{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T07:19:24Z","timestamp":1793085564448,"version":"4.5.0"},"reference-count":56,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,2,28]],"date-time":"2022-02-28T00:00:00Z","timestamp":1646006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002749","name":"Belgian Federal Science Policy Office","doi-asserted-by":"publisher","award":["BR\/175\/A5\/UN-MENAMAIS"],"award-info":[{"award-number":["BR\/175\/A5\/UN-MENAMAIS"]}],"id":[{"id":"10.13039\/501100002749","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003130","name":"Research Foundation - Flanders","doi-asserted-by":"publisher","award":["12C0616N"],"award-info":[{"award-number":["12C0616N"]}],"id":[{"id":"10.13039\/501100003130","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003130","name":"Research Foundation - Flanders","doi-asserted-by":"publisher","award":["12C0619N"],"award-info":[{"award-number":["12C0619N"]}],"id":[{"id":"10.13039\/501100003130","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Sexual violence (SV) has an important impact on mental health. Childhood sexual abuse is linked to internalising disorders in later life. In older adults, SV occurs more often than previously believed. Moreover, health care workers lack the skills to address SV in later life. Studies researching the mental health impact of lifetime SV, i.e., SV during childhood, adulthood, and old age, are lacking. Between July 2019 and March 2020, 513 older adults living in Belgium participated in structured face-to-face-interviews. Selection occurred via a cluster random probability sampling with a random walk finding approach. Depression, anxiety, and posttraumatic stress syndrome (PTSD) were measured using validated scales. Participants were asked about suicide attempts and self-harm during their lifetime and in the past 12 months. SV was measured using behaviourally specific questions based on a broad SV definition. We found rates for depression, anxiety, and PTSD of 27%, 26%, and 6% respectively, while 2% had attempted suicide, and 1% reported self-harm in the past 12 months. Over 44% experienced lifetime SV and 8% in the past 12 months. Lifetime SV was linked to depression (p = 0.001), anxiety (p = 0.001), and PTSD in participants with a chronic illness\/disability (p = 0.002) or no\/lower education (p &lt; 0.001). We found no link between lifetime SV and suicide attempts or self-harm in the past 12 months. In conclusion, lifetime SV is linked to mental health problems in late life. Tailored mental health care for older SV victims is necessary. Therefore, capacity building of professionals and development of clinical guidelines and care procedures are important.<\/jats:p>","DOI":"10.3390\/ijerph19052803","type":"journal-article","created":{"date-parts":[[2022,2,28]],"date-time":"2022-02-28T20:09:57Z","timestamp":1646078997000},"page":"2803","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["\u201cTime Does Not Heal All Wounds\u201d: Sexual Victimisation Is Associated with Depression, Anxiety, and PTSD in Old Age"],"prefix":"10.3390","volume":"19","author":[{"given":"Anne","family":"Nobels","sequence":"first","affiliation":[{"name":"International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium"},{"name":"Department of Psychiatry, Ghent University Hospital, 9000 Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilbert","family":"Lemmens","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Ghent University Hospital, 9000 Ghent, Belgium"},{"name":"Department of Head and Skin\u2013Psychiatry and Medical Psychology, Ghent University, 9000 Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6032-2384","authenticated-orcid":false,"given":"Lisa","family":"Thibau","sequence":"additional","affiliation":[{"name":"International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Beaulieu","sequence":"additional","affiliation":[{"name":"School of Social Work, Research Chair on Mistreatment of Older Adults and Research Centre on Aging, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9714-7006","authenticated-orcid":false,"given":"Christophe","family":"Vandeviver","sequence":"additional","affiliation":[{"name":"Department of Criminology, Criminal Law and Social Law, Ghent University, 9000 Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1707-0254","authenticated-orcid":false,"given":"Ines","family":"Keygnaert","sequence":"additional","affiliation":[{"name":"International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,28]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2021, April 04). Violence Against Women Factsheet No. 239. Available online: http:\/\/www.who.int\/mediacentre\/factsheets\/fs239\/en\/."},{"key":"ref_2","unstructured":"World Health Assembly (1996, January 13). Prevention of violence: A public health priority. Proceedings of the Forty-Ninth World Health Assembly, Geneva, Switzerland."