Sex and Urban–Rural Differences in the Relationship between Childhood Sexual Abuse and Mental Health among Chinese College Students

Abstract

This study aimed to reveal sex and urban–rural differences in the association between childhood sexual abuse (CSA) and mental health among Chinese college students. The study used data from the “National College Student Survey on Sexual and Reproductive Health 2019”, a cross-sectional study conducted in all 31 provinces of mainland China. Weighted logistic regression analysis was conducted to determine the association between CSA (noncontact CSA, contact CSA, and penetrative CSA) and mental health (suicide attempts and mental disorders). Among 49,728 students, 39.42% of the male participants and 43.55% of the female participants had ever experienced CSA. According to the OR results of logistic regression analysis, compared to females, males in the contact CSA group (AOR: 3.49, 95% CI: 1.95–6.23) and the penetrative CSA group (AOR: 8.79, 95% CI: 3.15–24.52) had higher odds of suicide attempts. Participants from rural and suburban areas that were categorized in the penetrative CSA group were more likely to report suicide attempts (rural: AOR: 4.01, 95% CI: 1.51–10.62, suburban AOR: 4.86, 95% CI: 2.52–9.36) and mental disorders (rural: AOR: 4.01, 95% CI: 1.51–10.62, suburban: AOR: 4.86, 95% CI: 2.52–9.36). In conclusion, the findings revealed a high prevalence of CSA in both sexes and reported that males are more vulnerable to the adverse effects of CSA. In addition, we also found that undergraduates growing up in rural and suburban areas are more vulnerable to the adverse psychological effects of CSA. Policymakers should pay more attention to this vulnerable population and implement effective measures to alleviate mental trauma.

The effect of childhood sexual abuse on depressive symptoms in female college students: a serial mediation model

“…This is consistent with previous studies which have found that adolescents who experience traumatic events are more likely to develop mental health problems ( Keiley et al, 2001 ; Brown et al, 2016 ; Li et al, 2023 ). CSA was significantly positively correlated with depressive symptoms in college students ( Zhang et al, 2022 ), and CSA had a positive predictive effect on depressive symptoms in female adolescents and adults ( Trickett et al, 2011 ; Girard et al, 2021 ). According to the diathesis-stress model, CSA, as a distal stress event, will have a negative impact on individuals’ mental health ( Broerman, 2020 ).…”

“…CSA, as early negative stress events experienced by individuals, has been shown in many studies to be a risk factor for mental health problems in adulthood ( Hillberg et al, 2011 ; Hébert et al, 2021 ). A cross-sectional study showed that CSA is significantly positively correlated with depressive symptoms among female college students ( Zhang et al, 2022 ). Multiple longitudinal studies have shown that CSA is an important predictor of depressive symptoms in female adolescents and adults ( Trickett et al, 2011 ; Girard et al, 2021 ).…”

Sex differences in the association of childhood sexual abuse severity with premarital sex among Chinese college students in Luzhou, China

“…The effects of CSA experiences on health vary from person to person and include low self-esteem, anxiety, or panic disorder in mild cases; depression or nonsuicidal self-injury in moderate cases; and suicide or even death in severe cases [ 17 , 25 , 26 ]. This may be related to the individual and the exposure to different levels of CSA severity.…”

Sex Differences in the Association of the Severity of Childhood Sexual Abuse with Premarital Sex among Chinese College Students in Luzhou, China

“…The health effects of CSA experiences vary from person to person and include low self-esteem, anxiety, or panic in mild cases; depression or nonsuicidal self-injury in moderate cases; and suicide or even death in severe cases [17,26,27]. This may be related to the individual and the exposure to different levels of severity of CSA.…”

“…Moreover, the CSA rate in female is twice as high as that in male [30]. In addition, sex differences also exist in both the level of child maltreatment [31] and the adverse effects [27]. However, it is unclear whether there are sex differences in the effect of the severity of CSA on premarital sexual behaviour.…”