Child Sexual Abuse, Post-Traumatic Stress Disorder, and Substance Use: Predictors of Revictimization in Adult Sexual Assault Survivors

Abstract

This study examined the unique effects of child sexual abuse simultaneously with post-traumatic stress disorder symptom clusters, problem drinking, and illicit drug use in relation to sexual revictimization in a community sample of female adult sexual assault victims. Participants (N = 555) completed two surveys a year apart. Child sexual abuse predicted more post-traumatic stress disorder symptoms in adult sexual assault victims. Post-traumatic stress disorder numbing symptoms directly predicted revictimization, whereas other post-traumatic stress disorder symptoms (reexperiencing, avoidance, and arousal) were related to problem drinking, which in turn predicted revictimization. Thus, numbing symptoms and problem drinking may be independent risk factors for sexual revictimization in adult sexual assault victims, particularly for women with a history of childhood sexual abuse.

KEYWORDS:

• child sexual abuse
• PTSD
• substance use
• sexual revictimization
• rape

This research was supported by National Institute on Alcohol Abuse and Alcoholism grant #13455 to Sarah Ullman. The research in this article was completed as part of a doctoral dissertation by Henrietta Filipas. We thank Stephanie Townsend, Laura Starzynski, and Kelly Kinnison for assistance with data collection.

Notes

1. Unfortunately, a measure of alcohol use/consumption was not usable because it was not completed by one-third of the sample. Therefore, we analyzed problem drinking instead of alcohol use in this study.

2. Alternate computations of the illicit drug use measure were also evaluated in this study including (a) an ordinal measure of illicit drug use coded: 0 = none, 1 = marijuana only, 2 = 1 illicit hard drug (heroin, cocaine, or psychedelics), 3 = 2 or more hard drugs; and (b) a dichotomous measure of illicit hard drug use (no/yes). Results were similar from analyses using these alternate computations, so only results from analyses using the summed measure are reported, which is most appropriate for the study purposes. Unfortunately, no measure of problematic drug use was collected in this study.

3. We replicated this analysis with income predicting revictimization at Time 2. Income was significantly and negatively related to revictimization such that lower income was associated with increased risk of revictimization (β = –.08, p = .05). However, this model demonstrated poorer fit (χ²[12, 556] = 45.67, p < .001; IFI = .95; NFI = .93, and RMSEA = .07) and therefore the more parsimonious model has been presented.

4. Results of the full model will be provided on request.

5. Mediational regression analyses and a Sobel test were used to confirm that numbing symptoms mediated the effect of CSA history on Time 2 revictimization (Sobel t = 2.61, p = .009; Preacher & Leonardelli, 2006).