Men who were sexually abused in childhood: Coping strategies and comparisons in psychological functioning

ObjectiveCoping strategies of men who were sexually abused in childhood were examined to ascertain their relationship to clinical diagnoses. Time elapsed since the abuse occurred was examined for its relationship to psychological functioning. Clinical psychopathology of this primary sample of sexually abused men was compared to a community sample of men.MethodsA primary sample of 147 Australian men was recruited from agencies and self-help groups who support adults who were sexually abused in childhood. For comparative purposes a secondary data set that consisted of 1,231 men recruited randomly in an Australian community survey was utilized. Both samples were administered the 28-item General Health Questionnaire (GHQ28). The primary sample was administered the 60-item coping style inventory instrument (COPE).ResultsCoping strategies influenced the possibility of being classified as clinical or nonclinical. The most important strategies associated with better functioning were positive reinterpretation and growth and seeking instrumental social support. Whereas strategies that were more associated with a clinical outcome were themed around internalization, acceptance and disengagement. The sample of men who were sexually abused in childhood was up to 10 times more likely to be classified as “clinical” then the sample of community men. Time elapsed since the abuse occurred did not have a moderating effect on men's psychological functioning.ConclusionsMen who have been sexually abused in childhood are more likely to have clinical diagnoses but coping strategies may play an important part in this outcome. Seeking active assistance appears to be important coping strategy in reframing the experience, however, the timing of this help seeking is not critical.Practice implicationsThe findings reinforce the importance of professionals being aware that men's psychiatric symptoms might be the sequel to past child sexual abuse. Coping strategies that focus on internalization or disengagement are potentially damaging to the men's long-term psychological functioning. Importantly there are coping strategies that appear to have a moderating effect on clinical diagnoses. Focus needs to be given to support services to male victims that provide practical strategies and allow for cognitive reframing to assist men to see their strength and positive growth arising from survival.     

The role of social support in well-being and coping with self-reported stressful events in adolescents

OBJECTIVE: This study investigated the role that social support plays in well-being and in coping after a stressful event in a group of non-clinical adolescents. Furthermore, this study aimed at replicating the finding that adolescents who reported sexual abuse reported more symptoms and less adequate coping strategies than adolescents who reported another type of stressful event or no stressful episode. METHOD: Eight hundred and twenty adolescents between 12 and 18 years of age filled out questionnaires assessing social support (Social Support Questionnaire, Sarason, Shearin, Pierce, & Sarason, 1987), trauma-related symptoms (Trauma Symptom Checklist for Children, Briere, 1996), behavior problems (Youth Self-Report, Achenbach, 1991), and coping (How I Cope Under Pressure Scale, Ayers, Sandler, West, & Roosa, 1996). RESULTS: 42% of the adolescents reported a stressful experience, and 4.4% reported sexual abuse. Sexually abused adolescents reported more stress-related symptoms and used more avoidance and fewer support-seeking coping strategies than the other adolescents. The main-effect hypothesis of social support was sustained, but social support did not moderate the relation between a stressful event and coping. Yet, a trend was found suggesting that high support from the family was associated with less avoidance coping and more support-seeking in adolescents who reported a non-sexually abusive, stressful event. CONCLUSIONS: Our findings show that a highly perceived availability of social support is directly associated with fewer trauma-related symptoms, especially in adolescents who are non-sexually abused. For adolescents who reported a sexual or another type of stressful event, social support did not play a different role in coping.     

Stress, coping, and adjustment in female adolescent incest victims

Although previous literature on incest has dealt extensively with the nature, parameters, and effects of such abuse, it has not focused on the role of coping in the psychological adjustment of victims. Forty-five female adolescent incest victims in treatment completed questionnaires regarding their current adjustment, characteristics of their molest, their perceptions of the stressful aspects of the molestations, how they appraised the molestations, and how they coped with the fact that it occurred. The majority of the girls in this study had been sexually abused by a father figure (82%). The coping strategies of wishful thinking and tension reduction, the lack of maternal support at the time of reporting, and appraisals of threat and "holding self back" accounted for 70% of the variance in self-reported distress. The coping strategies of detachment, seeking social support and appraisal of hold self back accounted for 38% of the variance in adolescent's global psychopathology as rated by their therapists. In light of these findings, the implications of the need to address appraisals and coping efforts in research and therapy with incest victims was emphasized.     

Coping strategies and social support as mediators of consequences in child sexual abuse victims.

