The Association Between a History of Sexual Violence and Romantic Relationship Functioning: A Systematic Review

Abstract

The consequences of sexual violence are substantial and include both intra- and interpersonal problems. Notably, sexual violence has been associated with difficulties in interpersonal relationships including intimate relationships. While there have been prior reviews considering various interpersonal and dyadic consequences associated with sexual violence, there has not been a comprehensive review considering the various aspects of adult dyadic functioning including intimacy, relationship conflict, and satisfaction satisfaction among both child and adult victims of sexual violence. The databases PsycINFO and PubMed were searched for terms related to sexual victimization (e.g., sexual assault, sexual victimization, sexual abuse, rape, revictimization), terms related to relationships (e.g., romantic relationship, intimate relationship), and terms related to relationship functioning (e.g., satisfaction, relationship quality, conflict, communication, intimacy, sexual functioning). Eligible studies for this review were required to (1) be an original study, (2) be written in English, (3) identify a sample or subsample consisting of women reporting a history of sexual violence in either childhood or adulthood, and (4) measure at least one of the following relationship areas: intimacy, relationship conflict, or relationship satisfaction in heterosexual adult romantic relationships. A total of 20 articles met inclusion criteria and were included in this review. Results demonstrated mixed findings on the association between sexual violence and relationship functioning, with some studies demonstrating an association between sexual violence and relationship functioning, and others failing to find such associations. These findings are discussed within the context of gaps in the extant literature and future research directions.

Keywords

attachment adult victims sexual assault sexual abuse child abuse

For centuries, close romantic relationships’ influence on the human experience has been recognized and appreciated by society, and evidence suggests that relationship quality from adolescence throughout adulthood has a significant impact on individuals’ overall well-being (Barr et al., 2013). In recent years, researchers have become increasingly interested in understanding various factors that affect, both positively and negatively, an individuals’ ability to function in stable and satisfying romantic relationships. One factor that has been the focus of numerous studies is sexual violence. This work suggests that a history of sexual violence, as either a child or adult, has a negative influence on the quality of romantic relationships (e.g., Whisman, 2006). Although several theoretical models have been proposed to explain victims’ responses to sexual abuse, such as Finkelhor and Browne’s (1985) model of traumagenic dynamics, or emotion regulation theories (e.g., Rellini et al., 2012), attachment theory (Bowlby, 1969; Hazan & Shaver, 1987) has gained increasing attention over the past few decades and provides a useful framework for understanding the association between sexual violence and adult romantic relationship functioning.

Attachment theory suggests that based on early childhood experiences with caregivers and/or with significant others, individuals develop attachment orientations that shape how they interact with other attachment figures throughout the life span (Bowlby, 1969; Hazan & Shaver, 1987). Secure attachment is posited to result from consistent and responsive care from an attachment figure, whereas insecure attachment (avoidant or anxious orientations) results from neglectful or inconsistent care. Both forms of attachment insecurity have been linked to the use of negative emotional, cognitive, and behavioral regulation strategies (Mikulincer et al., 2003). In contrast to attachment insecurity, securely attached individuals tend to engage in “problem-solving” coping, by which they deal with stress by acting to change their distressing circumstances (e.g., analyzing the problem and taking concrete steps to solve the problem) and seeking support from partners (Lussier et al., 1997).

Research has suggested that victims of sexual violence differ from those without histories of sexual violence in attachment orientations, such that individuals with histories of sexual violence tend to report less confidence in their partner’s dependability, less comfort with closeness, and greater fear of abandonment (Karakurt & Silver, 2014). From an attachment theory perspective, sexual violence plays a role in shaping individuals’ internal working models of the self, others, and relationships, which are used to guide interpersonal interactions later in life (Alexander, 1992). For example, a history of sexual violence not only shapes development of one’s attachment representations but also can negatively impact one’s socioemotional well-being and the development of interpersonal competencies (e.g., hyperactivating or deactivating coping strategies; Alexander, 1992). Moreover, research has supported a positive correlation between adult attachment and overall relationship functioning, and when both partners in a relationship are securely attached, they report the highest satisfaction with their romantic relationship (Mikulincer & Shaver, 2007; Mikulincer et al., 2003). Further, research has demonstrated that attachment orientation is likely to be related to difficulties with intimacy, commitment, and one’s ability to manage interpersonal conflict (Mikulincer & Shaver, 2007).

To date, several studies suggest that many victims of child sexual abuse (CSA) or adult sexual assault (ASA) have difficulty forming close relationships and report more instability in relationships as well as poorer romantic dyadic adjustment (e.g., Whisman, 2006). Conversely, some studies have failed to find significant associations between relationship functioning and a history of sexual violence (e.g., Miner et al., 2006; Paradis & Boucher, 2010). Three domains that have received attention in the literature include relationship intimacy, conflict and communication, and relationship satisfaction. For example, prior research has suggested that a history of sexual violence is linked to distrust of others and discomfort with intimacy (e.g., Georgia et al., 2018), and women with histories of CSA are more likely than nonsexually abused women to report feeling socially isolated and fearful of others (Davis & Petric-Jackson, 2000). Additionally, relationship conflict and resolution has been of particular interest to couple’s therapists and researchers because of its robust association to relationship satisfaction (Smith et al., 2008).

This review aims to shed light on some of these inconsistent findings across studies by systematically reviewing the extant literature on sexual violence and adult romantic relationship functioning and to highlight gaps and discrepancies present in the current body of literature. Furthermore, this review concludes with a discussion of potentially promising avenues for future research on dyadic functioning within the context of a history of sexual violence. Because limited research was found on sexual violence and romantic relationship functioning among ethnic and sexual minority populations, this review only included studies involving English-speaking females victimized sexually as children or adults. With this caveat, we note nonetheless that cultural and sexual orientation differences would presumably have important impacts on how individuals function in romantic relationships as well as relation dynamics between couple; thus, these are important populations to consider in future work in order to gain a more nuanced understanding of the impact of sexual violence. We discuss these groups briefly with respect to areas for future research.

