Comparison of the mental health of female adult film performers and other young women in California.

OBJECTIVE This study compared self-reported mental health status and current depression of female adult film performers and other young women. METHODS A cross-sectional structured online survey adapted from the California Women's Health Survey (CWHS) was self-administered to a convenience sample of 134 current female adult film performers via the Internet. Bivariate and multivariate analyses were used to compare data for these women with data for 1,773 women of similar ages who responded to the 2007 CWHS. Main outcome measures were self-reported mental health status, measured with the Behavioral Risk Factor Surveillance Survey core-instrument quality-of-life questions, and current depression, measured with the Patient Health Questionnaire-8. RESULTS Performers reported a mean of 7.2 days of poor mental health in the past 30 days, compared with 4.8 days for CWHS respondents, and 33% met criteria for current depression, compared with 13% of CWHS respondents (p<.01). As children, the adult film performers were more likely to have been victims of forced sex (37% compared with 13% of CWHS respondents), to have lived in poverty (24% and 12%), and to have been placed in foster care (21% and 4%) (p<.01). In the past 12 months, 50% of the performers reported living in poverty and 34% reported experiencing domestic violence, compared with 36% and 6%, respectively, of CWHS respondents (p<.01). As adults, 27% had experienced forced sex, compared with 9% of CWHS respondents (p<.01). CONCLUSIONS Female adult film performers have significantly worse mental health and higher rates of depression than other California women of similar ages.

[1]  Sharvari Karandikar,et al.  From Client to Pimp , 2010, Journal of interpersonal violence.

[2]  N. Singleton,et al.  Occupation and mental health in a national UK survey , 2009, Social Psychiatry and Psychiatric Epidemiology.

[3]  R. Kessler,et al.  Childhood adversities and adult psychopathology in the National Comorbidity Survey Replication (NCS-R) III: Associations with functional impairment related to DSM-IV disorders , 2009, Psychological Medicine.

[4]  J. Montaner,et al.  Prevalence and structural correlates of gender based violence among a prospective cohort of female sex workers , 2009, BMJ : British Medical Journal.

[5]  V. Patel,et al.  Suicidal behavior among female sex workers in Goa, India: the silent epidemic. , 2009, American journal of public health.

[6]  D. Grover,et al.  Sexual health of adults working in pornographic films , 2009, International Journal of STD and AIDS.

[7]  T. Patterson,et al.  History of Abuse and Psychological Distress Symptoms Among Female Sex Workers in Two Mexico–U.S. Border Cities , 2009, Violence and Victims.

[8]  C. Parry,et al.  Substance abuse, treatment needs and access among female sex workers and non-sex workers in Pretoria, South Africa , 2009, Substance abuse treatment, prevention, and policy.

[9]  T. Strine,et al.  The PHQ-8 as a measure of current depression in the general population. , 2009, Journal of affective disorders.

[10]  M. Elliott,et al.  Condom use and high-risk sexual acts in adult films: a comparison of heterosexual and homosexual films. , 2009, American journal of public health.

[11]  A. Meléis,et al.  Trapped in Circle of Threats: Violence Against Sex Workers in Thailand , 2009, Health care for women international.

[12]  Kamalesh Sarkar,et al.  Sex-trafficking, Violence, Negotiating Skill, and HIV Infection in Brothel-based Sex Workers of Eastern India, Adjoining Nepal, Bhutan, and Bangladesh , 2008, Journal of health, population, and nutrition.

[13]  B. Larance,et al.  Drug Dependence and Associated Risks Among Female Street-Based Sex Workers in the Greater Sydney Area, Australia , 2008, Substance use & misuse.

[14]  S. Luchters,et al.  Heavy episodic drinking among Kenyan female sex workers is associated with unsafe sex, sexual violence and sexually transmitted infections , 2007, International journal of STD & AIDS.

[15]  B. Stanton,et al.  Sexual Coercion, HIV-Related Risk, and Mental Health Among Female Sex Workers in China , 2007, Health care for women international.

[16]  Xiaoming Li,et al.  Depressive symptoms and condom use with clients among female sex workers in China. , 2007, Sexual health.

[17]  W. Wong,et al.  Silent Killers of the Night: An Exploration of Psychological Health and Suicidality among Female Street Sex Workers , 2007, Journal of sex & marital therapy.

[18]  Xiaoming Li,et al.  Correlates of Suicidal Ideation and Attempt Among Female Sex Workers in China , 2007, Health care for women international.

[19]  Bruce P. Bernard,et al.  Epidemiologic investigation of a cluster of workplace HIV infections in the adult film industry: Los Angeles, California, 2004. , 2007, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[20]  L. Degenhardt,et al.  Posttraumatic stress disorder among female street-based sex workers in the greater Sydney area, Australia , 2006, BMC psychiatry.

[21]  J. Brooks,et al.  Molecular analysis of HIV strains from a cluster of worker infections in the adult film industry, Los Angeles 2004 , 2006, AIDS.

[22]  C. Parry,et al.  Substance Use, Sexual Risk, and Violence: HIV Prevention Intervention with Sex Workers in Pretoria , 2006, AIDS and Behavior.

[23]  W. Wechsberg,et al.  Violence against substance-abusing South African sex workers: intersection with culture and HIV risk , 2005, AIDS care.

[24]  M. Lindeboom,et al.  The effect of work on mental health: does occupation matter? , 2004, Health economics.

[25]  R. Kessler,et al.  The impact of childhood psychopathology interventions on subsequent substance abuse: policy implications, comments, and recommendations. , 2002, Journal of consulting and clinical psychology.

[26]  R. Belmaker,et al.  The Motivation and Mental Health of Sex Workers , 2002, Journal of sex & marital therapy.

[27]  M. Elliott,et al.  Conducting Research Surveys Via E-Mail and The Web , 2001 .

[28]  R. Spitzer,et al.  The PHQ-9 , 2001, Journal of General Internal Medicine.

[29]  Christopher G. Davis,et al.  Childhood adversity and adult psychiatric disorder in the US National Comorbidity Survey , 1997, Psychological Medicine.

[30]  G. Satten,et al.  Time course of detection of viral and serologic markers preceding human immunodeficiency virus type 1 seroconversion: implications for screening of blood and tissue donors , 1995, Transfusion.

[31]  P. Scherr,et al.  Measuring health-related quality of life for public health surveillance. , 1994, Public health reports.

[32]  R. Kessler,et al.  Childhood family violence and adult recurrent depression. , 1994, Journal of health and social behavior.

[33]  R. Kessler,et al.  Childhood adversities and adult depression: basic patterns of association in a US national survey , 1993, Psychological Medicine.

[34]  R. Kessler,et al.  Childhood parental loss and adult psychopathology in women. A twin study perspective. , 1992, Archives of general psychiatry.

[35]  C E Koop,et al.  Report of the Surgeon General's workshop on pornography and public health. , 1987, The American psychologist.

[36]  J. Wolford.  MENTAL HEALTH AND OCCUPATION. , 1964, Public health reports.

[37]  G. Ryan,et al.  Pathways to Health Risk Exposure in Adult Film Performers , 2008, Journal of Urban Health.

[38]  N. El-Bassel,et al.  Correlates of partner violence among female street-based sex workers: substance abuse, history of childhood abuse, and HIV risks. , 2001, AIDS patient care and STDs.

[39]  L. Verbrugge,et al.  Measuring disability with parsimony. , 1999, Disability and rehabilitation.