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Sex Differences in Childhood Sexual Abuse and Suicide-Related Behaviors

Authors

  • Anne E. Rhodes PhD,

    1. Anne E. Rhodes, The Suicide Studies Research Unit and the Keenan Research Centre at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Toronto, Department of Psychiatry and Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto, The Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Michael H. Boyle, Department of Psychiatry and Behavioural Neurosciences and Offord Center for Child Studies, McMaster University, Hamilton, Ontario; Lil Tonmyr, Injury and Child Maltreatment Section, Health Surveillance and Epidemiology Division, Public Health Agency of Canada; Christine Wekerle, Department of Pediatrics, McMaster University; Deborah Goodman, The Children’s Aid Society of Toronto and Faculty of Social Work, University of Toronto; Bruce Leslie, Faculty of Social Work, University of Toronto and The Catholic Children's Aid Society of Toronto; Polina Mironova, The Suicide Studies Research Unit and the Keenan Research Centre at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital; Jennifer Bethell, The Suicide Studies Research Unit and the Keenan Research Centre at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital and Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto; Ian Manion, The Ontario Centre of Excellence for Child and Youth Mental Health.
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  • Michael H. Boyle PhD,

    1. Anne E. Rhodes, The Suicide Studies Research Unit and the Keenan Research Centre at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Toronto, Department of Psychiatry and Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto, The Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Michael H. Boyle, Department of Psychiatry and Behavioural Neurosciences and Offord Center for Child Studies, McMaster University, Hamilton, Ontario; Lil Tonmyr, Injury and Child Maltreatment Section, Health Surveillance and Epidemiology Division, Public Health Agency of Canada; Christine Wekerle, Department of Pediatrics, McMaster University; Deborah Goodman, The Children’s Aid Society of Toronto and Faculty of Social Work, University of Toronto; Bruce Leslie, Faculty of Social Work, University of Toronto and The Catholic Children's Aid Society of Toronto; Polina Mironova, The Suicide Studies Research Unit and the Keenan Research Centre at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital; Jennifer Bethell, The Suicide Studies Research Unit and the Keenan Research Centre at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital and Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto; Ian Manion, The Ontario Centre of Excellence for Child and Youth Mental Health.
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  • Lil Tonmyr PhD,

    1. Anne E. Rhodes, The Suicide Studies Research Unit and the Keenan Research Centre at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Toronto, Department of Psychiatry and Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto, The Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Michael H. Boyle, Department of Psychiatry and Behavioural Neurosciences and Offord Center for Child Studies, McMaster University, Hamilton, Ontario; Lil Tonmyr, Injury and Child Maltreatment Section, Health Surveillance and Epidemiology Division, Public Health Agency of Canada; Christine Wekerle, Department of Pediatrics, McMaster University; Deborah Goodman, The Children’s Aid Society of Toronto and Faculty of Social Work, University of Toronto; Bruce Leslie, Faculty of Social Work, University of Toronto and The Catholic Children's Aid Society of Toronto; Polina Mironova, The Suicide Studies Research Unit and the Keenan Research Centre at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital; Jennifer Bethell, The Suicide Studies Research Unit and the Keenan Research Centre at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital and Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto; Ian Manion, The Ontario Centre of Excellence for Child and Youth Mental Health.
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  • Christine Wekerle PhD,

    1. Anne E. Rhodes, The Suicide Studies Research Unit and the Keenan Research Centre at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Toronto, Department of Psychiatry and Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto, The Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Michael H. Boyle, Department of Psychiatry and Behavioural Neurosciences and Offord Center for Child Studies, McMaster University, Hamilton, Ontario; Lil Tonmyr, Injury and Child Maltreatment Section, Health Surveillance and Epidemiology Division, Public Health Agency of Canada; Christine Wekerle, Department of Pediatrics, McMaster University; Deborah Goodman, The Children’s Aid Society of Toronto and Faculty of Social Work, University of Toronto; Bruce Leslie, Faculty of Social Work, University of Toronto and The Catholic Children's Aid Society of Toronto; Polina Mironova, The Suicide Studies Research Unit and the Keenan Research Centre at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital; Jennifer Bethell, The Suicide Studies Research Unit and the Keenan Research Centre at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital and Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto; Ian Manion, The Ontario Centre of Excellence for Child and Youth Mental Health.
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  • Deborah Goodman PhD,

    1. Anne E. Rhodes, The Suicide Studies Research Unit and the Keenan Research Centre at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Toronto, Department of Psychiatry and Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto, The Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Michael H. Boyle, Department of Psychiatry and Behavioural Neurosciences and Offord Center for Child Studies, McMaster University, Hamilton, Ontario; Lil Tonmyr, Injury and Child Maltreatment Section, Health Surveillance and Epidemiology Division, Public Health Agency of Canada; Christine Wekerle, Department of Pediatrics, McMaster University; Deborah Goodman, The Children’s Aid Society of Toronto and Faculty of Social Work, University of Toronto; Bruce Leslie, Faculty of Social Work, University of Toronto and The Catholic Children's Aid Society of Toronto; Polina Mironova, The Suicide Studies Research Unit and the Keenan Research Centre at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital; Jennifer Bethell, The Suicide Studies Research Unit and the Keenan Research Centre at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital and Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto; Ian Manion, The Ontario Centre of Excellence for Child and Youth Mental Health.
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  • Bruce Leslie MSW,

