Longitudinal Study of the Effects of Childhood Sexual Abuse on Depressive Symptoms Among Men

Background/purpose: Recent evidence shows that childhood sexual abuse (CSA) of boys/men is an important public health concern that can impair mental health for survivors across the lifespan.  Despite its importance, there is a paucity of research on the effects of CSA on the long-term mental health of male survivors. Based on an integrated theoretical framework composed of complex trauma theory and life course perspective, the purpose of this study was to examine long-term trajectories of depressive symptoms for men with and without a history of CSA.  In addition, it examined the moderating effect of social support on the association between CSA and depressive symptoms over time.

Methods: This study used data from the Wisconsin Longitudinal Study (WLS), a multi-waved, population-based survey of 10,317 high school graduates in 1957 and their randomly selected siblings. We analyzed data from multiple waves of the WLS including 1993-1994, 2004-2005, and 2010-2011.  The final study 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).  To take advantage of the three-wave longitudinal data, growth curve modeling techniques were employed.

Results: Key findings indicated that men with a history of CSA had greater depressive symptoms than those with no history of CSA, after controlling for demographic, parental, and health factors (γ₀₁ = .06, p < .05).  For both abused and non-abused men, depressive symptoms decreased over time, but there was no significant difference between the two groups in terms of the linear slopes (γ₁₁ = .00, p = ns).  When adding the childhood adversities (ACE) variable, a one unit increase in ACE was positively associated with depressive symptoms (γ₀₂ = .03, p < .001); however, the effect of CSA was no longer significant (γ₀₁ = .04, p = ns).  In order to assess the potentially moderating effect of social support, we examined cross-level interactions with individual-level variables including CSA and other time-invariant variables. The levels of social support were negatively associated with depressive symptoms for both adults with and without a history of CSA: as social support increased, depressive symptoms decreased (β₂ = -.06, p < .001).  This protective effect of social support was stronger for men who experienced CSA, compared to those who did not experience CSA (-.06 (β₂) + (-.08 (γ₂₁) = -.14).

Conclusion and Implications: This innovative study extends general findings of previous studies that CSA impairs long-term deleterious effects on male survivors’ mental health across the lifespan and into old age.  In addition, higher levels of social support can help mitigate the negative effects of CSA by reducing depressive symptoms. These results have important clinical implications. When intervening with boys or men who survived CSA, clinicians should focus on strengthening support resources of the survivors for better mental health outcomes.