OBJECTIVE: The main objective of this study was to evaluate the mediator role of coping strategies and social support on the adaptation of children following CSA. Empirical studies indicate that short-term consequences of child sexual abuse (CSA) are multiple and varied (Kendall-Tackett, Williams, & Finkelhor, 1993; Wolfe & Birt, 1995). While abuse-related characteristics were first studied to explain the variability of CSA outcome, more recently, the influence of other variables such as coping strategies and social support have been considered. METHOD: Fifty sexually abused children aged between 7 and 12 participated in this study. The Child Behavior Checklist (Achenbach, 1991) and the Perceived Competence Scale for Children (Harter, 1985) were used to measure victims' adjustment. Coping strategies were evaluated by the Self-Report Coping Scale (Causey & Dubow, 1992) and the children completed the Perceived Social Support (Harter, 1985). A French version of the History of Victimization (Wolfe, Gentile, & Bourdeau, 1987) was used to gather abuse-related characteristics from medical records. RESULTS: Results indicate that sexually abused children exhibit internalizing and externalizing behavior problems following CSA. Coping strategies and social support exert direct effects on victims' adjustment instead of the mediator influences originally expected. Among abuse-related variables, only the perpetrator's identity is directly related to internalizing symptoms. CONCLUSIONS: The absence of mediational effects of coping and social support is discussed in light of the measures used and the cross-sectional nature of the study. Results highlight the importance of parental implication and the consideration of coping strategies in designing therapeutic interventions with this population.     

Depression,anxiety and PTSD in sexually abused adolescents: Association with self-efficacy,coping and family support

Sexual abuse has the potential to generate serious emotional consequences for its victims, but there is high variability in the symptoms reported by different victims. Therefore, it is necessary to ascertain the factors associated with the symptoms presented by sexual abuse victims. The aim of the study was to use a single model to evaluate the relationship between sexual abuse characteristics (frequency, violence, relation with the aggressor and physical commitment), cognitive and behavioral factors (self-efficacy, active coping and perceived family support) and internalizing symptoms (anxiety, depression and posttraumatic stress) in a group of sexually abused adolescents. The participants included 106 female adolescent victims of sexual abuse (M = 14.25 years, SD = 1.74). The results of a path analysis indicated that sexual abuse characteristics were unrelated to symptomatology. Only a negative relationship was observed between the victim’s relationship with the aggressor and PTSD symptomatology. The violence of the sexual abuse was negatively related to self-efficacy, and self-efficacy was positively related to active coping and negatively related to symptomatology. Finally, the perception of family support was positively related to self-efficacy and negatively related to symptomatology. These results suggest the need to consider the studied factors in the process of psychotherapy with victims of sexual abuse.     

Child sexual abuse consequences in community samples of Latino and European American adolescents

ObjectiveResearch investigating the impact of child sexual abuse (CSA) in community samples of adolescents has been limited. This study aims to identify sexual abuse among ethnically diverse high school adolescents of both genders and evaluate their psycho-emotional consequences.MethodThrough the use of self-report instruments, a sample of 223 Latino and European American 16–19-year-old high school students were identified as either victims of CSA or as nonabused. The emotional impact of sexual abuse was also investigated among these ethnically diverse adolescent males and females.ResultsInitial findings revealed that those adolescents who gave inconsistent responses to CSA assessments questions were much more similar in patterns of psychological distress to CSA victims compared to nonabused teenagers. Prevalence analyses revealed that females (45%) were nearly two times more likely to report CSA than males (24%). Latinos (44%) were significantly more likely to experience CSA compared to European Americans (27%), and Latinas (54%) had the highest prevalence overall. Other findings indicated substantial differences in type of perpetrator. While female victims of CSA identified male perpetrators in 91.9% of cases, male victims of CSA identified female perpetrators in 52.9% of cases. Consistent with past research, sexually abused adolescents reported significantly greater psychological distress than their nonabused peers, regardless of gender or ethnic group. Gender differences emerged with females reporting greater psychological symptoms, but these differences were substantially reduced when CSA was controlled. European Americans reported greater anxious arousal symptoms compared to Latinos.ConclusionsOur findings suggest that the prevalence of CSA among adolescents is higher than existing research has noted for both males and females and particularly higher for Latinos compared to European Americans. Perpetration by females upon males may also be higher than research has noted. Our findings also revealed many ethnic and gender similarities and fewer differences in the psychological impact and circumstances of sexual abuse in this diverse sample of adolescents.Practice implicationsThe high prevalence of CSA among adolescent males and particularly Latinas emphasize the need to intervene on a community level and with parents for both prevention and intervention regarding issues of sexual victimization. The numbers of female perpetrators, especially when boys are the targets of abuse, may be higher than previously imagined and thus must be assessed tactfully and thoroughly. This study found that adolescents who reported CSA inconsistently had similar symptoms as those with confirmed CSA and therefore warrant greater attention and more persistent intervention. When treating victims of CSA, the Trauma Symptom Inventory (TSI) is effective in identifying specific areas of emotional distress to treat in sexually abused ethnically diverse male and female adolescents. Culturally relevant prevention efforts are needed for ethnically diverse children of both genders.     

