Children Abused - Latter Abused AgainReese-Weber Smith 2011

Journal of Interpersonal
Violence
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Outcomes of Child Sexual Abuse as Predictors of Later Sexual

Victimization
Marla Reese-Weber and Dana M. Smith
J Interpers Violence 2011 26: 1884 originally published online 28 June 2010
DOI: 10.1177/0886260510372935
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Journal of Interpersonal Violence
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DOI: 10.1177/0886260510372935
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Sexual Victimization
Marla Reese-Weber1 and

Dana M. Smith1
Abstract
The association between a history of child sexual abuse (CSA) and specific
negative outcomes (attachment, feelings of power, and self-esteem) was
explored as was the relationship between those negative outcomes and
sexual victimization during the first semester of college. Two groups of
freshman college women (67 who had experienced CSA and 55 who
had not) completed measures of attachment, feelings of power, and self-
esteem at the beginning of their freshman year of college. At the end of
their first semester of college, participants (n = 93) provided information
about whether they had been sexually assaulted during their first semester
of college. The results indicated that participants in the CSA group did
not differ on reported attachment anxiety, attachment avoidance, feelings
of power, or self-esteem as compared to the control group. However,
participants in the CSA group were more like to be sexually victimized
during their first semester of college. Finally, logistic regression indicated
that the negative outcomes of CSA were significantly related to sexual
victimization during the first semester of college, with attachment anxiety
playing an important role. Theoretical and practical implications of the
findings are discussed.
1
Illinois State University, Normal
Corresponding Author:
Marla Reese-Weber, Department of Psychology, Illinois State University, Campus Box 4620,
Normal, IL 61790-4620
Email: mjreese@ilstu.edu

Reese-Weber and Smith 1885
Keywords
attachment, sexual abuse, sexual assault
Based on numerous studies conducted across several decades, approxi-

mately 25% of females experience child sexual abuse (CSA) prior to the age
of 18 (Briere & Elliott, 2003; Finkelhor, 1994; Pereda, Guilera, Forns, &
Gomez-Benito, 2009a, 2009b). Researchers investigating CSA have sought to
determine specific negative outcomes of abuse, such as attachment difficul-
ties, subjective feelings of powerlessness, and low self-esteem. Unfortunately,
research has also indicated that individuals who experience CSA are likely
to experience sexual revictimization (Messman & Long, 1996; Polusny,
Rosenthal, Aban, & Follette, 2004). Although the negative outcomes of CSA
have been speculated to contribute to revictimization (Messman & Long,
1996), the specific association between these negative outcomes (i.e., attach-
ment difficulties, feelings of power, and self-esteem) and revictimization
has not been examined. Thus, the current study assessed the association
between CSA and the aforementioned variables and determined which of
the negative outcomes were significantly related to sexual victimization of
women in their first semester of college.
Based on theoretical and empirical data, Finkelhor and Browne (1985)
proposed the traumagenic dynamics model of child sexual abuse, which
identified four traumagenic dynamics resulting from CSA. This model has
been used extensively over the past 20 years to provide a theoretical frame-
work for the negative outcomes of CSA. These negative outcomes include
trauma sexualization, betrayal, powerlessness, and stigmatization. Trau-
matic sexualization is the process by which a child’s concept of appropriate
sexuality becomes distorted and/or disrupted. As a result of abuse, a child
may learn inappropriate sexual behaviors varying widely from preoccupa-
tion with sexual activity to aversion of sexual activity (Stockdale, O’Connor,
Gutek, & Geer, 2002). Traumatic sexualization focuses more on behavioral
outcomes rather than internal cognitions or psychological aspects (Coffey,
Leitenberg, Henning, Turner, & Bennett, 1996). Because the focus of the
current study was on internal psychological processes, the current study did
not study the association between traumatic sexualization and revictimiza-
tion. Rather, the association between CSA and the other traumagenic dynam-
ics (i.e., betrayal, powerlessness, and stigmatization) was explored, as was
the relationship between those variables and sexual victimization during the
first semester of college.

