Linking Childhood Sexual Abuse and Early Adolescent Risk Behavior: The Intervening Role of Internalizing and Externalizing Problems
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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.
KeywordsChildhood sexual abuse Adolescence Risk behavior Internalizing problems Externalizing problems Gender
Funding for the current secondary analyses was provided by a Mentored Public Health Research Scientist Development Award awarded to the first author from the CDC (K01PS000795-01).
Funding for the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) is provided by grants from the National Center on Child Abuse and Neglect, the Children’s Bureau, Office of Child Abuse and Neglect Administration on Children, Youth, and Families, the National Institute for Child Health and Human Development, and National Institutes of Health. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the funding agencies.
We would like to acknowledge all the LONGSCAN principal investigators, coordinating center, and study staff. In addition, we would like to sincerely thank and recognize the families and participants of the LONGSCAN study for providing their time and valuable information.
- Achenbach, T., & Edelbrock, C. (1991). Manual for the child behavior checklist/4–18 and 1991 profile. Burlington: University of Vermont Department of Psychiatry.Google Scholar
- Advocates for Youth, “Child Sexual Abuse: An Overview,” January 1995. American Academy of Child and Adolescent Psychiatry. (2004). Child Sexual Abuse. Washington, D.C.: American Academy of Child and Adolescent Psychiatry.Google Scholar
- Angold, A. (1988). Childhood and adolescent depression: II. Research in clinical populations. The British Journal of Psychiatry, 153, 476–492. doi: 10.1192/bjp.153.4.476.
- Barnett, D., Manly, J. T., & Cicchetti, D. (1993). Defining child maltreatment: The interface between policy and research. In D. Cicchetti & S. L. Toth (Eds.), Child abuse, child development, and social policy (pp. 7–73). Norwood: Ablex.Google Scholar
- Briere, J. (2004). Integrating HIV/AIDS prevention activities into psychotherapy for sexual abuse survivors. In L. J. Koenig, L. S. Doll, A. O’Leary, & W. Pequegnat (Eds.), From child sexual abuse to adult sexual risk: Trauma, revictimization, and intervention (pp. 219–232). Washington, DC: APA.CrossRefGoogle Scholar
- Brown, L. K., Hadley, W., Stewart, A., Lescano, C., Whiteley, L., Donenberg, G., DiClemente, R., & the Project Style Study Group. (2010). Psychiatric disorders and sexual risk among adolescents in mental health treatment. Journal of Consulting and Clinical Psychology, 78, 590–597.PubMedCrossRefGoogle Scholar
- Bureau of Justice Statistics, US Department of Justice. (2000). Sexual assault of young children as reported to law enforcement: victim, incident, and offender characteristics. July.Google Scholar
- CDC, Centers for Disease Control and Prevention. (2009). Youth Risk Behavior Survey (YRBS): Selected health risk behaviors and health outcomes by race/ethnicity. U.S. Department of Health and Human Services.Google Scholar
- CDC, Centers for Disease Control and Prevention. (2011a). HIV among Youth. Retrieved from http://www.cdc.gov/hiv/youth/.
- CDC, Centers for Disease Control and Prevention. (2011b). Sexually transmitted disease surveillance 2010. Retrieved from http://www.cdc.gov/std/stats.
- CDC, Centers for Disease Control and Prevention. (2011c). Vital signs: teen pregnancy—United States, 1991–2009 MMWR Morb Mortal Wkly Rep (2011/04/08 ed., Vol. 60, pp. 414–420): Centers for Disease Control.Google Scholar
- Clum, G. A., Chung, S. E., Ellen, J. M., Perez, V., Murphy, D. A., Harper, G. W., et al. (2011). Victimization and sexual risk behavior in young, HIV positive women: exploration of mediators. AIDS and Behavior. Google Scholar
- Cohen, J. A., Mannarino, A. P., & Deblinger, E. (2006). Treating trauma and traumatic grief in children and adolescents. New York: Guilford.Google Scholar
- Everson, M. D., Smith, J. B., Hussey, J. M., English, D., Litrownik, A. J., Dubowitz, H., Thompson, R., Knight, E. D., & Runyan, D. (2008). Concordance between adolescent reports of childhood abuse and Child Protective Service determinations in an at-risk sample of young adolescents. Child Maltreatment, 13(1), 14–26.PubMedCrossRefGoogle Scholar
- Finkelhor, D., Hammer, H., & Sedlak, A. J. (2004). Sexually assaulted children: National estimates and characteristics, in OJJDP: Juvenile Justice Bulletin. U.S. Department of Justice.Google Scholar
- Hien, D. A., Campbell, A. N. C., Killeen, T., Hu, M.-C., Hansen, C., Jiang, H., Hatch-Maillette, M., Miele, G. M., Cohen, L. R., Gan, W., Resko, S. M., DiBono, M., Wells, E. A., & Nunes, E. V. (2010). The impact of trauma-focused group therapy upon HIV sexual risk behaviors in the NIDA Clinical Trials Network “Women and Trauma” multi-site study. AIDS and Behavior, 14, 421–430.PubMedCrossRefGoogle Scholar
- Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2009). Monitoring the Future national results on adolescent drug use: Overview of key findings, 2008 (NIH Publication No. 09-7401) (p. 73). Bethesda: National Institute on Drug Abuse.Google Scholar
- Jones, D. J., Runyan, D., Lewis, T., Litrownik, A., Black, M., Wiley, T., English, D., Proctor, L., Jones, B. L., & Nagin, D. (2010). Violence exposure trajectories among high risk youth and their association with two subsequent HIV/AIDS risk behaviors. Journal of Clinical Child and Adolescent Psychology, 39, 667–680.PubMedGoogle Scholar
- Kamphaus, R. W., & Frick, P. J. (1996). Clinical assessment of child and adolescent personality and behavior. Needham Heights, MA US: Allyn & Bacon.Google Scholar
- Maikovich-Fong, A., & Jaffee, S. R. (2010). Sex differences in childhood sexual abuse characteristics and victims’ emotional and behavioral problems: findings from a national sample of youth. Child Abuse & Neglect, 34(6), 429–437. doi: 10.1016/j.chiabu.2009.10.006.
