OBJECTIVE: The aim of this study was to examine the relationship
between childhood sexual abuse, childhood physical abuse, current
psychiatric illness, and measures of dissociation in an adult
population. METHOD: The authors used a randomly selected sample of
1,028 individuals. Each subject completed a semistructured
face-to-face interview that included measures of childhood sexual
abuse, childhood physical abuse, DSM-III-R psychiatric diagnoses, and
selected items from the Dissociative Experiences Scale. RESULTS: Many
individuals experienced occasional dissociative symptoms, and 6.3% of
the population suffered from three or more frequently occurring
dissociative symptoms. Among these individuals, the rate of childhood
sexual abuse was two and one-half times as high, the rate of physical
abuse was five times as high, and the rate of current psychiatric
disorder was four times as high as the respective rates for the other
subjects. Logistic regression modeling showed that physical abuse and
current psychiatric illness were directly related to a high rate of
dissociative symptoms but sexual abuse was not. The influence of
sexual abuse was due to its associations with current psychiatric
illness and with childhood physical abuse. Childhood physical abuse
was not directly related to current psychiatric illness. Its
association appeared to be mediated by its link to childhood sexual
abuse. CONCLUSIONS: This study confirms that a small proportion
(approximately 6%) of the general population suffer from high levels
of dissociative symptoms. It calls into question the hypothesized
direct relationship between childhood sexual abuse and adult
dissociative symptoms.