1886 Journal of Interpersonal Violence 26(9)
Attachment
According to Finkelhor and Browne (1985), CSA victims experience betrayal.
Subsequent to encountering abuse by authority figures (parents or other
adults) or those they otherwise trusted, CSA victims may have difficulty
knowing whom to trust. This difficulty in identifying trustworthy qualities
could potentially leave CSA victims vulnerable to revictimization. Although
not couched in the same terms, attachment theory provides a similar lens
through which to view the effects of CSA and the potential risk factors associ-
ated with revictimization.
According to attachment theory (Bowlby,1969), an infant’s early caregiving
experiences are internalized and develop into internal working models of the
self and others, which include expectations of others’ behaviors and motives as
well as one’s worthiness of an attachment figure’s attention and love. When
one’s needs are met, one develops and internalizes a view that he/she is good,
worthy of affection, and that the world is a safe place. However, children who
have experienced sexual abuse may learn and internalize beliefs that they are
not good, not worthy of respect, and that the world is not safe (Roche, Runtz,
& Hunter, 1999). Such internalizations may lead to identity confusion and
boundary issues. CSA victims may become dependent on others for validation
and unable to separate their needs from others’ needs, potentially allowing
them to be easily manipulated and violated again (Briere & Elliot, 1994).
To determine the role of CSA and attachment in later psychological func-
tioning, Roche et al. (1999) studied 307 female undergraduate students. Con-
sistent with national estimates, 27.6% of the participants had experienced
CSA. Results indicated that CSA predicted attachment style (effect size =
.07). CSA victims had significantly lower positive perceptions of themselves
than the nonabused group; they reported high dependence on others or high
level of anxiety attachment. CSA victims also reported significantly lower
positive perceptions of others than the nonabused group; they reported high
avoidance of others. More recently, Aspelmeier, Elliott, and Smith (2007)
assessed 324 female undergraduate students on rates of CSA (prior to age 16)
and attachment styles. Somewhat higher than national estimates, the rate of
CSA was 37.7 %. Results suggested that participants in the CSA group had
significantly lower levels of secure attachment as compared to the nonabuse
group (effect size = .08). Taken together, results of these studies provide sup-
port for the theory that CSA influences developing attachment styles. In addi-
tion, possessing a pervasively negative view of self (“I’m an object”) and
others (“People hurt me”) may put CSA victims at risk for subsequent abuse.

Victims may potentially view themselves as deserving victimization and

expect others to behave in harmful, deleterious ways.
Feelings of Power
According to Finkelhor and Browne’s (1985) traumagenic dynamics model,
powerlessness is another effect of CSA. Victims may learn that they have
little to no power/control over sexual situations. CSA victims may poten-
tially generalize their perceptions of powerlessness within the sexual arena
to dangerous situations they encounter later in life. Although labeled differ-
ently, Finkelhor and Browne’s (1985) concept of powerlessness is consistent
with the concept of learned helplessness and closely related to the idea of
generalized perception of control. Learned helplessness (Seligman, 1975)
occurs when an individual perceives his/her inability to control an important
aspect of his/her life. This perception is generalized in such a manner that
the individual perceives he/she does not have control in other areas of life
over which he/she might actually exert control. Due to one’s legitimate
helplessness in one area, one may incorrectly learn that one is helpless in
other areas. CSA victims, due to their age, size, and the inherent power dif-
ferential involved in childhood sexual abuse, have experienced uncontrollable
abuse. Thus, CSA victims may learn that they are helpless, therefore power-
less, in abuse situations. This knowledge potentially places CSA victims at
risk for revictimization when they encounter potentially abusive/dangerous
situations in the future. Thus, powerlessness may potentially serve as a pre-
cursor to revictimization (Stockdale et al., 2002).
Empirical studies have examined the connection between CSA and feel-
ings of powerlessness or lack of control in one’s life. Bolstad and Zinbarg
(1997) assessed 117 female undergraduate students and found that 31.6% had
experienced some form of CSA. Differences in feelings of power or control
were not found between the CSA and nonabuse groups. However, studies
using clinical samples have found, as children, CSA victims report little to no
power over their body, home life, social life, role within the family, and how
the meaning of their sexual abuse was conveyed to them (Hagan & Smail,
1997). By comparing childhood and adult power maps, Hagan and Smail
(1997) determined that the cumulative amount of power the CSA victim pos-
sessed changed only in small ways from childhood to adulthood. Thus, as
adults, CSA victims may remain in the same vulnerable position they occu-
pied as children. One’s general powerlessness in multiple domains potentially
makes one susceptible to manipulation and abuse; hence, it appears plausible
that generalizing one’s feelings of powerlessness could potentially leave one
vulnerable to revictimization.

Self-Esteem
Another traumagenic dynamic described by Finkelhor and Browne (1985) is
stigmatization. Children experience stigmatization from abuse and develop
both guilt and shame (Olafson & Boat, 2000). Conceptually, shame is an eval-
uative dimension of oneself and comparable to the concept of self-esteem (i.e.,
how one feels about oneself). Several studies have investigated self-esteem as
a possible effect of CSA. For instance, CSA victims have been found to score
significantly lower on self-esteem scales as compared to norm group scores
(Mennen & Meadow, 1994) and scores from control groups of nonabused
children (Grayston, De Luca, & Boyes, 1992). However, at least one study
using female undergraduate students found no difference in scores on self-
esteem between a CSA group and nonabuse group (Guelzow, Cornett, &
Dougherty, 2002).
Longitudinal studies using clinical samples have demonstrated the asso-
ciation between CSA and self-esteem. For example, Stern, Lynch, Oates,
O’Toole, and Cooney (1995) explored self-esteem in 86 CSA victims from
two child protection unit hospitals. The control group (85 children) was age
matched with the experimental group and drawn from a local school district.
Results revealed that significantly more CSA victims (62%) had low self-
esteem in comparison with the control group (30%). Oates, O’Toole, Lynch,
Stern, and Cooney (1994) completed a 19 month follow-up study on 64 of the
original CSA victim participants. Approximately, 56% of the CSA victims
were dysfunctional on the self-esteem scales at follow up, as opposed to 33%
of the controls. Tebbutt, Swanston, Oates, and O’Toole (1997) completed a
5-year follow-up assessment on 52 of the original CSA victim participants.
Results indicated no change in the average level of self-reported self-esteem
from intake to 5 years. It is further noteworthy that 20% of the children at the
5-year follow-up had experienced revictimization. Finally, a 9-year follow-
up indicated that the CSA group continued to have lower levels of self-esteem
as compared to the control group (Swanston et al., 2003). CSA victims with
low self-esteem may not possess enough self-value or initiative to resist
future abuse or may unintentionally engage in self-defeating behavior
increasing the probability of revictimization.
The Current Study

