Cancer Victim Identity for Individuals with Histories of Cancer and Childhood Sexual Abuse

  • Glynnis A. McDonnell
  • Madalina Sucala
  • Rachel E. Goldsmith
  • Guy H. Montgomery
  • Julie B. Schnur


Identifying as a ‘cancer victim’ has been linked to adverse psychosocial sequelae in individuals who have been diagnosed with cancer. Being a childhood sexual abuse (CSA) survivor may predispose individuals towards a “victim” identity in general. The aim of this study was to determine the prevalence of identifying as a ‘cancer victim’ among CSA survivors who were diagnosed with cancer as adults, and to explore psychological factors associated with identification as a cancer victim. 105 adults reporting both a history of CSA and of having been diagnosed with cancer as an adult were recruited through Amazon Mechanical Turk. Variables assessed included CSA severity, abuse-related powerlessness, general mastery, and cancer victim identity. Fifty-one percent of the sample endorsed a cancer victim identity. Path analysis revealed that abuse-related powerlessness was related to decreased feelings of general mastery, which was in turn associated with cancer victim identification (x 2 = .12, DF = 1, p < .73; RMSEA = .00; SRMR = .01: Bentler CFI = 1.0). From a clinical perspective, the results suggest that increasing general mastery in CSA survivors in the cancer setting may be an important mechanism for attenuating the risk for developing a cancer victim identity and, presumably, for downstream adverse psychosocial sequelae.


Oncology Identity Sexual abuse survivors Mastery 



Funding was provided by National Cancer Institute (Grant Nos. R21CA173163, R25 CA081137).


