This approach assumes data are missing at random, that is, missing at random conditional upon values observed. First, we provide descriptive information on the abuse characteristics of the sample and the study variables used in the proposed path models.

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Next, the results from SEM examining the path models of stigmatization and internalizing symptoms on sexual difficulties and dating aggression are reported. Direct and indirect effects on intimacy problems in the proposed conceptual model see Figure 1 were estimated with SEM Kline, Two separate models were fit for the stigmatization and internalizing symptom pathways.

Each type of intimacy problem was included in the same model, with all correlations among endogenous variable residuals freely estimated. The models were just-identified and recursive and included only observed variables. Since the models were not overidentified, the freely estimated model parameters regression coefficients, covariances, and variances were able to reproduce the observed covariance matrix exactly, and therefore no chi-square tests or fit indexes are reported.

Indirect effects were calculated and tested with the resampling method suggested by MacKinnon, Lockwood, and Williams The data were resampled a total of 1, times. Table 1 shows the descriptive statistics and correlations for the variables in the study. The continuous measures of stigmatization, internalizing symptoms, and intimacy outcomes showed good variability. As expected, similar types of variables were positively related.

The abuse indicators of number of events, duration, having a parent figure perpetrator, and living with the perpetrator at the time of the abuse were positively related to each other, whereas penetration and force were not related to other abuse characteristics. Stigmatization and internalizing symptoms were positively related to each other within and over time.

Childhood sexual abuse and dating experiences of undergraduate women.

However, we chose to consider each of these indicators of dating aggression separately to be consistent with previous literature and to examine whether there were different pathways to each indicator. No abuse characteristics were related to the T 1 and T 2 indicators of stigmatization or internalizing symptoms or to subsequent intimacy problems.

T 1 and T 2 stigmatization were not related to more of each type of intimacy problem, but T 3 stigmatization was. More T 1 and T 2 internalizing symptoms were related to more sexual difficulties and perpetration of dating aggression. More T 3 internalizing symptoms were related to more intimacy problems.

All correlations, means, and standard deviations were estimated by maximum likelihood to take missing data into account. To examine the direct pathways from abuse severity to stigmatization to intimacy problems, we estimated the following pathways: Figure 2 shows the sequence that unfolds from abuse discovery to stigmatization and then to intimacy problems, with the significant direct effects and the variance accounted for in each endogenous variable.

In the first step, penetration is the only abuse severity indicator that has a significant unique effect on T 1 stigmatization, such that being penetrated during the abuse is related to higher stigmatization. Next, T 1 stigmatization had a significant effect on T 2 stigmatization, with higher levels at abuse discovery related to higher levels a year later. In the final step of the sequence, the direct effect of T 2 stigmatization on sexual difficulties was significant, such that higher levels of stigmatization a year after abuse discovery predicted subsequent sexual concerns and dysfunction.

We were interested in whether, in addition to these direct effects, earlier abuse and stigmatization had indirect effects on subsequent sexual difficulties. As shown in Figure 2 and Table 2 , there were no significant direct effects of T 1 and T 2 stigmatization on being the perpetrator or victim of dating aggression. Indirect effects from earlier stigmatization to dating aggression outcomes also were not significant. Structural equation model results for predictive pathways to intimacy problems through stigmatization. The figure shows significant pathways with standardized path coefficients.

To examine the concurrent effects of T 3 stigmatization on intimacy problems, we expanded the SEM model in the following ways: As would be expected, the significant direct effect of T 2 stigmatization on sexual difficulties disappears when T 3 stigmatization is added to the model.

In other words, even when concurrent relations between stigmatization and sexual difficulties are considered, it is clear that there is a predictive pathway from earlier abuse-specific mechanisms to later functioning. There were no significant direct or indirect effects for T 3 stigmatization on dating aggression outcomes. SEM analyses parallel to those done for stigmatization were conducted to examine internalizing symptom pathways to intimacy problems.

