Characteristics of child sexual abuse as correlates of women's adjustment: A prospective study

Recent theoretical frameworks that explain the effects of childhood sexual abuse have encouraged the study of the associations between certain characteristics of abusive experiences and mental health outcomes. The assessment of abuse characteristics, however, has created a new set of methodological problems for measurement and analysis. This article presents findings on the associations between characteristics of abuse and mental health outcomes from a prospective study of 136 women. The strongest associations were among the experience of physical force and a close victim-offender relationship during abuse and increased levels of current mental health symptoms. Analyses were repeated for both prospective and retrospective accounts of the abuse incident, and the pros and cons of these different sources of information are discussed. Key Words: African American women, child sexual abuse. There is significant evidence of the widespread problem of the sexual abuse of children and its negative long-term consequences. Numerous studies have documented both immediate and long-term effects, including elevated levels of depression, sexual dysfunction, and revictimization among survivors of childhood sexual assault (Beitchman et al., 1992; Briere & Runtz, 1988; Browne & Finkelhor, 1986; Finkelhor, 1990; Kendall-Tackett, Williams, & Finkelhor, 1993; Moeller, Bachmann, & Moeller, 1993; Runtz & Briere, 1986). Researchers have proposed a number of frameworks to account for the links between sexual abuse and its negative consequences (Briere, 1992a; Finkelhor, 1987; Finkelhor & Browne, 1985; Herman, 1992). These include theories that suggest that the trauma of the abuse results in posttraumatic stress (Briere, 1992a; Herman, 1992; Rowan, Foy, Rodriguez, & Ryan, 1994; Wolfe, Sas, & Werkele, 1994) and others that focus on the more diverse emotional consequences of betrayal, stigmatization, traumatic sexualization, and powerlessness (Finkelhor, 1988; Finkelhor & Browne, 1985). Such theories attempt to explain the powerful and negative effects of abuse on survivors, as well as to account for findings that within groups of survivors there may be a wide range of outcomes (Briere, 1992a; Herman, 1992; Janoff-Bulman, 1992; KendallTackett et al., 1993). The development of these frameworks has led to increased attention to how various characteristics of the incident of sexual abuse may relate to long-term consequences (Beitchman, Zucker, Hood, daCosta, & Akman, 1991; Beitchman et al., 1992; Mennen & Meadow, 1995). As Finkelhor (1987) has pointed out, sexual abuse is complex and multidimensional. To appreciate its diverse effects, we may need to go beyond comparisons of abused and nonabused groups. Interest in how various dimensions of sexual abuse might differ within a group of survivors has raised a number of methodological questions. For instance, how should abuse characteristics be defined and assessed, and what are the research consequences of using prospective or retrospective data? The present study's purpose is to further examine links between characteristics of the abuse, such as the use of force, and longterm consequences for survivors and to explore how differences in data collection can impact the investigation of this topic. Two THEORIES OF THE EFFECTS OF SEXUAL ABUSE Researchers in the area of child sexual abuse have noted that the constellation of symptoms observed among abuse survivors matches the diagnostic criteria for Posttraumatic Stress Disorder (PTSD; Briere, 1992a; Herman, 1992). Herman asserts that psychological trauma occurs when human coping mechanisms are overwhelmed by a force in the face of which the individual is powerless. The overwhelming and threatening nature of trauma leads to a number of negative consequences, including hyperarousal, intrusion of memories of the event through flashbacks and constriction, as well as disconnection from human relationships (Herman, 1992). …