"Just something that happened?": Mental health impact of disclosure and framing of sexual violence in older victims

IntroductionDespite the important impact of sexual violence (SV) on mental health, few victims disclose their experiences. Although research in adult victims suggests that SV disclosure could protect against long-term mental health problems, studies in older adults are lacking.ObjectivesTo establish the prevalence of depression, anxiety, posttraumatic stress disorder (PTSD), suicide attempts, and self-harm, their association with SV disclosure, and the moderating effect of sociodemographic characteristics and SV framing in the relation between SV disclosure and the different mental health outcomes in older SV victims.MethodsData on sexual victimisation, mental health, SV framing, and disclosure were collected through structured face-to-face interviews with 171 randomly selected sexually victimised adults of 70 years and older living in Belgium. SV was measured using behaviourally specific questions based on a broad definition. Mental health outcomes were measured using validated scales.ResultsDepression, anxiety and PTSD were reported by 34%, 33% and 9% of participants respectively, 5% had attempted suicide and 1% reported self-harm during lifetime. SV framing was associated with the kind of help victims consulted. SV disclosure was not linked with depression and anxiety, but was associated with an increase of PTSD symptoms in older victims with care dependency (p = 0.004) or a chronic illness and/or disability (p = 0.025).ConclusionsSV disclosure in itself does not protect against adverse mental health outcomes in old age. Capacity building of professionals trough training and development of clinical guidelines and care procedures may increase appropriate response to SV disclosure by older victims. Mental health problems are prevalent among sexually victimised older adults, 34% of older victims showed symptoms of depression, 33% anxiety symptoms, and 9% suffered from posttraumatic stress disorder (PTSD).Over 50% of older victims disclosed their sexual violence (SV) experience(s) to their informal network, 6% sought professional help and 4% reported to the police.The way older victims framed their SV experience are to be linked to the kind of help they consulted.SV disclosure itself does not protect against adverse mental health outcomes in old age. We found no association between SV disclosure and depressive or anxiety symptoms. SV disclosure was, however, linked with increased symptoms of PTSD in older victims who are care dependent or suffer from a chronical illness and/or disability.