There were no significant direct effects from T 1 and T 2 internalizing symptoms to any of the intimacy problem outcomes and no significant indirect pathways. However, the expanded SEM model that included concurrent internalizing symptoms showed that the direct effect of T 3 symptoms was significant for each of the intimacy problem outcomes after controlling for past internalizing symptoms, age, gender, and abuse characteristics.

More T 3 internalizing symptoms were associated with the following: None of the indirect effects of earlier internalizing symptoms through T 3 symptoms on intimacy problem outcomes were significant. Thus, internalizing symptoms showed correlational relations with intimacy problems, but no predictive pathways from earlier symptoms to later intimacy outcomes were observed. Using three assessments over 6 years from childhood to early adulthood, we focused this longitudinal study on mechanisms that explain how youth with CSA histories become at risk for sexual difficulties and dating aggression.

Unlike much of the previous literature, the SEM analyses used to examine our conceptual model distinguished between mechanisms that showed predictive direct and indirect effects from earlier to later time points and correlational concurrent associations within time relations with intimacy problems. Abuse-specific stigmatization, more than abuse severity, explained which youth were at risk for sexual difficulties. Our findings extend previous work by demonstrating long-term effects of self-related processes specific to sexual abuse on later sexual anxieties and risk behavior.

In contrast to sexual problems, dating aggression was not predicted by earlier stigmatization.

When Your Partner Was Sexually Abused as a Child: A Guide for Partners

While more power may have detected significant associations, our findings suggest the operation of domain-specific effects in which early disruptions of the self related to sexuality put individuals at risk for the development of problems within this domain. Even after controlling for the effect of T 3 stigmatization on sexual difficulties, there was a persistent indirect effect of earlier stigmatization on subsequent problems.

Although the amount of variance accounted for by predictive variables was moderate J. Abuse-specific stigmatization and distorted feelings and beliefs about the self during nonconsensual sex may carry over to negative self-views about sexual feelings and behaviors during consensual sex.

It requires the synthesis of many aspects of the self and interpersonal relationships, such as changing views about the body and the experience of erotic feelings; learning about intimacy through interaction with peers; and sorting through conflicting messages from family, peers, and the media about the risks and benefits of sexual engagement Tolman, Self-blame and shame reflect ways in which the experience of CSA can disrupt the development of a positive sexual self-schema Meston et al.

For individuals with such abuse-specific distortions of the self-schema, the development of coherent sexuality becomes substantially more difficult. Although most of the existing literature is cross-sectional, one longitudinal study on a community sample of maltreated adolescents found a 1-year cross-time effect for internalizing symptoms on predicting perpetration of dating aggression D.

It is possible that the 5-year interval between the T 2 and T 3 assessments in this study was not optimal for detecting such predictive effects. Internalizing symptoms may show more fluctuation over this time interval compared with aspects of the self directly related to CSA, such as stigmatization. Failure to find predictive results for internalizing symptoms does not imply they are unimportant for understanding intimacy problems in CSA youth. We can only suggest that they are less likely to be salient for early intervention to address sexual difficulties and dating aggression several years following abuse discovery.

Strong concurrent associations between internalizing symptoms and intimacy problems suggest that such symptoms are related to worrying about and being dissatisfied with sexual intimacy and negative responses during conflicts including dating aggression. This should be particularly true in relationships that are similar to past abusive experiences in their intensity of emotion and sexual involvement.

Nevertheless, it must be acknowledged that, in the absence of predictive relations, internalizing symptoms may be caused by or at least exacerbated by intimacy problems. Although the findings from this study address long-term prediction of intimacy problems, limits to the results are acknowledged. Given the nonexperimental nature of the data, the findings are not conclusive concerning causal direction and rely exclusively on self-report methodology.

As suggested previously, the opportunity to observe patterns of prediction from stigmatization and internalizing symptoms to intimacy problems was restricted by the considerable time gap between the second and third assessments. Determination of whether the predictors of interest would contribute to change in intimacy problems over time was precluded by not having earlier indicators of such problems.