Method

Search Strategy and Study Selection

The literature search was conducted across two databases: PubMed and PsycINFO for peer-reviewed journal articles published between the years 1990 and 2019. The search strategy included terms related to sexual victimization (e.g., sexual assault, sexual victimization, sexual abuse, rape, revictimization), terms related to relationships (e.g., romantic relationship, intimate relationship), and terms related to relationship functioning (e.g., satisfaction, relationship quality, conflict, communication, intimacy, sexual functioning). Searches were conducted in August 2019. This search produced 77 papers from PubMed and 70 papers from PsycINFO. A total of 28 duplicates were removed, and 119 articles were subjected to abstract review.

Eligible studies had to (1) be an original study, (2) be written in English, (3) identify a sample or subsample consisting of women reporting a history of sexual violence in either childhood or adulthood, and (4) measure at least one of the following relationship areas: intimacy, relationship conflict, or relationship satisfaction in heterosexual adult romantic relationships. Given that this review focused explicitly on female sexual violence and relationship functioning, we excluded studies assessing sexual violence among males, sexual minority populations, or military sexual violence. The majority of studies found consisted of primarily Non-Hispanic White samples, which is undoubtedly a limitation of the extant literature; however, studies with more diverse samples were not excluded from this review as long as they met the inclusion criteria noted above. In order to draw precise conclusions about the consequences of sexual violence specifically, studies that did not distinguish between different types of violence (e.g., physical vs. sexual) were excluded from this review. To ensure the research included in the review was of high quality, studies including sample sizes less than 100 also were eliminated from review. Reference lists were hand-searched and relevant titles screened by the first author. After scanning the references sections for the remaining 35 articles and adding an additional 13 papers, a total of 20 articles were included in this review. Only studies meeting inclusion criteria were included in this review. Study findings are reviewed below and outlined in Tables 1 –3.

Table 1.

Summary of Studies Assessing Child Sexual Victimization Outcomes.

Study	Sample	Victimization Measure	Definition of Violence	Theoretical Framework	Major Findings
Colman & Widom (2004)	1,179 Community men and women	CSA assessed via information obtained through court and official records	CSA ranged from touching to rape; no age limits specified	Not specified	CSA associated significantly with higher rates of relationship conflict and divorce
DiLillo & Long (1999)	142 College women	Life Events Questionnaire (Long, 1999)	CSA defined as contact abuse only and (1) perpetrated by a relative, (2) greater than five years age difference between victim and perpetrator, or (3) by use of threat or force	Traumagenic Dynamics Model (Finkelhor & Browne, 1985)	CSA associated significantly with decreased relationship satisfaction, poor communication, and lower levels of trust
Dunlop et al. (2015)	808 Outpatient men and women	Childhood Trauma Questionnaire (Bernstein et al., 1994)	CSA defined as a traumatic sexual experience prior to the age of 17	Traumagenic Dynamics Model	CSA associated significantly with lower relationship satisfaction
Fairweather & (2013)	287 College women	Early Sexual Experiences Survey (Bartoi & Kinder, 1998)	CSA defined as any sexual contact between a child under the age of 16 and someone at least 5 years older; or unwanted and/or forcible sexual contact between a child under 16 and someone of any age	Not specified	No significant association between CSA and relationship satisfaction
Fleming et al. (1999)	3,958 Community women	Not specified	CSA defined as sexual contact before the age of 12 with a person 5 or more years older, and sexual contact occurring between 12 and 16 years with a person 5 or more years older, unless wanted or not distressing	Attachment Theory (Bowlby, 1969)	CSA associated significantly with experiences of domestic violence, greater sexual intimacy concerns, and decreased relationship satisfaction
Friesen, Woodward, Horwood & Fergusson (2010)	984 Community men and women	Not specified	CSA defined as non-contact episodes (e.g., indecent exposure) to attempted/ completed oral, anal, or vaginal intercourse prior to the age of 16	Not specified	CSA associated significantly with higher rates of partner adjustment problems, higher rates of IPV, and lower levels of relationships satisfaction
Larsen et al. (2011)	634 Outpatient men and women	CSA assessed via single item: “How often did sexual abuse happen to you while you were a child?”	CSA defined as sexual contact (e.g., touching, coercion of sexual acts) during childhood; no age limits specified	Not specified	No significant association between CSA and emotional intimacy, communication, or relationship conflict
Liang et al. (2006)	136 Community women	CSA assessed via medical records	CSA based on documented histories of CSA; no age limits specified	Attachment Theory	CSA associated significantly with greater marital dissatisfaction
Paradis & Boucher (2010)	1,728 College men and women	The Instrument to Measure Sexual Aggression in Childhood—Short Form (Cyr & Frappier, 2005)	CSA defined as inappropriate sexual experience prior to the age of 18 (e.g., indecent exposure, forced, unwanted sexual activities)	Interpersonal Theory (Sullivan, 1953)	No significant association between CSA and intimacy
Rellini et al. (2012)	192 Community women	Childhood Trauma Questionnaire	CSA defined as a traumatic sexual experience prior to the age of 17	Emotion Regulation Theory (e.g., Linehan, 1993)	CSA associated significantly with relationship dissatisfaction
Senn et al. (2012)	481 Women attending STI clinic	Not specified	CSA defined as oral, vaginal, or anal sex that occurred: (1) under the age of 13 with someone at least 5 years older, (2) under the age of 17 with someone at least 10 years older, or (3) under age 17 with force	Traumagenic Dynamics Model	CSA associated significantly with increased trust of a romantic partner
Tardif-Williams et al. (2017)	1,885 Community men and women	Childhood Experiences of Violence Questionnaire (Walsh et al., 2008)	CSA defined as unwanted sexual contact (e.g., touching, intercourse) before the age of 16	Attachment Theory	No significant association between CSA and relationship satisfaction
Testa et al. (2005)	732 Community women	CSA assessed via eight items describing unwanted sexual experiences before age 14	CSA defined as unwanted sexual contact (e.g., touching, intercourse) before the age of 16	Traumagenic Dynamics Model	No significant association between CSA and relationship satisfaction
Whisman (2006)	2,517 Community men and women	Subjects asked about various traumatic events (e.g., rape, sexual molestation); questions pulled from Diagnostic Interview Schedule (Robins et al., 1988)	CSA defined as sexual molestation or rape; no age limits specified	Traumagenic Dynamics Model	CSA associated significantly with higher rates of marital disruption and lower marital satisfaction

Note. CSA = Child sexual abuse.

