Child Sexual Abuse and Adulthood-Interpersonal Outcomes: Examining Pathways for Intervention

We examined a dual pathway, longitudinal mediational model in which child sexual abuse (CSA) influences adulthood-interpersonal functioning and sexual risk through its impact on resiliency resources and psychological distress. Women were recruited from two obstetrics and gynecological clinics serving primarily low-income, inner-city women (N = 693) and interviewed at pretest (Time 1) and 6-month follow-up (Time 2). The proposed mediators were resiliency resources (i.e., self-esteem and self-efficacy) and psychological distress (i.e., depressive and posttraumatic stress symptoms). The interpersonal outcomes were general interpersonal problems (measured via recent loss of interpersonal resources, lack of perceived current social support, and recent social conflict) and HIV/sexual risk (measured via lack of confidence asserting safe-sex practices, intimate-partner risk, and perceived barriers to safe sex). A respecified, partial structural equation model implying full mediation supported our hypotheses. Model fit was assessed using the chi-square goodness-of-fit statistic, comparative-fit index (CFI), root mean square error of approximation (RMSEA), and standardized root mean square residual (SRMR; CFI = .96, RMSEA = .05, SRMR = .04). The impact of CSA on interpersonal problems was mediated through its effect on psychological distress, whereas the impact of CSA on HIV/sexual risk was mediated through its effect on resiliency resources. Implications for intervention are discussed.