The measures of intimacy did not include more positive indicators of relationship skills and satisfaction. A more complete assessment of intimacy problems should include both positive and negative aspects of close relationships as well as reports from intimate partners. The external validity of the study is limited to individuals for whom the abuse was reported to the appropriate authorities. Nevertheless, this study is among the few to examine and find long-term effects of abuse-specific processes on intimacy problems by using data from multiple time points on confirmed cases of abuse.

The current findings highlight the clinical significance of longitudinal research that identifies mechanisms by which sexually abused youth become vulnerable to later intimacy problems. Whereas linking abuse characteristics to risk helps identify vulnerable youth, identifying risk mechanisms highlights psychological processes that may be amenable to clinical intervention.


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Our results indicate that sexually abused youth who experience persistent abuse-specific shame and self-blame may later encounter difficulties in sexual functioning. Trauma-focused cognitive—behavioral therapy is more effective than other forms of child-centered therapy in reducing self-blame attributions, shame, and symptoms such as PTSD and depression J. A longitudinal approach to identifying risk mechanisms can also discriminate between mechanisms that predict and those that co-occur with intimacy problems and hence inform the timing and content of intervention strategies.

For example, both internalizing symptoms and stigmatization warrant early clinical attention, as their associated distress can persist for years following abuse discovery. However, our results suggest that interventions focused on the reduction of internalizing symptoms, at least early on, may be insufficient for treating or preventing sexual difficulties or dating aggression. In contrast, the persistent effects of abuse-specific stigmatization on later sexual functioning suggest that trauma-focused therapies may be important in the prevention of later intimacy problems. Useful strategies include those that promote adaptive skills for processing and coping with the abuse, address concerns about body function and integrity, and provide age-appropriate education about sexual thoughts and feelings J.

Sexual problems speak not only to poor sexual health but also to relationship difficulties, which themselves can be a significant source of distress. Reducing abuse-specific stigmatization may help youth develop healthier sexuality that not only mitigates the risk of infection and sexual dysfunction but also promotes more satisfying and intimate romantic relationships. We gratefully acknowledge the efforts of Lynn Taska, Patricia Lynch, and Patricia Myers in data collection and the youth and their families for participation. Further reproduction is prohibited without permission from PAR, Inc.

National Center for Biotechnology Information , U. J Consult Clin Psychol. Author manuscript; available in PMC Sep Candice Feiring , Valerie A. Simon , and Charles M. Author information Copyright and License information Disclaimer. Box , Ewing, NJ The publisher's final edited version of this article is available at J Consult Clin Psychol. See other articles in PMC that cite the published article.

Abstract Potential pathways from childhood sexual abuse CSA to subsequent romantic intimacy problems were examined in a prospective longitudinal study of ethnically diverse youth with confirmed CSA histories. Open in a separate window. Method Participants Participants were recruited from urban and suburban populations in southern, central, and northern New Jersey. Procedure All the procedures for this study were approved by the institutional review boards of the academic institutions where the research took place. Measures Abuse characteristics To obtain information on specific characteristics of the abuse incidents that qualified the participant for inclusion in the study, trained staff members copied information from law enforcement agencies and CPS records to a checklist.

Stigmatization Abuse-related shame was obtained at each assessment by using four items: Internalizing symptoms Measures of PTSD and depressive symptoms were available at each assessment point. Romantic intimacy problems The measures of dating aggression and sexual difficulties were obtained at T 3 but not at prior assessment points.

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Results Data Analyses First, we provide descriptive information on the abuse characteristics of the sample and the study variables used in the proposed path models. Descriptive Information Table 1 shows the descriptive statistics and correlations for the variables in the study. Predicting Intimacy Problems From Stigmatization To examine the direct pathways from abuse severity to stigmatization to intimacy problems, we estimated the following pathways: Discussion Using three assessments over 6 years from childhood to early adulthood, we focused this longitudinal study on mechanisms that explain how youth with CSA histories become at risk for sexual difficulties and dating aggression.

From child victim to adult victim: A model for predicting sexual revictimization.

Psychological Assessment Resources; Psychometrics and association with childhood and adult victimization in clinical samples. Journal of Interpersonal Violence.

Missing the love boat: Why researchers have shied away from adolescent romance. The development of romantic relationships in adolescence.