It was hypothesized that sexual abuse severity and adult attachment (reflective of the more pervasive experience of growing up in a family) would each have significant but distinct effects on the long-term functioning of incest survivors. A sample of 112 incest survivors completed the Beck Depression Inventory, the Symptom Checklist-10, the Impact of Event Scale, the MCMI-II, and the Relationship Questionnaire (a measure of adult attachment). Hierachical regression analyses indicated that sexual abuse characteristics (particularly early age of onset) predicted depression, intrusive thoughts, and, to a lesser degree, avoidance of memories of the abuse (symptoms consistent with a traditional PTSD conceptualization). Adult attachment (in particular, a lack of secure attachment) predicted avoidance of memories of the abuse. In addition, adult attachment predicted avoidant, dependent, self-defeating, and borderline personality disorders. Implications for the focus of therapy with the sexual abuse survivor are discussed.
Get full access to this article
View all access options for this article.
References
1.
Ainsworth, M.D.S. , Blehar, M. C., Waters, E., & Wall, S. (1978). Patterns of attachment: A psychological study of the strange situation. Hillsdale, NJ: Erlbaum.
2.
Alexander, P.C. (1992). Application of attachment theory to the study of sexual abuse.Journal of Consulting and Clinical Psychology, 60, 185-195.
3.
Alexander, P. C. , & Lupfer, S. L. (1987). Family characteristics and long-term consequences associated with sexual abuse.Archives of Sexual Behavior, 16, 235-245.
4.
Bartholomew, K. , & Horowitz, L. M. (1991). Attachment styles among young adults: A test of a four-category model.Journal of Personality and Social Psychology, 61, 226-244.
5.
Beck, A. , Ward, C., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression.Archives of General Psychiatry, 4, 561-571.
6.
Beck, A. T. , Steer, R. A., & Garbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation.Clinical Psychology Review, 8, 77-100.
7.
Bowlby, J. (1969/1982). Attachment and loss: Attachment (Vol. 1). New York: Basic Books.
8.
Bowlby, J. (1973). Attachment and loss: Separation (Vol. 2). New York: Basic Books.
9.
Bowlby, J. (1977). The making and breaking of affectional bonds.British Journal of Psychiatry, 130, 201-210.
10.
Bowlby, J. (1980). Attachment and loss: Loss (Vol. 3). New York: Basic Books.
11.
Briere, J. , & Runtz, M. (1987). Post sexual abuse trauma: Data and implications for clinical practice.Journal of Interpersonal Violence, 2, 367-379.
12.
Briere, J. , & Runtz, M. (1990). Differential adult symptomatology associated with three types of child abuse histories.Child Abuse & Neglect, 14, 357-364.
13.
Browne, A. , & Finkelhor, D. (1986). Impact of child sexual abuse: A review of the research.Psychological Bulletin, 99, 66-77.
14.
Carlson, V. , Cicchetti, D., Barnett, D., & Braunwald, K. (1989). Disorganized/disoriented attachment relationships in maltreated infants.Developmental Psychology, 25, 525-531.
15.
Cole, P. M. , & Putnam, F. W. (1992). The effect of incest on self and social functioning: A developmental psychopathology perspective.Journal of Consulting and Clinical Psychology, 60, 174-184.
16.
Collins, N. L. , & Read, S. J. (1990). Adult attachment, working models, and relationship quality in dating couples.Journal of Personality and Social Psychology, 58, 644-663.
17.
Conte, J. R. , & Schuerman, J. R. (1987). The effects of sexual abuse on children: A multidimensional view.Journal of Interpersonal Violence, 2, 380-390.
18.
Derogatis, L. , Lipman, R., & Covi, L. (1973). The SCL-90: An outpatient rating scale.Psychopharmacology Bulletin, 9, 13-28.
19.
Edwards, J. J. , & Alexander, P. C. (1992). The contribution of family background to the long-term adjustment of women sexually abused as children.Journal of Interpersonal Violence, 7, 306-320.
20.
Egeland, B. , & Sroufe, L. A. (1981). Attachment and early maltreatment.Child Development, 52, 44-52.
21.
Feeney, J. A. , & Noller, P. (1990). Attachment style as a predictor of adult romantic relationships.Journal of Personality and Social Psychology, 58, 281-291.
22.
Finkelhor, D. (1990). Early and long-term effects of child sexual abuse: An update.Professional Psychology: Research and Practice, 21, 325-330.
23.
Friedrich, W. N. , Beilke, R., & Urquiza, A. J. (1987). Children from sexually abusive families: A behavioral comparison.Journal of Interpersonal Violence, 2, 391-402.
