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Effect of Abuse on Health
Results of a National Survey
Angela Diaz, MD;
Elisabeth Simantov, PhD;
Vaughn I. Rickert, PsyD
Arch Pediatr Adolesc Med. 2002;156:811-817.
Hypothesis The magnitude of risk would be highest for those reporting both types
of abuse compared with those reporting 1 type or none.
Objective To examine the independent associations between physical or sexual abuse
or both and self-reported health status, mental health, and health-risk behaviors
among a national school-based sample of adolescent girls.
Design A secondary data analysis of a cross-sectional survey.
Setting A nationally representative sample of 3015 girls in grades 5 through
12 from 265 public, private, and parochial schools (with an oversampling of
urban schools) completed an anonymous survey conducted by the Commonwealth
Fund Adolescent Health Survey.
Patients or Other Participants Girls were eligible for this study if they responded to 2 questions
assessing past physical and sexual abuse.
Results Among the respondents, 246 (8%) reported a history of physical abuse;
140 (5%), sexual abuse; and 160 (5%), both. Logistic regression controlling
for grade, ethnicity, family structure, and socioeconomic status found that
those who reported both types of abuse compared with those who did not report
any were significantly more likely to experience moderate to severe depressive
symptoms (adjusted odds ratio [AOR], 5.10), moderate to high levels of life
stress (AOR, 3.28), regular smoking (AOR, 5.90), regular alcohol consumption
(AOR, 3.76), use of other illicit drugs in the past 30 days (AOR, 3.44), and
fair to poor health status (AOR, 1.74). Finally, girls who reported both types
of abuse were 2.07 times more likely to report moderate to high depressive
symptoms compared with those reporting only sexual abuse (95% confidence interval,
1.14-3.74).
Conclusions The magnitude of risk for adolescents reporting both types of abuse
compared with no abuse is much greater than that for either abuse type alone.
However, compared with both types, no significant increase in risk was detected
in those reporting physical abuse only, and only depressive symptoms increased
in those reporting sexual abuse only.
From the Department of Pediatrics, Mount Sinai School of Medicine (Dr
Diaz), the Center for Home Care Policy and Research, Visiting Nurse Service
of New York (Dr Simantov), and the Center for Community Health and Education,
Mailman School of Public Health (Dr Rickert), New York, NY.
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