The Effects of Psychosocial Risk Factors and Severity of Abuse on the Development of Depressive Symptoms in Sexually Abused Turkish Youth.

Depression in sexually abused youth has a complex etiology involving various mechanisms related to adverse familial psychosocial factors and the severity of childhood sexual abuse (CSA). This study aimed to identify mediating mechanisms between CSA severity, adverse familial psychosocial factors and depressive symptoms in Turkish children and adolescents who have experienced sexual abuse. The files of 340 CSA cases, aged 6-18, who applied to the forensic outpatient clinic between 2014-2020 were retrospectively evaluated. Psychiatric diagnoses were made according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria. Depressive symptoms were evaluated through clinical examinations and Children's Depression Inventory (CDI). Sexual abuse severity was measured with the Sexual Abuse Severity Score (SASS) algorithm based on the information obtained from files. Both intrafamilial violence (IFV) (B = 2.67, 95%CI [0.56-4.77]) and chaotic family environment (CFE) (B = 2.57, 95%CI [0.43-4.72]) had significant effects on CDI scores under significant and full-mediating effects of verbal/physical coercion (B = 1.16, 95%CI [0.17-2.81] for IFV→CDI; B = 1.44, 95%CI [0.24-3.34] for CFE→CDI) and qualitative severity of sexual abuse (B = 0.91, 95%CI [0.17-2.06] for IFV→CDI; B = 1.04, 95%CI [0.14-2.44] for CFE→CDI). However, total SASS had no significant mediation in the relationship between adverse familial psychosocial factors and CDI scores. These findings provide evidence that both IFV and CFE appear to have significant associations with depressive symptoms, within the significant mediating roles of both verbal/physical coercion and qualitative severity of sexual abuse.