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Licensed Unlicensed Requires Authentication Published by De Gruyter July 10, 2013

Child sexual abuse and the pathophysiology of suicide in adolescents and adults

Betsy S. O’Brien and Leo Sher

Abstract

Background: Child sexual abuse (CSA) is widespread and is associated with various psychopathologies, including Axis I and II disorders, maladaptive and impulsive behaviors, and suicidal behavior in adolescence and adults. The pathophysiology of this association is not well understood; however, it is clear that suicidal behavior in individuals with a history of CSA is a significant social and medical problem that warrants further investigation.

Methods: An electronic search of the major behavioral science databases (limited to the most recent studies in the last 20 years) was conducted to retrieve studies detailing the social, epidemiological, and clinical characteristics of child sexual trauma and their relation to suicidal behavior in adolescents and adults.

Results: Studies indicate that CSA is related to an increase in Axis I and II diagnoses, including depression, post-traumatic stress disorder, conduct disorders, eating disorders, alcohol and drug abuse, panic disorders, and borderline personality disorder. CSA not just related to an increase in impulsivity and risky behaviors, it has also been linked to an increase in suicidality as well.

Conclusion: CSA makes both direct and indirect contributions to suicidal behavior. It is a complex process involving multiple variables, which include psychopathology, maladaptive personality features and the direct contribution of CSA itself. Psychopathologies, such as impulsivity and mood and personality disorders, may modulate the relationship between CSA and suicidal behavior. Some preventive measures for decreasing the prevalence of CSA and suicidality may include education as well as increased access to mental health services.


Corresponding author: Betsy S. O’Brien, MD, Mount Sinai School of Medicine, Department of Psychiatry, Box 1230, One Gustave L. Levy Place, New York, NY 10029, USA

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Received: 2012-7-2
Accepted: 2012-8-15
Published Online: 2013-07-10
Published in Print: 2013-09-01

©2013 by Walter de Gruyter Berlin Boston