The present study attempted to replicate previous research by comparing
levels of attachment difficulties (Aspelmeier et al., 2007; Roche, et al., 1999),
feelings of power (Bolstad & Zinbarg, 1997), and self-esteem (Guelzow et al.,
2002) for two groups of women beginning their freshman year of college;

(a) women who reported previous CSA (abuse group) and (b) women who
did not report previous CSA (nonabuse group). Few studies have examined
multiple traumagenic variables within one sample and we expected differ-
ences among these variables. The first hypothesis was that women who had
experienced CSA would report higher scores on anxiety and avoidance
attachment in comparison to women who had not experienced CSA; how-
ever, due to the nonclinical sample in the current study, differences on
feelings of power and self-esteem were not expected, which is consistent
with previous research using college samples.
We also attempted to replicate past findings that individuals who experi-
ence CSA are likely to experience sexual revictimization (Messman & Long,
1996; Polusny et al., 2004). However, our study took a unique approach to
assessing revictimization. Many studies define revictimization as sexual abuse
that has taken place in childhood and again in adolescence; whereas, other
studies define revictimization as sexual assault that has occurred anytime dur-
ing adulthood which many include a period of several years (i.e., Messman-
Moore & Long, 2003). We chose a college sample and, particularly, the first
semester of college because research indicates that a large number of young
women, regardless of past CSA, experience sexual victimization during their
college years, especially during their first year of college (Humphrey & White,
2000). In addition, the first semester of college is a time period in which one
study determined that 54% of CSA victims experience revictimization
(Gidycz, Hanson, & Layman, 1995). Even though our time frame for assess-
ing revictimization was very short (only 3 months) in comparison to previous
studies (reports spanning numerous years), we expected to replicate previous
findings. Hence, the second hypothesis was that women who reported CSA
would have a higher risk of sexual victimization during their first semester at
college than women who had not experienced CSA.
Finally, we attempted to extend the current literature by examining how the
traumatic dynamics of CSA (i.e., attachment, powerlessness, and self-esteem)
may be associated with sexual victimization in the first semester of college
regardless of CSA history. It appears plausible that the negative outcomes of
CSA may also serve as risk factors for revictimization. In addition, we were
interested in examining how these variables (attachment, feelings of power,
and self-esteem) may be important to sexual victimization during college for
individuals who had not previously experienced CSA. Messman-Moore and
Long (2003) view CSA risk factors as mechanisms that increase overall psy-
chological vulnerability for revictimization; we expected these same negative
outcomes to increase psychological vulnerability to sexual assault for those who
had not experienced CSA. Although most studies assessing CSA, negative

outcomes, and revictimization use only retrospective reports, the current study
used a short-term longitudinal design to assess the negative outcomes vari-
ables when entering college and sexual victimization later in the first semester
of college. The third study hypothesis was that the negative outcomes associ-
ated with CSA (attachment, feelings of power, and self-esteem) would be pre-
dictors of sexual victimization during the first semester of college for all
participants in the study, regardless of CSA history.
Method
Participants
The current study consisted of 363 female undergraduate students (conve-

nience sample) from a large midwestern university. First-year students in
psychology, English, history and political science classes were recruited
from late August to early September 2006 and afforded the opportunity to
voluntarily participate. Students were not provided a description of the
study but were told they would receive extra credit in a psychology course
for their participation. Although participants ranged in age from 17 to 52,
the mean age was 18.42 (SD = 2.21), with only 3.1% reporting ages above
20 years. The majority of participants were White (82.6%), whereas other
participants were African American (9.9%), Hispanic (4.1%), Asian Ameri-
can (1.9%), and Other (1.4%). The majority of participants’ parents were
married (74.7%), whereas some participants’ parents were divorced (17.1%),
and a small percentage of participants’ parents were single (5.0 %) or cate-
gorized as other (3.3%). Participants’ parents held a variety of educational
degrees. Many participants’ mothers (37.3%) earned a high school diploma
or less, whereas other mothers attended 2 years of college (19.9%), earned a
bachelor’s degree (30.1%), or earned a graduate degree (12.7%). Similarly,
participants’ fathers earned a high school diploma or less (33.2%), attended
2 years of college (14.1%), earned a bachelor’s degree (32.7%), or earned a
graduate degree (19.9%).
In the current study, 23.7% (86) of participants indicated they experienced
CSA, which is consist with national estimates and other studies of female
college students (37.7%, Aspelmeier et al., 2007; 31.6%, Bolstad & Zinbarg,
1997; 27.6%, Roche et al., 1999). All of the individuals who reported CSA
during Phase 1, and gave consent to be contacted, were invited to participate
in Phase 2; 63 of the 86 participants (73%) in the CSA group chose to partici-
pate. In addition, 61 nonabused participants, who were randomly selected
from individuals who completed Phase 1 and gave consent to be contacted,

