Academic journal article Violence and Victims

Predicting Risky Sexual Behavior in Emerging Adulthood: Examination of a Moderated Mediation Model among Child Sexual Abuse and Adult Sexual Assault Victims

Academic journal article Violence and Victims

Predicting Risky Sexual Behavior in Emerging Adulthood: Examination of a Moderated Mediation Model among Child Sexual Abuse and Adult Sexual Assault Victims

Article excerpt

Although having a sexual victimization history is associated with engaging in sexual risk behavior, the mechanisms whereby sexual victimization increases risk behavior are unclear. This study examined use of sex as an affect regulation strategy as a mediator of the relationship between depressive symptoms and sexual risk behavior among 1,616 sexually active college women as well as examined having a history of child sexual abuse (CSA), adolescent/adult sexual assault (ASA), or both (CSA/ASA) as moderators. Results supported the mediated model as well as moderated mediation, where depressive symptoms were more strongly associated with use of sex as an affect regulation strategy among ASA victims, and sex as an affect regulation strategy was more strongly related to sexual risk behavior for CSA/ASA victims.

Keywords: sexual risk behavior; child sexual abuse; sexual assault; moderated mediation; affect regulation

The effects of sexual victimization on mental health among women are wellestablished. Childhood sexual abuse (CSA), most often defined as unwanted sexual contact or intercourse that occurs between a child and an older individual (often a family member or individual in a caretaking role such as a physician, babysitter, or teacher; Bulik, Prescott, & Kendler, 2001; van Roode, Dickson, Herbison, & Paul, 2009), and adolescent/adult sexual assault (ASA), most often defined as sexual acts obtained by threat, force, or against someone who is not capable of consenting (such as because of incapacitation following substance use; Zinzow et ah, 2012), have repeatedly been associated with negative mental health outcomes. Outcomes that consistently have been found to be associated with sexual victimization include depression, anxiety, posttraumatic stress disorder (PTSD), and substance use disorders (Bulik et al., 2001; Danielson et al., 2010; Walsh, Galea, & Koenen, 2012; Zinzow et al., 2012).

In addition to the negative mental health consequences, there is growing evidence that sexual victimization is associated with engaging in health risk behaviors, including sexual risk behaviors. Research supports that adolescent women with a CSA history are more likely to engage in sexual risk behaviors than adolescents without a CSA history, including having multiple sexual partners, inconsistently using condoms, and using substances before sex (e.g., Howard & Wang, 2005; Lalor & McElvaney, 2010; Raj, Silverman, & Amaro, 2000; Senn, Carey, & Vanable, 2008). There is also evidence that a history of CSA may be associated with a greater likelihood of engaging in sexual risk behavior in adulthood (Meston, Heiman, & Trapnell, 1999; Parillo, Freeman, Collier, & Young, 2001; Testa, VanZile-Tamson, & Livingston, 2005; Van Bruggen, Runtz, & Kadlec, 2006). However, it should be noted that this relationship has not always been found (e.g., Hamburger et al., 2004; Littleton, Radecki Breitkopf, & Berenson, 2007; van Roode et al., 2009; Watson, Matheny, Gagne, Brack, & Ancis, 2013). Overall, the literature supports that having a CSA history is associated with engaging in sexual risk behavior during adolescence and may also be associated with the persistence of sexual risk behavior into adulthood.

There is also some research supporting that ASA is associated with sexual risk behavior. Green and colleagues (2005) found that having an ASA history was associated with a greater number of lifetime sexual partners, unplanned pregnancies, and sexually transmitted infections (STIs) among a sample of college women. Parillo and colleagues (2001) similarly found in a community sample that an ASA history was associated with having a greater number of recent partners. In addition, Campbell, Sefl, and Ahrens (2004) found that approximately one-third of a sample of ASA survivors retrospectively reported an increase in sexual risk behavior following their assault. In a longitudinal study, Testa, Hoffman, and Livingston (2010) found that an ASA history prior to college was associated with greater sexual risk behavior during the first semester of college. …

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