Relational outcomes of childhood sexual trauma in female survivors: a longitudinal study

This longitudinal study examines the effects of childhood sexual abuse (CSA) on the intimate and marital relationships of adult survivors from a sample composed primarily of African American women. In addition, the authors explore the protective role of maternal support. Interview data are collected on 136 women with documented histories of CSA who indicate the quality and nature of their current marital relationships and other interpersonal connections. Results suggest that CSA survivors with poor maternal attachment are more likely to enter into marital or cohabiting relationships. However, more severe sexual trauma in childhood correlates with greater marital dissatisfaction. Good maternal attachment during childhood has a negative main effect on adult interpersonal problems and a buffering effect on the relationship between abuse and marital dissatisfaction. These data can help guide future research on the adult relational outcomes of female CSA survivors, especially among minority populations.     

Trauma Characteristics and Posttraumatic Stress Disorder among Adolescent Survivors of Childhood Sexual Abuse

This study examined the relationship between the characteristics of childhood sexual abuse (CSA) and the severity of consequent posttraumatic stress disorder (PTSD), depression, suicidal ideation, and substance use in a sample of 83 female adolescents aged 13–18 years seeking treatment for PTSD. Nearly two-thirds of the sample (60.7 %, n?=?51) reported the perpetrator of the CSA was a relative. A large portion (40.5 %, n?=?34) of the sample reported being victimized once, while almost a quarter of the sample reported chronic victimization (23.8 %, n?=?20). PTSD and depression scores were in the clinical range, whereas reported levels of suicidal ideation and substance use were low. The frequency of victimizations was associated with suicidal ideation. Contrary to expectation, CSA characteristics including trauma type, perpetrator relationship, and duration of abuse were unrelated to PTSD severity, depressive symptoms, or substance abuse.     

Self-injurious behaviors, PTSD arousal, and general health complaints within a treatment-seeking sample of sexually abused women

Eighty-nine adult female survivors of childhood sexual abuse, presenting for psychological treatment, were assessed for self-reported rates of self-injurious behaviors (SIB), health complaints, and posttraumatic stress disorder (PTSD) symptoms of physiological arousal. A composite measure of current SIB was significantly and positively associated with health complaints, PTSD arousal, and three measures of sexual abuse severity: age of onset for sexual abuse, injury experienced during the sexual abuse, and perceived life threat. Tests of mediation revealed that symptoms of PTSD arousal mediated the relationship between earlier age of onset for sexual abuse and SIB. PTSD arousal moderated the relationship between sexual-abuse-related injury and SIB. SIB was a unique predictor of health complaints, even after controlling for sexual abuse severity and PTSD arousal.     

Positive Resolution of Childhood Sexual Abuse Experiences: The Role of Coping,Benefit-Finding and Meaning-Making

Resolution of the trauma of childhood sexual abuse (CSA), and the current adjustment of 60 adult female CSA survivors were explored through qualitative and quantitative analyses of their coping strategies, perceived benefits, and meaning-making attempts. While the majority of the women (87%) perceived at least some benefit resulting from coping with the CSA experience, many (29%) found it impossible to make any meaning of their trauma. Specific benefits that were associated with various aspects of positive adjustment (marital satisfaction, better physical health, less isolation) included improved relationships with others, religious or spiritual growth, and improved parenting skills. Some perceived benefits were actually associated with a negative outcome. Increased knowledge of sexual abuse was associated with more isolation and lower marital satisfaction. When positive meaning could be derived from the coping process, the women reported less isolation. Avoidant coping was strongly associated with more depressive symptoms and poorer resolution of abuse issues. Results highlight the importance of considering coping strategies and cognitive restructuring efforts in designing therapeutic interventions with this population. Portions of this paper were presented at the annual meeting of the Midwest Psychological Association, May 2004, Chicago, IL.     

Examining the relationship between a childhood history of sexual abuse and later dissociation, breast-feeding practices, and parenting anxiety

The purpose of this study is to compare Mexican American adolescent mothers with and without childhood sexual abuse (CSA) histories to examine the influence of CSA on dissociation, selection of infant feeding method, and intimate parenting anxiety. Participants are 78 English-speaking adolescents between 15 and 19 years of age and recruited from the southwestern United States. Nearly one third of the sample ( n = 24, 30.77%) reports CSA histories. There is no correlation between CSA history and intimate parenting anxiety, no difference between breast-feeding and formula-feeding mothers in CSA severity, and intimate parenting anxiety does not predict dissociation. These findings are inconsistent with previous research. Supportive resources may explain the inconsistency and play a role in adolescent mothers' responses to CSA. Further research is necessary to explore these possibilities.     

