The relationship of childhood sexual abuse with later psychological and sexual adjustment in a sample of college women

The purpose of the present study was to explore the relationship of childhood sexual abuse with later psychological and sexual adjustment. Subjects were 383 female college students recruited from undergraduate psychology classes. Each was asked to complete a packet which contained a victimization questionnaire as well as measures of adjustment. A number of small, but significant, relationships were found between a history of childhood sexual abuse and measures of later psychological and sexual adjustment. In light of the relationship between family background and sexual abuse, however, it was questioned whether these associations were due to the sexual abuse per se, or were due to the confounding of sexual abuse with family background. Indeed, once parental supportiveness was controlled, very few significant relationships emerged. There was a trend, however, for the significant correlations to involve the sexual measures rather than the more general adjustment measures. The implications of the current findings, particularly for future research, were discussed.     

Prevalence and psychological sequelae of self-reported childhood physical and sexual abuse in a general population sample of men and women

OBJECTIVE: This study examined the prevalence and psychological sequelae of childhood sexual and physical abuse in adults from the general population. METHOD: A national sampling service generated a geographically stratified, random sample of 1,442 subjects from the United States. Subjects were mailed a questionnaire that included the Traumatic Events Survey (TES) [Traumatic Events Survey, Unpublished Psychological Test, Harbor-UCLA Medical Center, Los Angeles] and the Trauma Symptom Inventory (TSI) [Trauma Symptom Inventory Professional Manual, Psychological Assessment Resources, Odessa, FL]. Of all potential subjects, 935 (64.8%) returned substantially completed surveys. RESULTS: Sixty-six men and 152 women (14.2% and 32.3%, respectively) reported childhood experiences that satisfied criteria for sexual abuse, and 103 males and 92 females (22.2% and 19.5%, respectively) met criteria for physical abuse. Twenty-one percent of subjects with one type of abuse also had experienced the other type, and both types were associated with subsequent adult victimization. After controlling for demographics, adult history of interpersonal violence, and other child abuse, childhood sexual abuse was associated with all 10 scales of the TSI, and physical abuse was related to all TSI scales except those tapping sexual issues. Sexual abuse predicted more symptom variance than did physical abuse or adult interpersonal victimization. Various aspects of both physical and sexual abuse experiences were predictive of TSI scores. Abuser sex, however, both alone and in interaction with victim sex, was not associated with additional TSI symptomatology. CONCLUSIONS: Childhood sexual and physical abuse is relatively common in the general population, and is associated with a wide variety of psychological symptoms. These relationships remain even after controlling for relevant background variables.     

Epidemiologic variations in childhood sexual abuse

We retrospectively reviewed records of 566 children ranging from 6 months to 16 years of age who presented to a sexual assault crisis center. They represented 33.2% of all alleged sexual assault victims seen over a 36 month period. There were 103 males (18.2%) and 463 females (81.8%). Significant differences in presentation were demonstrated with respect to the victim's age, sex, and race, but the major factor influencing the variation is the victim/assailant relationship. Younger children were more likely than older children to present with histories of multiple assaults (p less than .0005), by known assailants (p less than .0005), occurring in the child's or assailant's home (p less than .001) and to report less violence (p less than .05). More risk of violence (p less than .0005) or evidence of trauma (p less than .0005) and less reporting of home assaults (p less than .0005) or multiple assault episodes (p less than .0005) were found in assaults by strangers when compared with non-stranger assaults. A lower frequency of reporting was found in females between 7 and 11 years of age. The dynamics of childhood sexual abuse are discussed in relationship to these findings. A number of victim and assailant related factors determine reporting patterns of childhood sexual abuse.     

Understanding childhood sexual abuse as a predictor of sexual risk-taking among men who have sex with men: The Urban Men's Health Study

OBJECTIVE: The prevalence and characteristics of childhood sexual abuse (CSA) among men who have sex with men (MSM), and links with sexual risk are explored. A model linking CSA and sexual risk among MSM is proposed. METHOD: A telephone probability sample of urban MSM (n = 2881) was recruited and interviewed between November 1996 and February 1998. The interview covered numerous health issues, including history of sexual victimization. RESULTS: One-fifth reported CSA, primarily by non-family perpetrators. Initial CSA experiences are characterized by high levels of force (43% involved physical force/weapons), and penetrative sex (78%; 46% reported attempted or actual anal intercourse). Such men are more likely than nevercoerced men to engage in high risk sex (unprotected anal intercourse with a non-primary partner or with a serodiscordant male). In multivariate analyses, the effect of childhood sexual coercion on sexual risk is mediated by substance use, patterns of sexual contacts, and partner violence, but not by adult sexual revictimization or by depression. CONCLUSIONS: Findings are interpreted within the context of social learning theory and prior research on sexual risk-taking. The high risk for CSA among MSM, which can predispose such men to patterns of HIV sexual risk, warrants new approaches in HIV prevention.     

