Medium-term health and social outcomes in adolescents following sexual assault: a prospective mixed-methods cohort study

Abstract

Purpose To describe medium-term physical and mental health and social outcomes following adolescent sexual assault, and examine users’ perceived needs and experiences. Method Longitudinal, mixed methods cohort study of adolescents aged 13–17 years recruited within 6 weeks of sexual assault (study entry) and followed to study end, 13–15 months post-assault. Results 75/141 participants were followed to study end (53% retention; 71 females) and 19 completed an in-depth qualitative interview. Despite many participants accessing support services, 54%, 59% and 72% remained at risk for depressive, anxiety and post-traumatic stress disorders 13–15 months post-assault. Physical symptoms were reported more frequently. Persistent (> 30 days) absence from school doubled between study entry and end, from 22 to 47%. Enduring mental ill-health and disengagement from education/employment were associated with psychosocial risk factors rather than assault characteristics. Qualitative data suggested inter-relationships between mental ill-health, physical health problems and disengagement from school, and poor understanding from schools regarding how to support young people post-assault. Baseline levels of smoking, alcohol and ever drug use were high and increased during the study period (only significantly for alcohol use). Conclusion Adolescents presenting after sexual assault have high levels of vulnerability over a year post-assault. Many remain at risk for mental health disorders, highlighting the need for specialist intervention and ongoing support. A key concern for young people is disruption to their education. Multi-faceted support is needed to prevent social exclusion and further widening of health inequalities in this population, and to support young people in their immediate and long-term recovery.

Interpersonal violence and mental health: new findings and paradigms for enduring problems

“…Future research on all gender categories is very much needed to further our understanding. However this series includes rich and methodologically innovative research a which attempts to address many of the limitations of the current evidence base by: ensuring quantitative data is disaggregated and analysed by sex, using datasets large enough to have the statistical power to examine sex differences [7][8][9]; considering carefully the measurement of abuse-for example, including technology-enabled abuse [9]; similarly, reevaluating measurement of outcomes by carrying out longer follow-ups and including several domains important to survivors of abuse; and taking a life course approach [10], for example, on how childhood sexual abuse may impact on the experience of assessments for psychotherapy [11] and the 1-year outcomes in adolescents following sexual assault [10].…”

“…D'Cruz and Chandra suggest that another paradigm shift is needed so that there is collective responsibility for outcomes which emphasises that recovery and outcomes are a function of not only the "survivor " but also their social systems [16]. The data in the study of adolescents from a Sexual Assault Referral Centre illustrates this well, with the response of the school, and social relationships at home and with peers, being key in determining outcomes [10].…”

“…The effects of such trauma in adolescents include brain development, mental and physical health, emotion regulation, self-esteem, and relationships so it is timely to include a prospective mixedmethods cohort study of adolescents experiencing sexual assault attending a specialist sexual assault referral centre in London. Clarke et al [10] recruited 141 adolescents (134 female, 6 male and one transgender woman) and followed them up at 13 to 15 months post assault. Very high proportions of participants (many of whom had experienced multiple disadvantages before the index assault) were experiencing symptoms of anxiety disorder, PTSD, or depression (60%, 72% and 54%, respectively) and/or self-harmed (51%) at this follow-up.…”

The Relative Impact of Different Types of Military Sexual Trauma on Long-Term PTSD, Depression, and Suicidality

“…The experience of sexual assault clearly can have substantial and long-lasting impacts across a wide range of outcomes including negative psychological and psychiatric distress (Chivers-Wilson, 2006;Ullman et al, 2005), negative physical health outcomes (Clarke et al, 2021;Wadsworth & Records, 2013;World Health Organization, 2013), and impairment in functioning across major life domains (Millegan et al, 2015). Indeed, sexual trauma is one of the leading causes of posttraumatic stress disorder (PTSD; Chivers- Wilson, 2006;Liu et al, 2017).…”

Penerapan Play Therapy Dalam Pendampingan Psikologis Pada Remaja Di Panti Asuhan Putra Muhammadiyah Medan

“…belajar bahkan merasa pesimis dengan masa depannya(Clarke et al, 2021). Risiko ini juga bisa terjadi pada mitra remaja di Panti Asuhan Putra Muhammadiyah Medan.…”