Child peer sexual abuse: preliminary data on outcomes and disclosure experiences

OBJECTIVE: This study compared experiences of children sexually abused by peers to those of children abused by adolescents/adults. Variables examined included perceived negativity of the abuse, self-reported outcomes, overall psychological functioning, and disclosure. METHOD: An archival data set containing retrospective reports of childhood sexual experiences was culled for instances of sexual abuse by child peers and adolescents/adults. An equivalent nonabused comparison group was identified. The Self-Report Outcome Checklist (SROC; Gilbert, 1994b), the MMPI-Hugo Short Form (Hugo, 1971) and a disclosure survey were also retrieved from these data. RESULTS: Compared to abuse by peers, abuse perpetrated by adolescents/adults was more intrusive and intrafamilial. Both groups rated their experiences as equally negative, and reported equally pervasive outcomes. Those abused by adolescents/adults reported significantly higher scores on the Psychopathic Deviate, Psychasthenia, and Schizophrenia scales compared to nonabused controls; similar findings did not emerge for those abused by child peers. Less than a fourth in either abuse group reported disclosing their experience to a parent. Among those who did not disclose, participants abused by child peers anticipated less support from both parents and more anger from their mothers. CONCLUSIONS: The findings suggest that child peer sexual abuse may be associated with adverse outcomes.     

Association between child sexual abuse and infectious disease diagnoses

BackgroundThough many studies have linked child sexual abuse (CSA) to psychological health problems, little is known regarding the relationship between CSA and children and adolescents’ physical health.ObjectiveThe objective of this study was to assess the relationship between CSA and infectious disease diagnoses.ParticipantsOf the 955 eligible children and adolescents who had a substantiated report of sexual abuse between 2001 and 2010, medical data was retrieved for 882 individuals, who formed the sexually abused group. These 882 participants were matched to 882 participants on age, gender, and administrative healthcare region to form the general population group.Setting and methodsThis matched-cohort study, conducted in a large Canadian city, compared the number of infectious disease diagnoses between the date of the substantiated sexual abuse report and August 1, 2013, between the two groups.ResultsResults indicate that sexually abused participants had 1.27 times more (95% CI – 1.13 to 1.42) infectious diseases diagnoses than those from the general population. They received 1.83 times more genitourinary infection diagnoses (95% CI – 1.43 to 2.33), 1.31 times more diagnoses for other types of infections (95% CI – 1.11 to 1.55) and 1.21 times more respiratory and ear infection diagnoses (95% CI – 1.05 to 1.40). There was no statistically significant difference regarding skin infection diagnoses. These results indicate an association between CSA and more frequent infectious diseases diagnoses.     

A retrospective study of long-term methods of coping with having been sexually abused during childhood.

Methods of coping with childhood sexual abuse were retrospectively studied in a community sample of 54 adult women who had been sexually abused in childhood. From the time the abuse ended until the present, "denial" and "emotional suppression" were the coping methods most commonly employed of the nine methods measured. One purpose of this study was to determine if the methods used to cope with the aftermath of being sexually abused during childhood were associated with current psychological adjustment beyond what could be predicted by the characteristics of the abusive experience per se. A partial correlation analysis and a multiple regression analysis suggested that avoidant/emotion suppressing coping strategies although frequently used and rated by subjects as helpful, were in fact associated with poorer adult psychological adjustment.     