The impact of childhood sexual abuse in anorexia nervosa

OBJECTIVE: The aim of this study was to examine the impact of childhood sexual abuse (CSA) on clinical characteristics and premature termination of treatment in anorexia nervosa (AN). METHOD: The participants were 77 consecutive patients with AN admitted to an inpatient eating disorders unit. The patients were assessed in terms of eating disorder symptoms, general psychopathology, and CSA history at admission to hospital. RESULTS: Thirty-seven patients (48%) reported a history of CSA before the onset of the eating disorder. Individuals with a history of CSA reported significantly greater psychiatric comorbidity, including higher levels of depression and anxiety, lower self-esteem, more interpersonal problems, and more severe obsessive-compulsive symptoms. Patients with the binge-purge subtype of AN (AN-BP) were significantly more likely to report a history of CSA prior to the onset of the eating disorder as compared with patients with the restricting subtype (AN-R) of the illness (65% of the AN-BP patients vs. 37% of the AN-R patients; p<.02). Contrary to our predictions, abused patients were not significantly more likely to dropout of treatment overall. However, patients of the binge-purge subtype (AN-BP) with a history of CSA were significantly more likely to terminate treatment prematurely as compared with the other patients. CONCLUSIONS: Consistent with previous findings, the present results indicate that the prevalence of CSA is high among individuals seeking inpatient treatment for AN. A history of CSA was associated with greater psychiatric disturbance overall and a higher rate of dropout for patients of the binge-purge subtype.     

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.     

Emotional support and adult depression in survivors of childhood sexual abuse

The goals of this study were to evaluate the effects of emotional support from friends and parents at two time points (adolescence and adulthood) on adult depression in a nationally representative sample of survivors of childhood sexual abuse (CSA), and examine whether the associations were moderated by the identity of the perpetrator (parent/caregiver vs. not). Data were taken from Waves I and IV of the National Longitudinal Study of Adolescent Health (Add Health). The study sample included 1,238 Add Health participants with a history of CSA and an equivalently sized comparison group of individuals with no history of CSA. Parental support was measured using four items from each wave that assessed the warmth of participants’ relationships with their parents and their satisfaction with those relationships. Friend support in adolescence was measured using participants’ perceptions of how much their friends cared about them and in adulthood using participants’ self-reported number of close friends. Depression was measured using a 10-item subscale of the CES-D. Logistic regressions showed that support from friends and parents in adulthood were significantly associated with lower odds of adult depression in CSA survivors who reported non-parent/caregiver abuse. Among survivors of parent/caregiver abuse, emotional support was not significantly associated with adult depression regardless of when or by whom it was provided. In conclusion, emotional support in adulthood from friends and parents is associated with reduced odds of adult depression in CSA survivors, but only in cases where the abuse was perpetrated by someone other than a parent or caregiver.     

Prevalence of childhood sexual abuse among incarcerated males in county jail

OBJECTIVE: The current study examined the prevalence and characteristics of childhood sexual abuse in a jailed-based population. METHODOLOGY: A retrospective, self-reported survey was administered over an 8-week period to a random sample of 100 men who were incarcerated in a county jail in Southeastern Texas. The survey included questions about childhood sexual experiences before and after puberty, drug history and use, and sexual risk-taking behaviors. RESULTS: Of the 100 male inmates who participated in this study, 59% reported experiencing some form of sexual abuse before puberty, and all such instances occurred before or at the age of 13 years. The first episode of childhood sexual abuse began at an average age of 9.6 years (SD = 2.4), and ended at an average age of 13.0 years (SD = 2.3). Kissing and touching without intercourse (64%) was the common pattern of sexual abuse experience reported. The total number of perpetrators was 165, with 10% male and 90% female. Friends (n = 72) and family (n = 56) were the most frequent perpetrators. CONCLUSION: Childhood sexual abuse may be more prevalent among inmates than among males in the general population. These results show a high percentage of inmates who report a history of childhood sexual abuse; this rate is higher than those reported by other studies for incarcerated males. The findings support the belief held by professionals in the criminal justice field that a significant number of incarcerated males may have been victims of sexual abuse.     

The abuse-related beliefs questionnaire for survivors of childhood sexual abuse

OBJECTIVE: To evaluate the psychometric properties of a new measure, the Abuse-Related Beliefs Questionnaire (ARBQ), designed to assess abuse-related beliefs among adult survivors of childhood sexual abuse (CSA). Study 1 examined the structure of the scale, and Study 2 evaluated its reliability and validity. METHOD: One hundred and seventy female CSA survivors recruited into a group psychotherapy intervention study were administered the ARBQ in Study 1. A subsample of 45 women completed the ARBQ again 12 months later. In Study 2, 70 women from a health maintenance organization who identified themselves as survivors of CSA completed the ARBQ along with the Trauma Symptom Checklist-40 (TSC-40) and the Symptom Checklist 90R (SCL-90-R). RESULTS: Three reliable ARBQ subscales emerged in Study 1: Guilt, Shame, and Resilience. Twelve-month test-retest reliability was high (r=.60-.64). The internal consistency of the subscales was further supported in Study 2, and validity was demonstrated by moderate to high correlations with the distress measures. CONCLUSIONS: The results indicate that the ARBQ has good psychometric characteristics, supporting the feasibility of its use in measuring abuse-related beliefs in research on survivors of CSA. A next step for validation of the ARBQ would be to evaluate its sensitivity in measuring changes in studies of interventions for treating CSA survivors.     