    1. Anne E. Rhodes, The Suicide Studies Research Unit and the Keenan Research Centre at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Toronto, Department of Psychiatry and Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto, The Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Michael H. Boyle, Department of Psychiatry and Behavioural Neurosciences and Offord Center for Child Studies, McMaster University, Hamilton, Ontario; Lil Tonmyr, Injury and Child Maltreatment Section, Health Surveillance and Epidemiology Division, Public Health Agency of Canada; Christine Wekerle, Department of Pediatrics, McMaster University; Deborah Goodman, The Children’s Aid Society of Toronto and Faculty of Social Work, University of Toronto; Bruce Leslie, Faculty of Social Work, University of Toronto and The Catholic Children's Aid Society of Toronto; Polina Mironova, The Suicide Studies Research Unit and the Keenan Research Centre at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital; Jennifer Bethell, The Suicide Studies Research Unit and the Keenan Research Centre at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital and Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto; Ian Manion, The Ontario Centre of Excellence for Child and Youth Mental Health.
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  • Polina Mironova BA,

    1. Anne E. Rhodes, The Suicide Studies Research Unit and the Keenan Research Centre at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Toronto, Department of Psychiatry and Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto, The Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Michael H. Boyle, Department of Psychiatry and Behavioural Neurosciences and Offord Center for Child Studies, McMaster University, Hamilton, Ontario; Lil Tonmyr, Injury and Child Maltreatment Section, Health Surveillance and Epidemiology Division, Public Health Agency of Canada; Christine Wekerle, Department of Pediatrics, McMaster University; Deborah Goodman, The Children’s Aid Society of Toronto and Faculty of Social Work, University of Toronto; Bruce Leslie, Faculty of Social Work, University of Toronto and The Catholic Children's Aid Society of Toronto; Polina Mironova, The Suicide Studies Research Unit and the Keenan Research Centre at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital; Jennifer Bethell, The Suicide Studies Research Unit and the Keenan Research Centre at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital and Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto; Ian Manion, The Ontario Centre of Excellence for Child and Youth Mental Health.
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  • Jennifer Bethell MSc,

    1. Anne E. Rhodes, The Suicide Studies Research Unit and the Keenan Research Centre at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Toronto, Department of Psychiatry and Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto, The Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Michael H. Boyle, Department of Psychiatry and Behavioural Neurosciences and Offord Center for Child Studies, McMaster University, Hamilton, Ontario; Lil Tonmyr, Injury and Child Maltreatment Section, Health Surveillance and Epidemiology Division, Public Health Agency of Canada; Christine Wekerle, Department of Pediatrics, McMaster University; Deborah Goodman, The Children’s Aid Society of Toronto and Faculty of Social Work, University of Toronto; Bruce Leslie, Faculty of Social Work, University of Toronto and The Catholic Children's Aid Society of Toronto; Polina Mironova, The Suicide Studies Research Unit and the Keenan Research Centre at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital; Jennifer Bethell, The Suicide Studies Research Unit and the Keenan Research Centre at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital and Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto; Ian Manion, The Ontario Centre of Excellence for Child and Youth Mental Health.
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  • Ian Manion PhD

    1. Anne E. Rhodes, The Suicide Studies Research Unit and the Keenan Research Centre at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Toronto, Department of Psychiatry and Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto, The Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Michael H. Boyle, Department of Psychiatry and Behavioural Neurosciences and Offord Center for Child Studies, McMaster University, Hamilton, Ontario; Lil Tonmyr, Injury and Child Maltreatment Section, Health Surveillance and Epidemiology Division, Public Health Agency of Canada; Christine Wekerle, Department of Pediatrics, McMaster University; Deborah Goodman, The Children’s Aid Society of Toronto and Faculty of Social Work, University of Toronto; Bruce Leslie, Faculty of Social Work, University of Toronto and The Catholic Children's Aid Society of Toronto; Polina Mironova, The Suicide Studies Research Unit and the Keenan Research Centre at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital; Jennifer Bethell, The Suicide Studies Research Unit and the Keenan Research Centre at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital and Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto; Ian Manion, The Ontario Centre of Excellence for Child and Youth Mental Health.
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  • The authors gratefully acknowledge Carolyn Ziegler, MA, MISt, Information Specialist, St. Michael’s Hospital, Health Sciences Library for carrying out the electronic literature searches. Funding for this project was provided by an operating grant from the Canadian Institutes of Health Research PCY86888 in conjunction with support and partnership from the Child Welfare League of Canada; The Ontario Association for Children’s Aid Societies; The Ontario Centre of Excellence for Child and Youth Mental Health; The Injury and Child Maltreatment Section, Health Surveillance and Epidemiology Division, Public Health Agency of Canada, and the Centre of Excellence for Child Welfare.Preliminary results were presented at the International Federation of Psychiatric Epidemiology in Vienna, Austria, April 2009 and the International Association for Suicide Prevention, October 2009. The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the affiliated or acknowledged organizations.

Address correspondence to Dr. Anne E. Rhodes, Suicide Studies Research Unit, St. Michael's Hospital, 2 Shuter Wing, Suite 2010f, 30 Bond Street, Toronto, ON M5B 1W8; E-mail: rhodesa@smh.ca

Abstract

Child sexual abuse and suicide-related behaviors are associated, but it remains unclear if the strength of this association differs in boys and girls. In a systematic review of this association in children and youth, we identified 16 relevant studies, all cross-sectional surveys of students. The association is stronger in boys specific to suicide attempt(s). Adjustments for potential confounding variables explained some, but not all of this sex difference. While additional research would strengthen causal inferences, this sex difference may be influenced by the nature and timing of child sexual abuse as well as the sex of the perpetrator, which in turn shapes the disclosure of these events.

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