24.
Haft, W. L. , & Slade, A. (1989). Affect attunement and maternal attachment: A pilot study.Infant Mental Health Journal, 10, 157-172.
25.
Harter, S. , Alexander, P. C., & Neimeyer, R. A. (1988). Longterm effects of incestuous child abuse in college women: Social adjustment, social cognition, and family characteristics.Journal of Consulting and Clinical Psychology, 56, 5-8.
26.
Hazan, C. , & Shaver, P. (1987). Romantic love conceptualized as an attachment process.Journal of Personality and Social Psychology, 52, 511-524.
27.
Herman, J. L. , & van der Kolk, B. A. (1987). Traumatic antecedents of Borderline Personality Disorder. In B. A. van der Kolk (Ed.), Psychological trauma (pp. 111-126). Washington, DC: American Psychiatric Press.
28.
Hoffmann, N. G. , & Overall, P. B. (1978). Factor structure of the SCL-90 in a psychiatric population.Journal of Consulting and Clinical Psychology, 2, 197-207.
29.
Horowitz, M. , Wilner, N., & Alvarez, W. (1979). Impact of Event Scale: A measure of subjective stress.Psychosomatic Medicine, 41, 209-218.
30.
Kobak, R. , & Sceery, A. (1988). Attachment in late adolescence: Working models, affect regulation, and representations of self and others.Child Development, 59, 396-399.
31.
Main, M. , & Cassidy, J. (1988). Categories of response to reunion with the parent at age 6: Predictable from infant attachment classifications and stable over a one-month period.Developmental Psychology, 24, 415-426.
32.
Main, M. , & Goldwyn, R. (1984). Predicting rejection of her infant from mother's representation of her own experience: Implications of the abused-abusing intergenerational cycle.Child Abuse & Neglect, 8, 203-217.
33.
Millon, T. (1969). Modern psychopathology.Philadelphia: Saunders.
34.
Millon, T. (1981). Disorders of personality: DSM-III, Axis II.New York: Wiley Interscience.
35.
Millon, T. (1986a). A theoretical derivation of pathological personalities. In T. Millon & G. L. Klerman (Eds.), Contemporary directions in psychopathology: Toward the DSM-IV (pp. 639-669). New York: Guilford.
36.
Millon, T. (1986b). Personality prototypes and their diagnostic criteria. In T. Millon & G. L. Klerman (Eds.), Contemporary directions in psychopathology: Toward the DSM-IV (pp. 671-712). New York: Guilford.
37.
Millon, T. (1987). Manual for the MCMI-II.Minneapolis, MN: National Computer Systems.
38.
Murphy, S. M. , Kilpatrick, D. G., Amick-McMullen, A., Veronen, L. J., Paduhovich, J., Best, C. L., Villeponteaux, L. A., & Saunders, B. E. (1988). Current psychological functioning of child abuse survivors: A community study.Journal of Interpersonal Violence, 3, 55-79.
39.
Nguyen, T. D. , Attkisson, C. C., & Stegner, B. L. (1983). Assessment of patient satisfaction: Development and refinement of a service evaluation questionnaire.Evaluation and Program Planning, 6, 299-314.
40.
Peters, S. D. (1988). Child sexual abuse and later psychological problems. In G. E. Wyatt & G. J. Powell (Eds.), Lasting effects of child sexual abuse (pp. 101-117). Newbury Park, CA: Sage.
41.
Roth, S. , & Lebowitz, L. (1988). The experience of sexual trauma.Journal of Traumatic Stress, 1, 79-107.
42.
Sroufe, L. A. (1988). The role of infant-caregiver attachment in development. In J. Belsky & T. Nezworski (Eds.), Clinical implications of attachment (pp. 18-38). Hillsdale, NJ: Erlbaum.
43.
Trepper, T. S. , & Barrett, M. J. (1986). Introduction. In T. S. Trepper & M. J. Barrett (Eds.), Treating incest: A multiple systems perspective (pp. 5-12). New York: Haworth.
44.
Waterman, J. (1986). Family dynamics of incest with young children. In K. MacFarlane, J. Waterman, S. Conerly, L. Damon, M. Durfee, & S. Long (Eds.), Sexual abuse of young children (pp. 204-219). New York: Guilford Press.
45.
Wheeler, B. R. , & Walton, E. (1987). Personality disturbances of adult incest victims.Social Casework, 597-602.
46.
Zeanah, C. H. , & Zeanah, P. D. (1989). Intergenerational transmission of maltreatment: Insights from attachment theory and research.Psychiatry, 52, 177-196.