Gender differences in social reactions to abuse disclosures, post-abuse coping, and PTSD of child sexual abuse survivors

OBJECTIVE:This research examines the understudied issue of gender differences in disclosure, social reactions, post-abuse coping, and PTSD of adult survivors of child sexual abuse (CSA). METHOD:Data were collected on a cross-sectional convenience sample of 733 college students completing a confidential survey about their demographic characteristics, sexual abuse experiences, disclosure characteristics, post-abuse coping, and social reactions from others. RESULTS:Female students reported greater prevalence and severity of CSA, more distress and self-blame immediately post-assault, and greater reliance on coping strategies of withdrawal and trying to forget than male students. Women were more likely to have disclosed their abuse to others, to have received positive reactions, and to report greater PTSD symptom severity, but were no more likely to receive negative reactions upon disclosure than men. Women delaying disclosure had greater PTSD symptom severity, whereas men's symptoms did not vary by timing of disclosure. Additional regression analyses examined predictors of PTSD symptom severity and negative and positive social reactions to abuse disclosures. CONCLUSIONS:Several gender differences were observed in this sample of college students in terms of sexual abuse experiences, psychological symptoms, coping, PTSD, and some aspects of disclosure and social reactions from others.     

Sexual abuse history among adult sex offenders and non-sex offenders: A meta-analysis

ObjectiveThe sexually abused–sexual abuser hypothesis states there is a specific relationship between sexual abuse history and sexual offending, such that individuals who experience sexual abuse are significantly more likely to later engage in sexual offenses. Therefore, samples of adult sex offenders should contain a disproportionate number of individuals who have experienced sexual abuse, but not necessarily other types of abuse, compared with samples of other types of offenders.MethodsWe compared rates of sexual and other forms of abuse reported in 17 studies, involving 1,037 sex offenders and 1,762 non-sex offenders. We also examined the prevalence of different forms of abuse in 15 studies that compared adult sex offenders against adults (n = 962) and against children (n = 1,334), to determine if the sexually abused–sexual abuser association is even more specific to individuals who sexually offend against children.ResultsWe observed a higher prevalence of sexual abuse history among adult sex offenders than among non-sex offenders (Odds Ratio = 3.36, 95% confidence intervals of 2.23–4.82). The two groups did not significantly differ with regard to physical abuse history (OR = 1.50, 95% CI = 0.88–2.56). There was a significantly lower prevalence of sexual abuse history among sex offenders against adults compared to sex offenders against children (OR = 0.51, 95% CI = 0.35–0.74), whereas the opposite was found for physical abuse (OR = 1.43, 95% CI = 1.02–2.02).ConclusionThere is support for the sexually abused–sexual abuser hypothesis, in that sex offenders are more likely to have been sexually abused than non-sex offenders, but not more likely to have been physically abused. We discuss potential mechanisms for the relationship between sexual abuse history and sexual offending, including the possibility that a third factor might account for the relationship.Practice implicationsThe most obvious implications of these findings is that the prevention of sexual abuse of children, either through prevention programs directly targeting children or through treatment programs targeting individuals who are likely to sexually offend against children (e.g., known sex offenders against extra-familial boys), may eventually reduce the number of sex offenders. This implication is dependent, however, on a causal role of childhood sexual abuse, and on the effectiveness of prevention and treatment practices.     

Early-married and sexually abused girls differ in their psychiatric outcomes

Early marriage and sexual abuse are the two of the most frequent types of childhood abuse. Although early marriage is also a type of sexual abuse, it is associated with different physical, social, and mental outcomes than sexual abuse alone. The purpose of this study was to compare early-married girls and sexually abused girls who were referred for forensic evaluation in Turkey in terms of their sociodemographic characteristics, mental disorder rates, and mental symptom severity. We included 63 adolescent girls for whom a judicial report had been demanded and who were under 15 years old when they were married but were not yet 18 years old during the evaluation (15.51 ± 0.78) and 72 sexually abused adolescent girls between 14 and 18 years old (15.80 ± 1.10) in this study. Following a psychiatric evaluation, the study participants completed the Child Posttraumatic Stress Disorder Reaction Index (CPTS-RI) and the Brief Symptom Inventory (BSI). We used the Windows SPSS 16.0 software program to assess the results. At least one psychiatric disorder was determined in 44.4% of the early-married and 77.8% of the sexually abused cases (p < 0.001). A diagnosis of PTSD or ASD was observed in 11.1% of the early-married cases and in 54.2% of the sexually abused victims (p < 0.001). MDD was determined in 33.3% of the early-married cases and 56.9% of the sexually abused cases (p = 0.006). The CPTS-RI scores of the sexually abused victims were higher than those of the early-married cases (p < 0.001). All of the subscale scores of the BSI were higher in the sexually abused adolescents than in the early-married cases (p < 0.001). Although early marriage has severe physical, social and mental outcomes, it is not as severe as sexual abuse in terms of psychiatric disorder rates and the psychiatric symptom severity it causes.     

