Sexual orientation differences in childhood sexual abuse, suicide attempts, and DSM-5 alcohol, tobacco, other drug use, and mental health disorders in the US. (January 2022)

• Record Type: Journal Article
• Authors: McCabe, Sean Esteban; Hughes, Tonda L.; Beal, Sarah; Evans-Polce, Rebecca J.; Kcomt, Luisa; Engstrom, Curtiss; West, Brady T.; Veliz, Phil; Leary, Kate; McCabe, Vita V.; Boyd, Carol J.
• Is Part Of: Child abuse & neglect. Volume 123(2022)
• Publication Date: 2022-01
• Subjects: Child sexual abuse -- Alcohol use disorder -- Tobacco use disorder -- Suicide -- Mental health -- Sexual minority; Child abuse -- Periodicals; 362.76
• DOI: 10.1016/j.chiabu.2021.105377
• Languages: English
• ISSNs: 0145-2134

Abstract

Abstract: Background: Childhood sexual abuse (CSA) contributes to increased risk of substance use and mental health disorders in the general population. Objective: To assess the prevalence and associations of CSA and suicide attempts, substance use, and mental health disorders as a function of sex (female, male) and sexual orientation (lesbian, gay, bisexual, heterosexual-identified with same-sex attraction and/or behavior, heterosexual-identified without same-sex attraction and/or behavior, and unsure). Participants and setting: Data were collected using structured diagnostic face-to-face interviews in a nationally representative sample of 36, 309 US adults. Methods: We used descriptive statistics and logistic regression modeling to analyze data from the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III). Results: Childhood sexual abuse was most prevalent among sexual minorities, especially bisexual females. Nearly one-third of bisexual females (30.6%) reported experiencing two or more types of CSA, p < .001. Among all participants, exposure to one or more types of CSA was associated with greater odds of lifetime suicide attempts, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) alcohol, tobacco or other drug use disorder, and mental health disorders, after adjusting for other childhood adversity/maltreatment and general life stressors. Conclusions: Sexual minority females and males in the US are more likely than their heterosexual counterparts to report CSA. Higher risk of suicide attempts and DSM-5 alcohol, tobacco, other drug use, and mental health disorders in adulthood was directly associated with CSA, particularly among bisexual females. Health professionals working with individuals who have experienced CSA should assess these risks and intervene as needed. Highlights: Childhood sexual abuse (CSA) was most prevalent among bisexual females. CSA was more prevalent among sexual minority adults than heterosexual adults. CSA was associated with greater odds of alcohol, tobacco, and drug use disorders. Sexual orientation discrimination was associated with all outcomes in males. CSA history should be assessed in substance use or mental health treatment.