Terri L. Messman-Moore

The role of childhood sexual abuse sequelae in the sexual revictimization of women: an empirical review and theoretical reformulation

There is now widespread empirical evidence that child sexual abuse (CSA) survivors are at greater risk for sexual revictimization in adulthood, but less is known of the mechanisms underlying this relationship. Despite the lack of a conceptual framework to guide research, there has been a recent influx of studies examining explanatory variables, with most focusing on the psychological sequelae of CSA: alcohol and drug use, sexual behavior, dissociation, posttraumatic symptomatology, poor risk recognition, and interpersonal difficulties. With the exception of sexual behavior, the studies reviewed here provide limited or mixed support for the role of intrapersonal factors in revictimization. Future research may benefit from a focus on the function of psychological distress that is expressed as psychological vulnerability, as opposed to individual forms of psychopathology or maladaptive behavior. An ecological framework may be useful as a guide to future investigations, as this model focuses on factors outside of the victim, including childhood factors such as family environment, contextual factors including the behavior of the perpetrator, and societal and cultural factors that impact revictimization. Future investigations should focus on the interaction between victim vulnerability and perpetrator behavior. Implications for prevention programming, clinical intervention, and future research are discussed.

Emotion dysregulation and risky sexual behavior in revictimization

OBJECTIVE The current study examined emotion dysregulation as a mechanism underlying risky sexual behavior and sexual revictimization among adult victims of child sexual abuse (CSA) and child physical abuse (CPA). METHODS Participants were 752 college women. Victimization history, emotion dysregulation, and risky sexual behavior were assessed with anonymous, self-report surveys utilizing a cross-sectional design. RESULTS Approximately 6.3% of participants reported CSA, 25.5% reported CPA, and 17.8% reported rape during adolescence or adulthood. CSA and CPA were associated with increased risk for adolescent/adult rape; 29.8% of CSA victims and 24.3% of CPA victims were revictimized. Path analytic models tested hypothesized relationships among child abuse, emotion dysregulation, adolescent/adult rape and three forms of risky sexual behavior (e.g., failure to use condoms, contraception, or having sex with someone under the influence of alcohol/drugs), including frequency of risky sexual behavior with a regular dating partner, with a stranger, and lifetime number of intercourse partners. Emotion dysregulation mediated revictimization for both CSA and CPA. Emotion dysregulation also predicted lifetime number of sexual partners and frequency of risky sex with a stranger, but not frequency of risky sex with a regular dating partner. CONCLUSIONS Findings suggest that emotion dysregulation is a distal predictor, and risky sex, particularly with lesser known partners, is a proximal predictor of sexual revictimization. Because emotion dysregulation also maintained a significant direct path to revictimization, risky sexual behavior appears to be one of several proximal risk factors for revictimization. PRACTICE IMPLICATIONS Findings confirm that emotion dysregulation is a critical pathway to more proximal risk factors such as risky sexual behavior, and suggest that clinical interventions aimed at improving emotion dysregulation may help reduce risky sexual behavior and risk for revictimization.

Unique and combined contributions of multiple child abuse types and abuse severity to adult trauma symptomatology

Studies have documented the co-occurrence and cumulative impact of multiple types of child maltreatment on later psychosocial difficulties. Other research suggests that child abuse characteristics indicative of severity may also increase risk of later adjustment problems. However, little effort has been made to examine the co-occurrence of both multiple types of maltreatment and abuse severity within a single study. The present investigation examines self-reported child maltreatment and adult functioning in a geographically diverse sample of 1,396 undergraduate students. Results indicate that experiencing multiple types of maltreatment is positively associated with more severe abuse. Although increased maltreatment types and more severe abuse are each associated with greater trauma symptomatology, abuse severity is the stronger of the two predictors. Finally, number of maltreatment types and severity of maltreatment interact to predict greater levels of trauma symptomatology. These results highlight the importance of considering both co-occurring abuse types and severity in research and clinical work with adult victims.

Sexuality, Substance Use, and Susceptibility to Victimization: Risk for Rape and Sexual Coercion in a Prospective Study of College Women

An 8-month prospective study examined behavioral, personality, and psychological variables thought to increase vulnerability for college womens experience of rape and verbal sexual coercion. Participants were 276 college women who completed self-report surveys. During 1 academic year, 9.5% of women were raped and 11.7% reported verbal sexual coercion. Elevated levels of sexual concerns, dysfunctional sexual behavior, and impaired self-reference were associated with both verbal sexual coercion and rape. Alcohol and marijuana use increased risk only for rape, whereas self-criticism and depression increased risk only for verbal coercion. Findings suggest that multiple aspects of sexuality, such as shame regarding sexuality and using sex to meet nonsexual needs, may increase risk for both types of sexual victimization. Results support conclusions that rape and verbal sexual coercion have both shared and unique risk factors. Implications for future research and intervention programs are discussed.

Substance Use and PTSD Symptoms Impact the Likelihood of Rape and Revictimization in College Women

The present study utilized a mixed retrospective and prospective design with an 8-month follow-up period to test a model of revictimization that included multiple childhood (i.e., child sexual, physical, and emotional abuse) and situational variables (i.e., substance use, sexual behavior) for predicting rape among 276 college women. It was of particular interest to determine whether traumatic responses (e.g., posttraumatic symptomatology or risky behavior) increased vulnerability for revictimization. During the 8-month follow-up period, 9% of participants were raped; 88% of assaults involved substance use by the victim. Posttraumatic stress disorder (PTSD) symptomatology predicted rape, substance use, and sexual behavior. Substance use, but not sexual behavior, mediated the relation between PTSD symptomatology and rape during the follow-up period. Sexual behavior indirectly impacted risk for rape via substance use. Results suggest that college women with PTSD symptomatology may be at greater risk for rape if they use substances to reduce distress.