were invited to participate in Phase 2. Four of these participants were moved

to the CSA group subsequent to completing study measures. Of the 67 par-
ticipants who reported CSA, 22.4% (15) of participants reported CSA prior
to the age of 16 only, 35.8% (24) reported CSA prior to the age of 16 and after
the age of 16, and 52.2% (35) reported CSA after the age of 16 only. All par-
ticipants who reported CSA were placed into one CSA group.
Instruments—Phase 1
Hot Topics Questionnaire. Participants completed the Hot Topics Question-
naire, a measure created for this study and used in Phase 1 (late August to
early September) as an initial screening device. The questionnaire consists of
50 questions that query participants’ experience of CSA, adolescent/adult
sexual victimization experience, and a number of filler questions (e.g., cheat-
ing, skipping class, smoking cigarettes, smoking marijuana, alcohol use, sex-
ual partners in the past month, whether previous family members attended
college, multiple sexual partners in the past month). Participants responded to
questions in a dichotic, yes/no format. Given the large variation in questions,
participants were unlikely to know which items were of interest in the study.
Participants were initially identified as potential CSA victims and selected
for participation in Phase 2 based on if they gave consent to be contacted and
responded yes to one of seven questions: (a) Before the age of 16, I had a
sexual experience with an individual 5 or more years older than myself (any
sexual activity involving physical contact; 6.3% responded yes), (b) Before
the age of 16, another person forced me to engage in sexual activity (inter-
course, oral sex, anal sex, petting/fondling; 5.6%), (c) I have engaged in sex-
ual activity (intercourse, oral/anal sex, petting) when I didn’t want to because
someone threatened to use physical force (4.0%), (d) Since the age of 16, I
have been raped (2.4%), (e) In the past 5 years, someone has coerced or forced
me to engage in sexual acts (any sexual activity involving contact; 11.1%), (f)
I have been sexually assaulted by two or more people (6.3%), or (g) More than
one person has made me have sex or do sexual things with them (4.8 %). The
Cronbach’s alpha of these seven items was .73. Confirmation of child and/or
adolescent sexual abuse was determined by more established measures in
Phase 2 of the study.
CSA. Participants completed 10 items from the Child Sexual Abuse Ques-
tionnaire (CSAQ; Finkelhor, 1979) during Phase 2 (early to mid-September).

The CSAQ is a self-report measure that queries childhood sexual experi-

ences; it was used to confirm CSA before the age of 16. Participants responded
to questions in a dichotic, yes/no format. Childhood sexual experiences were
considered abusive if either one or both of the following conditions were
met: (a) The perpetrator was at least 5 years older than the victim or (b) some
form of force or coercion was used. Participants were given the opportunity
to provide information on up to three sexual victimization experiences; three
participants categorized their perpetrator in more than one way. Additional
information regarding the identified perpetrator, the duration in which par-
ticipants experienced abuse, and the percentage of victims who disclosed
abuse are presented in Table 1. Previous research has indicated that this mea-
sure has good concurrent validity (Risin & Koss, 1988).
Adolescent sexual abuse. Participants completed a modified version of the
Sexual Experiences Survey (SES; Koss & Oros, 1982) in Phase 2 (early to
mid-September). The measure was used to confirm sexual victimization expe-
riences that occurred after the age of 16 but prior to one’s first semester of
college. Participants answered the 13-item survey in a dichotic, yes/no format.
Descriptive data for the criteria questions are presented in Table 2. The SES has
previously demonstrated good internal consistency reliability (Koss & Gidycz,
1985). For Phase 2 of the study (n = 122), the Cronbach’s alpha was .82.
Attachment. Participants completed the Experiences in Close Relation-
ships Inventory (ECR; Brennan, Clark & Shaver, 1998), a paper and pencil
self-report measure of attachment. The ECR contains 36 items; each item is
rated on a 7-point likert-type scale and responses range from (1) disagree
strongly to (7) agree strongly. Two subscale scores, anxiety and avoidance,
are created by averaging items, with higher scores indicating more anxiety
and avoidance. A representative anxiety question is “I worry a lot about my
relationships,” and a representative avoidance question is “I try to avoid get-
ting too close to my partner.” Within the current study, the Cronbach’s alpha
was .92 for the anxiety scale and .94 for the avoidance scale.
Feelings of power. Participants completed the General Self-Efficacy Scale
(GSE; Schwarzer & Jerusalem, 1995), a self-report measure of how effi-
cacious (powerful) one is across a variety of domains. Specific forms of
self-efficacy combine creating an individual’s general cognitive sense of
self-efficacy. The GSE scale contains 10 items and each item is rated on a
4-point likert-type scale. Responses are rated as (1) not at all true, (2) hardly
true, (3) moderately true, or (4) exactly true. Items are summed, creating a
score range of 10 to 40; higher scores indicate higher general self-efficacy
(feelings of power). A representative item is “Thanks to my resourcefulness,
I can handle unforeseen situations.” Previous studies have confirmed the

