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Associations of Anxiety-Related Symptoms With Reported History of Childhood Sexual Abuse in Schizophrenia Spectrum Disorders

J Clin Psychiatry 2005;66(10):1279-1284

Objective: Research suggests that persons with schizophrenia tend to experience significant levels of anxiety and that history of childhood sexual abuse may predispose some with schizophrenia to experience significant levels of persistent anxiety. It is unclear whether childhood sexual abuse is more closely linked to specific forms of anxiety including symptoms of posttraumatic stress disorder (PTSD).

Method: Data were gathered from April 2004 through November 2004 on trauma history, PTSD symptoms, social anxiety, and state and trait anxiety from 45 men with a SCID-I-confirmed diagnosis of schizophrenia or schizoaffective disorder and 11 with a SCID-I-confirmed diagnosis of PTSD with no history of psychosis. Participants with schizophrenia spectrum disorders (schizophrenia group) were divided into those with and without history of childhood sexual abuse. Five participants in the schizophrenia group with a history of adult but not childhood sexual assault were excluded from analyses.

Results: Analysis of variance comparing the childhood sexual abuse (N=21) and non-abused (N=19) schizophrenia groups and the PTSD group on all anxiety assessments revealed that the sexually abused schizophrenia group had significantly higher levels of dissociation, intrusive experiences, and state and trait anxiety than the non-abused schizophrenia group. The schizophrenia groups did not differ statistically on levels of anxious arousal, defensive avoidance, or social anxiety. When compared with participants with PTSD and no psychosis, the sexually abused schizophrenia group had significantly lower levels of state anxiety, anxious arousal, intrusive experiences, and fearful social avoidance but failed to differ statistically on other scores.

Conclusion: These results, if replicated, could lead to identification of those at risk for anxiety and PTSD and to targeted interventions.