Journal of Abnormal Child Psychology

, Volume 41, Issue 1, pp 139-150

First online:

Linking Childhood Sexual Abuse and Early Adolescent Risk Behavior: The Intervening Role of Internalizing and Externalizing Problems

  • Deborah J. JonesAffiliated withDepartment of Psychology, University of North Carolina at Chapel Hill Email author 
  • , Terri LewisAffiliated withDepartment of Health Behavior, School of Public Health, University of Alabama at Birmingham
  • , Alan LitrownikAffiliated withDepartment of Psychology, San Diego State University
  • , Richard ThompsonAffiliated withJuvenile Protective Association
  • , Laura J. ProctorAffiliated withJudge Baker Children’s Center, Harvard Medical School
  • , Patricia IsbellAffiliated withMaternal and Child Health, Gillings School of Public Health, University of North Carolina at Chapel Hill
  • , Howard DubowitzAffiliated withDepartment of Pediatrics, University of Maryland School of Medicine
  • , Diana EnglishAffiliated withSchool of Social Work, University of Washington
  • , Bobby JonesAffiliated withDepartment of Psychiatry, University of Pittsburgh School of Medicine
    • , Daniel NaginAffiliated withDepartment of Psychology, University of North Carolina at Chapel HillHeinz College, Carnegie Mellon University
    • , Desmond RunyanAffiliated withDepartment of Psychology, University of North Carolina at Chapel HillKempe Center for the Prevention and Treatment of Child Abuse and Neglect, University of Colorado Denver School of Medicine

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A robust literature links childhood sexual abuse (CSA) to later substance use and sexual risk behavior; yet, relatively little empirical attention has been devoted to identifying the mechanisms linking CSA to risky behavior among youth, with even less work examining such processes in boys. With the aim of addressing this gap in the literature, the current study examined the indirect effect of childhood sexual abuse (CSA; from age 2 to 12) trajectory group on risky behavior at age 14 (alcohol use & sexual intercourse) via the intervening role of caregiver-reported internalizing and externalizing problems at age 12. Analyses were conducted with a subsample of youth (n = 657 sexual intercourse; n = 667 alcohol use) from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN), a multisite prospective study of youth at risk for maltreatment. For boys and girls, there was an indirect effect from CSA to sexual intercourse through externalizing problems. The same pattern emerged for alcohol use, but only for girls. Findings did not support an indirect path through internalizing problems for either boys or girls for either outcome. Findings suggest more focal targets for prevention efforts aimed at maintaining the health and safety of maltreated boys and girls during the adolescent transition.


Childhood sexual abuse Adolescence Risk behavior Internalizing problems Externalizing problems Gender