Social and emotional factors, including social support and lifetime history of mental health conditions, play a significant role in achieving complete mental health among childhood sexual abuse survivors, according to findings of a Canadian nationally representative survey published in Social Psychiatry and Psychiatric Epidemiology.
“These findings illustrate the amazing power of human resiliency,” Esme Fuller-Thomson, PhD, professor at the University of Toronto’s Factor-Inwentash Faculty of Social Work, told Healio Psychiatry. “Childhood sexual abuse is one of the hardest things anyone can experience, yet two-thirds of survivors manage to be mentally healthy and flourish in adulthood.”
Fuller-Thomson and colleagues defined complete mental health as, “the absence of mental illness in combination with almost daily happiness and/or life satisfaction, as well as high levels of social and psychological well-being.” In their study, they evaluated links between childhood sexual abuse and complete mental health in adulthood and estimated protective factors and the magnitude of risk associated with complete mental health among childhood sexual abuse survivors.
They analyzed data from 17,014 individuals aged 20 years or older who responded to the 2012 Canadian Community Health Survey-Mental Health, and of these, 651 had a history of childhood sexual abuse. Using path analysis, they estimated indirect and direct pathways between childhood sexual abuse, complete mental health and a priori hypothesized protective and risk factors. They investigated the magnitude of effects of the same risk and protective factors on complete mental health among childhood sexual abuse survivors using multivariable logistic regression.
Fuller-Thomson and colleagues controlled for age, sex, race, education and martial status, and found that the association between childhood sexual abuse and complete mental health was mediated by having a confidant, lifetime depression, chronic pain, anxiety and substance abuse. Among those with a history of childhood sexual abuse, the strongest predictor of past-year complete mental health was lifetime depression (OR = 0.12; 95% CI, 0.07-0.2), followed by having a confidant (OR = 6.78; 95% CI, 1.89-24.38). The odds of complete mental health among those with substance misuse decreased by more than three times and halved for those with lifetime anxiety/and or presence of pain, according to the researchers.
“Health care professionals now have good news to share with childhood sexual abuse survivors: Not only is full recovery possible, the majority of survivors are doing extremely well,” Fuller-Thomson said. “However, survivors who did not have a confidant were much less likely to be in excellent mental health. Clearly interventions are needed to help isolated abuse survivors develop and maintain positive social connections.” – by Joe Gramigna
Disclosures: The authors report no relevant financial disclosures.