Treatment in Public Centers for Adult Jewish Women Survivors of Childhood Sexual Abuse in Israel: Abuse Characteristics, Psychiatric Profiles, and One-Year Treatment Outcomes.

BACKGROUND

Childhood sexual abuse (CSA) is associated with significant psychiatric morbidity and has been reported at notable rates among Jewish Israeli women. Yet data regarding abuse characteristics, psychiatric history and longitudinal treatment outcomes in this population are lacking.

OBJECTIVE

We assessed abuse experiences, clinical profiles and psychiatric histories of adult Jewish women CSA survivors and evaluated the effectiveness of designated psychotherapy over one year.

PARTICIPANTS AND

SETTING

A clinical sample of women CSA survivors (N = 122) were treated in weekly psychotherapy in public specialized outpatient centers in Israel.

METHODS

Patients self-reported on Childhood Maltreatment (CM), posttraumatic stress disorder (PTSD) symptoms, dissociation, borderline personality (BPD) traits, and psychological well-being at treatment onset (T1), after six months (T2), and after one year of therapy (T3). CSA characteristics and psychiatric history were assessed by a semi-structured clinical interview at T1.

RESULTS

Most (85.3%) patients reported prolonged CSA histories, with 71.3% reporting intrafamilial abuse. At T1, 7.5% reported currently being abused and 8.3% were currently living with the abuser. Higher levels of CM were significantly associated with higher PTSD, dissociative and BPD symptoms and lower psychological well-being at T1. CM was significantly associated with suicide attempts, psychiatric hospitalizations and psychiatric medication use at T1. Specifically, nearly all individuals with these clinical histories reported moderate to extreme CM. Over the course of treatment (T1 to T3), PTSD symptoms significantly decreased and dissociative symptoms showed reductions from baseline to the one-year assessment, although the overall time effect approached statistical significance. Psychological well-being demonstrated a positive trend throughout the treatment year, with significant improvements observed between baseline and the one-year follow-up, while BPD traits did not change.

CONCLUSIONS

These findings underscore the complex clinical needs of CSA survivors and demonstrate that specialized, long-term psychotherapy effectively reduces core trauma symptoms while fostering significant gains in psychological well-being.