The prevalence rate of sexual trauma in a primary care clinic.

Natalie Torkelson · Wayne J. Katon · Mary P. Koss

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Sexual Assault and Victimization Studies Intimate Partner and Family Violence Child Abuse and Trauma

Abstract

BACKGROUND: Despite the high prevalence rate of sexual victimization in the general population, little is known about the characteristics of abuse victims in primary care. We studied the prevalence rate of childhood and adult sexual trauma in a primary care clinic, associated psychological distress, and patients' attitudes about physician inquiry into past sexual victimization. METHODS: Self-report questionnaires were given to 162 women in a primary care clinic inquiring about past episodes of childhood sexual abuse, adult sexual assault, and patients' desire that their physicians be aware of their sexually traumatic experiences. The women also completed the Trauma Symptom Checklist-40 (TSC-40), a measure of psychological distress. RESULTS: The rates of childhood sexual abuse (37 percent) and adult sexual assault (29 percent) in this primary care clinic were comparable with, but somewhat above, the rates reported for the general population. Although most of the women (61 percent) believed it was appropriate for their physician to ask about previous victimization, only 4 percent had been asked. Women who had experienced sexual trauma were more distressed when compared with nonvictimized women, as measured by the TSC-40. Childhood sexual abuse was associated with greater distress than was adult sexual assault, and combinations of childhood and adult trauma were associated with the highest distress levels. CONCLUSIONS: A history of sexual abuse or assault can be a relatively common finding in primary care clinics. Patients might benefit from routine physician inquiry into histories of childhood and adult sexual victimization, and physicians should be mindful of the long-term medical and psychological sequelae that frequently result from this trauma.

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References

1978The De Facto US Mental Health Services System 1987Criminal Victimization: Lifetime Prevalence, Reporting to Police, and Psychological Impact 1992Inquiry about victimization experiences. A survey of patient preferences and physician practices 1991Deleterious effects of criminal victimization on women's health and medical utilization.

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2000Symptomatology and health care utilization of women primary care patients who experienced childhood sexual abuse 1999Violence in the Lives of Adult Borderline Patients 2001Physical Symptoms, Posttraumatic Stress Disorder, and Healthcare Utilization of Women with and without Childhood Physical and Sexual Abuse 2008Direct and Indirect Links Between Childhood Maltreatment, Posttraumatic Stress Disorder, and Women's Health 1995Medical and psychiatric symptoms in female gastroenterology clinic patients with histories of sexual victimization 2004Retrospective Measurement of Childhood Sexual Abuse: A Review of Instruments 2017Sexual violence associated with poor mental health in women attending Australian general practices 2003Sexual violence against adult women primary care attenders in east London.

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