Personal and Perceived Peer Attitudes Supporting Sexual Aggression as Predictors of Male College Students’ Willingness to Intervene Against Sexual Aggression

Male college students ( N = 395) completed anonymous surveys to report personal attitudes supporting sexual aggression and estimated the attitudes of their peers. Participants also indicated their willingness to intervene against a peer if they witnessed sexual aggression. Although both personal and peer attitudes were correlated with willingness to intervene, in regression analyses only perceived peer attitudes emerged as a significant predictor of willingness to intervene. Results suggest that personal attitudes supporting sexual aggression are not as relevant to men’s willingness to intervene against sexual aggression as are perceived peer norms regarding sexual aggression. Findings are relevant to sexual assault prevention education with men, suggesting that attempts to encourage bystander intervention may be best presented in the context of challenging perceived norms.

Psychological Consequences of Sexual Victimization Resulting From Force, Incapacitation, or Verbal Coercion

Recently, incapacitated rape has emerged as a distinct type of sexual victimization. However, little is known about its longer-term psychological consequences. Two studies compare the psychological consequences of incapacitated rape to those of forcible rape and verbal coercion. Generally, the traumatic impact of incapacitated rape was intermediate to that of verbal coercion and forcible rape; however, there were domains (e.g., current perceived trauma and emotional impact) in which incapacitated and forcible rape had a similar impact and other domains (e.g., attributions of responsibility) in which incapacitated rape was similar to verbal coercion. This research suggests that sexual assault researchers might benefit from separately examining forcible and incapacitated rape.

The Impact of Childhood Psychological Abuse on Adult Interpersonal Conflict : The Role of Early Maladaptive Schemas and Patterns of Interpersonal Behavior

Abstract The impact of childhood psychological abuse on adult interpersonal conflict was examined among 382 college women. Psychological abuse predicted adult interpersonal conflict above and beyond the effects of parenting behavior (i.e., parental warmth and control). The relationship between psychological abuse and conflict was mediated or partially mediated by three early maladaptive schemas: mistrust/abuse, abandonment, and defectiveness/shame. Paternal warmth had a significant, direct relationship with interpersonal conflict. The association between mistrust/ abuse schemas and interpersonal conflict was partially mediated by three patterns of interpersonal behavior: overly accommodating behavior, social isolation, and domineering/controlling behavior. Of the three patterns, domineering/controlling behavior explained the most variance in adult conflict. Findings provide support for the long-lasting impact of childhood psychological abuse and suggest that effects of psychological abuse persist via early maladaptive schemas.

Alcohol and substance use disorders as predictors of child to adult sexual revictimization in a sample of community women.

Alcohol- and substance-related diagnoses were examined as factors in child to adult sexual revictimization. Three hundred community women completed interviews and self-report instruments to obtain information regarding victimization and to diagnose substance use disorders (alcohol and substance abuse/dependence). Childhood sexual abuse (CSA) survivors were more likely than nonvictims to meet criteria for both substance use disorders and to report rape (e.g., unwanted intercourse due to threat or use of force, or due to the inability to consent due to the respondent’s alcohol or drug use) and coerced intercourse (e.g., unwanted intercourse due to verbal coercion or misuse of authority by the perpetrator) by acquaintances, strangers, and husbands. In general, both CSA and substance use disorders were predictive of adult sexual victimization, but there were no significant interactions between these factors. Overall, substance use disorders were related to rape for all women; this relationship was not unique to CSA survivors. Alcohol- and substance-related diagnoses predicted rape by all three types of perpetrators, but CSA was predictive of rape only by acquaintances and strangers and not husbands. In contrast, CSA predicted coerced intercourse by all three perpetrators, while alcohol- and substance-related diagnoses predicted coerced intercourse by acquaintances and strangers, but not husbands. Results highlight the need to continue the study of revictimization of CSA survivors, including examination of both rape and sexually coercive experiences by different types of perpetrators. Findings support continued research of substance use disorders as risk factors for sexual victimization among all women.

Retrospective Assessment of Childhood Sexual and Physical Abuse: A Comparison of Scaled and Behaviorally Specific Approaches.

This study compared retrospective reports of childhood sexual and physical abuse as assessed by two measures: the Childhood Trauma Questionnaire (CTQ), which uses a Likert-type scaling approach, and the Computer Assisted Maltreatment Inventory (CAMI), which employs a behaviorally specific means of assessment. Participants included 1,195 undergraduate students recruited from three geographically diverse universities. Agreement was high across the two measures in the classification of victim status (92% and 80% for sexual and physical abuse, respectively). However, the CTQ classified more participants as sexually abused than did the CAMI, whereas the opposite trend was found for physical abuse. For child physical abuse, many participants reporting abusive acts on the CAMI scored below the cut-point for physical abuse on the CTQ. Classification differences for both types of abuse were largely unrelated to demographic factors, socially desirable responding, or self-reported withholding of information. The implications of these results are discussed in light of future research using retrospective methods of assessing childhood abuse.