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Jonathan R. T. Davidson, MD; Dana C. Hughes, RN, PhD; Linda K. George, PhD; Dan G. Blazer, MD, PhD

Arch Gen Psychiatry. 1996;53(6):550-555.

Abstract
Background
Lifetime community rates of attempted suicide were compared between those who reported a history of sexual assault and a control group without such a history.

Methods
The 2918 respondents in the Duke University Epidemiological Catchment Area Study were placed into groups with reported sexual assault (n=67) and those with no known history of such (n=2851). Multivariate and bivariate procedures were used to examine the relation between sexual assault and attempted suicide.

Results
Subjects reporting a history of sexual assault were more likely to be female, younger, and to report higher rates of lifetime suicide attempt and posttraumatic stress symptoms; no differences were found in the number of chronic medical disorders, major depression, substance abuse or substance dependence, or panic attacks. Nine (14.9%) of the 67 index group subjects reported a suicide attempt, 4 of whom reported their first sexual assault as occurring before age 16 years. A sexual assault history was associated with increased prevalence of lifetime suicide attempt after controlling for sex, age, education, posttraumatic stress symptoms, and psychiatric disorder. Findings were similar in the femaleonly subsample (n=1778). For women, the odds of attempting suicide was 3 to 4 times greater when the first reported sexual assault occurred prior to age 16 years compared with age 16 years or older.

Conclusions
Sexual assault is associated with an increased lifetime rate of attempted suicide. In women, a history of sexual trauma before age 16 years is a particularly strong correlate of attempted suicide.

Author Affiliations
From the Departments of Psychiatry and Behavioral Sciences (Drs Davidson, George, and Blazer) and Sociology (Dr George), and School of Nursing (Dr Hughes), Duke University Medical Center, Durham, NC.

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