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Nobels, A., Vandeviver, C., Beaulieu, M., Cismaru-Inescu, A., Nisen, L., Van Den Noortgate, N., Vander Beken, T., Lemmens, G., and Keygnaert, I. (2020). \u201cToo Grey to Be True?\u201d Sexual Violence in Older Adults: A Critical Interpretive Synthesis of Evidence. Int. J. Environ. Res. Public Health, 17.","DOI":"10.1101\/2020.04.24.20077990"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Nobels, A., Cismaru-Inescu, A., Nisen, L., Hahaut, B., Beaulieu, M., Lemmens, G., Adam, S., Schapanksy, E., Vandeviver, C., and Keygnaert, I. (2021). Sexual Violence in Older Adults: A Belgian Prevalence Study. BMC Geriatr., 21.","DOI":"10.1186\/s12877-021-02485-3"},{"key":"ref_5","unstructured":"(2021, March 30). Mental Health of Older Adults-Factsheet. Available online: https:\/\/www.who.int\/newsroom\/fact-sheets\/detail\/mental-health-of-older-adults."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.jad.2010.09.015","article-title":"A tune in \u201ca minor\u201d can \u201cb major\u201d: A review of epidemiology, illness course, and public health implications of subthreshold depression in older adults","volume":"129","author":"Meeks","year":"2011","journal-title":"J. Affect. Disord."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1002\/da.20653","article-title":"Anxiety disorders in older adults: A comprehensive review","volume":"27","author":"Castriotta","year":"2010","journal-title":"Depress. Anxiety"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1002\/gps.2725","article-title":"Posttraumatic stress disorder in older adults: An overview of characteristics and treatment approaches","volume":"27","author":"Kuwert","year":"2012","journal-title":"Int. J. Geriatr. Psychiatry"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"d5219","DOI":"10.1136\/bmj.d5219","article-title":"Depression in older adults","volume":"343","author":"Rodda","year":"2011","journal-title":"BMJ"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1016\/j.puhe.2012.01.015","article-title":"Fear of crime and psychological and physical abuse associated with ill health in a Swedish population aged 65\u201384 years","volume":"126","author":"Olofsson","year":"2012","journal-title":"Public Health"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.jagp.2014.08.014","article-title":"Adverse childhood experiences and geriatric depression: Results from the 2010 BRFSS","volume":"23","author":"Ege","year":"2015","journal-title":"Am. J. Geriatr. Psychiatry"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.jad.2018.10.095","article-title":"Childhood sexual abuse, poly-victimization and internalizing disorders across adulthood and older age: Findings from a 25-year longitudinal study","volume":"244","author":"Rapsey","year":"2019","journal-title":"J. Affect. Disord."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1093\/ageing\/afr107","article-title":"Elder abuse and neglect in Ireland: Results from a national prevalence survey","volume":"41","author":"Naughton","year":"2012","journal-title":"Age Ageing"},{"key":"ref_14","unstructured":"Luoma, M., Koivusilta, M., Lang, G., Enzenhofer, E., De Donder, L., Vert\u00e9, D., Reingarde, J., Tamutiene, I., Ferreira-Alves, J., and Santos, A.J. (2011). Prevalence Study of Abuse and Violence against Older Women; Results of a Multi-Cultural Survey in Austria, Belgium, Finland, Lithuania, and Portugal (European Report of the AVOW Project), National Institute for Health and Welfare (THL)."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1348\/147608305X53684","article-title":"Two subjective factors as moderators between critical incidents and the occurrence of post-traumatic stress disorders: Adult attachment and perception of social support","volume":"79","author":"Declercq","year":"2006","journal-title":"Psychol. Psychother. Theory Res. Pract."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1002\/jclp.20426","article-title":"Posttraumatic distress in security guards and the various effects of social support","volume":"63","author":"Declercq","year":"2007","journal-title":"J. Clin. Psychol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.jpsychores.2014.06.008","article-title":"The impact of childhood trauma on depression: Does resilience matter? Population-based results from the Study of Health in Pomerania","volume":"77","author":"Schulz","year":"2014","journal-title":"J. Psychosom. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"NP1335","DOI":"10.1177\/0886260517746183","article-title":"Moderating effects of resilience on depression, psychological distress, and suicidal ideation associated with interpersonal violence","volume":"36","author":"Fedina","year":"2021","journal-title":"J. Interpers. Violence"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1007\/s11920-016-0697-y","article-title":"The Mental Health of Older LGBT Adults","volume":"18","author":"Yarns","year":"2016","journal-title":"Curr. Psychiatry Rep."