The development of a sexual abuse severity score: characteristics of childhood sexual abuse associated with trauma symptomatology, somatization, and alcohol abuse

Childhood sexual abuse (CSA) is common and is associated with both mental and physical health problems in adulthood. Using data from an age- and sex-stratified population survey of 600 Olmsted County, Minnesota, residents, a Sexual Abuse Severity Score was developed. The abuse characteristics of 156 CSA respondents were associated with self-reported trauma, somatization, and alcohol use. Characteristics included age of first sexual abuse, more than one perpetrator, degree of coercion, severity of abuse (i.e., attempted intercourse is more severe than fondling), and the number of occurrences. This is one of the few reports to develop a risk summary that quantifies the severity of CSA.     

Perceived Parenting Competencies following Childhood Sexual Abuse: A Moderated Mediation Analysis

Childhood sexual abuse (CSA) survivors may face specific challenges in their parental role because of the negative sequelae of their abuse. This study explored factors that might heighten or buffer the risk for problems in parenting for intrafamilial CSA survivors. A community sample of 54 CSA mothers completed questionnaires assessing the severity of their CSA experiences, current depressive symptoms, partner support, and key parenting dimensions. Six moderated mediational models revealed that CSA severity indirectly impacted the survivor’s bond with her child, limit setting ability, communication, and parental involvement through depressive symptoms at high levels of partner support. Partner support was protective against many difficulties in parenting at low levels of depressive symptoms, but did not promote, and at times hindered, effective parenting at high depressive symptoms. This study’s findings highlight the importance of attending to risk and protective factors in understanding parenting among CSA survivors.     

Prevalence and predictors of dating violence among adolescent female victims of child sexual abuse

The purpose of this study was to advance knowledge of dating violence behaviors among adolescent victims of child sexual abuse (CSA), first, by determining the prevalence of psychological and physical dating violence and the reciprocity of violence, and second, by investigating the influence of certain CSA characteristics to dating violence. Respondents included 126 females ages 13 to 17 years. More than 45% reported experiencing some sort of physical violence in their dating relationships. Psychological violence was reciprocal in more than 90% of the cases. Multiple regression analysis revealed a significant contribution of CSA characteristics. Multiple regression analyses revealed that the duration of the sexual abuse and the presence of violence or completed intercourse during the abuse could significantly contribute to dating violence above and beyond other known risk factors. Discussion underscores the need to gain a better understanding of CSA and other risk factors that might influence violent dating behaviors.     

Reasons for Returning to Abusive Relationships: Effects of Prior Victimization

Studies have demonstrated that women with a history of childhood sexual abuse (CSA) are at increased risk of revictimization, but research has not yet examined whether a history of CSA may affect patterns of remaining in or returning to abusive relationships in adulthood. This study examines the impact of a CSA history on decisions to return to abusive relationships in a sample of 104 adult domestic violence survivors. Participants were interviewed about the number of times that they had previously separated from and returned to their abusive partner, the factors that influenced their decision to return (both psychological/internal and environmental/external factors), and their perceived likelihood of returning in the future. As predicted, CSA survivors (n = 34) reported a significantly greater number of past separations than non-CSA survivors (n = 70). CSA survivors were also significantly more likely to report that their decisions to return were influenced by emotional attachment to the batterer. CSA survivors did not perceive themselves to be at greater risk of returning in the future, suggesting that they may be more likely to underestimate their vulnerability to returning to the battering relationship. Clinical implications of the findings are discussed.     

Childhood Sexual Abuse and Intimate Partner Violence among Women in Methadone Treatment: A Direct or Mediated Relationship?

Women in substance use treatment report rates of childhood sexual abuse and intimate partner violence that far exceed those reported by women in the general population. Previous research with nonrandom samples of women in substance use treatment suggests that there is a statistically significant relationship between childhood sexual abuse and intimate partner violence; however, little is known about the mechanisms of risk between these two public health concerns among this population of women. To address this gap in knowledge and to inform intervention strategies, this study examined direct and mediated relationships between childhood sexual abuse and intimate partner violence risk among a random sample of 416 women in methadone treatment. In addition to high rates of childhood sexual abuse (57.9%), intimate partner violence (lifetime prevalence, 89.7%; 6-month prevalence, 78.4%), posttraumatic stress disorder (PTSD, 28.6%), and global psychological distress (19.5%), findings suggest that the relationship between childhood sexual abuse and intimate partner violence is mediated by mental health problems and that women experiencing PTSD or global psychological distress are 2.7 and 2.4 times more likely to experience intimate partner violence than women without such experiences, respectively. Although not a mediator in this relationship, financial independence reduced women's risk of partner violence by two-thirds. The paper includes discussion of social learning and stress and coping theories to explicate the findings and to inform intervention strategies. This study is based, in part, on the first author's dissertation. A previous version of this paper was presented at the Society for Social Work and Research Annual Conference held in January 2005 in New Orleans, Louisiana. The following grants provided funding for this study: R01DA11027 and 3T32MH014623-22S1.     

