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Gender, victimization, and psychiatric outcomes

  • A. Gershon (a1), K. Minor (a1) and C. Hayward (a1)

Although gender differences in rates of internalizing disorders, particularly depression, are well documented, the causes of these differences are not well understood. One influential hypothesis [Cutler & Nolen-Hoeksema, Sex Roles (1991), 24, 425–438] proposes that higher rates of depression in females compared to males may be partially attributable to gender differences in the effects of childhood sexual abuse. The present study has evaluated this possibility by reviewing evidence for gender moderating the effects of childhood victimization on psychiatric outcomes.


Literature search using PsycINFO and Medline, applying the following inclusion criteria: publication from 1996 to 2006, community-based sampling, adequate male-to-female sample ratio, use of clearly defined psychiatric outcomes, and a statistical test of gender differences in the effects of childhood victimization on psychiatric outcomes.


Thirty studies met inclusion criteria. Overall, the results were mixed. Nearly half of all studies find no gender differences. In studies that do observe gender differences, victimization tends to be associated with higher psychiatric risk in females in studies with adult samples, whereas in samples of youth, victimization tends to be associated with higher psychiatric risk in males. With respect to outcome, when gender differences were observed, outcomes were distributed across both internalizing and externalizing categories for both genders.


The gender differences in prevalence rates of internalizing disorders, such as depression, do not appear to be attributable to differential effects of childhood victimization.

