Child Abuse and Revictimization: Implications for Treatment and Research

1. Child Abuse and Revictimization: Implications for Treatment and Research Lisa Van Bruggen, M.A. Marsha Runtz, Ph.D. Department of Psychology University of Victoria Victoria, British Columbia, Canada

2. Background • Recent research has found overlap between maltreatment types (Higgins & McCabe, 2003) • A need to evaluate multiple forms of abuse when doing research • A lack of articles examining Child Psychological Abuse (CPsychA) over the last 25 years (Behl, Conyngham & May, 2003)

3. Background • Sexual Assault • 15% of college or university women have experienced sexual assault since the age of 14 (Rozee & Koss, 2001) • Child Sexual Abuse (CSA) • Later sexual assault is 2 to 3 times more likely for women who have experienced CSA (Arata, 2002) • Child Physical Abuse (CPA) • Mixed findings as a risk factor for sexual assault • CPsychA • No published studies have explored the role of CPsycA as a risk factor for sexual assault

4. Purpose of the study • The present study examined the relationships between child maltreatment before age 14 and sexual assault after age 14 in university women • Retrospective study • Structural equation modeling was used to explore the role of sexual attitudes and behaviors as possible mediators between child abuse and later sexual assault • 13-page anonymous and confidential questionnaires were completed by participants

5. Method: Participants

6. Measures • Child Maltreatment Interview Schedule (Briere, 1992) • Child Sexual Abuse (CSA) • Sexual contact before age 14 that involved force, or was with someone five+ years older, or was self-identified as CSA • Child Physical Abuse (CPA) • A physical and purposeful act by a parental guardian (e.g., being hit) that resulted in an injury (e.g., bruises or scratches) • Child Psychological Abuse (CPsycA) • By a parental guardian; E.g., “yell at you,” criticize you” & “ridicule or humiliate you” • 7 statements ranging from 0 (never) to 6 (20+ times a year)

7. Measures • Sexual Experiences Survey(Koss & Oros, 1982) • Sexual assault after age 14 • Unwanted sexual contact • Sexual coercion • Attempted rape • Rape • Sexual Self-Esteem Inventory for Women(Zeanah & Schwartz, 1996) • Skill/Experience • Attractiveness • Control • Moral Judgement • Adaptiveness

8. Measures • Trauma Symptom Inventory(Briere, 1995) • 2 of the 10 scales used: • Sexual Concerns: e.g., “wishing that you didn’t have any sexual feelings” • Dysfunctional Sexual Behaviors: e.g., “having sex to keep from feeling lonely or sad” • Sociosexual Orientation Inventory(Simpson & Gangestad, 1991) • Number of sexual partners in the last year • Number of predicted sexual partners in the next five years • Number of partners participants had sex with on one and only one occasion

9. Results: Child Maltreatment • CSA: 13% (n = 54) • 39% (n = 21) interfamilial CSA • 20% (n = 11) force used • 56% (n = 30) defined their experience as CSA • CPA: 14% (n = 55) • 16 women (30% of CSA survivors) experienced both CSA and CPA • Significant relationship between CSA and CPA, 2(1) = 13.43, p < .01 • CPsycA: M = 14.28 (SD = 9.84) • CPsycA was related to both CSA and CPA • CSA: t (397) = -2.28, p = .02 • CPA: t (397) = -8.64, p <.001

10. Sexual Assault After Age 14 • 36% (n = 145) of participants endorsed 1 or more questions on the Sexual Experiences Survey • Most common offenders were known to the victim: • Boyfriends/dates (51%) • Friends/acquaintances (36%)

11. CSA and the Mediating Variables • CSA was related to lower sexual self-esteem, F (5, 385) = 3.13, p = .01 • Greater incongruence between sexual thoughts and behaviors and moral standards (Moral Judgement), F (1, 395) = 11.75, p < .001 • Difficulty managing sexual thoughts, feelings, and interactions (Control), F (1, 393) = 6.53, p = .01 • Greater incongruence between sexual thoughts and behaviors with personal goals (Adaptiveness), F (1, 393) = 4.13, p = .04 • CSA was related to greater sexual concerns • t (397) = -2.6, p = .01

12. CSA and Sexual Assault Women with CSA are almost twice as likely as nonCSA women to experience later sexual assault, Wald(1) = 9.81, p < .01, Odds Ratio = 2.53

13. Results: CPsycA • CPsycA related to lower sexual self-esteem, p <.001 • Attractiveness r = -.27 • Control r = -.25 • Skill/Experience r = -.23 • Moral Judgement r = -.21 • Adaptiveness r = -.21 • CPsycA was also correlated with: • Greater sexual concerns r = .16* • Dysfunctional sexual behaviors r = .19* • Sex on only one occasion r = .12* • CPsycA was related to experiencing later sexual assault, r = .18*

14. Results: CPA • CPA was not found to be related to any of the mediating variables • CPA was related to sexual assault, t(400) = -2.50, p = .001 • This relationship was no longer significant when CSA was controlled, F (1, 399) = 3.31, ns

15. Revictimization • The 3 child maltreatment variables were entered simultaneously in a multiple regression to predict sexual assault, F (3, 395) = 8.70, p <.001

16. Results: Path Diagram Child Sexual Abuse Control .24 -.25 .33 .49 Sexual Self Esteem Child Psych Abuse Adaptiveness .18 .42 -.48 .51 -.87 Sex with s/o only 1 time .20 Moral Judgement .26 .76 Sexual Behaviors .44 .60 Dysfunctional Sexual Behaviors .36 Sexual Assault After Age 14 .42 .64 2(15) = 64.66  = Standardized Regression Coefficients • = Squared Multiple Correlations

17. Conclusions • Among university women, a history of childhood sexual and psychological abuse were found to be related to later sexual assault • The path analysis suggests that poor sexual self-esteem and dysfunctional sexual behaviors may play a role in mediating the influence of CSA and CPsycA on later sexual assault • The results point to the need for additional research exploring the association between different types of child maltreatment and later sexual assault

18. Conclusions • There needs to be more research in how child psychological abuse relates to: • Other forms of abuse • Adolescent and adult adjustment • Involvement in romantic relationships with psychological abuse • Dating violence and sexual assault • However, there are definitional and measurement issues that need to be discussed and resolved • E.g., What is psychological abuse and how should we measure it?

19. Clinical Relevance • The results illustrate the need for increased prevention efforts • Educating young women of risk factors for sexual assault • Help women to be aware of how they feel about their sexuality, and how such feelings may influence their sexual behaviors

20. Clinical Relevance • Provide information on the psychological effects of victimization experiences, and how factors related to victimization may put women at a higher risk for revictimization • E.g., problem-solving and communication skill deficits around making sexual decisions (Marx et al., 2001) • Lack of assertiveness in interpersonal relationships (Classen et al., 2001)

21. Limitations of the Study • Issue of causality • E.g., experiencing sexual assault is also likely to affect sexual self-esteem and future sexual behaviors • Selection issues • Undergraduate university women may not be representative, thus limiting generalizability • Lack of cultural diversity • Predominantly Caucasian women • Only women in the study • Literature on revictimization focuses primarily on women’s experiences • Self-report retrospective questionnaire

22. Contact information Lisa Van Bruggen & Marsha Runtz Department of Psychology University of Victoria Victoria, BC, V8W 3P5 (250) 472-4177 (250) 721-8929 (fax) email: lkv@uvic.ca or runtz@uvic.ca