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1550","DOI":"10.1002\/gps.5565","article-title":"\u2018Breaking the silence\u2019: Sexual victimisation in an old age psychiatry patient population in Flanders","volume":"36","author":"Nobels","year":"2021","journal-title":"Int. J. Geriat. Psychiatry."},{"key":"ref_21","unstructured":"Steward, E.D., and Chandra, P.S. (2021, June 30). WPA Position Paper on Intimate Partner Violence and Sexual Violence against Women: Geneva, Switerland. Available online: https:\/\/globalalliancematernalmentalhealth.org\/wp-content\/uploads\/2018\/03\/WPA_position_Intimate_Partner_Violence_Sexual_Violence_Against_Women29012018.pdf."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Goldblatt, H., Band-Winterstein, T., Lev, S., and Harel, D. (2020). \u201cWho Would Sexually Assault an 80-Year-Old Woman?\u201d Barriers to Exploring and Exposing Sexual Assault Against Women in Late Life. J. Interpers. Violence, 1\u201325.","DOI":"10.1177\/0886260520934440"},{"key":"ref_23","first-page":"28","article-title":"Seksueel geweld in Belgi\u00eb: Eerste representatieve prevalentiestudie naar de aard, omvang en impact van seksueel geweld in Belgi\u00eb","volume":"59","author":"Keygnaert","year":"2018","journal-title":"Sci. Connect."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Nobels, A., Cismaru-Inescu, A., Nisen, L., Hahaut, B., Lemmens, G., Vandeviver, C., and Keygnaert, I. (2021). Challenges in conducting sexual health and violence research in older adults beyond the general data protection regulation: A Belgian case study. J. Interpers. Violence, 1\u201321.","DOI":"10.1186\/s12877-021-02485-3"},{"key":"ref_25","unstructured":"World Health Organization (2016). Ethical and Safety Recommendations for Intervention Research on Violence against Women: Building on Lessons from the WHO Publication Putting Women First: Ethical and Safety Recommendations for Research on Domestic Violence against Women, WHO."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"509","DOI":"10.3928\/0048-5713-20020901-06","article-title":"The PHQ-9: A new depression diagnostic and severity measure","volume":"32","author":"Kroenke","year":"2002","journal-title":"Psychiatr. Ann."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1097\/MLR.0b013e318160d093","article-title":"Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population","volume":"46","author":"Decker","year":"2008","journal-title":"Med. Care"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Prins, A., Bovin, M.J., Kimerling, R., Kaloupek, D.G., Marx, B.P., Pless Kaiser, A., and Schnurr, P.P. (2015). Primary Care PTSD Screen for DSM-5 (PC-PTSD-5).","DOI":"10.1037\/t92032-000"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1080\/10705500802222972","article-title":"The brief resilience scale: Assessing the ability to bounce back","volume":"15","author":"Smith","year":"2008","journal-title":"Int. J. Behav. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1037\/0022-006X.53.3.422","article-title":"Sexual experiences survey: Reliability and validity","volume":"53","author":"Koss","year":"1985","journal-title":"J. Consult. Clin. Psychol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1080\/13691058.2014.989265","article-title":"Prevalence and correlates of young people\u2019s sexual aggression perpetration and victimisation in 10 European countries: A multi-level analysis","volume":"17","author":"Berger","year":"2015","journal-title":"Cult. Health Sex."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1093\/eurpub\/cku066","article-title":"Sexual and gender-based violence in the European asylum and reception sector: A perpetuum mobile?","volume":"25","author":"Keygnaert","year":"2015","journal-title":"Eur. J. Public Health"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Depraetere, J., Cismaru-Inscu, A., De Schrijver, L., Nobels, A., Keygnaert, I., and Vandeviver, C. (2020). Measuring Sexual Victimisation and Perpetration in Today\u2019s Society: Modifications to the Sexual Experience Survey. SocArXiv.","DOI":"10.31235\/osf.io\/cgevu"},{"key":"ref_34","unstructured":"Allison, P.D. (2012). Logistic Regression Using SAS: Theory and Applications, SAS Institute."},{"key":"ref_35","unstructured":"IBM Corp (2019). IBM SPSS Statistics for Windows, Version 26.0. Armonk, IBM Corp."},{"key":"ref_36","unstructured":"R Core Team (2014). R: A Language and Environment for Statistical Computing, R Foundation for Statistical Computing. Available online: http:\/\/www.R-project.org\/."},{"key":"ref_37","unstructured":"Hair, J., Black, W.C., Babin, B.J., and Anderson, R.E. (2010). Multivariate Data Analysis, Pearson Educational International. [7th ed.]."},{"key":"ref_38","unstructured":"Byrne, B.M. (2010). Structural Equation Modeling with AMOS: Basic Concepts, Applications, and Programming, Routledge."},{"key":"ref_39","unstructured":"Kaiser, A.P., Wachen, J.S., Potter, C., Moye, J., and Davison, E. (2022, February 07). With the Stress, Health, and Aging Research Program (SHARP. Posttraumatic Stress Symptoms among Older Adults: A Review. PTSD: National Centre for PTSD, Available online: https:\/\/www.ptsd.va.gov\/professional\/treat\/specific\/symptoms_older_adults.asp."