Sexual abuse and the life course: An analysis of factors linking child sexual abuse to adult sexual revictimization and perpetration
Abstract
This project examined the associations between childhood sexual abuse (CSA) and both adult sexual victimization (ASV) and perpetration (ASP), with a particular focus on the moderating and mediating factors that explained these relationships. Additionally, the reliability of retrospective CSA measures was assessed, with a particular focus on the impact of gender and problem avoidance on the stability of CSA reporting. For the first paper, I conducted a systematic review of peer-reviewed primary research on United States (US) populations. Thirty studies examining the CSA-ASV relationship and 9 exploring the CSA-ASP relationship were assessed. Overwhelmingly, the included studies confirmed the association between CSA and ASV. Previous sexual victimization, mental and emotional distress, substance abuse, and risky sexual behavior emerged as possible explanatory factors. The findings for the CSA-ASP relationship were mixed. Due in part to the paucity of studies examining explanatory factors in this relationship, there was no evidence of mediating or moderating factors. The purpose of the second paper was to 1) test the reliability of retrospective CSA measurement in a nationally representative sample of adults, 2) assess sex differences in reliability patterns, and 3) examine the extent to which reporting reliability is associated with problem avoidance. Reporting reliability was examined among 12,438 adults in the National Longitudinal Study of Adolescent to Adult Health (Add Health), over two data collection periods. Nearly 3 in 4 of the CSA cases in the former wave were not again reported, and two-thirds of the CSA cases in the latter wave were not previously reported. Regarding problem avoidance, participants who reported CSA in the former wave, but not in the latter, were more avoidant than those who were consistent in reporting. This pattern held for both females and males. Our findings suggest that of those who may have experienced CSA, females report the experience more consistently than males. Furthermore, inconsistent reporting may be a symptom of general problem avoidance. Focusing on the context of romantic partnerships, the final paper assessed the mediating influence of depression, self-esteem, problem avoidance, and gender roles in the CSA-ASV/ASP relationships. A similar set of associations was examined for child physical abuse (CPA) and ASV/ASP. Analyses were based on 3,278 Add Health participants, and focused on the last two waves of data collection (2001-2002 and 2007-2008). For females, there was evidence of mediation for depression in the CSA-ASV association, and for both depression and self-esteem in the CPA-ASV relationship. Depression also mediated the relationships between both forms of child abuse and ASP. For males, there were no direct or indirect associations between CSA and ASV/ASP. Child physical abuse showed associations with ASV, both directly and through self-esteem and problem avoidance. We also found evidence of the mediational effect of problem avoidance in the relationship between CPA and recent ASP. Gender roles did not play a mediational role in any of the models.
Subject Area
Public health
Recommended Citation
Okeke, Nnenna L, "Sexual abuse and the life course: An analysis of factors linking child sexual abuse to adult sexual revictimization and perpetration" (2014). Texas Medical Center Dissertations (via ProQuest). AAI3689785.
https://digitalcommons.library.tmc.edu/dissertations/AAI3689785