- Mash, E. J., & Barkley, R. A. (2003). Child psychopathology. New York: Guilford Press.Google Scholar
- Muthen, L. K., & Muthen, B. O. (2008). MPlus user’s guide (5th ed.). Los Angeles: Muthen & Muthen.Google Scholar
- Nagin, D. (2005). Group-based modeling of development. Cambridge: Harvard University.Google Scholar
- NIAAA. (2003). National academies report to Congress released. Available from www.alcoholfreechildren.org/en/news/articles.
- Putnam, F. W. (2003). Ten year research update review: Child sexual abuse. Journal of the Academy of Child and Adolescent Psychiatry, 42. Google Scholar
- Quina, K., Morokoff, P. J., Harlow, L. L., & Zurbriggen, E. L. (2003). Cognitive and attitudinal paths from childhood trauma to adult HIV risk. In L. Koenig, L. Doll, A. O’Leary, & W. Pequegnat (Eds.), From child sexual abuse to adult sexual risk: Trauma, revictimization, and intervention (pp. 117–134). Washington, DC: American Psychological Association.Google Scholar
- Runyan, D. K., Curtis, P. A., Hunter, W. M., Black, M. M., Kotch, J. B., Bangdiwala, S., Dubowitz, H., English, D., Everson, M. D., & Landsverk, J. (1998). LONGSCAN: a consortium for longitudinal studies of maltreatment and the life course of children. Aggression and Violent Behavior, 3, 275–285.CrossRefGoogle Scholar
- Schofield, H. L., Bierman, K. L., Heinrichs, B., Nix, R. L., & the Conduct Problems Prevention Research Group. (2008). Predicting early sexual activity with behavior problems exhibited at school entry and in early adolescence. Journal of Abnormal Child Psychology, 36, 1175–1188.PubMedCrossRefGoogle Scholar
- Sedlak, A. J., & Broadhurst, D. D. (1996). Executive summary of the third national incidence study of child abuse and neglect. Washington, D.C.: U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, National Center on Child Abuse and Neglect.Google Scholar
- Shaffer, D., Fisher, P., Lucas, C., Dulcan, M., & Schwab-Stone, M. (2000). NIMH Diagnostic Interview Schedule for Children version IV (NIMH DISC-IV): description, differences from previous versions, and reliability of some common diagnoses. Journal of the American Academy of Child & Adolescent Psychiatry, 39, 28–38.CrossRefGoogle Scholar
- Sikkema, K. J., Wilson, P. A., Hansen, N. B., Kochman, A., Neufeld, S., Ghebremichael, M. S., et al. (2008). Effects of a coping intervention on transmission risk behavior among people living with HIV/AIDS and a history of childhood sexual abuse. Journal of Acquired Immune Deficiency Syndromes, 47, 506–513.PubMedCrossRefGoogle Scholar
- Stanton, B., Black, M., & Fiegelman, S. (1995). Development of a culturally, theoretically, and developmentally based survey instrument for assessing risk behaviors among African American early adolescents living in urban low income neighborhoods. AIDS Prevention and Education, 7, 160–177.Google Scholar
- Substance Abuse and Mental Health Services Administration. (2005). Results from the 2004 National Survey on Drug Use and Health: National Findings (Office of Applied Studies, NSDUH Series H-28, DHHS Publication No. SMA 05-4062). Rockville, MD.Google Scholar
- U.S. Department of Health and Human Services. (2007). The surgeon general’s call to action to prevent and reduce underage drinking: A guide to action for educators. U.S. Department of Health and Human Services, Office of the Surgeon General.Google Scholar
- Wilson, H. W., & Widom, C. S. (2011). Pathways from childhood abuse and neglect to HIV-risk sexual behavior in middle adulthood. Journal of Consulting and Clinical Psychology.Google Scholar