The prevalence rate of sexual trauma in a primary care clinic

Despite the high prevalence rate of sexual victimization in the general population, little is known about the characteristics of abuse victims in primary care. We studied the prevalence rate of childhood and adult sexual trauma in a primary care clinic, associated psychological distress, and patients' attitudes about physician inquiry into past sexual victimization.

Self-report questionnaires were given to 162 women in a primary care clinic inquiring about past episodes of childhood sexual abuse, adult sexual assault, and patients' desire that their physicians be aware of their sexually traumatic experiences. The women also completed the Trauma Symptom Checklist-40 (TSC-40), a measure of psychological distress.

The rates of childhood sexual abuse (37 percent) and adult sexual assault (29 percent) in this primary care clinic were comparable with, but somewhat above, the rates reported for the general population. Although most of the women (61 percent) believed it was appropriate for their physician to ask about previous victimization, only 4 percent had been asked. Women who had experienced sexual trauma were more distressed when compared with nonvictimized women, as measured by the TSC-40. Childhood sexual abuse was associated with greater distress than was adult sexual assault, and combinations of childhood and adult trauma were associated with the highest distress levels.

A history of sexual abuse or assault can be a relatively common finding in primary care clinics. Patients might benefit from routine physician inquiry into histories of childhood and adult sexual victimization, and physicians should be mindful of the long-term medical and psychological sequelae that frequently result from this trauma.