Table 1. Childhood Sexual Abuse Descriptive Data (Phase 2)
Percentage of Victimization Experience

First (n = 42) Second (n = 9) Third (n = 3)
Identified perpetrator
Stranger 7.1
Person known, not a friend 26.2 44.4 33.3
Friend 47.6 33.3 66.7
Friend of parents 4.8 33.3
Cousin 4.8 22.2
Brother 7.1
Father 2.4
Duration of abuse
1 day 31.6 50.0
More than 1 day but less
13.2
than 1 week
More than 1 week but less
5.3
than 1 month
More than 1 month but
21.1 12.5 66.7
less than 6 months
More than 6 months but
7.9
less than 1 year
More than 1 year but less
5.3 12.5 33.3
than 2 years
2 years or more 15.8 25.0
Decided not to tell someone
74.0 73.0 100.0
about abuse
M (SD)
First (n = 42) Second (n = 9) Third (n = 3)
Victim age 13.23 (2.96) 14.22 (1.79) 15.67 (0.58)
Perpetrator age 19.42 (8.04) 19.22 (5.65) 19.67 (6.43)
Note: No victim reported abuse by an aunt, uncle, grandparent, sister, stepfather, mother, or
stepmother.
GSE scale’s high reliability and stability (Leganger, Kraft, & Roysamb,
2000; Luszczynska, Scholz, & Schwarzer, 2005). In the current study, the
Cronbach’s alpha was .75.
Self-esteem. Participants completed the Rosenberg Self-esteem Scale
(RSE; Rosenberg, 1965), a self-report measure of global self-esteem. The

Table 2. Sexual Abuse Descriptive Data (Phases 2 and 3)
Percentage of Yes
Responses
Question Phase 2 Phase 3
Have you ever been in a situation where a man became so
sexually aroused that you felt it was useless to stop him 32.8 15.1
even though you did not want to have sexual intercourse?
Have you ever had sexual intercourse with a man even
though you really didn’t want to because he threatened 5.7 3.2
to end your relationship otherwise?
Have you ever had sexual intercourse with a man when you
really didn’t want to because you felt pressured by his 16.4 8.6
continual arguments?
Have you ever found out that a man had obtained sexual
intercourse with you by saying things that he didn’t really 22.1 9.8
mean?
Have you ever been in a situation where a man used some
degree of physical force (twisting your arm, holding
20.5 6.5
you down, etc.) to try to make you engage in kissing or
petting when you didn’t want to?
Have you ever been in a situation where a man tried to get
sexual intercourse with you when you really didn’t want
to by threatening to use physical force (twisting your arm, 4.9 3.2
holding you down, etc.) if you didn’t cooperate but for
various reasons sexual intercourse did not occur?
Have you ever been in a situation where a man used some
degree of physical force (twisting your arm, holding you
down, etc.) to get you to have sexual intercourse with 8.2 5.4
him when you didn’t want to but for various reasons
sexual intercourse did not occur?
Have you ever had sexual intercourse with a man when
you didn’t want to because he threatened to use physical
1.6 1.1
force (twisting your arm, holding you down, etc.) if you
didn’t cooperate?
Have you ever had sexual intercourse with a man when you
really didn’t want to because he used some degree of 4.9 2.2
physical force (twisting your arm, holding you down, etc.)?
Have you ever been in a situation where a man obtained
sexual acts with you, such as anal or oral intercourse,
8.2 3.2
when you didn’t want to by using threats or physical
force (twisting your arm, holding you down, etc.)?
Have you ever been raped? 6.6 1.1

RSE contains 10 items, such as “I feel that I’m a person of worth at least on
an equal plane with others.” Items are rated on a 5-point likert-type scale
from (1) strongly agree to (5) strongly disagree. Higher scores indicate higher
self-esteem. The RSE has demonstrated both reliability and validity. Test-retest
reliability over 2 weeks was .85, and correlations with related measures have
ranged from .56 to .83 (Silber & Tippett, 1965). Within the current study, the
Cronbach’s alpha was .89.
Later sexual victimization. At the time of follow-up (Phase 3; early December),
participants completed the SES again. They were asked the following: “Please
respond to the following questions for experiences which you have had since
completing the last phase of the study in September (i.e., in the intervening
time period).” Using a broad definition of sexual victimization, participants
who indicated yes to any of the 11 criteria questions listed in Table 2 were
placed in the sexual victimization group. In the third phase of the study (n =
92), the Cronbach’s alpha was .82. Descriptive data for the criteria questions
used to assess sexual victimization during the follow-up period are presented
in Table 2.
Procedure
Phase 1. The current study included three phases of participant involve-
ment. In the first phase, occurring in late August to early September, recruited
participants (N = 363) convened in large lecture classrooms on campus. Par-
ticipants were seated with one empty chair in between each participant to
decrease the likelihood of viewing each other’s answers. In addition, partici-
pants were given a manila envelope to cover their answers and to use to return
the study materials. Participants read and signed an informed consent form
and then completed a demographic questionnaire and the Hot Topics Ques-
tionnaire (initial screening measure). The demographic questionnaire asked
students to provide their name and contact information to contact them for
participation in later phases of the study. After completion of both question-
naires, participants received a written debriefing form with the phone number
for the local crisis center. All research assistants were also trained to observe
participants for signs of distress (e.g., tearfulness, distractedness, fidgeting).
No incidents of distress were observed during any phase of the study.
Phase 2. Participants who gave consent to be contacted, and were initially
identified as experiencing CSA, were invited to participate in Phase 2; 63 of 86