Resilience factors in the victims of sexual abuse: state of affairs

OBJECTIVE: The aim of this literature review is to examine factors leading to the recovery of child sexual abuse survivors. METHOD: This paper provides a definition of resilience and presents the individual and environmental protective factors. A methodological examination of the studies is carried through. RESULTS: Researchers have documented that 20% to 44% of adult who were sexually abused during their childhood show no apparent signs of negative outcome. However, very few studies as been interested in resilient women and their protective mechanisms. Recent research on protective factors reveal that searching for support, disclosing the abuse and giving a meaning to the abuse are all adaptative cognitive strategies. Furthermore, the perception of benefits and having an external attributional style are both related to less psychological distress. Social support, in general and after the revelation, also appears as a determinant of resilience. However, avoidance, even if victims find it very useful, proves to be a non-adaptative strategy, which may lead to be a catalyst to victims' symptomatology. Definitional problems and the lack of longitudinal studies limit the conclusions that can be drawn. CONCLUSION: The rare studies involving resilient victims show that social support as well as certain cognitive coping strategies may lead to recovery. However the extent of their contribution remains unknown.     

Emotional support and adjustment over a year's time following sexual abuse discovery

OBJECTIVE: This study investigated age and gender differences in perceived emotional support in children and adolescents who experienced sexual abuse from the time of discovery to 1 year later. Also examined were the relations among sources of support and adjustment and whether support explained resilience, defined as better adjustment over a year's time. METHOD: One hundred and forty-seven sexually abused youth were interviewed at the time of discovery (T1) and 1 year later (T2). Information gathered included severity of the sexual abuse, satisfaction with support from caregivers, same-sex and other-sex friends, feelings of shame about the abuse, and attributional style. Youth adjustment was measured using reports from the youth themselves, caregivers, and teachers. RESULTS: Children reported the most satisfaction with support from caregivers followed by friends whereas adolescents reported similar levels of support from friends and caregivers. Satisfaction with support was differentially related to adjustment. Youth who reported more satisfaction with caregiver support at T1, reported less depression, better self-esteem but more sexual anxiety 1 year later. More satisfaction with support from friends predicted lower self-esteem but less sexual anxiety. More satisfaction with initial caregiver support at T1 predicted better parent- and teacher-rated adjustment 1 year later, after controlling for initial adjustment. CONCLUSIONS: In general, initial caregiver emotional support at the time of abuse discovery predicted resilience in child and adolescent victims of sexual abuse. Findings suggested that treatment should include a focus on helping caregivers provide appropriate emotional support.     

Sexual abuse: somatic and emotional reactions

A chart review and telephone interview of 72 sexual abuse victims was conducted to determine if children and adolescents who are victims of sexual abuse suffer from symptoms similar to the "rape trauma syndrome," which has been reported in adults. Symptoms similar to the rape trauma syndrome were found in 48 of the 72 abused children and only 26 of the matched control group, p less than .01. Common somatic complaints in the sexual abuse patients included dysuria, vaginal discharge and chronic abdominal pain. Some of the emotional and behavioral problems noted during the follow-up period among the sexual abuse patients included sleep problems, runaway behavior, and suicide attempts. The duration of abuse and age of the victim at the time of abuse significantly affected the frequency of reported somatic symptoms, but the type of abuse and type of assailant did not significantly affect the frequency of reported somatic and emotional reactions. There was no difference in the occurrence of school problems and early pregnancy between sexually abused patients and controls. Since 67% of all sexually abused patients suffered from emotional and somatic reactions, close follow-up of these patients is indicated.     

Childhood sexual abuse and revictimization in adolescence.

OBJECTIVE: The aim of this study was to examine the link between childhood experiences of sexual abuse and subsequent revictimization in adolescence. METHOD: A sample of 281 female adolescents between 17-20 years of age, who participated in a prevalence survey of unwanted sexual contacts, completed the Sexual Experiences Survey as a measure of unwanted sexual contacts in adolescence and indicated whether or not they had experienced childhood sexual abuse. RESULTS: Childhood experiences of sexual abuse were reported by 8.9% of the respondents, a further 8.5% indicated they were not sure if they had been sexually abused as children. Both abused women and women uncertain about their victimization status were significantly more likely to report unwanted sexual contacts as adolescents than women who did not state abuse. The link between childhood abuse and subsequent victimization was mediated by a higher level of sexual activity among the abuse victims. CONCLUSIONS: The results support existing evidence on the impact of childhood sexual abuse on sexual relationships in subsequent developmental stages and underline the need to consider childhood sexual abuse as a risk factor of adolescent sexual victimization.     