Childhood sexual abuse, gender, and depression among incarcerated youth

This study examined whether sexual abuse was related to higher levels of psychological distress among incarcerated youth and if the effects were invariant across gender. Participants were male and female adolescents, aged 11 to 20 years, incarcerated in six juvenile correctional institutions in five states. Using data from a national study of juveniles confined to secure institutions, this study assessed the relationship between gender, sexual abuse, and depression. Adolescents who were sexually abused during childhood compared to adolescents who were not report higher levels of depression. Sexually abused girls and boys report higher levels of depression compared to boys not sexually abused. These findings suggest the importance of understanding the relationship between childhood sexual abuse and depressive symptoms among incarcerated youth. Additionally, the findings suggest that the effects of childhood sexual abuse are similar for males and females among a high-risk sample of institutionalized juvenile delinquents. Implications for treatment of incarcerated youth are discussed.     

Interpersonal rejection sensitivity in childhood sexual abuse survivors: mediator of depressive symptoms and anger suppression

This study investigated whether interpersonal rejection sensitivity serves a mediating role between childhood sexual abuse (CSA) and three long-term psychological correlates of CSA in adult female survivors: depressive symptoms, anger suppression, and attenuated emotional expression. Interpersonal rejection sensitivity has been shown to be a risk factor for the development of depression and is elevated in CSA survivors. Similarly, attenuated emotional expression, particularly anger, has been related to adjustment difficulties in CSA survivors. Participants in this study were 355 female undergraduates, 34 of whom reported a history of CSA. Results demonstrated that interpersonal rejection sensitivity mediates the relationship between CSA and later depressive symptoms. Interpersonal rejection sensitivity partially mediated the relationship between CSA and anger suppression; however, it did not mediate the relationship between CSA and attenuated emotional expression. These results are examined within the context of the current literature on adult CSA survivors and their implications are discussed.     

The links between religiosity, childhood sexual abuse, and subsequent marijuana use: an empirical inquiry of a sample of female college students

A number of studies indicate that childhood sexual abuse (CSA) has a negative impact on later psychological well-being. It is well documented that experiences of CSA are associated with depression, self-destructiveness, and subsequent substance abuse or alcohol consumption. Compared with women who experienced no such sexual abuse in childhood, women who were victims of sexual abuse in childhood were more likely to be depressed and use drugs or consume alcohol in later life. Analyzing data of 1,569 females derived from the "Longitudinal Study of Violence Against Women," this study examines whether the strain caused by sexual victimization leads to a higher level of subsequent marijuana use and whether religiosity moderates the negative effects of CSA. It was found that CSA was associated with an increased level of marijuana use in high school. However, more proximate sexual victimization (victimization in college) seemed to override the impact of CSA on subsequent marijuana use. Religiosity was found to moderate the effect of CSA on marijuana use in high school. Religiosity was negatively associated with marijuana use in high school as well as the second and fourth collegiate years. Policy implications and promising directions for future research are discussed.     

Resilience in Sexually Abused Women: Risk and Protective Factors

The goal of this study was to evaluate the contribution of family characteristics (family conflict and cohesion) and abuse characteristics (age at which abuse occurred, abuse severity, and relationship to perpetrator) to resilience (self-acceptance, ability to engage in positive relationships with others, and environmental mastery) in a sample of one hundred and 77 university women who had experienced childhood sexual abuse (CSA). The respondents completed a questionnaire that focused on childhood experiences including family environment in childhood, characteristics of the abuse they had experienced in addition to degree of current resilience defined as their level of well-being (self-acceptance, ability to engage in positive relationships with others, and environmental mastery). The results indicated that family characteristics accounted for 13–22% of the variance in the well-being outcomes. In contrast, abuse characteristics accounted for 3% or less of the variance in the well-being outcomes. The clinical implications of these findings are discussed.     

Ethnicity and Sexual Orientation as PTSD Mitigators in Child Sexual Abuse Survivors

Purpose and Potential benefits: Research, to our knowledge, has not examined the effect of demographic variables on PTSD symptoms among adult survivors of childhood sexual abuse (CSA). This study explores the relationship between demographic variables and scores of CSA survivors on the Impact of Scale (IES). Participants were 257 women CSA survivors entering outpatient treatment at a university-based mental health center. All participants reported a CSA history and presented with psychological difficulties associated with CSA. The demographic variables investigated were relationship status, religious affiliation, ethnicity, educational level, spousal educational level income, and sexual orientation. Significance tests were used to examine each variable and scores on the Total IES and Avoidance and Intrusion Subscales. Total IES and Intrusion scores differed for sexual orientation and ethnicity in accord with conventional standards of significance ( < .05). Self-reported asexuals indicated fewer intrusive and total PTSD symptoms than heterosexuals, lesbians, and bisexuals. Likewise, Hispanics reported less intrusive PTSD symptoms than Non-Hispanic Caucasians. Our findings invite further exploration of the relationship between ethnicity and sexual orientation and the long-term effects of CSA. A question for empirical investigation is whether asexuality shields against the triggering of CSA memories by a sexual relationship. Another possible area of inquiry is whether particular characteristics of Hispanic culture as a whole serve to moderate the detrimental effects of CSA.     