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.1002\/gps.5514","article-title":"Symptoms profiles and treatment status of older adults with chronic post-traumatic stress disorder","volume":"36","author":"Rutherford","year":"2021","journal-title":"Int. J. Geriatr. Psychiatry"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1032","DOI":"10.1002\/da.22012","article-title":"The effect of draft DSM-V criteria on posttraumatic stress disorder prevalence","volume":"29","author":"Calhoun","year":"2012","journal-title":"Depress. Anxiety"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1002\/jts.21848","article-title":"National estimates of exposure to traumatic events and PTSD prevalence using DSM-IV and DSM-5 criteria","volume":"26","author":"Kilpatrick","year":"2013","journal-title":"J. Trauma. Stress"},{"key":"ref_43","unstructured":"Weathers, F.W., Blake, D.D., Schnurr, P.P., Kaloupek, D.G., Marx, B.P., and Keane, T.M. (2013). Clinician-Administered PTSD Scale for DSM-5 (CAPS-5)."},{"key":"ref_44","unstructured":"Weathers, F.W., Litz, B.T., Keane, T.M., Palmieri, P.A., Marx, B.P., and Schnurr, P.P. (2013). PTSSD Checklist for DSM-5 (PCL-5)."},{"key":"ref_45","unstructured":"(2021, June 30). Zelfmoord 1813. Zelfmoord Bij Ouderen Factsheet 2018. Available online: https:\/\/www.zelfmoord1813.be\/sites\/default\/files\/Factsheet%20Ouderen-min.pdf."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1176\/appi.ajp.160.6.1147","article-title":"Risk factors for depression among elderly community subjects: A systematic review and meta-analysis","volume":"160","author":"Cole","year":"2003","journal-title":"Am. J. Psychiatry"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1111\/j.1532-5415.2004.52065.x","article-title":"Resilience of community-Dwelling older persons","volume":"52","author":"Hardy","year":"2004","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"100074","DOI":"10.1016\/j.ejtd.2018.07.002","article-title":"Perspectives on resilience: Personality trait or skill?","volume":"4","author":"Leys","year":"2020","journal-title":"Eur. J. Trauma Dissociation"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Akatsuka, E., and Tadaka, E. (2021). Development of a resilience scale for oldest-old age (RSO). BMC Geriatr., 21.","DOI":"10.1186\/s12877-021-02036-w"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Nobels, A., De Schrijver, L., Van Landuyt, M., Vandeviver, C., Lemmens, G., Beaulieu, M., and Keygnaert, I. (2022). \u201cIn the end you keep silent\u201d: Help-seeking behaviour upon sexual victimisation in older adults. Preprint.","DOI":"10.1177\/08862605231220017"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.bpobgyn.2012.08.002","article-title":"Sexual violence against women: The scope of the problem","volume":"27","author":"Dartnall","year":"2013","journal-title":"Best Pract. Res. Clin. Obstet. Gynaecol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1017\/S0033291714001962","article-title":"Domestic and sexual violence against patients with severe mental illness","volume":"45","author":"Khalifeh","year":"2015","journal-title":"Psychol. Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1192\/bjp.bp.111.103267","article-title":"Childhood maltreatment and DSM-IV adult mental disorders: Comparison of prospective and retrospective findings","volume":"200","author":"Scott","year":"2012","journal-title":"Br. J. Psychiatry"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.jpsychires.2016.09.004","article-title":"Is developmental timing of trauma exposure associated with depressive and post-traumatic stress disorder symptoms in adulthood?","volume":"84","author":"Dunn","year":"2017","journal-title":"J. Psychiatr. Res."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1037\/0021-843X.116.1.176","article-title":"Age of onset of child maltreatment predicts long-term mental health outcomes","volume":"116","author":"Kaplow","year":"2007","journal-title":"J. Abnorm. Psychol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1097\/NMD.0b013e3182948096","article-title":"Characteristics of child maltreatment and their relation to dissociation, posttraumatic stress symptoms, and depression in adult psychiatric patients","volume":"201","author":"Moergeli","year":"2013","journal-title":"J. Nerv. Ment. Dis."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/5\/2803\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:29:07Z","timestamp":1760135347000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/5\/2803"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,28]]},"references-count":56,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,3]]}},"alternative-id":["ijerph19052803"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19052803","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2021.06.05.21258397","asserted-by":"object"}]},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,28]]}}}