Effect of abuse on health: results of a national survey.

HYPOTHESIS The magnitude of risk would be highest for those reporting both types of abuse compared with those reporting 1 type or none. OBJECTIVE To examine the independent associations between physical or sexual abuse or both and self-reported health status, mental health, and health-risk behaviors among a national school-based sample of adolescent girls. DESIGN A secondary data analysis of a cross-sectional survey. SETTING A nationally representative sample of 3015 girls in grades 5 through 12 from 265 public, private, and parochial schools (with an oversampling of urban schools) completed an anonymous survey conducted by the Commonwealth Fund Adolescent Health Survey. PATIENTS OR OTHER PARTICIPANTS Girls were eligible for this study if they responded to 2 questions assessing past physical and sexual abuse. RESULTS Among the respondents, 246 (8%) reported a history of physical abuse; 140 (5%), sexual abuse; and 160 (5%), both. Logistic regression controlling for grade, ethnicity, family structure, and socioeconomic status found that those who reported both types of abuse compared with those who did not report any were significantly more likely to experience moderate to severe depressive symptoms (adjusted odds ratio [AOR], 5.10), moderate to high levels of life stress (AOR, 3.28), regular smoking (AOR, 5.90), regular alcohol consumption (AOR, 3.76), use of other illicit drugs in the past 30 days (AOR, 3.44), and fair to poor health status (AOR, 1.74). Finally, girls who reported both types of abuse were 2.07 times more likely to report moderate to high depressive symptoms compared with those reporting only sexual abuse (95% confidence interval, 1.14-3.74). CONCLUSIONS The magnitude of risk for adolescents reporting both types of abuse compared with no abuse is much greater than that for either abuse type alone. However, compared with both types, no significant increase in risk was detected in those reporting physical abuse only, and only depressive symptoms increased in those reporting sexual abuse only.