Abstract
Potential pathways from childhood sexual abuse (CSA) to negative self-schemas to subsequent dissociative symptoms and low global self-esteem were examined in a prospective longitudinal study of 160 ethnically diverse youth with confirmed CSA histories. Participants were interviewed at the time of abuse discovery, when they were 8 to 15 years of age, and again 1 and 6 years later. Abuse-specific indicators of stigmatization, in particular the combination of shame and self-blame more than general self-blame attributions for everyday events, explained which youth with CSA histories experienced more dissociative symptoms and clinically significant levels of dissociation. Abuse-specific stigmatization was found to operate as a prospective mechanism for subsequent dissociative symptoms but not self-esteem.
Acknowledgments
The preparation of this article was made possible by a grant from the National Institute of Mental Health—MH49885. We gratefully acknowledge the efforts of Lynn Taska, Patricia Lynch, and Patricia Myers in data collection and the youth and their families for participation.
Notes
Note: For each variable, means and standard deviations (in parentheses) are on the main diagonal. All correlations, means, and standard deviations were estimated by maximum likelihood to take missing data into account. Conservatively (based on the listwise deletion sample size of n = 106), correlations with an absolute value greater than .20 are significant at p < .05. Age = age at abuse discovery; Nevents = number of abuse events, value shows percentage with two or more events; Parfig = parent figure perpetrator; Livtog = living with perpetrator at time of abuse; Force = use of force during abuse, value shows percentage with threat or use of force; Longdur = duration of abuse a year or more; Stigma1-2-3 = stigmatization at T1, T2, and T3 respectively; Gsb1-2-3 = general self-blame at T1, T2, and T3, respectively, note that lower scores indicate more self-blame; DISSOC = T3 dissociative symptoms; SELFEST = T3 global self-esteem.
Note: 95% CIL and 95% CIU = lower and upper limits of the bootstrap confidence intervals, respectively; Age = age at abuse discovery; Nevents = number of abuse events, value shows percentage with two or more events; Parfig = parent figure perpetrator; Livtog = living with perpetrator at time of abuse; Force = use of force during abuse, value shows percentage with threat or use of force; Longdur = duration of abuse 1 year or more; Stigma1-2-3 = stigmatization at T1, T2, and T3, respectively; GSB1-2-3 = general self-blame at T1, T2, and T3, respectively; DISSOC = T3 dissociative symptoms; SELFEST = T3 global self-esteem.
1A version of the main structural equation model presented in Table 2 was fit to examine the unique relations of abuse-specific shame and self-blame on self-functioning. Each abuse-specific variable was entered separately, rather than as a summary score of stigmatization, along with general self-blame. In this model, none of the abuse-specific or general self-schema variables at T2 were significantly related to dissociative symptoms at T3. This suggests that later dissociative symptoms were related to what earlier shame and abuse-specific self-blame have in common rather than the unique components of each. Therefore, it is the combination of variables that define stigmatization that yields prospective relations with symptoms. Self-esteem at T3 was not predicted by any of the T2 negative self-schema variables when all three were entered separately.
2Although duration of abuse was not related to having dissociative symptoms in the clinical range, the number of abuse events was related to being in this group) B = –0.896, 95% CI = –1.732 to –0.139; β = –0.37, p < .05). This finding must be approached with caution because it was in an unexpected direction) more events less likely to be in the clinical group), it was not found in the analyses using a continuous outcome, and it involves a difficult to interpret suppression effect (i.e., the bivariate relation between number of events and dissociative symptoms was not significant).