such individuals (73%) chose to participate. An additional 61 participants who

consented to be contacted, but did not report child sexual assault, were ran-
domly selected for participation in Phase 2 of the study as the nonabuse group.
In the second phase, occurring early to mid September, participants (n =
124) convened using a staggering methodology where each individual arrived
in the laboratory every 10 minutes. Participants individually met with a
trained research assistant to review and sign an informed consent form. Once
students signed the informed consent, they were asked to complete paper and
pencil self-report measures of childhood sexual abuse, adolescent sexual
abuse, attachment, generalized self-efficacy (feelings of power), and self-
esteem. After completing all the measures, participants were provided with
both an individual verbal debriefing and a written debriefing statement. Prior
to the commencement of Phase 2, 2 nonabuse participants’ data were
excluded, due to incorrectly completing the measures. In addition, 4 partici-
pants who were initially screened for the nonabuse group were moved to the
CSA group, subsequent to completing Phase 2 measures. Thus, at the end of
Phase 2, the CSA group contained 67 participants and the nonabuse group
contained 55 participants (n = 122).
Phase 3.The third phase occurred approximately 8 to 12 weeks after the
second phase in early December. Participants (n = 122) who completed Phase
2 were followed up; 93 individuals (76%) opted to participate. Of those par-
ticipating in Phase 3, 51 individuals (55%) were from the CSA group and 42
individuals (45%) were from the nonabuse group. Participants convened
again using a staggering method, such that individuals arrived every 10 min-
utes and read and signed an informed consent form. Once participants signed
the informed consent, they were asked to complete the Sexual Experiences
Survey based on sexual victimization experiences subsequent to their previ-
ous participation in the study. After completion of the survey, participants
received an individual verbal debriefing and a written debriefing statement.
Results
Hypothesis 1
Correlations among the four negative outcomes variables are presented in

Table 3. To examine the differences in attachment scores, feelings of power,
and self-esteem, between the CSA and nonabuse groups, a MANOVA was
conducted that considered the variables together in the model. CSA group
status did not predict scores on any of the four negative outcome variables,
F(4, 117) = 1.35, p = .26. This finding supports the hypothesis that feelings

Table 3. Correlations Among the Negative Outcome Variables (Phase 2)
Attachment Attachment Feelings

Anxiety Avoidance of Power
Attachment anxiety
Attachment avoidance .14
Feelings of power -.16 -.07
Self-esteem -.50** -.31** .43**
Note: n = 122.
**p < .01.
of power and self-esteem would not vary in a college sample but is contrary
to the expectation that attachment anxiety and attachment avoidance would
be different even within a college sample.
Hypothesis Two
A logistic regression analysis revealed a significant association between the
CSA group and later sexual victimization, c2(1, N = 93) = 4.37, p = .036. The
percentage of correctly categorized (victimized or not victimized) individu-
als at follow-up did not change (78.5% in both models), which is most likely
due to the low rate occurrence of the study variables (below 50%). Of the 93
participants who completed the follow-up measure at Phase 3, 73 (78.5%)
did not report sexual victimization and 20 (21.5%) did report sexual victimiza-
tion during their first semester of college. However, 15 of the 20 participants
(75%) who reported sexual victimization at the follow-up period were in the
CSA group. Of the 51 participants in the CSA group who completed all
phases, 29.4% reported sexual victimization at follow-up, whereas only
11.9% of the 42 participants in the nonabuse group reported sexual victimiza-
tion. The later sexual victimization experiences reported by most participants
included penetration (89.5%), with many including threats of violence or
violent acts (25%). These findings support the hypothesis that the CSA group
would be more likely to be sexually victimized than the nonabuse group
during their first semester of college.
Hypothesis 3
A hierarchical logistic regression analysis was conducted to determine
whether the negative outcomes of CSA at Phase 2 were significantly related

