Age at sexual assault and posttraumatic stress disorder among women: prevalence, correlates, and implications for prevention.

BACKGROUND: Posttraumatic stress disorder (PTSD) is a debilitating psychiatric condition that can occur in people who experience extremely stressful or traumatic life events. Sexual assault is one of the most traumatic stressors in life. Although several studies have investigated the association between history of sexual assault and PTSD, studies on the impact of age at first sexual assault on PTSD are limited.
METHODS: A cross-sectional telephone survey was conducted among 1,769 adult female residents of Virginia. A detailed screening questionnaire was used to ascertain the occurrence and age at first sexual assault. The DSM-IV diagnostic criteria were used to define PTSD.
RESULTS: The prevalences of PTSD among women with no history of sexual assault, those victimized for the first time before the age of 18, and those assaulted for the first time at >or=18 were 8.1%, 35.3%, and 30.2%, respectively. Multivariate logistic regression model showed an increased risk of PTSD among women assaulted at a younger age. Compared with women reporting no history of sexual assault, women who were victimized before age 18 were 3.8 times more likely to suffer from PTSD (OR = 3.75, 95% CI 2.33-6.53). The risk of PTSD among women victimized as adults was 2.9 times higher compared with women who reported no history of sexual assault (OR = 2.89, 95% CI 1.46-5.74).
CONCLUSIONS: The risk of PTSD is slightly higher among those assaulted before the age of 18 compared with those who were assaulted at age >or=18. The adverse effect of sexual assault as a risk for PTSD is a major public health concern. Primary prevention strategies should be in place to detect sexual assault victims and prevent the occurrence of PTSD.