A new study from the University of Montreal shows that, among victims of childhood sexual abuse, the psychological and physical effects are closely linked.
- An interdisciplinary approach has shown that young girls and young women who have suffered sexual violence during their childhood are more likely to develop psychiatric disorders, but also to consult for urinary and genital problems.
What are the long-term physical and psychological effects of childhood sexual abuse? Until now, few studies have looked into the physical and psychological sequelae of this sexual violence on minor victims. In recent years, however, studies have established that survivors of sexual abuse are affected for years.
Thus, in 2018, a study by the Department of Psychology at the University of Montreal (Canada) showed that girls who had suffered sexual abuse received 2.1 times more diagnoses of urinary problems and 1.4 times more diagnoses of genital problems than girls in the general population.
This finding prompted new work aimed at understanding why and how survivors of sexual abuse suffered from recurring genitourinary problems. Published this week in the magazine Health Psychologythey tend to show that it is the psychological distress in which the victims find themselves which is partly responsible for the higher incidence of genitourinary problems, in particular urinary tract infections, vaginitis and pain during sexual intercourse or the rules.
Urogenital and psychiatric problems
“The main conclusion of this study is that unilateral treatment — which only addresses psychological sequelae or physical trauma — is inadequate.says Pascale Vézina-Gagnon, co-author of the study. We need to take a combined approach to treatment that doesn’t see these issues as separate.”
To study the link between physical and psychological sequelae, the researchers used medical data provided by the Régie de l’Assurance Maladie du Québec and the Quebec Ministry of Health and Social Services. The study involved 661 girls aged 1 to 17 who had survived one or more cases of proven sexual abuse and a comparison group of 661 girls from the general population.
“Results show that girls who were sexually abused were more likely to see a health care professional for a wider range of psychiatric problems — anxiety, mood disorders, schizophrenia or substance abuse — than girls in the comparison group.explains Pascale Vézina-Gagnon. These consultations were also associated with more frequent medical appointments or hospitalizations for genital and urinary problems in the years following the report of the sexual abuse.
Additionally, researchers found that girls who had been sexually abused during childhood consulted or were hospitalized for multiple psychiatric problems, which explains later genital (62%) and urinary (23%) health problems.
For an interdisciplinary approach
How can this link between psychological and physical sequelae be explained? The researchers formulated two hypotheses explaining these results. “The first is that the association is due to a hypervigilant response. Sexual abuse survivors who are affected by multiple mental health issues (…) may become hypervigilant or more likely to notice symptoms related to their genital or urinary health, which would cause them to see their doctor more frequently”says Professor Vézina-Gagnon.
“In contrast, she continues,he second hypothesis is that the association is due to avoidance behavior. Survivors may procrastinate or avoid seeking help or seeing a doctor for genitourinary problems, increasing the risk that these problems will deteriorate or become chronic conditions. Gynecological care can trigger memories of past abuse (due to power imbalance between patients and doctors, removal of clothing, feelings of vulnerability, and physical pain) and so it can be particularly difficult for these girls.”
For the authors of the study, these results show that it is necessary to better “consider the relationship between physical and mental” in particular by directing victims of sexual abuse towards interdisciplinary care. According to them, “early and targeted intervention aimed at reducing the psychological distress of survivors can be helpful in preventing genitourinary problems from deteriorating or developing into chronic diseases.”
According to a WHO report dating back to 2014, 20% of women and 5-10% of men worldwide have experienced childhood sexual violence.
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