Association Between Adult Sexual Assault and Psychiatric Disorders: Results From the National Epidemiologic Survey on Alcohol and Related Conditions-III.

Background: Sexual assault is a significant public health issue with high prevalence rates, particularly among women. Previous research suggests strong associations between sexual assault and psychiatric disorders, but studies focusing on adult sexual assault (ASA) and its sex specific consequences are limited. Objective: To estimate the prevalence of ASA in the US and assess its associations with psychiatric disorders and quality of life, focusing on sex differences. Methods: We analyzed cross-sectional data from the National Epidemiologic Study of Alcohol and Related Conditions III (NESARC-III), a nationally representative survey of US adults (N = 36,309). The study included assessments of self-reported ASA and lifetime psychiatric disorders (Alcohol Use Disorder and Associated Disabilities Interview Schedule 5) and quality of life (Short-Form 12-Item Survey version 2). Results: The prevalence of self-reported ASA was 2.6% (n =922), with higher rates in women (4.26%) compared to men (0.53%). ASA was associated with all lifetime psychiatric disorders and a poorer quality of life. Among participants who experienced ASA, 85.25% had at least one lifetime psychiatric disorder. Specifically, among women, 86.09% of victims had at least one lifetime psychiatric disorder (vs 54.43% in women control). The strongest associations were found with posttraumatic stress disorder (PTSD) (adjusted odds ratio [aOR] =5.96), borderline personality disorder (aOR= 4.06), and suicide attempts (aOR= 4.67). Among men, 78.27% of victims had at least one lifetime psychiatric disorder (vs 58.09% in men control). The strongest associations were with psychotic disorders (aOR=6.65), PTSD (aOR=6.62), and suicide attempts (aOR=5.01). Conclusions: ASA was associated with many psychiatric disorders and reduced quality of life, with significant sex differences. These findings highlight the need for targeted interventions and support for sexual assault survivors, emphasizing the importance of routine screening and sex-specific prevention strategies.