Sexual abuse in people with alcohol problems. A study of the prevalence of sexual abuse and its relationship to drinking behaviour

Abstract

Background: There is evidence that people with a history of sexual abuse may have an increased risk of developing alcohol and drug problems.

Method: A self-completion sexual abuse questionnaire was designed and administered to a sample of attenders at three London alcohol services. Drinking behaviour was assessed using the Severity of Alcohol Dependence Questionnaire and the Alcohol Problems Questionnaire, and additional data were derived from case notes.

Results: Fifty-four per cent of women and 24% of men identified themselves as victims of sexual abuse or assault For the majority this had started before the age of 16 and involved non-relatives. Subjects with a history of sexual abuse were younger, reached drinking milestones earlier, were more likely to have a family history of alcohol misuse and had more alcohol-related problems than non-abused subjects. Sexual abuse, age and alcohol dependence predicted level of problems in a regression analysis.

Conclusions: The high rates of sexual abuse and its association with indications of increased morbidity suggest it is an important issue for the management of alcohol problems. More use could be made of self-completion questionnaires for the investigation of sexual abuse.

PIP: Several community-based studies have found significantly higher rates of alcohol and drug abuse among those with a history of child sexual abuse. This association was investigated further in a sample of 126 consecutive attendees (89 men and 37 women) at three alcohol treatment centers in London, England. 25 men (24%) and 21 women (54%) reported a sexual abuse history. 43 (69%) of the 62 perpetrators reported by respondents were not family members. The mean age at first occurrence of abuse was 12.6 years and 75% of victims were 15 years of age or younger at first incident. Victims of sexual abuse were younger at presentation for treatment and had significantly higher scores on the Severity of Dependence Questionnaire and the Alcohol Problem Questionnaire than their nonabused counterparts. They also developed drinking problems at an earlier age and were more likely to have other psychiatric problems. 53.4% of the variance in drinking was contributed by alcohol dependence, age, and sexual abuse. These findings suggest that sexual abuse is a common childhood experience among men and women who seek help for alcohol problems. However, the lack of a control group of non-drinkers limits assessment of a possible causal link between child sexual abuse and subsequent alcohol misuse.