Using the Trauma Symptom Checklist for Children-Short form (TSCC-SF) on abused children in South Africa: Confirmatory factor analysis and Rasch models

BackgroundWhile assessment measures of trauma-related symptoms in children exist, few of them are at once brief, self-reports, normed, comprehensive (i.e., cover both general and trauma-specific symptoms), and thus suitable for poorly resourced clinical contexts.ObjectiveThis study validated the short form of the Trauma Symptom Checklist for Children (TSCC-SF) in a sample of children and adolescents.Participants and settingsParticipants were school-age children and adolescents (N = 270; M_age = 12.55 yrs., SD = 1.19; 67% = Female) exposed to different types of abuse (i.e., sexual, physical, emotional and neglect) receiving counselling at a non-governmental organisation.MethodsThe TSCC-SF’s factor structure and Differential Item Functioning (DIF) across sexes were examined using confirmatory factor analysis and Rasch analysis.ResultsResults revealed a satisfactory construct validity of the scale, while internal consistency was also adequate. No DIF was found across the sexes.ConclusionsThe TSCC-SF appears to be a viable option for use with children exposed to different types of abuse, particularly in low resource clinical contexts.     

Development and initial validation of the institutional child abuse processes and coping inventory among a sample of Irish adult survivors of institutional abuse

ObjectiveTo develop a psychometric instrument to evaluate psychological processes associated with institutional abuse and coping strategies used to deal with such abuse.MethodsAs part of a comprehensive assessment protocol, an inventory containing theoretically derived multi-item rational scales which assessed institutional abuse-related psychological processes and coping strategies were administered to 247 Irish adult survivors of institutional child abuse. Exploratory and confirmatory factor analyses were used to derive 6-factor scales, the reliability and validity of which were assessed.ResultsFactor scales to assess the following constructs were developed (1) traumatization, (2) re-enactment, (3) spiritual disengagement, (4) positive coping, (5) coping by complying, and (6) avoidant coping. There were varying degrees of support for the validity of the scales with most support for the traumatization and re-enactment scales.ConclusionsThe Institutional Child Abuse Processes and Coping Inventory (ICAPCI), particularly its traumatization and re-enactment scales, may be used in future research on adult survivors of institutional child abuse because they are currently the only scales that have been developed with this population to provide reliable and valid assessments of these constructs.Practice implicationsThe ICAPCI may be used, cautiously, to assess adult survivors of institutional child abuse.     

The influence of childhood sexual abuse,physical abuse,family environment,and gender on the psychological adjustment of adolescents

OBJECTIVE: The primary aim of the current study was to examine the contributions of sexual abuse, physical abuse, family cohesion, and conflict in predicting the psychological functioning of adolescents. Additional analyses were conducted to determine whether adolescent victims of child sexual abuse and physical abuse perceive their family environments as more conflictual and less cohesive than nonabused adolescents. METHOD: Participants were 131 male and female adolescents, ages 16 years to 18 years, receiving services at a residential vocational training program. Participants completed well established psychological assessment tools to assess abuse history, family environment characteristics, and current adjustment. RESULTS: Physically abused adolescent females perceived their family environments as more conflictual and less cohesive than females without physical abuse, and sexually abused females perceived their family environments as more conflictual and less cohesive than females without sexual abuse. Physically abused adolescent males reported more conflict than males without physical abuse, but did not differ with regard to cohesion. Adolescent males with and without a sexual abuse history did not differ on the family dimensions. Multiple regression analyses revealed that both conflict and cohesion, in addition to a history of sexual and physical abuse, predicted depression and distress. Separate analyses by gender revealed these variables differentially impact adjustment in male and female adolescents. Results of a power analysis indicated sufficient power to detect these differences. CONCLUSIONS: Findings indicate that in addition to child sexual abuse and physical abuse, family conflict and cohesion are risk factors for the development of psychological distress and depression in adolescence. Implications for treatment and directions for future research are discussed.