Table 2.

Summary of Studies Assessing Adult Sexual Victimization Outcomes.

Study	Sample	Victimization Measure	Definition of Violence	Theoretical Framework	Major Findings
Gidycz et al. (2008)	312 College women	ASA assessed via single item: “Did you ever have unwanted sexual contact with someone because you were threatened or physically forced?”	ASA defined as unwanted sexual contact since the age of 14	Problem Behavior Theory (Champion et al., 2004)	ASA associated significantly with physical violence in relationships
Katz & Myhr (2008)	193 College women	Sexual Experiences Survey (SES; Koss & Oros, 1982)	ASA defined as verbal sexual coercion	Not specified	ASA associated significantly with decreased relationship satisfaction and poor communication
Thelen et al. (1998)	111 Community women	SES	ASA defined as unwanted sexual contact since the age of 14	Attachment Theory	No significant differences in intimacy levels between ASA victims and controls

Note. ASA = Adult sexual assault.

Table 3.

Summary of Studies Assessing Both Child and Adult Sexual Victimization Outcomes.

Study	Sample	Victimization Measure	Definition of Violence	Theoretical Framework	Major Findings
Georgia et al., (2018)	701 Heterosexual couples	Victimization assessed via single item: “Did you ever have unwanted sexual contact with someone because you were threatened or physically forced?”	CSA defined as unwanted sexual contact before the age of 18; ASA defined as unwanted sexual contact since the age of 18	Not specified	ASA (not CSA) associated significantly with lower satisfaction; CSA and ASA associated with poorer emotional intimacy, but not sexual intimacy
Messman-Moore et al. (2000)	648 College women	CSA assessed via Life Events Questionnaire; ASA assessed via Sexual Experiences Survey	CSA defined as unwanted sexual contact prior to the age of 17 with someone 5 or more years older; ASA defined as unwanted sexual contact after age of 17	Not specified	CSA and revictimized women reported higher levels of hostility compared to ASA only and nonvictims; ASA only not significantly different than nonvictims on levels of hostility
Miner et al. (2006)	230 Community women	Victimization assessed via Compulsive Sexual Behavior Inventory (Coleman et al., 2001)	CSA defined as sexual encounters with either parent, or having had sexual encounters with a sibling; ASA defined as forced intercourse; no age limits specified	Not specified	No significant association between CSA/ASA and partner communication

Note. CSA = child sexual abuse; ASA = adult sexual assault.

Results

Intimacy

Our examination of the literature results found a total of seven studies that assessed the association between a history of sexual violence and intimacy in romantic relationships. Results were mixed, as two studies showed a significant association between a history of sexual violence and decreased intimacy (e.g., DiLillo & Long, 1999), three failed to find significant associations (e.g., Thelen et al., 1998), and two found discrepant findings (e.g., Paradis & Boucher, 2010). For example, Senn et al. (2012) found a significant association between a history of CSA and increased trust of romantic partners, compared to women without histories of sexual violence. Additionally, there appeared to be discrepant findings among different types of intimacy. For example, Georgia and colleagues (2018) found significant associations between both CSA and ASA and lower emotional intimacy; however, sexual violence was not significantly associated with sexual intimacy. Furthermore, Paradis and Boucher (2010) examined the correlation between a history of child maltreatment (sexual, physical, and emotional abuse) and intimacy in adult romantic relationships. Results revealed an association between other forms of maltreatment and difficulties in intimate relationships, yet results did not provide evidence of an association between CSA and current difficulties in relationship functioning, suggesting there may be differential outcomes based on type of abuse.

It is also important to note that the study characteristics varied greatly among studies. All seven of the studies examined the prospective linkage between sexual violence and relationship intimacy, and six of the seven utilized validated measures of intimacy (e.g., the Quality Marriage Index; Norton, 1983). Additionally, of the seven studies investigating the association between a history of sexual violence and intimacy within romantic relationships, five assessed CSA only, one assessed ASA only, and one study assessed both CSA and ASA outcomes. Given the lack of CSA/ASA comparison studies and the mixed results among both CSA and ASA studies, it is difficult to draw clear conclusions about differential outcomes of CSA versus ASA experiences.

Relationship Conflict and Communication

Results revealed a total of 11 studies that assessed the association between a history of sexual violence and romantic relationship conflict. Two studies found a significant association between a history of CSA and increased reports of conflict and divorce within romantic relationships, suggesting that a history of CSA is associated with increased romantic relationship conflict and disruption in adulthood (Colman & Widom, 2004; Whisman, 2006). No studies were located which assessed relationship conflict and disruption among women sexually victimized in adulthood. Additionally, four studies investigated the association between a history of sexual violence and communication with romantic partners. Results were mixed, with two studies finding a significant association between a history of either CSA or ASA and poor relationship communication (e.g., DiLillo & Long, 1999), and two studies failing to find a significant association between a history of CSA or ASA and poor relationship communication (e.g., Miner et al., 2006).

Five studies evaluated the association between a history of sexual violence and increased physical aggression and hostility in romantic relationships. Results demonstrated an association between a history of sexual violence and an increased risk of physical violence, such that women with histories of CSA and/or ASA both were more likely than women without abuse histories to commit and experience intimate partner aggression (e.g., Fleming et al., 1999; Friesen et al., 2010). Interestingly, Messman-Moore et al. (2000) found that CSA and revictimized women (i.e., CSA-ASA or ASA-ASA) reported higher levels of hostility compared to ASA only and nonvictims. Furthermore, women experiencing ASA only did not differ from women with no abuse histories on levels of reported hostility. These findings suggest that there may be differential outcomes based on types of abuse experienced (i.e., childhood vs. adult sexual violence).

Of the 11 studies assessing relationship conflict/communication, there also was great variability among study quality. Seven of the 11 studies assessed CSA only, 2 assessed ASA only, and 2 studies assessed both CSA and ASA outcomes. Four studies were prospective in design, while seven were cross-sectional. Furthermore, seven studies utilized validated measures to assess relationship conflict (e.g., Conflict Tactics Scale; Straus, 1979), while four studies assessed conflict via single, Likert-type scale items (e.g., “How many times have you separated from your partner?”).