Corresponding author
*Address for correspondence: C. Hayward, M.D., M.P.H., Department of Psychiatry and Behavioral Sciences, Room 1316, Stanford University, Stanford, CA94305-5722, USA. (Email:
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Ackard DM, Neumark-Sztainer D (2002). Date violence and date rape among adolescents: associations with disordered eating behaviors and psychological health. Child Abuse and Neglect 26, 455473.
Ackard DM, Neumark-Sztainer D, Hannan PJ, French S, Story M (2001). Binge and purge behavior among adolescents: associations with sexual and physical abuse in a nationally representative sample: the Commonwealth Fund survey. Child Abuse and Neglect 25, 771785.
Anderson JC, Williams S, McGee R, Silva PA (1987). DSM-III disorders in preadolescent children: prevalence in a large sample from the general population. Archives of General Psychiatry 44, 6976.
Bergen HA, Martin G, Richardson AS, Allison S, Roeger L (2003). Sexual abuse and suicidal behavior: a model constructed from a large community sample of adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 42, 13011309.
Bergen HA, Martin G, Richardson AS, Allison S, Roeger L (2004). Sexual abuse, antisocial behavior and substance use: gender differences in young community adolescents. New Zealand Journal of Psychiatry 38, 3441.
Bond L, Carlin JB, Thomas L, Rubin K, Patton G (2001). Does bullying cause emotional problems? A prospective study of young teenagers. British Medical Journal 323, 480484.
Boney-McCoy S, Finkelhor D (1996). Is youth victimization related to trauma symptoms and depression after controlling for prior symptoms and family relationships? A longitudinal, prospective study. Journal of Consulting and Clinical Psychology 64, 14061416.
Breslau N, Chilcoat HD, Kessler RC, Peterson EL, Lucia VC (1999). Vulnerability to assaultive violence: further specification of the sex difference in post-traumatic stress disorder. Psychological Medicine 29, 813821.
Breslau N, Davis GC, Andreski P, Peterson EL (1997). Sex differences in posttraumatic stress disorders. Archives of General Psychiatry 54, 10441048.
Briggs-Gowan MJ, Owens P, Schwab-Stone M, Leventhal J, Leaf P, Horowitz SM (2003). Persistence of psychiatric disorders in pediatric settings. Journal of the American Academy of Child and Adolescent Psychiatry 42, 13601369.
Chartier MJ, Walker JR, Stein MB (2001). Social phobia and potential childhood risk factors in a community sample. Psychological Medicine 31, 307315.
Cohen P, Cohen J, Kasen S, Velez CN, Hartmark C, Johnson J, Rojas M, Brook J, Streuning EL (1993). An epidemiological study of disorders in late childhood and adolescence. I. Age- and gender-specific prevalence. Journal of Child Psychology and Psychiatry 34, 851867.
Craig WM (1998). The relationship among bullying, victimization, depression, anxiety, and aggression in elementary school children. Personality and Individual Differences 24, 123130.
Cutler S, Nolen-Hoeksema S (1991). Accounting for sex differences in depression through female victimization: childhood sexual abuse. Sex Roles 24, 425438.
Davis PJ (1999). Gender differences in autobiographical memory for childhood emotional experiences. Journal of Personality and Social Psychology 76, 498510.
Dinwiddie S, Heath AC, Dunne MP, Bucholz KK, Madden PA, Slutske WS, Bierut LJ, Statham DB, Martin NG (2000). Early sexual abuse and lifetime psychopathology: a co-twin-control study. Psychological Medicine 30, 4152.
Duncan RD (2000). Childhood maltreatment and college drop-out rates: implications for child abuse researchers. Journal of Interpersonal Violence 15, 987995.
Fergusson DM, Swain-Campbell NR, Horwood LJ (2002). Does sexual violence contribute to elevated rates of anxiety and depression in females? Psychological Medicine 32, 991996.
Garnefski N, Arends E (1998). Sexual abuse and adolescent maladjustment: differences between male and female victims. Journal of Adolescence 21, 99107.
Garnefski N, Diekstra RF (1997). Child sexual abuse and emotional and behavioral problems in adolescence: gender differences. Journal of the American Academy of Child and Adolescent Psychiatry 36, 323329.
Goodwin RD, Fergusson DM, Horwood LJ (2005). Childhood abuse and familial violence and the risk for panic attacks and panic disorder in young adulthood. Psychological Medicine 35, 881890.
Gorey KM, Leslie DR (1997). The prevalence of child sexual abuse: integrative review adjustment of potential response and measurement bias. Child Abuse and Neglect 21, 391398.
Hankin BL, Abramson LY, Moffitt TE, Silva PA, McGee R, Angell KE (1998). Development of depression from preadolescence to young adulthood: emerging gender differences in a 10-year longitudinal study. Journal of Abnormal Psychology 107, 128140.
Hodges EVE, Perry DG (1999). Personal and interpersonal antecedents and consequences of victimization by peers. Journal of Personality and Social Psychology 76, 677685.
Howard DE, Wang MQ (2005). Psychosocial correlates of U.S. adolescents who report a history of forced sexual intercourse. Journal of Adolescent Health 36, 372379.
Jumper SA (1995). A meta-analysis of the relationship of child sexual abuse to adult psychological adjustment. Child Abuse and Neglect 19, 715728.
Kendall-Tackett KA, Williams LM, Finkelhor D (1993). Impact of sexual abuse on children: a review and synthesis of recent empirical studies. Psychological Bulletin 113, 164180.
Kessler RC, Davis CG, Kendler KS (1997). Childhood adversity and adult psychiatric disorder in the US National Comorbidity Survey. Psychological Medicine 27, 1101–1019.
Kessler RC, McGonagle KA, Swartz M, Blazer DG, Nelson CB (1993). Sex and depression in the National Comorbidity Survey. I: Lifetime prevalence, chronicity and recurrence. Journal of Affective Disorders 29, 8596.
Kessler RC, Sonnega A, Bromet E, Hughes M, Nelson CB (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry 52, 10481060.
