Sexual Abuse History and Problems in Adolescence: Exploring the Effects of Moderating Variables
Luster, Tom, Small, Stephen A., Journal of Marriage and Family
TOM LUSTER Michigan State University
STEPHEN A. SMALL University of Wisconsin-Madison*
This study explores the relationship between sexual abuse and two problem outcomes, binge drinking and suicidal ideation, in a sample of 42,568 adolescents. The effects of current and prior sexual abuse on these outcomes were examined for females and males separately. Of particular interest were factors related to the likelihood of problem behaviors among adolescents who had been sexually abused. Adolescents who had been both physically abused and sexually abused exhibited more problems than those who experienced only one type of abuse. High levels of parental monitoring and high levels of support from at least one parent decreased the risk of problem outcomes among sexually abused adolescents. School success also reduced the risk of problem outcomes for some of the groups studied.
Key Words: adolescence, alcohol abuse, binge drinking, resilience, sexual abuse, suicide.
In 1993, there were approximately 150,000 substantiated cases of child sexual abuse in the United States (Finkelhor, 1994). The prevalence of child sexual abuse is likely to be much higher, however. Based on retrospective reports by adults, Finkelhor estimated that approximately 500,000 children are sexually abused each year. Although estimates of the prevalence of sexual abuse vary considerably from study to study, Finkelhor concluded that approximately 20% of females and from 5% to 10% of males are sexually abused in childhood or adolescence.
During the past decade, researchers have found that a history of sexual abuse is associated with a range of problem behaviors in childhood, adolescence, and adulthood. (See Briere & Elliott, 1994, and Kendall-Tackett, Williams, & Finkelhor, 1993 for recent reviews.) Those who have been sexually abused are more likely than others to experience various emotional problems, including posttraumatic stress disorder, sexualized behavior, depression, anxiety, high levels of anger and aggression, and low self-esteem. Interpersonal difficulties are also more common among victims of sexual abuse.
Based on their review of studies involving victims of abuse who were 18 years old or younger, Kendall-Tackett and her colleagues (1993) concluded that the symptoms displayed by minors may depend on their age. The symptoms that were commonly found in adolescents who had been abused included "depression; withdrawn, suicidal, or self-injurious behaviors; somatic complaints; illegal acts; running away; and substance abuse" (p. 167).
Briere and Elliott (1994) concluded that victims of sexual abuse resort to a variety of methods to cope with the pain associated with this traumatic experience; many activities used to cope with the pain, however, are problematic because they tend to be self-destructive or lead to further problems or both. Avoidance behaviors used by victims of sexual abuse include the use of alcohol and other drugs, indiscriminate sexual behavior, and bulimia. For example, Briere and Runtz (1987) found that adult females who had been sexually abused were twice as likely as females in a comparison group to suffer from alcoholism. Research on minors, however, has not yet shown that alcohol abuse or other forms of substance abuse are more common in victims of sexual abuse (Kendall-Tackett et al., 1993). In this study, we examine the relationship between sexual abuse history and alcohol abuse among adolescents.
Some victims of abuse may resort to even more drastic methods to cope with the pain. Sexual abuse has been linked to an increased risk of suicidal ideation and suicide attempts in adults (Briere & Runtz, 1986). As Briere and Elliott (1994) note, "The ultimate avoidance strategy may be suicide" (p. 60). Although research has established that many adolescent victims of abuse are suicidal, there is little evidence yet that abuse victims are more likely to be suicidal than other adolescents (Kendall-Tackett et al. …