Relationship Satisfaction

Results revealed that 12 studies assessed the association between a history of sexual violence and romantic relationship satisfaction. Results were mixed, with 10 studies supporting the link between a history of sexual violence and relationship satisfaction (e.g., DiLillo & Long, 1999; Rellini et al., (2012), and 2 failing to find a significant relationship (Fairweather & Kinder, 2013; Tardif-Williams et al., 2017). Interestingly, Georgia, Roddy, & Doss (2018) found differential outcomes for CSA verses ASA, such that ASA (not CSA) was significantly associated with lower relationship satisfaction, suggesting there might be differential outcomes among CSA versus ASA victims with respect to relationship satisfaction. However, only one study compared CSA with ASA outcomes (Georgia et al., 2018), thus additional work is needed in order to better compare and contrast the relationship between sexual violence and relationship satisfaction among women reporting disparate victimization experiences.

Across studies, there appeared to be notable inconsistencies among study characteristics. Ten of the 12 studies assessed CSA only, 1 assessed ASA only, and 1 assessed both CSA and ASA outcomes. Three studies included a prospective study design, while nine were cross-sectional. Lastly, there was a great amount of variability among measures used to assess relationship satisfaction. Eight studies utilized validated measures of relationship satisfaction (e.g., Dyadic Adjustment Scale; Spanier, 1976), while four studies assessed satisfaction via unvalidated Likert-type scale items (e.g., “All in all, how satisfied are you with your relationship?”).

Inconsistencies Within the Literature and Problematic Methodological Issues

Findings from this review suggest that not all women who experience sexual violence exhibit relationship dysfunction, and while several studies have found a relationship between a history of sexual violence in both childhood and adulthood and relationship difficulties in adulthood (e.g., Georgia et al. 2018; Tardif-Williams et al., 2017; Whisman, 2006), some studies have failed to find strong relationships between victimization experiences and later relationship difficulties (e.g., Larsen et al., 2011). Thus, the association between sexual violence and dyadic functioning appears to be a complicated one. There are several possible explanations that may help shed light on the discrepant findings including conceptual and methodological issues.

Measurement Issues With Assessing Sexual Violence

Across studies, there have been notable inconsistencies in the definitional criteria of sexual violence (Briere, 1992; Cook et al., 2011). For instance, some researchers have utilized broad definitions of sexual violence to encompass unwanted sexual contact of any kind (e.g., Testa et al., 2005), whereas others have employed more narrow definitions such as attempted/completed rape specifically (e.g., Garneau-Fournier et al., 2017; Whisman, 2006). Broad definitions of sexual violence may disguise important difference among women who have experienced different forms of violence, while narrow definitions ignore experiences that might impact an individual’s subsequent functioning. Additionally, researchers who restrict definitions more narrowly are more likely to demonstrate more extreme outcomes compared to those using broader definitions (Briere, 1992). Furthermore, there have been inconsistencies among age cutoffs used to distinguish CSA from adult sexual abuse. For example, some researchers have defined CSA as any nonconsensual sexual contact (i.e., fondling of genitals, attempted/completed penetration) prior to the age of 19 (e.g., DiLillo et al., 2009), while others have limited definitions of CSA to completed sexual molestation or rape before the age of 17 (e.g., Garneau-Fournier et al., 2017; Whisman, 2006). Variability in these definitions makes it difficult to compare findings across studies and draw firm conclusions about associations between sexual violence and dyadic functioning. Until researchers settle on standard definitions of CSA and ASA, findings will need to be placed within specific definitional contexts (and their inherent limitations) used in the studies.

Measurement Issues With Assessing Romantic Relationship Functioning

Within the existing literature, there are noteworthy inconsistencies in conceptualizations of healthy romantic relationship functioning as well as varying methods utilized to assess relationship functioning (Davila et al., 2009). Some researchers have conceptualized relationship functioning more broadly by obtaining an overall rating of relationship functioning comprising of various constructs (e.g., satisfaction, conflict), whereas others have assessed relationship functioning through individuals’ subjectively held attitudes and evaluations of their romantic relationships by distinguishing between separate components of perceived relationship quality such as commitment or satisfaction.

While researchers have provided rationales for employing both of these approaches, neither approach is without faults. From a theoretical standpoint, assessing relationship functioning broadly is problematic because it confounds relationship processes (e.g., communication) with outcomes (e.g., satisfaction; Fletcher et al., 2000). On the other hand, while there has been a recent interest among relationship researchers in distinguishing between the different components of relationship functioning, this approach leads to the problem of method variance. For example, while relationship satisfaction is one the most widely studied relationship variables, there is not a single universally used and agreed-upon measure (Sánchez-Fuentes et al., 2014).

Sampling Bias

Sampling biases have characterized much of the work in the field of sexual violence. A significant proportion of studies have utilized small samples consisting of college students, clinical, or convenience samples recruited via local communities (DiLillo, 2001). College students tend to be younger, perhaps better adjusted, and less diverse in terms of social class than other individuals having experienced sexual violence. On the other hand, individuals sampled from clinical populations tend to be less well-adjusted and likely have experienced more severe types of abuse, with an increased risk of comorbid interpersonal or psychological concerns. With samples drawn from the community, there comes the concern of self-selection as these individuals may not adequately represent victims as a subgroup. Additionally, a large proportion of studies investigating dyadic functioning focus on White, heterosexual individuals. Sampling from such a specific population limits the generalizability of findings to other populations, such as ethnic and sexual minorities.

Unknown Role of Confounding Variables

Studies assessing CSA and adult outcomes often do not account for the potential influence of background characteristics (e.g., family conflict or social class) that may impact the relationship between sexual violence and relationship functioning. For example, prior research has posited that factors such as parental conflict and divorce place individuals at greater risk of developing poor interpersonal skills, negative perceptions/expectations about romantic relationships, and relationship dysfunction irrespective of having a history of sexual violence (Amato & Patterson, 2017). While some studies have examined the effects of sexual violence longitudinally, much of the research in this area has relied on cross-sectional and retrospective self-reports of victimization experiences typically obtained at a single assessment period (Fergusson et al., 2013). Retrospective self-reports run the risk of biased reporting, as participants may attempt to link past experiences to later adult functioning. Since these measures are subject to errors such as recall bias, some researchers have advocated for using samples of children and following them prospectively, to be able to draw more concise conclusions about the relationship between sexual violence and subsequent relationship outcomes (e.g., Friesen et al., 2010). Nevertheless, when longitudinal research designs have been used, most have been relatively short, usually with only two to three different time points of assessment, leaving important gaps in our understanding of these outcomes (Testa et al., 2005).