Khatri P, Kupersmidt JB, Patterson C (2000). Aggression and peer victimization as predictors of self-reported behavioral and emotional adjustment. Aggressive Behavior 26, 345358.
Kilpatrick DG, Acierno R, Saunders B, Resnick HS, Best CL, Schnurr PP (2000). Risk factors for adolescent substance abuse and dependence: data from a national sample. Journal of Consulting and Clinical Psychology 68, 1930.
Knopik VS, Heath AC, Madden PA, Bucholz KK, Slutske WS, Nelson EC, Statham D, Whitfield JB, Martin NG (2004). Genetic effects on alcohol dependence risk: re-evaluating the importance of psychiatric and other heritable risk factors. Psychological Medicine 34, 15191530.
Lewinsohn PM, Hops H, Roberts RE, Seeley JR, Andrews JA (1993). Adolescent psychopathology: I. Prevalence and incidence of depression and other DSM-III-R disorders in high schools students. Journal of Abnormal Psychology 102, 133144.
MacMillan HL, Fleming JE, Streiner DL, Lin E, Boyle MH, Jamieson E, Duku EK, Walsh CA, Wong MY, Beardslee WR (2001). Childhood abuse and lifetime psychopathology in a community sample. American Journal of Psychiatry 158, 18781883.
MacMillan HL, Fleming JE, Trocme N, Boyle MH, Wong M, Racine YA, Beardslee WR, Offord DR (1997). Prevalence of child physical and sexual abuse in the community: results from the Ontario Health Supplement. Journal of the American Medical Association 278, 131135.
Martin G, Bergen HA, Richardson AS, Roeger L, Allison S (2004). Sexual abuse and suicidality: gender differences in a large community sample of adolescents. Child Abuse and Neglect 28, 491503.
Molnar BE, Berkman LF, Buka SL (2001 a). Psychopathology, childhood sexual abuse and other childhood adversities: relative link to subsequent suicidal behaviour in the US. Psychological Medicine 31, 965977.
Molnar BE, Buka SL, Kessler RC (2001 b). Child sexual abuse and subsequent psychopathology: results from the National Comorbidity Survey. American Journal of Public Health 91, 753760.
Nelson EC, Heath AC, Lynskey MT, Bucholz KK, Madden PA, Statham DJ, Martin NG (2006). Childhood sexual abuse and risks for licit and illicit drug-related outcomes: a twin study. Psychological Medicine 36, 14731483.
Nelson EC, Heath AC, Madden PA, Cooper ML, Dinwiddie SH, Bucholz KK, Glowinski A, McLaughlin T, Dunne MP, Statham DJ, Martin NG (2002). Association between self-reported childhood sexual abuse and adverse psychosocial outcomes: results from a twin study. Archives of General Psychiatry 59, 139145.
Neumann DA, Houskamp BM, Pollock VE, Briere J (1996). The long-term sequelae of childhood sexual abuse in women: a meta-analytic review. Child Maltreatment 1, 616.
Neumark-Sztainer D, Story M, Hannan PJ, Beuhring T, Resnick MD (2000). Disordered eating among adolescents: associations with sexual/physical abuse and other familial/psychosocial factors. International Journal of Eating Disorders 28, 249258.
Nolen-Hoeksema S, Girgus JS (1994). The emergence of gender differences in depression during adolescence. Psychological Bulletin 115, 424443.
Norris FH (1992). Epidemiology of trauma: frequency and impact of different potentially traumatic events on different demographic groups. Journal of Consulting and Clinical Psychology 60, 409418.
Paolucci EO, Genuis ML, Violato C (2001). A meta-analysis of the published research on the effects of child sexual abuse. Journal of Psychology 135, 1736.
Pimlott-Kubiak S, Cortina LM (2003). Gender, victimization, and outcomes: reconceptualizing risk. Journal of Consulting and Clinical Psychology 71, 528539.
Prinstein MJ, Boergers J, Vernberg EM (2001). Overt and relational aggression in adolescents: social-psychological adjustment of aggressors and victims. Journal of Clinical Child Psychology 30, 479491.
Putnam FW (2003). Ten-year research update review: child sexual abuse. Journal of the American Academy of Child and Adolescent Psychiatry 42, 269278.
Reinherz HZ, Paradis AD, Giaconia RM, Stashwick CK, Fitzmaurice G (2003). Childhood and adolescent predictors of major depression in the transition to adulthood. American Journal of Psychiatry 160, 21412147.
Rind B, Tromovitch P (1997). A meta-analytic review of findings from national samples on psychological correlates of child sexual abuse. Journal of Sex Research 34, 237255.
Rind B, Tromovitch P, Bauserman R (1998). A meta-analytic examination of assumed properties of child sexual abuse using college samples. Psychological Bulletin 124, 2253.
Schwartz D, McFayden-Ketchum SA, Dodge KA, Pettit GS, Bates JE (1998). Peer group victimization as a predictor of children's behavior problems at home and in school. Development and Psychopathology 10, 8799.
Sullivan TN, Farrell AD, Kliewer W (2006). Peer victimization in early adolescence: association between physical and relational victimization and drug use, aggression, and delinquent behaviors among urban middle school students. Development and Psychopathology 18, 119137.
Tolin DF, Foa EB (2006). Sex differences in trauma and posttraumatic stress disorder: a quantitative review of 25 years of research. Psychological Bulletin 132, 959992.
Weiss EL, Longhurst JG, Mazure CM (1999). Childhood sexual abuse as a risk factor for depression in women: psychosocial and neurobiological correlates. American Journal of Psychiatry 156, 816828.
Weissman MM, Bland RC, Canino GJ, Faravelli C, Greenwald S, Hwu HG, Joyce PR, Karam EG, Lee CK, Lellouch J, Lépine JP, Newman SC, Rubio-Stipec M, Wells JE, Wickramaratne PJ, Wittchen H, Yeh EK (1996). Cross-national epidemiology of major depression and bipolar disorder. Journal of the American Medical Association 276, 293299.
Widom LM, Morris S (1997). Accuracy of adult recollections of childhood victimization: Part 2. Childhood sexual abuse. Psychological Assessment 9, 3446.
Williams LM (1994). Recall of childhood trauma: a prospective study of women's memories of child sexual abuse. Journal of Consulting and Clinical Psychology, 62, 11671176.
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