Hostname: page-component-f554764f5-fnl2l Total loading time: 0 Render date: 2025-04-10T12:11:18.189Z Has data issue: false hasContentIssue false
  • English
  • Français

Factors that mediate between child sexual abuse and adult psychological outcome

Published online by Cambridge University Press:  09 July 2009

S. E. Romans ,
J. L. Martin ,
J. C. Anderson ,
M. L. O'Shea  and
P. E. Mullen
S. E. Romans*
Affiliation:
Department of Psychological Medicine, Otago Medical School, Dunedin, New Zealand
J. L. Martin
Affiliation:
Department of Psychological Medicine, Otago Medical School, Dunedin, New Zealand
J. C. Anderson
Affiliation:
Department of Psychological Medicine, Otago Medical School, Dunedin, New Zealand
M. L. O'Shea
Affiliation:
Department of Psychological Medicine, Otago Medical School, Dunedin, New Zealand
P. E. Mullen
Affiliation:
Department of Psychological Medicine, Otago Medical School, Dunedin, New Zealand
*
1Address for correspondence: Professor S. E. Romans, Department of Psychological Medicine, PO Box 913, Dunedin, New Zealand.
Get access Rights & Permissions [Opens in a new window]

Synopsis

The psychological outcome for a random community sample of women who had experienced significant childhood sexual abuse was assessed, using two outcome measures: (i) psychiatric morbidity (measured with the short PSE); (ii) self-esteem. Sexual abused women with a good outcome, i.e. who were not a PSE ‘case’ or who had high self-esteem were compared with abused women with a poor outcome. This paper describes the post-abuse factors that modified the two outcomes.

In general, a range of variables, all correlated with each other in a complex manner, distinguished good outcome subjects from poor outcome subjects. Post-abuse adolescent variables included family factors (poor mother–father and parent–child relationships), high school factors (poor academic, sporting and social performance) and early pregnancy. Women who had a good adolescent relationship with their father did better than expected statistically. Sport emerged as an alternative at secondary school to academic achievement in catalysing a good psychological outcome.

Adult factors included the quality of relationship with partner, which was associated with a good outcome on both measures. Current paid employment was linked to high self-esteem but not to lowered psychiatric morbidity, while the converse applied for high socio-economic status. These findings imply that different processes operate for each outcome measure.

A clear recognition by the school of childhood sexual abuse may help to provide the opportunity for the girl to experience success in some arena; this in turn may protect her against the likely adult consequences of low self-esteem and increased psychiatric morbidity.

