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Incest Tied to Later Mental Illness : Psychiatry: Study shows long-term effects on a victim's mind. Therapists are urged to ask each patient about sexual abuse.


ST. LOUIS — It probably isn't surprising to hear that women who were victims of incest as children are more likely to suffer disabling psychiatric problems than other women.

What is surprising is that little has been documented about the long-term effects of childhood sexual abuse.

Those were the findings of a study by Stephen Dinwiddie and Elizabeth Pribor, researchers and teachers at the Washington University School of Medicine in St. Louis.

"This very basic descriptive study was designed to see if we can put some numbers and some percentages on what is a general perception," Dinwiddie said. What Dinwiddie and Pribor learned in their study, published earlier this year in the American Journal of Psychiatry, will surprise few.

"The impact of child psychiatric trauma is a very important factor in the development of serious disorders in children and in adults," said Linda Smith, a psychotherapist in the department of psychiatry at St. Louis University Medical Center.

There is a great deal of anecdotal literature that ties incest to psychiatric problems, Smith said, but "it can be very helpful to put it in the scientific arena."

It's been difficult to research the prevalence and long-term effect of incest and sexual abuse because the victims often feel ashamed and stigmatized. "These are people who have learned from a very young and vulnerable age that you just don't talk about it," Dinwiddie said.

By age 16, one woman in five has had sexual contact with a relative, and one in three has had unwanted sexual contact with an adult, the researchers said.

In their study of 75 area women receiving psychotherapy, Dinwiddie and Pribor found the 52 incest victims in that group each, on average, had suffered seven psychiatric illnesses, more than twice the number suffered by the 23 women who hadn't been sexually abused as children.

The incest victims also suffered certain psychiatric disorders more frequently than did the other women.

The incest victims most often suffered alcohol dependence, depression, panic attacks and phobias, especially a fear of public places--all potentially disabling and all highly treatable.

While Pribor and Dinwiddie don't claim to have found a link between severity of abuse and depth of illness, they did find that the women who had been most severely abused had higher levels of anxiety-related problems.

Despite results that seem to confirm assumptions, Dinwiddie remains cautious.

"It's premature to try to propose some simple cause-and-effect relationship between this kind of trauma and the development of mental illness," he said.

The researchers also learned that of the 24 women who previously had received therapy, 21 weren't satisfied with their treatment. They said their counselors dismissed sexual abuse as a possible reason for their problems.

Unlike their therapists, the women themselves "saw incest as something massive, painful and terrible--an issue important for them to address," Dinwiddie said.

In part because it can remove some of the stigma associated with incest, therapists should ask everyone they treat if they've been sexually abused, the researchers recommended.

Phyllis Froehle, vice president of Voices in Action, an international organization of incest and sexual abuse survivors based in Chicago, agrees therapists must ask everyone about abuse.

Not until she was an adult did a question from a therapist help her recall that she'd been sexually abused as a child, Froehle said.

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