An investigation and comparison of the long-term psychological effects of childhood sexual abuse, adult sexual assault and re-victimisation in adult females

The present thesis investigated the similarities and differences in the long-term consequences of three different types of sex abuse namely, childhood sexual abuse, adult sexual assault, and childhood sexual abuse followed by adult sexual assault, in order to assess and compare the effect of each type of sex abuse on anxiety, depression and trauma symptoms, perceived self-esteem and self-esteem in interpersonal functioning and general coping styles. Eighty-eight adult female participants were classified into a childhood sexual abuse group (n = 21), an adult sexual assault group (n = 22), a re-victimised group (n = 23) and a control group (n = 22). The participants were recruited from a Sexual Assault Support Service, a university sample, and a community sample in Hobart, Tasmania. All participants completed an Interview Schedule, the Clinical Analysis Questionnaire, the Trauma Symptom Inventory, the Self-Description Questionnaire III and the Coping Orientation to Problems Experienced scale. The results of multivariate and univariate analyses of variance showed a general negative effect in the three sex abuse groups, reflected in a decrease in general self-esteem, an increase in a negative emotionality factor, and an increase in trauma symptoms relative to the control group. A comparison of the three sex abuse groups showed that the effects of the three kinds of abuse were similar for general self-esteem and trauma, but the re-victimised group showed significantly higher levels of negative emotionality, and more impulsive and disinhibited behaviour, referred to as Psychopathic Deviation on the Clinical Analysis Questionnaire, and lower levels of confidence in dealing with the opposite sex relative to the other sex abuse groups. Within the three sex abuse groups there was variation in the level of symptoms reported. Few of the abuse or assault characteristics were found to be associated with outcome. An analysis of correlations between the measures revealed three broad patterns of response to sex abuse in the long-term. One pattern was an increase in negative emotionality, a decrease in self-esteem and a decrease in confidence in interacting with the opposite sex. A second pattern revealed an increase in general trauma symptoms. A third pattern involved an increase in Psychopathic Deviation, an increase in substance use to cope and a decrease in confidence in Parent Relations. It is concluded that sex abuse has several relatively independent negative effects on self-esteem, negative emotionality, and trauma symptoms. Victims of re-victimisation experienced more negative emotionality, which included anxiety and depression related symptoms.