Table 4. Hierarchical Logistic Regression for Negative Outcomes Predicting

Sexual Victimization During the First Semester of College (Phase 3)
95% Confidence
B SE (B) Odds Ratio
Interval
Step 1
CSA group* 1.13 .57 3.08 1.02-9.37
Step 2
CSA group 1.12 .64 3.06 0.87-10.75
Attachment anxiety* 0.78 .28 2.19 1.26-3.82
Attachment avoidance –0.03 .29 0.97 0.55-1.72
Feelings of power 0.16 .13 1.18 0.91-1.51
Self-esteem -0.07 .07 0.93 0.80-1.07
Note: CSA = child sexual abuse.
*p < .05.
to sexual victimization at follow-up for all participants regardless of CSA

history (see Table 4). Considered in the model together, anxiety attachment,
avoidance attachment, feelings of power, and self-esteem were significantly
related to sexual victimization at follow-up, c2(5, N = 93) = 19.71, p = .001.
The percentage of correctly categorized (victimized or not victimized) indi-
viduals at follow-up increased from 78.5% to 79.6% as a result of logistic
regression. However, the anxiety subscale was the only variable that signifi-
cantly contributed to the regression. Although the CSA group was no longer
significant when considered with the negative outcome variables, the odds
ratio was virtually unchanged. The results partially support the hypothesis
that the same negative outcomes of CSA are also predictors of sexual victim-
ization during the first semester of college, particularly attachment anxiety.
Discussion
The current study did not find that sexual abuse history was associated with
scores on variables measuring the traumagenic dynamics (attachment, feel-
ings of power, and self-esteem). Our study did confirm that sexual abuse
history was associated with an elevated risk of experiencing sexual victim-
ization during the first semester of college. An association was also found
between the traumagenic dynamics and the experience of sexual victimiza-
tion during the first semester of college, with attachment anxiety playing a
particularly important role.
The lack of significant differences on all measures of the traumagenic
dynamics between those who had experienced CSA and those who had not

is somewhat surprising. Differences between the CSA and nonabuse groups

were expected on measures of attachment anxiety and avoidance. Other
studies using a sample of college woman have found differences on attach-
ment scores (Aspelmeier et al., 2007; Roche et al., 1999); however, those
studies did not have a multiphase study. Participants in the current study
were asked to return to the research lab to complete measures. Those in the
CSA group who choose to participate in the subsequent phases of the current
study may have had fewer problems with attachment than those CSA vic-
tims who chose not to participate, making them indistinguishable from the
nonabuse participants.
Studies using college samples have not consistently found differences on
other traumagenic variables, such as feelings of power (Bolstad & Zinbarg,
1997) or self-esteem (Guelzow et al., 2002). Consistent with these findings,
our results indicated no differences. Previous research that has found feelings
of power (Hagan & Smail, 1997) and self-esteem (Stern et al., 1995) to be
lower in victims of CSA have included clinical samples. This difference in
samples is important because college students are typically higher functioning
and from higher socioeconomic backgrounds than the general population. The
participants in the current study may represent well-adjusted victims of CSA
but are not representative of all CSA victims. Future studies explicitly exam-
ining sample selection and volunteer bias in research on CSA victims in adult-
hood is needed to better understand whether differences found between studies
are due to methodological issues.
As well as investigating the association between CSA and the traumagenic
dynamics, the current study also investigated the relationship between CSA
and sexual victimization during the first semester of college. As expected, the
current study found a large number of women (21.5%) were sexually victim-
ized during their first semester of college, and sexual victimization was expe-
rienced more often by CSA victims than those women who had not been
victims of CSA. This finding is consistent with previous research that indi-
cates that a large number of young women in general (Humphrey & White,
2000) and approximately 54% of CSA victims (Gidycz et al., 1995) experi-
ence sexual victimization during their first year of college. The higher rate of
sexual victimization by those in the CSA group is particularly noteworthy
given that differences in the traumagenic dynamic variables between the CSA
and nonabuse group were not significant. The rationale above suggests that
the lack of differences on the traumagenic variables between these groups
may have been due to the high functioning nature of the CSA group included
in the present study. Following that rationale, these seemingly well-adjusted
victims of CSA were still more likely to be sexually victimized during the

very first semester of college than their nonabuse counterparts. Future research
examining other variables that may differentiate between CSA and nonabuse
participants and contribute to the increased probability of sexual victimization
among CSA victims is needed. For example, future studies may examine the
behavioral component of traumatic sexualization (in the traumagenic dynamic
model) which was not included in the current study. In addition, threat cue
perception deficits may be important in explaining revictimization of CSA
victims (Chu, 1992; Kluft, 1989, 1990). Threat cue perception deficits include
not being able to appropriately identity dangerous situations that may render
CSA victims vulnerable to revictimization.
Of particular interest to the current study was whether the negative out-
comes of CSA were associated with sexual victimization during the first
semester of college, regardless of CSA history. When considered together,
attachment, powerlessness, and self-esteem were significantly related to
sexual victimization at follow-up. These results support the view espoused
by Messman-Moore and Long (2003) that CSA risk factors are mecha-
nisms that increase overall psychological vulnerability for revictimization.
Our results also suggest that these same psychological variables are impor-
tant for increased vulnerability for sexual victimization among college
freshman who did not experience CSA. However, anxiety attachment was
the only variable that significantly contributed to the regression, indicat-
ing that high anxiety attachment scores were most strongly related to sex-
ual victimization during the first semester of college. Future studies are
needed that replicate the short-term longitudinal nature of the current
study and examine similarities as well as differences among CSA victims
and nonabuse groups.
The findings of the current study have both theoretical and practical impli-
cations. From a theoretical standpoint, support for the traumagenic dynamic
model was not found for this specific sample. The negative outcomes of
betrayal (attachment difficulties), powerlessness, and stigmatization (self-
esteem) may not be relevant for CSA victims who function well enough to be
accepted and enroll in a 4-year university. More specifically, those CSA vic-
tims who attend college and volunteer to participate in psychological research
may represent a portion of individuals who do not continue to experience the
negative outcomes of CSA. From a practical standpoint, the results of the
present study suggest that college campuses may need to develop services
that target freshman women who have high levels of attachment anxiety. Pro-
grams or services that identify this group as at-risk for sexual victimization
during the first semester of college may able to decrease the large number of
sexual assaults that occur on college campuses.