  1. American Cancer Society. (2016). Cancer facts and figures 2016. Retrieved from
  2. Arch, J. A., & Carr, A. L. (2016). Using Mechanical Turk for research on cancer survivors. Psycho-Oncology. doi: 10.1002/pon.4173.Google Scholar
  3. Basile, K. C., Smith, S. G., Breiding, M. J., Black, M. C., & Mahendra, R. R. (2014). Sexual violence surveillance: Uniform definitions and recommended data elements, version 2.0. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.Google Scholar
  4. Bellizzi, K. M., & Blank, T. O. (2007). Cancer-related identity and positive affect in survivors of prostate cancer. Journal of Cancer Survivorship, 1, 44–48. doi: 10.1007/s11764-007-0005-2.CrossRefPubMedGoogle Scholar
  5. Bentler, P. M. (1990). Comparative fit indexes in structural models. Psychological Bulletin, 107, 238–246. doi: 10.1037/0033-2909.107.2.238.CrossRefPubMedGoogle Scholar
  6. Briere, J. N. (1992). Child abuse and trauma: Theory and treatment of the lasting effects. Interpersonal violence: The practice series. Thousand Oaks, CA: Sage Publications.Google Scholar
  7. Chambers, S. K., Baade, P., Meng, X., Youl, P., Aitken, J., & Dunn, J. (2012). Survivor identity after colorectal cancer: Antecedents, prevalence and outomes. Psycho-Oncology, 21, 962–969. doi: 10.1002/pon.1991.CrossRefPubMedGoogle Scholar
  8. Cho, D., & Park, C. L. (2014). Cancer-related identities in people diagnosed during late adolescence and young adulthood. British Journal of Health Psychology, 20, 594–612. doi: 10.1111/bjhp.12110.CrossRefPubMedGoogle Scholar
  9. Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155–159. doi: 10.1037/0033-2909.112.1.155.CrossRefPubMedGoogle Scholar
  10. Cromer, L. D., & Smyth, J. M. (2010). Making meaning of trauma: Trauma exposure doesn’t tell the whole story. Journal of Contemporary Psychotherapy, 40, 65–72. doi: 10.1007/s10879-009-9130-8.CrossRefGoogle Scholar
  11. Dallam, S. J. (2010). A model of the retraumatization process: A meta-synthesis of childhood sexual abuse survivors’ experiences in healthcare. Unpublished doctoral dissertation. Retrieved from KU ScholarWorks.Google Scholar
  12. Deimling, G. T., Bowman, K. F., & Wagner, L. J. (2007). Cancer survivorship and identity among long-term survivors. Cancer Investigation, 25, 758–765. doi: 10.1080/07357900600896323.CrossRefPubMedGoogle Scholar
  13. DePrince, A. P., Chu, A. T., & Pineda, A. S. (2011). Links between specific posttrauma appraisals and three forms of trauma-related distress. Psychological Trauma: Theory, Research, Practice, and Policy, 3, 430–441. doi: 10.1037/a0021576.CrossRefGoogle Scholar
  14. Dickinson, L. M., de Gruy, F. V., III, Dickinson, P., & Candib, L. M. (1999). Health-related quality of life and symptom profiles of female survivors of sexual abuse. Archives of Family Medicine, 8, 35–43. doi: 10.1001/archfami.8.1.35.CrossRefPubMedGoogle Scholar
  15. Dukett, J. D. (2015). Childhood sexual abuse and identify development: The role of attachment and self-esteem. Retrieved from ISU ReD. (391).Google Scholar
  16. Fassler, I. R., Amodeo, M., Griffin, M. L., Clay, C. M., & Ellis, M. A. (2004). Predicting long-term outcomes for women sexually abused in childhood: Contribution of abuse severity versus family environment. Child Abuse and Neglect, 29, 269–284. doi: 10.1016/j.chiabu.2004.12.006.CrossRefGoogle Scholar
  17. Havig, K. (2008). The health care experiences of adult survivors of child sexual abuse: A systematic review of evidence on sensitive practice. Trauma, Violence, and Abuse, 9, 19–33. doi: 10.1177/1524838007309805.CrossRefPubMedGoogle Scholar
  18. Hazzard, A. (1998). Trauma-related beliefs questionnaire. In C. M. Davis, W. L. Yarber, R. Bauserman, G. Schreer, & S. L. Davis (Eds.), Handbook of sexuality-related measures (pp. 18–21). Thousand Oaks, CA: SAGE Publications.Google Scholar
  19. Josselson, R. (1987). Finding herself: Pathways to identity development in women. San Francisco: Jossey-Bass.Google Scholar
  20. Kline, R. B. (2011). Convergence of structural equation modeling and multilevel modeling. In M. Williams & W. P. Vogt (Eds.), Handbook of methodological innovation in social research methods (pp. 562–589). London: SAGE Publications.CrossRefGoogle Scholar
  21. Lieblich, A., McAdams, D. P., & Josselson, R. (Eds.). (2004). Healing plots: The narrative basis of psychotherapy. The narrative study of lives series. Washington D.C.: American Psychological Association.Google Scholar
  22. Martsolf, D. S., & Draucker, C. B. (2008). The legacy of childhood sexual abuse and family adversity. Journal of Nursing Scholarship, 40, 333–340. doi: 10.1111/j.1547-5069.2008.00247.x.CrossRefPubMedPubMedCentralGoogle Scholar
  23. McGregor, K., Glover, M., Gautam, J., & Jülich, S. (2010). Working sensitively with childhood sexual abuse survivors: What female childhood sexual abuse survivors want from health professionals. Women and Health, 50, 737–755. doi: 10.1080/03630242.2010.530931.CrossRefPubMedGoogle Scholar
  24. Merrill, L. L., Thomsen, C. J., Sinclair, B. B., Gold, S. R., & Milner, J. S. (2001). Predicting the impact of child sexual abuse on women: The role of abuse severity, parental support, and coping strategies. Journal of Consulting and Clinical Psychology, 69, 992–1006. doi: 10.1037/0022-006X.69.6.992.CrossRefPubMedGoogle Scholar
  25. Morris, B. A., Lepore, S. J., Wilson, B., Lieberman, M. A., Dunn, J., & Chambers, S. K. (2014). Adopting a survivor identity after cancer in a peer support context. Journal of Cancer Survivorship, 8, 427–436. doi: 10.1007/s11764-014-0355-5.CrossRefPubMedPubMedCentralGoogle Scholar
  26. Park, C. L., Zlateva, I., & Blank, T. O. (2009). Self-identity after cancer: “Survivor”, “victim”, “patient”, and “person with cancer”. Journal of General Internal Medicine, 24, 430–435. doi: 10.1007/s11606-009-0993-x.CrossRefPubMedCentralGoogle Scholar
  27. Pearlin, L. I., Lieberman, M. A., Menaghan, E. G., & Mullan, J. T. (1981). The stress process. Journal of Health and Social Behavior, 22, 337–356.CrossRefPubMedGoogle Scholar
  28. Pearlin, L. I., & Schooler, C. (1978). The structure of coping. Journal of Health and Social Behavior, 19, 2–21. doi: 10.2307/2136319.CrossRefPubMedGoogle Scholar
  29. Philips, A., & Daniluk, J. C. (2004). Beyond “survivor”: How childhood sexual abuse informs the identity of adult women at the end of the therapeutic process. Journal of Counseling and Development, 84, 177–184. doi: 10.1002/j.1556-6678.2004.tb00299.x.CrossRefGoogle Scholar
  30. Schachter, C. L., Stalker, C. A., Teram, E., Lasiuk, G. C., & Danilkewich, A. (2009). Handbook on sensitive practice for health care practitioners: Lessons from adult survivors of childhood sexual abuse. Ottowa: Public Health Agency of Canada.Google Scholar
  31. Shapiro, D. N., Chandler, J., & Mueller, P. A. (2013). Using Mechanical Turk to study clinical populations. Clinical Psychological Science, 1, 213–220. doi: 10.1177/2167702612469015.CrossRefGoogle Scholar
  32. Turner, R., & Noh, S. (1988). Physical disability and depression: A longitudinal analysis. Journal of Health and Social Behavior, 29, 23–37. doi: 10.2307/2137178.CrossRefPubMedGoogle Scholar
  33. Whiffen, V. E., & MacIntosh, H. B. (2005). Mediators of the link between childhood sexual abuse and emotional distress. Trauma, Violence, and Abuse, 6, 24–39. doi: 10.1177/1524838004272543.CrossRefPubMedGoogle Scholar
  34. Zink, T., Klesges, L. M., Stevens, S., & Decker, P. (2009). The development of a sexual abuse severity score: Characteristics of childhood sexual abuse associated with trauma symptomatology, somatization and alcohol abuse. Journal of Interpersonal Violence, 24, 537–546. doi: 10.1177/088626050831.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Glynnis A. McDonnell
    • 1
  • Madalina Sucala
    • 2
  • Rachel E. Goldsmith
    • 2
  • Guy H. Montgomery
    • 2
  • Julie B. Schnur
    • 2
  1. 1.Department of PsychologySt. John’s UniversityJamaicaUSA
  2. 2.Department of Oncological SciencesIcahn School of Medicine at Mount SinaiNew YorkUSA

Personalised recommendations