Medical and psychiatric symptoms in female gastroenterology clinic patients with histories of sexual victimization

Several recent retrospective reports have associated prior sexual victimization and long-term medical sequelae such as increased medical clinic utilization and reports of physical symptoms. However, methodoligical constraints have limited the generalizability of these findings. Our study was designed using structured interviews with a sequential sample of 89 female gastroenterology clinic patients, who were classified by severity of sexual trauma and studied for differences in lifetime psychiatric diagnoses, physical abuse, and medicially unexplained symptom patterns. Compared with the 46 women who had expeirenced less severe or no prior sexual trauma, the 43 patients with severe victimization had significantly higher lifetime and current rates of several selected psychiatric disorders as well as significantly higher mean numbers of lifetime psychiatric distorders, medically unexplained physical and anxiety symptoms, greater harm avoidance and dissociation scores, and increased functional disability. A logistic regression showed that the main predictors of a history of severe sexual abuse were the number of medically unexplained symptoms, adult physical abuse, and lifetime dysthymic disorder. We concluded that women with prior severe sexual trauma episodes may express medically unexplained symptoms as part of the long-term adaption to their victimization.
Author: 
Walker,Edward A.
Gelfand,Ann N.
Gelfand,Martin D.
Koss,Mary P.
Katon,Wayne J.
Notes: 
LA- English AN- 1995-37582-001
Reprint Status: 
IN FILE
Start Page: 
85
End Page: 
92
Journal/Periodical Name: 
General Hospital Psychiatry
Volume: 
17
Issue: 
2
Abstract: 
The authors interviewed 89 adult female gastroenterology clinic patients, classified by severity of sexual trauma and studied for differences in lifetime psychiatric diagnoses, physical abuse, and medically unexplained symptom patterns. Compared with the 46 women with less severe or no prior sexual trauma, the 43 participants with severe victimization had significantly higher lifetime and current rates of several selected psychiatric disorders and significantly higher mean numbers of lifetime psychiatric disorders, medically unexplained physical and anxiety symptoms, greater harm avoidance and dissociation scores, and increased functional disability. Logistic regression showed that main predictors of a history of severe sexual abuse were the number of medically unexplained symptoms, adult physical abuse, and lifetime dysthymic disorder.
Topic Areas: 
Effects; treatment
Reference Type: 
JOUR
Reference ID: 
414
Publication Date: 
1995