“Time Does Not Heal All Wounds”: Sexual Victimisation Is Associated with Depression, Anxiety, and PTSD in Old Age

Abstract

Sexual violence (SV) has an important impact on mental health. Childhood sexual abuse is linked to internalising disorders in later life. In older adults, SV occurs more often than previously believed. Moreover, health care workers lack the skills to address SV in later life. Studies researching the mental health impact of lifetime SV, i.e., SV during childhood, adulthood, and old age, are lacking. Between July 2019 and March 2020, 513 older adults living in Belgium participated in structured face-to-face-interviews. Selection occurred via a cluster random probability sampling with a random walk finding approach. Depression, anxiety, and posttraumatic stress syndrome (PTSD) were measured using validated scales. Participants were asked about suicide attempts and self-harm during their lifetime and in the past 12 months. SV was measured using behaviourally specific questions based on a broad SV definition. We found rates for depression, anxiety, and PTSD of 27%, 26%, and 6% respectively, while 2% had attempted suicide, and 1% reported self-harm in the past 12 months. Over 44% experienced lifetime SV and 8% in the past 12 months. Lifetime SV was linked to depression (p = 0.001), anxiety (p = 0.001), and PTSD in participants with a chronic illness/disability (p = 0.002) or no/lower education (p < 0.001). We found no link between lifetime SV and suicide attempts or self-harm in the past 12 months. In conclusion, lifetime SV is linked to mental health problems in late life. Tailored mental health care for older SV victims is necessary. Therefore, capacity building of professionals and development of clinical guidelines and care procedures are important.

“Just something that happened?”: Mental health impact of disclosure and framing of sexual violence in older victims

“…These numbers are higher compared to the prevalence estimates in community‐dwelling older adults, which ranged from 4% to 23% for depressive symptoms, 1%–7% for anxiety, and 2.5% and 4% for PTSD 45‐47 . Our results are in line with previous studies suggesting that sexual victimisation is linked with adverse mental health outcomes in later life 9,15,16 . Regarding suicide attempts our sample showed higher prevalence rates compared to community samples.…”

“…[45][46][47] Our results are in line with previous studies suggesting that sexual victimisation is linked with adverse mental health outcomes in later life. 9,15,16 Regarding suicide attempts our sample showed higher prevalence rates compared to community samples. Around 5% of sexually victimised older adults in our study reported a suicide attempt during lifetime compared to 2.6% in a community sample of adults aged 75 years in older in Flanders.…”

“…9,15 Experiencing SV during lifetime has also been associated with depression, anxiety and PTSD in old age. 16 Despite the important mental health impact of SV, victims find it difficult to talk about their experiences. Research has shown that only few SV victims disclose their experiences to their informal network, seek professional help or report to the police.…”

“…Several studies found a link between childhood sexual abuse and internalising disorders in later life 9,15 . Experiencing SV during lifetime has also been associated with depression, anxiety and PTSD in old age 16 …”

“In the End You Keep Silent”: Help-Seeking Behavior Upon Sexual Victimization in Older Adults

“…Hence, it is never too late to disclose or seek professional help upon SV. Given the high prevalence numbers of SV in older adults, both during lifetime and in the past 12-months, and the important mental health impact of sexual victimization in old age (Ege, 2015;Nobels et al, 2021bNobels et al, , 2022aRapsey, 2019), we recommend a routine inquiry about sexual victimization in all older adults with mental health problems. However, research has shown healthcare workers do not feel comfortable discussing SV with older adults (Goldblatt et al, 2020;Gott et al, 2004;Saunamäki & Engström, 2014).…”