Child Sexual Abuse and Late Life Mental Health Outcomes for Men; Results from the Wisconsin Longitudinal Study

Background/purpose: Recent epidemiological studies confirm that childhood sexual abuse (CSA) of boys is an important public health concern.  Some cross-sectional studies indicate that CSA can impair mental health for men in early and middle adulthood.  However, few longitudinal studies have explored long-term effects of CSA on men’s mental health in late life; the knowledge base is at a nascent stage.  Guided by life course perspective and masculine gender socialization, this study examined long-term trajectories of three mental health outcomes (i.e., hostility, somatic symptoms, anxiety) for men with and without a history of CSA.  The study also investigated the potentially moderating role of social support on these relationships.

Methods: The secondary analysis was based on data from the Wisconsin Longitudinal Study (WLS), a multi-wave, population-based survey of 10,317 high school graduates in 1957 and their randomly selected siblings.  We analyzed data from three time points (i.e., 1993-1994, 2004-2005, 2010-2011) when participants were in their 50s, 60s, and 70s.  The final sample was composed of 2,451 men, including respondents who reported a history of being sexually abused (n = 129) and a matched comparison group of non-abused men (n = 2322).  Demographic characteristics, parental factors, and other childhood adversities (ACE) were controlled.  To examine effects of CSA on mental health trajectories, growth curve modeling was conducted. 

Results: Key findings indicated that men with a history of CSA had higher levels of hostility (γ₀₁ = .11, p < .05) and somatic symptoms (γ₀₁ = .09, p < .05) than men with no history of CSA, after demographic characteristics, parental factors, and ACE were controlled.  For both abused and non-abused men, hostility (B₁ = -.01, p < .001) and somatic symptoms (B₁ = -.01, p < .001) decreased over time; there was no significant difference between the groups in terms of the rate of change (i.e., linear slope of time, γ₁₁ = .00, p = ns).  CSA was not associated with levels of anxiety in the model that included the set of covariates.  Additionally, ACE was positively related to all three outcomes; levels of social support were negatively related to hostility (B₂  = -.07, p < .001) and anxiety (B₂ = -.13, p < .001), but not somatic symptoms.  Interestingly, we did not find support for our hypothesis that the protective effect of social support would be stronger for men who experienced CSA for all three outcomes.

Conclusion and Implications: This investigation was one of the first population-based, longitudinal studies to examine far-reaching effects of CSA on three seldom-explored mental health outcomes for men.  Results indicate that after a robust set of controls, CSA contributes to hostility and somatic symptoms in middle and late adulthood.  Based on these findings, mental and physical healthcare providers should include CSA and ACE in clinical assessments for men.  Future research should explore interventions and effective treatment modalities for this population.