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A new study published in The Lancet, Psychiatry, looked at the impact of sexual violence in mid-adolescence on mental health.

“Our study is about estimating the population level mental health impacts of sexual violence experiences in mid-adolescence and understanding whether and to what extent sexual violence contributes to the gender gap in mental health problems in adolescence,” study author Francesca Bentivegna told us. “We did this by examining the link between sexual violence and psychological distress, self-harm, and attempted suicide, in both girls and boys aged 14-17 years. We also estimated the effect of eliminating sexual violence at this stage (in a hypothetical scenario) on mental health problems.”

The research team’s hypotheses were based on the findings from the existing literature on sexual violence and mental health. They wanted to investigate whether they could robustly estimate the impact of sexual violence on mental health. In addition, the current research on this topic highlights the existence of a gender gap whereby females tend to experience more depressive and anxiety symptoms, and to self-harm more, than males. While this is due to a number of different reasons, the researchers were particularly interested in investigating whether and to what extent sexual violence was one of these factors.

“The gender gap that emerges in adolescents for the mental health outcomes studied is well established, however less is known about why this gap occurs and there are a lot of possible drivers of this gap,” study author Praveetha Patalay told us. “Although sexual violence is a gendered experience, there is little investigation to-date about the role this might play in the gender-gap in mental ill-health. We wanted to estimate the impact of sexual violence in this age group and investigate whether it might contribute to the gender gap and to what extent.”

Researchers used information from 9,971 young people from the Millennium Cohort Study, which is a UK nationally representative birth cohort of young people born in 2000-02. They examined girls and boys with experiences of sexual violence (including unwelcome sexual approach and sexual assault), and matched them to girls and boys who were very similar in terms of some key characteristics (e.g. ethnicity, previous mental health problems), but who did not experience sexual violence.

“This was done so that we could compare the effect of having experienced sexual violence or not on mental health,” Bentivegna told us. “We then used these estimates from our analyses to describe the predicted prevalences of mental ill-health in two different scenarios: a hypothetical one, where no one experienced sexual violence; and the current one, where boys and especially girls experienced it, and we estimated the effect that preventing sexual violence at this age would have on mental ill-health.”

Researchers found that one fifth of the girls reported experiences of sexual violence in mid-adolescence, which is four times higher than the number of experiences reported by boys. Overall, having experienced sexual violence in mid-adolescence increased the likelihood of experiencing mental health problems in both girls and boys.

“We also estimated that, if sexual violence did not occur, there would be a sizeable reduction in mental health problems,” Patalay told us. “For instance, we were able to assess the real-world impact of preventing sexual violence for self-harm, and found an approximate 17% reduction in the number of girls self-harming (in the UK) if they had not experienced sexual violence in mid-adolescence. We would also see an approximate 15% reduction of high levels of psychological distress.”

The researchers were not surprised by the findings that sexual violence impacted on mental ill-health, however, they were struck by the extent of the impact that experiences of sexual violence might cause in young adolescents.

“Our findings highlight how crucial it is to prevent sexual violence in order to protect teenagers’ mental health,” Patalay told us. “They also highlight how these experiences contribute to the gender gap, further highlighting the need for prevention to protect disproportionate impacts on teenage girls.”

These results will mean something only if substantial changes at the society and policy levels take place, Bentivegna explained. The tolerance towards sexual violence and its effects is a likely contributor to the high rates of mental health problems that victims experience.

“We are calling for the enforcements of laws and policies aimed at the prevention of sexual violence and the protection of teenagers’ mental health, for instance, by ensuring appropriate legal consequences for perpetrators,” Bentivegna told us. “It should be highlighted that our study had some limitations, especially with regard to the measures used to assess both sexual violence and mental health problems.”

For instance, researchers did not have access to potentially relevant information such as types, frequency and severity of sexual violence experiences, nor had they information on perpetrators. Moreover, while they considered a wide range of factors that might have influenced the link between sexual violence and mental health problems, it is possible that they might have missed something.