Suicidality Following Sexual Abuse Among Children Aged 10 to 17 Years

Survivors of child sexual abuse often experience trauma-related sequelae, including increased risk for psychiatric disorders. The objectives of this study are to (1) epidemiologically describe youth evaluated at a child advocacy center for concerns of child sexual abuse and compare the characteristics of those who did and did not experience subsequent suicidality and (2) explore associations between the presentation of suicidality and the victim-alleged perpetrator relationship.

Electronic health records of children aged 10 to 17 years who were evaluated for child sexual abuse at a medically based child advocacy center in the Midwestern United States between January 1, 2018, and December 31, 2022, were retrospectively reviewed to identify suicidality within 90 days following assessment. Demographic, medical, mental health, and alleged perpetrator relationship data were descriptively analyzed.

Among 1391 youth medically assessed for child sexual abuse, 11.1% of youth reported suicidality within 90 days. Of those youth, 21.9% attempted suicide within that time period. When the relationship between the adolescent and alleged perpetrator was known, a significantly greater percentage of suicide attempts occurred among youth whose perpetrator was a nonrelative, rather than a relative (3.2% vs 1.4%, respectively; P = .03).

This study supports the need for suicidality screening for youth both at the time of child sexual abuse evaluation and in the weeks and months following disclosure. Prompt, trauma-informed mental health care is critical for preventing further harm, especially for high-risk youth, including individuals with current depressive symptoms, those with prior suicidal ideation, and those who identify as sexual and gender diverse.