Type
Research Article
Information
Psychological Medicine , Volume 25 , Issue 1 , January 1995 , pp. 127 - 142
Copyright
Copyright © Cambridge University Press 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Anderson, J., Martin, J., Mullen, P., Romans, S. & Herbison, P. (1993). The prevalence of childhood sexual abuse experiences in a community sample of women. Journal of the American Academy of Child and Adolescent Psychiatry 32, 911–919.CrossRefGoogle Scholar
Bagley, C. & Ramsay, R. (1986). Sexual abuse in childhood: psychological outcomes and implications for social work practice. Journal of Social Work and Human Sexuality 4, 33–47.CrossRefGoogle Scholar
Begel, D. (1992). An overview of sports psychiatry. American Journal of Psychiatry 149, 606–614.Google Scholar
Beitchman, J. H., Zucker, K. J., Hood, J. E., da Costa, G. A. & Akman, D. (1991). A review of the short-term effects of child sexual abuse. Child Abuse and Neglect 15, 537–556.CrossRefGoogle ScholarPubMed
Beitchman, J. H., Zucker, K. J., Hood, J. E., da Costa, G. A., Akman, D. & Cassavia, E. (1992). A review of the long term effects of child sexual abuse. Child Abuse and Neglect 16, 101–118.CrossRefGoogle Scholar
Bifulco, A., Brown, G. W. & Adler, Z. (1991). Early sexual abuse and clinical depression in adult life. British Journal of Psychiatry 159, 115–122.CrossRefGoogle ScholarPubMed
Briere, J. (1988). The long-term clinical correlates of childhood sexual victimization. In Human Sexual Aggression: Current Perspectives. Annals of the New York Academy of Sciences (ed. Prentky, R. A. and Quinsey, V. L.), pp. 327–334.Google Scholar
Brown, G. W. & Harris, T. (1978). Social Origins of Depression: a Study of Psychiatric Disorder in Women. Tavistock Publications: London.Google Scholar
Brown, G. W. & Harris, T. (1986). Stressor, vulnerability and depression; a question of replication. Psychological Medicine 17, 739–744.CrossRefGoogle Scholar
Brown, G. W., Andrews, B., Harris, T., Adler, Z. & Bridge, L. (1986). Social support, self-esteem and depression. Psychological Medicine 16, 813–831.CrossRefGoogle ScholarPubMed
Brown, G. W., Bifulco, A. & Harris, T. O. (1987). Life events, vulnerability and onset of depression. British Journal of Psychiatry 150, 30–42.CrossRefGoogle ScholarPubMed
Browne, A. & Finkelhor, D. (1986). Impact of child sexual abuse: a review of the research. Psychological Bulletin 99, 66–77.CrossRefGoogle Scholar
Burnam, M. A., Stein, J. A., Siegel, J. M., Sorenson, S. B., Forsythe, A. B. & Telles, C. A. (1988). Sexual assault and mental disorders in a community population. Journal of Consulting and Clinical Psychology 56, 843–850.CrossRefGoogle Scholar
Bushnell, J. A., Wells, J. E. & Oakely-Browne, M. (1992). Long-term effects of intrafamilial sexual abuse in childhood. Acta Psychiatrica Scandinavica 85, 136–142.CrossRefGoogle ScholarPubMed
Calam, R. & Slade, P. (1987). Eating problems and sexual experience: some relationships, British Review of Bulimia and Anorexia Nervosa 2, 37–43.Google Scholar
Cohen, P. & Brook, J. (1987). Family factors related to the persistence of psychopathology in childhood and adolescence. Psychiatry 50, 332–345.CrossRefGoogle Scholar
Conte, J. R. & Schuerman, J. R. (1987). Factors associated with an increased impact of child sexual abuse. Child Abuse and Neglect 11, 201–211.CrossRefGoogle ScholarPubMed
Conte, J. R. & Schuerman, J. R. (1988). The effects of sexual abuse on children. In Lasting Effects of Child Sexual Abuse (ed. Wyatt, G. E. and Powell, G. J.), pp. 157–170. Sage Publications: Newbury Park, California.Google Scholar
Garmezy, N., Masten, A. S. & Tellegen, A. (1984). The study of stress and competence in children: a building block for developmental psychopathology. Child Development 55, 97–111.CrossRefGoogle Scholar
Harris, T., Brown, G. W. & Bifulco, A. (1987). Loss of parent in childhood and adult psychiatric disorder: the role of social class position and premarital pregnancy. Psychological Medicine 17, 163–183.CrossRefGoogle ScholarPubMed
Ingham, J. G., Kreitman, N. B., Miller, P. Mc., Sashidharan, S. P. & Surtees, P. D. (1986). Self-esteem, vulnerability and psychiatric disorder in the community. British Journal of Psychiatry 148, 375–385.CrossRefGoogle Scholar
Long, J. V. F. & Vaillant, G. E. (1984). Natural history of male psychological health. XI. Escape from the underclass. American Journal of Psychiatry 141, 341–346.Google ScholarPubMed
McGuffin, P. E., Katz, R. & Aldrich, J. (1986). Past and present state examinations: the assessment of ‘lifetime ever’ psychopathology. Psychological Medicine 16, 461–465.CrossRefGoogle Scholar
Morrow, K. B. (1991). Attributions of female adolescent incest victims regarding their molestation. Child Abuse and Neglect 15, 477–483.CrossRefGoogle ScholarPubMed
Mullen, P. E., Romans-Clarkson, S. E., Walton, V. A. & Herbison, G. P. (1988). Impact of sexual and physical abuse on women's mental health. Lancet 16, 841–845.CrossRefGoogle Scholar
Mullen, P. E., Romans-Clarkson, S. E., Martin, J. L. & Anderson, J. C. (1989). The long term effects of sexual assault on women's mental health. New Zealand Medical Journal 102, 633–634.Google Scholar
