The devastating impact of child sexual abuse has been highlighted in a new study which shows it was frequently reported among people who self-harm, with those who were abused much more likely to repeatedly self-harm into their adult years. Researchers looked into data regarding adults with five or more self-harm presentations, in three Irish hospitals over a period of more than three years, and said this at-risk group may require specific interventions to help them.
Information was obtained on 188 consecutive participants, with 36 participants completing an interview, two-thirds of whom were women. Child sexual abuse was recorded in 42% of the total sample and 72.2% of those interviewed. It also found that those who repeatedly self-harmed were more likely to have experienced child sexual abuse. The study was carried out by a team of researchers led by Dr Maria Isabela Troya of the School of Public Health, College of Medicine and Health at University College Cork, and the National Suicide Research Foundation. The study was conducted in three emergency departments in Cork and Limerick, from March 2016 to July 2019.
"According to the study: "Seventy-nine of the 188 people in the frequent self-harm group (42.0%) reported a history of CSA. Most (97.8%) had a recorded mental health condition, with personality disorders being the most common (45.4%). Over three-quarters (76.2%) had more than one mental health condition. More than half (55.4%) had a recorded physical illness."
As to the link between child sexual abuse and self-harming, it said there was a "key finding":
"Those with a history of CSA were 6.26 times more likely to experience self-harm repetition (five or more self-harm presentations) than those with no history of CSA." The researchers said three themes emerged from the study data: child sexual abuse as a precipitating factor for self-harm throughout different life stages; the secrecy of the abuse accentuating feelings of shame; and experiences of loss, such as estrangement from family and bereavement.
"Most participants described the start of their self-harm as a response to traumatic abuse experiences," it said. One woman said: "She [doctor] wrote that I had … not come to terms with it [CSA] yet and … my inappropriate behaviours were my way of dealing with it." It also impacted on relationships during adulthood. One woman said: "‘The sexual abuse that would have been major. That's definitely shaped my life."
As to the feelings of shame, one man said: "I was 13 when it happened to me. I wasn't told what was right or wrong. I didn't say that to my sister, didn't say that to my father, just kept it to myself. I never sought help, I just buried my head inside the pint to drown my sorrows." "People who frequently self-harm are an at-risk group, with high prevalence of CSA, record of mental and physical conditions and access to prescribed medications because of their medical conditions," the study said, adding that "the identification of such characteristics is essential" and "such patient history should inform and tailor the recommended treatment for these patients."