Another concern with cross-sectional study designs is that many studies have not controlled for earlier relationship functioning/adjustment prior to victimization experiences and therefore are limited in their ability to disentangle the effects of sexual violence from prior adjustment (Briere, 1992). Similarly, there has been a tendency to assess sexual violence separately from other types of abuse or maltreatment. This can be problematic as sexual violence has been shown to co-occur frequently with other forms of abuse (Scott-Storey, 2011). Studies that have included other confounding factors have mixed findings, with some studies suggesting that early childhood and family factors have a larger influence on interpersonal functioning than CSA (e.g., Bhandari et al., 2011) and others suggesting that the effects of CSA are withstanding even after controlling for covariates (e.g., Noll et al., 2019). As a consequence, recent research has shifted toward investigating possible mediating factors influencing the association between sexual violence and overall relationship functioning. For example, Testa et al. (2005) found support for a model suggesting that sexually victimized women’s relationship satisfaction was mediated via partner aggression and partner sexual risk, such that female CSA was associated with affiliation with sexually risky and aggressive male partners, resulting in lower relationship satisfaction. These results highlight the need for future studies to explore additional pathways by which a history of sexual violence may influence adult dyadic functioning through prospective studies. In sum, researchers must be careful not to overemphasize causal relationships between a history of sexual violence and the development of later relationship dysfunction.

Future Directions

The goal of this review was to examine the extant literature and highlight discrepant findings among studies to help elucidate the relationship between a history of sexual violence and subsequent romantic relationship quality. Findings from this review suggest that this relationship is complex and multifaceted, as some studies have found support for the association between a history of sexual violence in childhood and/or adulthood and lower relationship quality, and some studies have failed to find support for that relationship. Additionally, the unique differences between CSA and ASA experiences and relationship quality are less clear as few studies have investigated both CSA and ASA experiences, making it difficult to draw comprehensible conclusions. Furthermore, outcomes among one-time sexual trauma relative to sexual revictimization are unclear as few studies distinguish between various degrees of severity among victims. However, it does appear that greater victimization severity (i.e., number of victimization experiences and extent of victimization experience) is associated with lower relationship quality (e.g., Friesen et al., 2010), which is consistent with previous research on the detrimental effect of the cumulative trauma (Messman-Moore et al., 2000). Additional work is needed in order to assess whether there are distinct differences between one-time trauma experiences and histories of repeated sexual violence.

Our review identified several gaps in the literature regarding the relationship between sexual violence and relationship functioning. While there have been numerous studies in the past few decades investigating the negative interpersonal consequences of sexual violence there still remains many unanswered questions, discrepancies among findings, and areas that warrant future investigation.

Resiliency

While the short- and long-term consequences associated with CSA and ASA have been well-documented in the literature, a large proportion of sexually abused individuals retain normal levels of functioning following a sexual violence including relatively stable romantic relationships (Domhardt et al., 2015). These observed patterns of relatively healthy functioning following trauma are termed “resiliency.” While resiliency is characterized by mild disruptions in normal functioning, these observed increases in distress are often short-lived and do not prohibit an individual from continuing to function effectively (Bonanno, 2005). Sexual violence is wrong for a plethora of reasons, and the victim is never responsible for being victimized. Despite sexual violence being wrong and morally reprehensible, some individuals appear to retain normal levels of functioning. A recent systematic review investigating resiliency in survivors of CSA found that between 10% and 53% of CSA survivors appear to function within normal levels, despite histories of sexual violence (Domhardt et al., 2015). Findings from this systematic review suggest that a variety of internal and external factors influence the impact that sexual violence has on various developmental periods such as interpersonal/emotional competence, active coping mechanisms, social attachment, and external attributions of blame (Domhardt et al., 2015).

Resiliency is an important construct to consider as it can help inform clinical practice and the development of interventions aiming to increase positive outcomes following sexual violence (Macy, 2008). Specifically, research identifying protective factors may provide valuable information for designing prevention and intervention programs against the adverse effects sexual violence has on romantic relationships. For example, interventions targeting beliefs around romantic relationships and adaptive coping mechanisms could benefit victims of sexual violence and help them engage in satisfying and productive romantic relationships. This notion is consistent with attachment theory, as Bowlby (1969) suggested that individuals’ early experiences with attachment figures shape the internal working models that they draw upon in relationships later in life. Given that victimization experiences are associated with insecure attachment orientations (Rosen et al., 2017), such as anxiety about abandonment in close relationships, targeting internal beliefs about close relationships or coping mechanisms could help bolster protective factors relating to more positive relationship outcomes. Although resiliency is an important factor to consider when evaluating the interpersonal outcomes of sexual violence, these statements are not meant to suggest that CSA or ASA is acceptable given the (sometimes) lack of negative consequences to victims.

Differences Between CSA and ASA

While there is an abundance of literature suggesting that CSA is associated with a variety of negative relationship outcomes such as decreased intimacy, relationship satisfaction, and greater relationship conflict, fewer studies have investigated the effects of ASA on dyadic functioning. Additionally, many studies have investigated either CSA or ASA separately, and consequently, many systematic reviews of this literature have limited their scope to either CSA or ASA. This is problematic as the degree to which these bodies of literature are comparable is still unclear (Dworkin et al., 2017). Furthermore, a large proportion of studies that have assessed both CSA and ASA experiences have not distinguished between childhood and adulthood victimization. This runs the risk of potentially overlooking differences in the effects on dyadic functioning on childhood and adulthood-only victimization separately; therefore, the research is limited with respect to the conclusions that can be drawn (e.g., Garneau-Fournier et al., 2017; Lévesque et al., 2016). It could be the case that there are significant differences between CSA, ASA, and revictimized women in how they relate to subsequent dyadic functioning (e.g., one group displaying greater difficulties in a particular area of functioning relative to the other). One study investigating the prevalence of hostility in intimate relationships among women with histories of CSA, ASA, or revictimization with women without abuse histories found that CSA and revictimized women reported higher levels of hostility compared to ASA only and nonvictims. Additionally, results suggested that ASA only was not significantly different than nonvictims on levels of hostility (Messman-Moore et al., 2000). These findings suggest that there are likely notable differences between CSA, ASA, and women who have experienced revictimization in regard to their romantic relationship quality, and future work that allows for comparisons across these groups is needed to elucidate these potential differences.