Mullen, P. E., Martin, J. L., Anderson, J. C., Romans, S. E. & Herbison, G. P. (1993). Child sexual abuse and mental health in adult life. British Journal of Psychiatry 163, 721–731.CrossRefGoogle ScholarPubMed
Oppenheimer, R., Howells, K., Palmer, R. L. & Chaloner, D. A. (1985). Adverse sexual experience in childhood and clinical eating disorders: a preliminary description. Journal of Psychiatric Research 19, 357–361.CrossRefGoogle ScholarPubMed
Palmer, R. L., Oppenheimer, R. & Dignon, A. (1990). Childhood sexual experience with adults reported by women with eating disorders: an extended series. British Journal of Psychiatry 156, 699–703.CrossRefGoogle Scholar
Parker, G. (1979). Parental characteristics in relation to depressive disorders. British Journal of Psychiatry 134, 138–147.CrossRefGoogle ScholarPubMed
Parker, G. (1983). Parental Overprotection a Risk Factor in Psychosocial Development. Grune Stratton: New York.Google Scholar
Parker, G. & Hadzi-Pavlovic, D. (1984). Modification of levels of depression in mother-bereaved women by parental and marital relationships. Psychological Medicine 14, 125–135.CrossRefGoogle ScholarPubMed
Parker, G., Tupling, H. & Brown, L. B. (1979). A parental bonding instrument. British Journal of Medical Psychology 52, 1–10.CrossRefGoogle Scholar
Peters, S. D. (1988). Child sexual abuse and later psychological problems. In Lasting Effects of Child Sexual Abuse (ed. Wyatt, G. E. and Powell, G. J.) pp. 101–117. Sage Publications: Newbury Park, California.Google Scholar
Quinton, D., Rutter, M. & Liddle, C. (1984). Institutional rearing, parenting difficulties and marital support. Psychological Medicine 14, 107–124.CrossRefGoogle ScholarPubMed
Rae-Grant, N., Thomas, H., Offord, D. R. & Boyle, M. H. (1989). Risk, protective factors and the prevalence of behavioral and emotional disorders in children and adolescents. American Academy of Child and Adolescent Psychiatry 28, 262–268.CrossRefGoogle ScholarPubMed
Robson, P. J. (1988). Self-esteem—a psychiatric view. British Journal of Psychiatry 153, 6–15.CrossRefGoogle Scholar
Robson, P. J. (1989). Development of a new self-report questionnaire to measure self-esteem. Psychological Medicine 19, 513–518.CrossRefGoogle ScholarPubMed
Romans-Clarkson, S. E., Walton, V. A., Herbison, G. P. & Mullen, P. E. (1990). Psychiatric morbidity among women in urban and rural New Zealand: psychosocial correlates. British Journal of Psychiatry 156, 84–91.CrossRefGoogle Scholar
Romans-Clarkson, S. E., Walton, V. A., Herbison, G. P. & Mullen, P. E. (1992). Social networks and psychiatric morbidity. Australian and New Zealand Journal of Psychiatry 26, 485–492.CrossRefGoogle Scholar
Rutter, M. (1985). Resilience in the face of adversity: protective factors and resistance to psychiatric disorder. British Journal of Psychiatry 147, 598–611.CrossRefGoogle ScholarPubMed
Rutter, M. (1987). Psychosocial resilience and protective mechanisms. American Journal of Orthopsychiatry 57, 316–331.CrossRefGoogle ScholarPubMed
Rutter, M., Maughan, B., Mortimore, P., Ouston, J. & Smith, A. (1979). Fifteen Thousand Hours: Secondary Schools and Their Effects on Children. Open Books: London.Google Scholar
Simonsick, E. M. (1991). Personal health habits and mental health in a national probability study. American Journal of Preventive Medicine 7, 425–437.CrossRefGoogle Scholar
Stein, J. A., Golding, J. M., Siegel, J. M., Burnam, M. A. & Sorenson, S. B. (1988). Long-term psychological sequelae of child sexual abuse: the Los Angeles Epidemiological Catchment Area Study. In Lasting Effects of Child Sexual Abuse (ed. Wyatt, G. and Powell, G.), pp. 135–154. Sage: Beverley Hills, California.Google Scholar
Thorlindsson, T., Vilhjalmsson, R. & Valgeirsson, G. (1990). Sports participation and perceived health status: a study of adolescents. Social Science and Medicine 31, 551–556.CrossRefGoogle ScholarPubMed
Tong, L. & Oates, R. K. (1990). Long-term effects of child sexual abuse. In Understanding and Managing Child Sexual Abuse (ed. Oates, R. K.), pp. 354–369. Harcourt, Brace, Jovanovich Publishers: London.Google Scholar
Werner, E. E. & Smith, R. S. (1982). Vulnerable but Invincible: A Study of Resilient Children. McGraw Hill: New York.Google Scholar
Wilheim, K. & Parker, G. (1988). The development of a measure of intimate bonds. Psychological Medicine 18, 225–234.CrossRefGoogle Scholar
Winfield, I., George, L. K., Swartz, M. & Blazer, D. G. (1990). Sexual assault and psychiatric disorders among a community sample of women. American Journal of Psychiatry 147, 335–341.Google ScholarPubMed
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974). The Measurement and Classification of Psychiatric Symptoms. Cambridge University Press: London.Google Scholar
Wing, J. K., Nixon, J. M., Mann, S. A. & Leff, J. P. (1977). Reliability of the PSE used in a population study. Psychological Medicine 7, 505–516.CrossRefGoogle ScholarPubMed
Wyatt, G. E. & Newcombe, M. (1990). Internal and external mediators of women's sexual abuse in childhood. Journal of Consulting and Clinical Psychology 58, 758–767.CrossRefGoogle ScholarPubMed