Although the current study contributes to the literature on CSA and risk
factors for sexual victimization during the first semester of college, the study
does have limitations. For instance, many of the measures relied on self-report
data. However, due to the nature of the variables investigated, data could only
be gathered via self-report. For instance, it is not possible to determine how
much power an individual subjectively feels without asking the individual.
Furthermore, due to the sensitive nature of the study, participants could self-
select themselves out of Phases 2 and 3. Thus, it is possible that the most
anxious or most avoidant participants self-selected out of participation; if their
data had been included, results may have been even stronger.
In addition, the majority of participants were White, middle-class women.
It is possible that results may have differed if the participants more appropri-
ately represented the ethnic diversity within the United States. For instance,
although some previous research (Arroyo, Simpson, & Aragon, 1997) has
found the CSA prevalence rate among Hispanic undergraduate women (27.1%)
to be similar to that of non-Hispanic White undergraduate students, other
research (Ullman & Filipas, 2005) has demonstrated that Hispanic women
experience revictimization less than African American or White women. In
addition, particular ethnic groups place more emphasis on family and com-
munity relationships over individualism. Thus, it is possible that attachment
may be even more strongly disrupted for CSA victims, such as Asian Americans
or Hispanic Americans, living in a more collectivistic culture. In such cul-
tures, victims might view the perpetrator as part of a community that abused
him or her. Furthermore, gender and sex roles may be more pronounced within
certain ethnic groups. Thus, it is possible that female CSA victims within
paternalistic cultures may subjectively report more powerlessness, as that
conceptualization reflects realistic societal norms (Feiring, Coates, & Taska,
2001). Thus, the current study’s results should be considered in the context of
the mostly White sample from which data were collected.
Although the current study has limitations, it contributes to the literature
in several significant ways. First, the study examined several aspects of the
traumagenic dynamic model within one study. Second, the short-term longi-
tudinal design of the study highlights the predictive nature of the study vari-
ables. Specifically, our findings help understand how the negative outcomes
of CSA may also serve as predictors of sexual victimization during a time
when sexual assault is likely—the first semester of college.
Acknowledgment
The authors wish to thank the participants who were willing to return on three sepa-
rate occasions to the research lab and provide such personal information. Much

appreciation is also expressed to the reviewers for their thoughtful comments on

earlier drafts of this article. We also wish to thank Jeffrey Kahn for his assistance
during the revisions of the manuscript.
Declaration of Conflicting Interests

The authors declared that they had no conflicts of interests with respect to their
authorship or the publication of this article.
Funding
The authors declared that they received no financial support for their research and/or
authorship of this article.
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Bios
Marla Reese-Weber, PhD, received her doctorate degree from the Ohio State Uni-
versity in 1998 from the department of human development and family science. She
began as an assistant professor at Illinois State University in the department of psy-
chology that same year. She was promoted to associate professor in 2004. She
currently serves as the coordinator for the Developmental Master’s Sequence. Her
research interests include conflict and violent behaviors during the adolescent and
young adult years. She is particularly interested in dating and sibling violence.
Dana M. Smith was a graduate student at Illinois State University in the Clinical-
Counseling Master’s program. She completed her thesis project under the supervision
of Dr. Marla Reese-Weber and graduated in May 2007. She has received her LCPC
and is currently employed in a human service agency.

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Journal of Interpersonal

Outcomes of Child Sexual Abuse as Predictors of Later Sexual

The online version of this article can be found at:

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>> Version of Record - May 9, 2011

OnlineFirst Version of Record - Jun 28, 2010

Marla Reese-Weber1 and

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Based on numerous studies conducted across several decades, approxi-

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Victims may potentially view themselves as deserving victimization and

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The Current Study

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The current study consisted of 363 female undergraduate students (conve-

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were invited to participate in Phase 2. Four of these participants were moved

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The CSAQ is a self-report measure that queries childhood sexual experi-

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Table 1. Childhood Sexual Abuse Descriptive Data (Phase 2)

Percentage of Victimization Experience

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Table 2. Sexual Abuse Descriptive Data (Phases 2 and 3)

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such individuals (73%) chose to participate. An additional 61 participants who

Correlations among the four negative outcomes variables are presented in

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Table 3. Correlations Among the Negative Outcome Variables (Phase 2)

Attachment Attachment Feelings

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Table 4. Hierarchical Logistic Regression for Negative Outcomes Predicting

to sexual victimization at follow-up for all participants regardless of CSA

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is somewhat surprising. Differences between the CSA and nonabuse groups

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appreciation is also expressed to the reviewers for their thoughtful comments on

Declaration of Conflicting Interests

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