Investigation of Mediators and Moderators

Given that there have been notable inconsistencies among study findings, researchers have started to posit that additional factors (e.g., emotion regulation difficulties, alcohol consumption) might play important roles in the relationship between experiences of sexual violence and subsequent adult dyadic functioning. For example, Kallstrom-Fuqua et al. (2004) found that perceptions of betrayal and powerlessness among CSA survivors mediated the relationship between CSA severity and maladaptive relationship functioning. Findings such as these suggest that other factors associated with relationship functioning may work in conjunction with the effects of CSA that may ultimately lead to increased risk of unhealthy dyadic functioning (Friesen et al., 2010).

In order to gain a full understanding of the long-term effects of sexual violence, future work would benefit from examining other variables that might influence the relationship between sexual violence and dyadic adjustment such as disclosure of abuse or coping styles. As noted above, a few studies have looked at mediating variables such as adolescent risk taking; however, there are likely other variables that could provide additional insight into these relationships. For example, some research has suggested that disclosure, post sexual assault, can have an important impact on victims’ relationships with friends, family, and romantic partners (Ahrens & Aldana, 2012). These findings have also suggested that the perceived quality of the relationship (i.e., positive, neutral, poor) may also impact the type of reaction received/interpreted by the victim and subsequently influence those relationships. Many facets of relationship functioning also appear to be associated with one another. For example, Litzinger and Gordon (2005) examined relationships among couple commination, sexual satisfaction, and marital satisfaction. Regression analyses demonstrated that communication and sexual satisfaction independently predicted marital satisfaction among couples. Including such variables in prospective studies would allow us to draw for more thorough conclusions about the relationships between victimization experiences and adult relationship functioning.

Minority Population Considerations

Ethnic and sexual minority differences have only recently begun to gain attention by researchers with respect to their experiences of sexual violence. To date, very few studies have investigated how these differences may influence relationship functioning among members of these populations. This work appears especially relevant given that these groups appear to be at an increased risk of a multitude of inter- and intrapersonal problems (Balsam et al., 2015). For example, lesbian and bisexual women, relative to heterosexual women, are at an increased risk of experiencing sexual violence in both childhood (Austin et al., 2008; Balsam et al., 2005) and adulthood (Balsam et al., 2015). Additionally, research has found higher rates of CSA (e.g., Ullman & Filipas, 2005), ASA (e.g., Balsam et al., 2015), and revictimization among ethnic and racial minorities (Balsam et al., 2011). Given that research has suggested that ethnic and sexual minority populations are at an increased risk of experiencing sexual violence, it is imperative that research focusing on dyadic functioning within these groups examines the association between a history of sexual violence and subsequent relationship quality.

While the CSA/ASA literature on ethnic and sexual minority populations is gaining attention, studies of relationship functioning among ethnic/sexual minorities are virtually nonexistent, and the majority of studies investigating the association between sexual violence and romantic relationship functioning have focused on White, heterosexual populations. Given the homogeneity of populations frequently used in research, there are likely limitations to the generalizability of conclusions which can draw from these studies. Dyadic functioning among minority populations is an important issue to address because the sociocultural context in which sexual violence occurs influences not only the associated symptomology (e.g., relationship distress) but other issues such as definitions of abuse, initial reactions to the abuse, the meaning the abuse has to the victim, and the likelihood of disclosure and help-seeking behaviors (Loeb et al., 2002). Additionally, there are potentially cultural differences in assumptions about what constitutes a “good” relationship. For example, Marshall (2008) found that Chinese couples valued greater gender-role traditionalism, resulting in lower intimacy and self-disclosure compared to European couples. In order to advance prevention and intervention efforts, additional research might be conducted to understand how the increased vulnerability of certain subpopulations (e.g., sexual and ethnic minority populations) is associated with dyadic functioning (Coulter et al., 2017). Given that there appears to be differences in relationship values across cultures, it is important for future research to explicate how experiences of sexual violence shape an individual’s assumptions about romantic relationships to help tailor interventions based on relationship values.

Sexual Violence and Dyadic Functioning Among Men

Men are an additional population that is relatively understudied within the sexual violence field (Chapleau et al., 2008). While the majority of ASA crimes are perpetrated by men against women, approximately 3%–8% of men report experiencing an incident of adult sexual violence during their lifetime (Tjaden & Thoennes, 2006). There is some data to suggest that there may be sex differences with respect to the consequences of sexual violence; however, the few studies that have examined male victims often show mixed results, with some studies finding similar difficulties in couple functioning for both male and female victims (e.g., Colman & Widom, 2004) and others finding nonsignificant relationships between sexual violence and relationship functioning for males (e.g., DiLillo et al., 2009).

One reason why some studies report differential outcomes in relationship functioning among male versus female victims is that men tend to report fewer and less severe instances of sexual violence, in childhood or adulthood, compared to females (Weiss, 2010). Given that men are less likely to disclose unwanted sexual experiences and less likely to seek out sexual assault support services, this population is at an increased risk of experiencing negative consequences of sexual violence that could potentially extend to their interpersonal relationships (Turchik, 2012). More research is needed to better understand the relationship between sexual violence and relationship functioning among men, as this has important implications for males’ desire to seek romantic relationships as well as their satisfaction within those relationships.

Conclusion

With roughly one half to two thirds of marriages ending in divorce, it is not surprising that researchers have shifted their attention toward investigating what builds a healthy relationship (Litzinger & Gordon, 2005). Sexual violence is one factor that has gained increased attention in its association with relationship functioning and one that likely has important implications for clinical work with victims. If, as the extant literature suggests, prior sexual violence experiences adversely affect romantic relationship functioning, then a thorough assessment of past victimization experiences and related distress among clients may be advantageous, particularly in couples therapy settings. Additionally, depending upon clients’ presenting problems, clinicians may not be focused on women’s sexual health and relationship functioning concerns; however, these may be important issues for many women, especially those with prior histories of sexual violence. Thus, clinicians might assess for sexual and relational problems (e.g., intimacy concerns: difficulties with sexual assertiveness, sexual dysfunctions) and integrate these targets into treatment planning, if appropriate.