Memories of childhood sexual abuse: a survey of young adults

Objective: To explore the prevalence of, characteristics of, and factors associated with forgetting of childhood sexual abuse memories in a large non-clinical sample (N = 1712).Method: Using an anonymous survey, we asked respondents about (a) the nature and severity of their childhood abuse; (b) the continuity of their abuse memories; and (c) their experiences with others suggesting to them that they might have been abused.Results: A substantial minority of victims in our sample reported having temporarily forgotten their childhood sexual abuse. Forgetting was largely unassociated with victim or abuse characteristics. Compared to individuals who always remembered their abuse, however, individuals who temporarily forgot were more likely to report that someone had suggested to them that they might have experienced abuse. Those who received such suggestions were particularly likely to suspect that they may have experienced childhood sexual abuse that they do not yet remember.Conclusion: Forgetting may be less common than implied by earlier estimates from clinical samples, yet it is not uncommon. Also, a sizable minority of the population is wondering whether they have experienced unremembered abuse, and these suspicions are linked to having encountered suggestions from others. We discuss the implications of these findings for understanding the phenomenon sometimes labeled repression.Spanish abstract was not available at time of publication.     

Higher prevalence of childhood sexual abuse among Latino men who have sex with men than non-Latino men who have sex with men: data from the Urban Men's Health Study

OBJECTIVE: The prevalence of childhood sexual abuse among Latino adult men who have sex with men who live in the US was estimated because a history of childhood sexual abuse increases HIV sexual risk behaviors and other negative health outcomes in adulthood. METHOD: The Urban Men's Health Study is a random-digit telephone probability survey of 2881 adult men who have sex with men (MSM) aged 18 years or older residing in San Francisco, New York, Los Angeles, and Chicago. Self-reported history of childhood sexual abuse was the main outcome measure gathered from 2692 MSM. RESULTS: A significantly higher proportion of Latino MSM reported sexual abuse before age 13 (22%) than did non-Latino MSM (11%). CONCLUSIONS: Latino MSM are twice as likely to report a history of childhood sexual abuse than are non-Latino MSM. Given the association between childhood sexual abuse and increased risk for HIV and other negative health outcomes, health providers must remain vigilant to the possibility of childhood sexual abuse histories among their Latino patients.     

Multivariate correlates of childhood psychological and physical maltreatment among university women

Little is known about the long-term effects of psychological or physical child abuse, despite recent advances in the related area of childhood sexual victimization. The present study used multivariate techniques to examine the relationship between four newly devised scales, measuring extent of psychological and physical maltreatment by mothers and fathers and a variety of current psychological symptoms in 251 university women. Results suggest two independent relationships: a global association between all four forms of maltreatment and almost all symptom variables and specific connections between paternal psychological and physical maltreatment, maternal physical maltreatment, and smaller subsets of symptoms. The data are interpreted as supporting an "ecological" perspective on abuse effects as well as demonstrating the value of multivariate methodologies in this area.     

Exposure to childhood sexual and physical abuse and adjustment in early adulthood

OBJECTIVE: This research examined linkages between exposure to childhood sexual abuse (CSA) and childhood physical punishment/abuse (CPA) and mental health issues in early adulthood. METHOD: The investigation analyzed data from a birth cohort of over 1,000 New Zealand young adults studied to the age of 25. RESULTS: Exposure to CSA and CPA was associated with increased risks of later mental disorders including depression, anxiety disorder, conduct/anti-social personality disorder, substance dependence, suicidal ideation, and suicide attempts at ages 16-25. Control for social, family, and individual factors reduced the associations between CPA and mental health outcomes to the point of statistical non-significance. However, there was a consistent finding for CSA to remain associated with increased risks of later mental health problems. After adjustment, those exposed to CSA including attempted or completed sexual penetration had rates of disorder that were 2.4 times higher than those not exposed to CSA. Those exposed to harsh or abusive physical punishment had rates of disorder that were 1.5 times higher than those exposed to no or occasional physical punishment. It was estimated that exposure to CSA accounted for approximately 13% of the mental health problems experienced by the cohort. Findings showed that exposure to CPA had only weak effects on later mental health. It was estimated that exposure to CPA accounted for approximately 5% of the mental health problems experienced by the cohort. CONCLUSIONS: Exposure to CSA was associated with consistent increases in risks of later mental health problems. Exposure to CPA had weaker and less consistent effects on later mental health. These findings suggest that much of the association between CPA and later mental health reflects the general family context in which CPA occurs, whereas this is less the case for CSA.     

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.