{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T15:18:56Z","timestamp":1783523936788,"version":"3.55.0"},"reference-count":61,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi260618-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Childhood sexual abuse (CSA) is a severe early-life trauma with well-established psychiatric sequelae. Prior studies have been limited by nonrepresentative samples, broad adversity measures, and a lack of dose-response characterization or formal effect modification testing in contemporary US populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260618-5\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To examine the association between prior CSA and adult loneliness and whether this association varies by sex, race and ethnicity, and age group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260618-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This cross-sectional study used data on 53\u202f444 adults from the 2023-2024 Behavioral Risk Factor Surveillance System, a nationally representative survey of US adults. CSA was ascertained through retrospective self-report.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260618-7\">\n                    <jats:title>Exposure<\/jats:title>\n                    <jats:p>Self-reported history of CSA (never, once, or more than once).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260618-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>The main outcome was ordinal loneliness frequency (never, rarely, sometimes, usually, or always) estimated via survey-weighted multinomial logistic regression, adjusted for age, sex, race and ethnicity, marital status, educational level, employment, language, general health status, and tobacco use. Effect modification by sex, race and ethnicity, and age was formally tested. Analyses incorporated complex survey weights and inverse probability weighting to reduce confounding by measured covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260618-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The analytic sample comprised 53\u202f444 US adults (mean [SD] age, 56.8 [17.7] years; 55.1% female). CSA was associated with a clear dose-response gradient. The probability of never feeling lonely decreased from 40.9% (95% CI, 40.1%-41.8%) among unexposed adults to 23.1% (95% CI, 20.0%-26.3%) after repeated exposure. The probability of always feeling lonely increased from 2.1% (95% CI, 1.8%-2.3%) to 5.3% (95% CI, 3.9%-6.6%)\u2014a 2.5-fold increase (adjusted OR, 4.48; 95% CI, 3.05-5.91;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.001). In a binary analysis, any CSA was associated with an absolute risk difference of 18.1 percentage points (95% CI, 15.5-20.7 percentage points;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.001), number needed to harm of 6, and population attributable fraction of 7.5% (95% CI, 6.4%-8.5%), suggesting approximately 6.2 million US adult loneliness cases may be associated with CSA. The dose-response pattern was consistent across sex, racial and ethnic groups, and age groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260618-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>In this cross-sectional study of 53\u202f444 US adults, CSA was associated with higher adjusted probabilities of adult loneliness in a graded dose-response pattern. This finding underscores the importance of trauma-informed strategies to address long-term psychosocial vulnerability among adults who were exposed to CSA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.22180","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T15:00:30Z","timestamp":1783522830000},"page":"e2622180","source":"Crossref","is-referenced-by-count":0,"title":["Childhood Sexual Abuse and Rates of Loneliness in Adulthood"],"prefix":"10.1001","volume":"9","author":[{"given":"Oluwasegun","family":"Akinyemi","sequence":"first","affiliation":[{"name":"The Clive O. 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