Attachment theory also offers important implications for victims of CSA and/or ASA, as sexual violence has often been associated with insecure forms of attachment (Karakurt & Silver, 2014). Numerous studies have investigated attachment as a mediator of the relationship between sexual violence and adult dyadic functioning (e.g., Givertz et al., 2016). According to the theory, individuals’ internal working models are not only affected by past relationships/abuse but also function in a reciprocal nature with current relationships (Alexander, 1992). Therefore, a focus on current relationship experiences offers a unique and critical opportunity for individuals who have experienced past victimization to modify implicit, and potentially deleterious, expectations about relationships. In sum, it is imperative that research continues to investigate the negative effects sexual violence can have on both women’s and men’s abilities to sustain healthy and satisfying intimate relationships. Collectively, these findings suggest that CSA and ASA victims are possibly at an increased risk of experiencing difficulties in romantic relationships; however, future research is needed to better elucidate the nature of these relationships.

Implications for Policy, Practice, and Research

Given the evidence suggesting a positive association between sexual violence and relationship difficulties, thorough assessment of relationship problems and incorporation into treatment may prove advantageous and should be assessed by clinicians.

While there is evidence suggesting a negative correlation between sexual violence and relationship functioning, it is important to note that not all studies have found such associations, and a large proportion of victims of sexual violence maintain normal levels of dyadic functioning following sexual violence. Future work should focus on identifying factors contributing to these differences.

More work is needed to identify the mediators and moderators that may influence the relationship between sexual violence and relationship functioning.

Future research should work on cultivating more widely accepted definitions and methods of assessing both sexual violence and romantic relationship functioning to allow for more comparisons and generalizations across study findings.

Future studies might benefit from examining multiple types of sexual violence (i.e., CSA only, ASA only, and revictimization) so as to facilitate to comparisons across groups and assess potential differences in relationship outcomes.

More research is needed to investigate relationship outcomes among understudied populations (i.e., men and sexual and ethnic minorities) so as to evaluate whether work in this area generalizes to these more vulnerable and understudied populations.

Footnotes

Declaration of Conflicting Interests

The author(s) declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Kristen N. Vitek

References

Ahrens

C. E.

Aldana

(2012). The ties that bind: Understanding the impact of sexual assault disclosure on survivors’ relationships with friends, family, and partners. Journal of Trauma & Dissociation, 13(2), 226–243.

Alexander

P. C.

(1992). Application of attachment theory to the study of sexual abuse. Journal of Consulting and Clinical Psychology, 60(2), 185–195.

Amato

P. R.

Patterson

S. E.

(2017). The intergenerational transmission of union instability in early adulthood. Journal of Marriage and Family, 79(3), 723–738.

Austin

S. B.

Roberts

A. L.

Corliss

H. L.

Molnar

B. E.

(2008). Sexual violence victimization history and sexual risk indicators in a community-based urban cohort of “mostly heterosexual” and heterosexual young women. American Journal of Public Health, 98(6), 1015–1020.

Balsam

K. F.

Lehavot

Beadnell

(2011). Sexual revictimization and mental health: A comparison of lesbians, gay men, and heterosexual women. Journal of Interpersonal Violence, 26(9), 1798–1814.

Balsam

K. F.

Molina

Blayney

J. A.

Dillworth

Zimmerman

Kaysen

. (2015). Racial/ethnic differences in identity and mental health outcomes among young sexual minority women. Cultural Diversity and Ethnic Minority Psychology, 21(3), 380–390.

Balsam

K. F.

Rothblum

E. D.

Beauchaine

T. P.

(2005). Victimization over the life span: A comparison of lesbian, gay, bisexual, and heterosexual siblings. Journal of Consulting and Clinical Psychology, 73(3), 477.

Barr

Culatta

Simons

(2013). Romantic relationships and health among African American young adults: Linking patterns of relationship quality over time to changes in physical and mental health. Journal of Health and Social Behavior, 54(3), 369–385.

Bartoi

M. G.

Kinder

B. N.

(1998). Effects of child and adult sexual abuse on adult sexuality. Journal of Sex & Marital Therapy, 24(2), 75–90.

10.

Bernstein

D. P.

Fink

Handelsman

Foote

. (1994). Initial reliability and validity of a new retrospective measure of child abuse and neglect. American Journal of Psychiatry, 151, 1132–1136.

11.

Bhandari

Winter

Messer

Metcalfe

(2011). Family characteristics and long-term effects of childhood sexual abuse. British Journal of Clinical Psychology, 50(4), 435–451.

12.

Bonanno

G. A.

(2005). Resilience in the face of potential trauma. Current Directions in Psychological Science, 14(3), 135–138.

13.

Bowlby

. (1969). Attachment and loss: Vol. 1. Loss. Basic Books.

14.

Briere

. (1992). Methodological issues in the study of sexual abuse effects. Journal of Consulting and Clinical Psychology, 60(2), 196–203.

15.

Champion

H. L. O.

Foley

K. L.

DuRant

R. H.

Hensberry

Altman

Wolfson

(2004). Adolescent sexual victimization, use of alcohol and other substances, and other health-risk behaviors. Journal of Adolescent Health, 35, 321–328.

16.

Chapleau

K. M.

Oswald

D. L.

Russell

B. L.

(2008). Male rape myths: The role of gender, violence, and sexism. Journal of Interpersonal Violence, 23(5), 600–615.

17.

Coleman

Miner

Ohlerking

Raymond

(2001). Compulsive sexual behavior inventory: A preliminary study of reliability and validity. Journal of Sex & Marital Therapy, 27(4), 325–332.

18.

Colman

R. A.

Widom

C. S.

(2004). Childhood abuse and neglect and adult intimate relationships: A prospective study. Child Abuse & Neglect, 28(11), 1133–1151.

19.

Cook

S. L.

Gidycz

C. A.

Koss

M. P.

Murphy

(2011). Emerging issues in the measurement of rape victimization. Violence Against Women, 17(2), 201–218.

20.

