as these depressed respondents, every 10th woman (aged over 18) attending on the day of sampling was also invited for the second stage interview (regardless of whether she was classed as depressed on the screening questionnaires). This systematic sampling procedure allowed the formation of a comparison group of non-depressed women.

At the second stage the women were interviewed by MC in a private room away from the waiting room. At this interview demographic data were collected, such as age, marital status, employment status, and psychiatric history. The interviewer used the affective items relating