Young girls who are forced to have sex are three times more likely to develop psychiatric disorders or abuse alcohol and drugs in adulthood, than girls who are not sexually abused, researchers report. The study, which involved more than 1,400 adult female twins, found that the sibling who was abused had a consistently higher risk of psychiatric disorders, such as depression and bulimia, despite being raised in the same family and having the same genetic makeup as her sister.

“These results strongly suggest that… childhood sexual abuse and subsequent psychological disorders and substance abuse is indeed causal,” Dr. Kenneth S. Kendler, the study’s lead author, told Reuters Health in an interview. Kendler and colleagues, from the Medical College of Virginia Commonwealth University in Richmond, examined the psychological impact of different types of childhood sexual abuse ranging from exposure and sexual suggestions to unwanted intercourse.

Their findings are published in the October issue of the Archives of General Psychiatry. In the study, women had psychiatric evaluations and answered detailed questions about their sexual experiences as children. The women’s parents were asked about their history of psychiatric disorders and their relationships with family members.

Just over 30% of women reported some form of childhood sexual abuse, with 8.4% reporting that they had unwanted intercourse. These women had the greatest risk of being diagnosed with a psychiatric disorder or substance abuse problem, results show. “The strongest association was confined to those exposed to the most severe forms of sexual abuse,” Kendler explained. He noted that the relationship was only slightly less when other factors, such as psychiatric problems or substance abuse among parents, and family income were taken into account.

Sexual abuse was also more strongly linked with substance abuse than with psychiatric disorders. Kendler speculated that sexual abuse might affect certain personality traits that involve impulsiveness and predict drug abuse in girls. He also suggested that sexual abuse may lead some girls to become sexually active at an earlier age and seek out older boyfriends who might, in turn, introduce them to drugs.

Future studies, however, should help clarify the association between sexual abuse and the increased risk of substance use, Kendler noted.

SOURCE: Archives of General Psychiatry 2000;57:953-959. ?

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