Publication year
2013
Citation Title
Prevalence of childhood physical and sexual abuse in veterans with psychiatric diagnoses.
Journal Name
Journal of Nervous and Mental Disease
Journal Volume
201
Issue Number
4
Page Numbers
348-352
DOI
10.1097/NMD.0b013e318288e333
Summary
Researchers conducted a retrospective chart review of 603 consecutive psychiatric inpatients at one Veterans Affairs (VA) hospital to assess the prevalence of reported childhood physical and sexual abuse. The prevalence of reported childhood physical or sexual abuse was 19%. Researchers compared the rates of abuse with psychiatric diagnoses. More patients with posttraumatic stress disorder (PTSD) reported physical and sexual abuse than did those without PTSD.
Key Findings
Overall, 19% of the Veterans reported childhood physical or sexual abuse (occurring before age 18 years); 13% reported physical abuse (23% women, 12% men), 11% reported sexual abuse (33% women, 8% men), and 5% reported both physical and sexual abuse.
Among Veterans with PTSD, 18% reported childhood physical abuse compared to 12% without PTSD. Similarly, 16% of Veterans with PTSD reported sexual abuse compared to 9% without PTSD.
Among patients with depressive disorders, 14% reported a history of sexual abuse compared to 9% without depressive disorders.
Men with substance-induced mood disorder were more likely to report a history of childhood physical abuse than men without the disorder.
Implications for Program Leaders
Provide supportive skills training to military families with Service members who are dealing with mental health issues such as depression, PTSD, and substance abuse
Collaborate with community services and programs to provide a range of mental health referrals for Service members with childhood abuse
Teach evidence-based parenting classes designed to help couples manage parenting stress and use respectful, healthy discipline strategies
Implications for Policy Makers
Continue to support programs for identification and prevention of domestic violence in military families
Recommend education for service providers about the possible effects of deployment on Service members’ families
Promote the development of support groups and in-home services for military families at installations
Methods
Data consisted of a retrospective chart review of patients admitted to a psychiatric ward from August 1, 2004 to July 31, 2005 at the Atlanta VA Medical Center.
In the medical chart, information about the patients' childhood and current diagnoses were completed by the psychiatrists who admitted the patient into the hospital.
Statistical analyses were used to test associations among the different types of abuse and psychiatric disorders.
Participants
Six hundred and three consecutive psychiatric inpatients at Atlanta Veterans Affairs Medical Center participated.
The sample was predominately male (86%), and either Black (56%), or White (28%). The average age of participants was 49.2 years (SD = 9.7; Range: 22–86 years).
Only 13% of the sample reported a history of combact experience.
The average number of days in the hospital was 11.7 days (SD = 11.7) and the average number of hospital admissions during the study period were 1.3 days (SD = 0.7).
Limitations
Information on branch, component, rank, and conflict of the Veterans was not specified, making the ability to generalize this data to other Veterans uncertain.
Data were collected from one VA medical center, limiting the generalizability of the findings beyond that hospital.
As this study was solely a chart review of medical records, a possible limitation surrounds completeness of data. Information about abuse may not have been thoroughly or accurately reported in the medical records.
Avenues for Future Research
Investigate best-practices for treating psychiatric patients with histories of childhood abuse
Explore the effects of childhood abuse on military functioning
Use longitudinal designs to assess the effects of childhood abuse on the clinical course of psychiatric illnesses over time among Service members
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
We examined the prevalence of childhood (?18 years) physical and sexual abuse reported among patients admitted to the psychiatric inpatient service and the differential rates of this abuse associated with psychiatric diagnoses. This study consisted of a retrospective chart review of 603 patients admitted to a psychiatric ward during a period of 1 year at Atlanta Veterans Affairs Medical Center who had data on childhood physical and sexual abuse. The prevalence of reported childhood physical or sexual abuse in this inpatient clinical population was 19.4% (117/603). The prevalence of reported physical abuse was 22.6% (19/84) in the women and 12.0% (62/519) in the men (p = 0.008); the prevalence of sexual abuse was 33.3% (28/84) in the women and 7.7% (40/519) in the men (p < 0.0001). More patients with depressive disorders reported sexual abuse than did those without these disorders. More patients with posttraumatic stress disorder (PTSD) reported physical and sexual abuse than did those without these disorders. Stratifying by race, sex, and diagnoses, multivariate analyses showed that the women with PTSD had a greater likelihood to report physical abuse (p = 0.03) and sexual abuse histories (p = 0.008) than did the women without PTSD. The men with substance-induced mood disorder (p = 0.01) were more likely to report physical abuse compared with the men without substance-induced mood disorder. Screening for abuse in patients with depressive disorders and PTSD is warranted to tailor individualized treatments for these patients. More research is needed to better understand the potential implications of childhood abuse on psychiatric diagnoses
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