Childhood sexual abuse and multiple dimensions of self-concept

The purpose of this investigation was to examine the relationship between child sexual abuse (CSA) and self-concept in a nonclinical sample of female college students. Participants with a history of CSA had lower scores than participants without a history of CSA on four domains of self-concept: familial, affect, competence, and physical. History of CSA was not associated with lower self-concept in the social and academic domains. The primary conclusions to be drawn from this study are that CSA may be differentially associated with various domains of self-concept, and thus multidimensional assessment of self-concept can yield useful information that cannot be gathered from global measures which yield a single composite score.     

Child sexual abuse, coping responses, self-blame, posttraumatic stress disorder, and adult sexual revictimization

The present study examined the psychological sequelae of child sexual abuse (CSA) and the factors that contributed to revictimization in the form of adult sexual assault (ASA) using a survey of 577 female college students. CSA characteristics, maladaptive coping in response to CSA, degree of self-blame at the time of the abuse and currently, and posttraumatic stress disorder (PTSD) symptoms were examined as predictors of revictimization. Results indicated that individuals who reported both CSA and ASA had more PTSD symptoms, were more likely to use drugs or alcohol to cope, act out sexually, withdraw from people, and seek therapy services. In addition, the revictimized group reported more self-blame at the time of the abuse and currently. The only factor that predicted revictimization in this study was the number of maladaptive coping strategies used. Implications of these findings are discussed.     

The association between childhood sexual abuse and sexual coercion in men: a test of possible mediators

ABSTRACT

We examined the associations between childhood sexual abuse (CSA), childhood physical abuse (CPA), sexual domain variables, antisocial tendencies, and sexually coercive behaviour in a non-forensic sample of 173 heterosexual men. CSA was associated with paraphilic interests and experiences, a more extensive sexual life history, and early antisocial tendencies. CPA was associated with paraphilic interests and experiences, more self-reported delinquency, higher sensation seeking, and early antisocial tendencies. Sexual domain variables (e.g. number of sexual partners, sexual interest in sadomasochism) mediated the link between CSA and sexually coercive behaviour, but antisocial domain variables (e.g. delinquency, sensation seeking) did not. Of the two sexual domains examined, extensive sexual life history rather than paraphilias mediated the association between CSA and sexually coercive behaviour. These results suggest CSA and CPA are associated with both sexual and antisocial outcomes, and that, for some victims of CSA, having an extensive sexual life history may account for the association between CSA and sexually coercive behaviour later in life.     

Towards a common framework for assessing the activity and associations of groups who sexually abuse children

Abstract

Extensive social psychological research emphasises the importance of groups in shaping individuals' thoughts and actions. Within the child sexual abuse (CSA) literature criminal organisation has been largely overlooked, with some key exceptions. This research was a novel collaboration between academia and the UK's Child Exploitation and Online Protection Centre (CEOP). Starting from the premise that the group is, in itself, a form of social situation affecting abuse, it offers the first systematic situational analysis of CSA groups. In-depth behavioural data from a small sample of convicted CSA group-offenders (n =3) were analysed qualitatively to identify factors and processes underpinning CSA groups' activities and associations: group formation, evolution, identity and resources. The results emphasise CSA groups' variability, fluidity and dynamism. The foundations of a general framework are proposed for researching and assessing CSA groups and designing effective interventions. It is hoped that this work will stimulate discussion and development in this long-neglected area of CSA, helping to build a coherent knowledge-base.     

Testing a Theoretical Model of the Relationship Between Impulsivity,Mediating Variables,and Husband Violence

The present study involved a multimethod assessment of impulsivity among 86 men. Using two questionnaires and four performance-based measures of impulsivity, the factor structure of the impulsivity data was examined. Four constructs that theoretically mediate the relationship between impulsivity and husband violence (i.e., substance abuse, anger/hostility, marital dissatisfaction, and psychological abuse) were assessed to examine a mediational model predictive of husband violence. Substance abuse and marital dissatisfaction mediated the relationship between impulsivity and psychological abuse. Psychological abuse mediated the relationship between substance abuse and marital dissatisfaction and husband violence. Although anger/hostility was not a mediator, there were bivariate associations between anger/hostility and impulsivity, psychological abuse, and husband violence. The results of the regression analyses were virtually identical when controlling for the effect of intelligence on the model variables. The implications of the findings for the assessment of impulsivity and for future husband violence research are discussed.