Relationship between dissociation, childhood sexual abuse, childhood physical abuse, and mental illness in a general population sample.

OBJECTIVE: The aim of this study was to examine the relationship between childhood sexual abuse, childhood physical abuse, current psychiatric illness, and measures of dissociation in an adult population.

METHOD: The authors used a randomly selected sample of 1,028 individuals. Each subject completed a semistructured face-to-face interview that included measures of childhood sexual abuse, childhood physical abuse, DSM-III-R psychiatric diagnoses, and selected items from the Dissociative Experiences Scale.

RESULTS: Many individuals experienced occasional dissociative symptoms, and 6.3% of the population suffered from three or more frequently occurring dissociative symptoms. Among these individuals, the rate of childhood sexual abuse was two and one-half times as high, the rate of physical abuse was five times as high, and the rate of current psychiatric disorder was four times as high as the respective rates for the other subjects. Logistic regression modeling showed that physical abuse and current psychiatric illness were directly related to a high rate of dissociative symptoms but sexual abuse was not. The influence of sexual abuse was due to its associations with current psychiatric illness and with childhood physical abuse. Childhood physical abuse was not directly related to current psychiatric illness. Its association appeared to be mediated by its link to childhood sexual abuse.

CONCLUSIONS: This study confirms that a small proportion (approximately 6%) of the general population suffer from high levels of dissociative symptoms. It calls into question the hypothesized direct relationship between childhood sexual abuse and adult dissociative symptoms.