Mental health after sexual violence: the role of behavioral and demographic risk factors.

摘要

BACKGROUND: Sequelae of sexual violence include a range of physical and emotional problems, and negative mental health outcomes are particularly severe and long lasting. OBJECTIVES: To evaluate associations among sociodemographic and behavioral factors and mental health after exposure to sexual violence. METHODS: Participants were 780 men and women who experienced sexual violence who participated in the 2005 South Carolina Behavioral Risk Factor Surveillance Survey. The factors analyzed were gender, age, race, income, and education; having health insurance, an identified healthcare provider, and adequate emotional support; and diet, exercise, smoking, and alcohol use. Poor mental health was defined as 5 or more poor mental health days in the past 30 days. Data were analyzed using the SAS Procedures for Analysis of Sample Survey Data. RESULTS: Victims of sexual violence were at greater risk of experiencing 5 or more poor mental health days than those who did not (95% confidence interval for odds ratio =2.05-3.07, p < .0001). Poor mental health among those who experienced sexual violence was associated with younger age (p = .005), lower income (p = .02), lower educational attainment (p = .0007), lack of emotional support (p = .0001), and lack of health insurance (p = .03). Gender, race, and having an identified healthcare provider were not associated significantly with mental health. Behavioral factors significantly associated with better mental health (after controlling for socio-economic status) were healthy diet (p = .05), exercise (p = .02), and not smoking (p = .0001). Alcohol use was not associated with mental health. DISCUSSION: Treatment after sexual violence should include attention to risk factors including low income, low educational attainment, and lack of emotional support and to the protective influence of behavioral factors including a healthy diet, exercise, and not smoking. Comprehensive integrated models of care addressing mental, physical, and social sequelae of sexual violence are needed.