Objective
The current study examined emotion dysregulation as a mechanism underlying risky sexual behavior and sexual revictimization among adult victims of child sexual abuse (CSA) and child physical abuse (CPA).
Methods
Participants were 752 college women. Victimization history, emotion dysregulation, and risky sexual behavior were assessed with anonymous, self-report surveys utilizing a cross-sectional design.
Results
Approximately 6.3% of participants reported CSA, 25.5% reported CPA, and 17.8% reported rape during adolescence or adulthood. CSA and CPA were associated with increased risk for adolescent/adult rape; 29.8% of CSA victims and 24.3% of CPA victims were revictimized. Path analytic models tested hypothesized relationships among child abuse, emotion dysregulation, adolescent/adult rape and three forms of risky sexual behavior (e.g., failure to use condoms, contraception, or having sex with someone under the influence of alcohol/drugs), including frequency of risky sexual behavior with a regular dating partner, with a stranger, and lifetime number of intercourse partners. Emotion dysregulation mediated revictimization for both CSA and CPA. Emotion dysregulation also predicted lifetime number of sexual partners and frequency of risky sex with a stranger, but not frequency of risky sex with a regular dating partner.
Conclusions
Findings suggest that emotion dysregulation is a distal predictor, and risky sex, particularly with lesser known partners, is a proximal predictor of sexual revictimization. Because emotion dysregulation also maintained a significant direct path to revictimization, risky sexual behavior appears to be one of several proximal risk factors for revictimization.
Practice implications
Findings confirm that emotion dysregulation is a critical pathway to more proximal risk factors such as risky sexual behavior, and suggest that clinical interventions aimed at improving emotion dysregulation may help reduce risky sexual behavior and risk for revictimization.
Child sexual abuse (CSA) victims are between 2 and 11 times more likely to be raped in adulthood, with risk increasing exponentially with severity of CSA (Fergusson et al., 1997 and Wyatt et al., 1992). In a review of the then nascent literature, Messman and Long (1996) noted that few empirical studies were designed to examine the issue of revictimization. Since then, studies designed specifically to examine this phenomenon provide evidence of revictimization among college students (Messman-Moore & Long, 2000), community women (Kimerling, Alvarez, Pavao, Kaminski, & Baumrind, 2007), inpatients (Cloitre, Tardiff, Marzuk, Leon, & Portera, 1996), female inmates (Walsh, DiLillo, & Scalora, in press), and military veterans (Schultz, Bell, Naugle, & Polusny, 2006). Revictimization also has been documented among ethnically diverse populations, including Latina, African American, and Asian American women (Urquiza & Goodlin-Jones, 1994), bisexual women and gay men (Heidt, Marx, & Gold, 2005), and low-income, urban women (Siegel & Williams, 2003). Revictimization appears to compound the psychological impact of prior victimization, and is associated with increased distress among victims, including higher levels of anxiety, lifetime and current depression, lifetime and current PTSD, dissociation, binge drinking and past month drug use (Casey and Nurius, 2005, Cloitre et al., 1997 and Kimerling et al., 2007). The widespread psychological impact of revictimization raises the critical question of why some CSA survivors experience additional victimizations while others do not. Identifying factors that distinguish these groups will inform interventions designed to prevent revictimization and the psychological burden associated with it.
