Childhood Trauma and Mental Health Outcomes in Later Life for Men; Examining the Role of Sexual Abuse, Adverse Child Experiences and Masculine Norms (WITHDRAWN)

Background/purpose: A history of child sexual abuse (CSA) increases the risk of psychopathology for survivors in childhood and early adulthood.  However, existing studies have been limited by the use of non-probability samples consisting primarily of female survivors, clinical patients, or young adults.  Despite prevalence rates of CSA between 5%-15% for boys, little is known about its effects on the long-term mental health of men in the general population.  The purpose of this study was to examine the role of CSA on three mental health outcomes (i.e., depression, somatization, hostility) for older men using a life course perspective.  Based on poly-victimization and masculinity theories, we also examined the effects (both direct and moderating) of adverse childhood experiences (ACE) and adherence to masculine norms on later-life mental health outcomes. 

Methods: We analyzed data from the Wisconsin Longitudinal Study, a long-term population-based study of a random sample of 1957 graduates from Wisconsin high schools (10, 317) and randomly selected siblings (5,823).  Using data from the 2004-2005 wave, the sample for this study consisted of 2,451 men, including those who reported being sexually abused in childhood (n = 129) and others from a non-abused, matched comparison group with similar socio-demographic characteristics (n = 2,322).  Participants had a mean age of 64.2 years (range = 44-84 years), had completed 14.5 years of education (S.D. = 2.7), and were predominately White (85.9%).  The three dependent variables were measured using adapted versions of well-established instruments: depression (Center for Epidemiologic Studies Depression Scale), somatic symptoms (Patient Health Questionnaire-15), and hostility (State-Trait Anger Expression Inventory).  Ordinary least squares regression and logistic regression were used for data analysis.

Results: In bivariate analyses, abused men reported higher levels of depression (t(2,385) = -2.96, p < .05) and somatic symptoms (t(2,274) = -4.20, p < .001) and were more likely to report feeling hostile ((1, N = 2,386) = 4.25, p < .05) than non-abused counterparts.  After controlling for demographic, parental, and health factors, multivariate analyses found that CSA was positively related to depression (b = .39), somatic symptoms (b = 2.26), and hostility (OR = 1.70).  Both ACE and masculine norms also predicted higher levels (or odds) of all three mental health outcomes for the sample.  Additionally, we found that ACE moderated the relationship between CSA and depression (b = .42).  Among those who were sexually abused, ACE exerted an even stronger effect on depression. 

Conclusion and Implications: This innovative study is one of the first to find empirical support that CSA is associated with long-term psychopathology for older men in the general population.  General healthcare providers working with older men should include histories of childhood traumatic events such as CSA and ACE in assessments.  Clinicians should provide sexually abused men with psychoeducational materials (i.e., prevention) or referrals to mental health counseling (i.e., treatment).  Mental health practitioners should also incorporate measures of masculine norms in assessment and help older male clients modify rigid or excessive gender beliefs that can inhibit well-being.