Coulter

R. W.

Mair

Miller

Blosnich

J. R.

Matthews

D. D.

McCauley

H. L.

(2017). Prevalence of past-year sexual assault victimization among undergraduate students: Exploring differences by and intersections of gender identity, sexual identity, and race/ethnicity. Prevention Science, 18(6), 726–736.

21.

Cyr

Frappier

J.-Y.

(2005). Instrument pour mesurer l’ASE—Version Courte [Instrument to measure sexual aggression in childhood—short form] [Unpublished manuscript]. Université de Montréal.

22.

Davila

Steinberg

S. J.

Ramsay

Stroud

C. B.

Starr

Yoneda

(2009). Assessing romantic competence in adolescence: The romantic competence interview. Journal of Adolescence, 32, 55–75.

23.

Davis

J. L.

Petric-Jackson

P. A.

(2000). The impact of child sexual abuse on adult interpersonal functioning: A review and synthesis of the empirical literature. Aggression and Violent Behavior, 5(3), 291–328.

24.

DiLillo

(2001). Interpersonal functioning among women reporting a history of childhood sexual abuse: Empirical findings and methodological issues. Clinical Psychology Review, 21(4), 553–576.

25.

DiLillo

Long

P. J.

(1999). Perceptions of couple functioning among female survivors of child sexual abuse. Journal of Child Sexual Abuse, 7(4), 59–76.

26.

DiLillo

Peugh

Walsh

Panuzio

Trask

Evans

(2009). Child maltreatment history among newlywed couples: A longitudinal study of marital outcomes and mediating pathways. Journal of Consulting and Clinical Psychology, 77(4), 680.

27.

Domhardt

Münzer

Fegert

J. M.

Goldbeck

(2015). Resilience in survivors of child sexual abuse: A systematic review of the literature. Trauma, Violence, & Abuse, 16(4), 476–493.

28.

Dunlop

B. W.

Hill

Johnson

B. N.

Klein

D. N.

Gelenberg

A. J.

Rothbaum

B. O.

Thase

M. E.

Kocsis

J. H

. (2015). Mediators of sexual functioning and marital quality in chronically depressed adults with and without a history of childhood sexual abuse. The Journal of Sexual Medicine, 12(3), 813–823.

29.

Dworkin

E. R.

Menon

S. V.

Bystrynski

Allen

N. E.

(2017). Sexual assault victimization and psychopathology: A review and meta-analysis. Clinical Psychology Review, 56, 65–81.

30.

Fairweather

Kinder

(2013). Predictors of relationship adjustment in female survivors of childhood sexual abuse. Journal of Interpersonal Violence, 28(3), 538–557.

31.

Fergusson

D. M.

McLeod

G. F.

Horwood

L. J.

(2013). Childhood sexual abuse and adult developmental outcomes: Findings from a 30-year longitudinal study in New Zealand. Child Abuse & Neglect, 37(9), 664–674.

32.

Finkelhor

Browne

(1985). The traumatic impact of child sexual abuse: A conceptualization. American Journal of Orthopsychiatry, 55(4), 530–541.

33.

Fleming

Mullen

P. E.

Sibthorpe

Bammer

(1999). The long-term impact of childhood sexual abuse in Australian women. Child Abuse & Neglect, 23(2), 145–159.

34.

Fletcher

G. J.

Simpson

J. A.

Thomas

(2000). The measurement of perceived relationship quality components: A confirmatory factor analytic approach. Personality and Social Psychology Bulletin, 26(3), 340–354.

35.

Friesen

M. D.

Woodward

L. J.

Horwood

L. J.

Fergusson

D. M.

(2010). Childhood exposure to sexual abuse and partnership outcomes at age 30. Psychological Medicine, 40(4), 679–688.

36.

Garneau-Fournier

McBain

Torres

Turchik

(2017). Sexual dysfunction problems in female college students: Sexual victimization, substance use, and personality factors. Journal of Sex & Marital Therapy, 43(1), 24–39.

37.

Georgia

E. J.

Roddy

M. K.

Doss

B. D.

(2018). Sexual assault and dyadic relationship satisfaction: Indirect associations through intimacy and mental health. Violence Against Women, 24(8), 936–951.

38.

Gidycz

C. A.

Orchowski

L. M.

King

C. R.

Rich

C. L.

(2008). Sexual victimization and health-risk behaviors: A prospective analysis of college women. Journal of Interpersonal Violence, 23(6), 744–763.

39.

Givertz

Woszidlo

Segrin

Jia

. (2016). Direct and indirect effects of attachment orientation on relationship quality and constraint commitment in married couples. Journal of Family Studies, 25(2), 133–150.

40.

Hazan

Shaver

(1987). Romantic love conceptualized as an attachment process. Journal of Personality and Social Psychology, 52(3), 511–524.

41.

Kallstrom-Fuqua

A. C.

Weston

Marshall

L. L.

(2004). Childhood and adolescent sexual abuse of community women: Mediated effects on psychological distress and social relationships. Journal of Consulting and Clinical Psychology, 72(6), 980–992.

42.

Karakurt

Silver

K. E.

(2014). Therapy for childhood sexual abuse survivors using attachment and family systems theory orientations. The American Journal of Family Therapy, 42(1), 79–91.

43.

Katz

Myhr

(2008). Perceived conflict patterns and relationship quality associated with verbal sexual coercion by male dating partners. Journal of Interpersonal Violence, 23(6), 798–814.

44.

Koss

M. P.

Oros

C. J.

(1982). Sexual experiences survey: A research instrument investigating sexual aggression and victimization. Journal of Consulting and Clinical Psychology, 50(3), 455–457.

45.

Larsen

C. D.

Sandberg

J. G.

Harper

J. M.

Bean

(2011). The effects of childhood abuse on relationship quality: Gender differences and clinical implications. Family Relations, 60(4), 435–445.

46.

Lévesque

Rodrigue

Beaulieu-Prévost

Blais

Boislard

M. A.

Lévy

J. J.

(2016). Intimate partner violence, sexual assault, and reproductive health among university women. The Canadian Journal of Human Sexuality, 25(1), 9–20.

47.

Liang

Williams

L. M.

Siegel

J. A.

(2006). Relational outcomes of childhood sexual trauma in female survivors: A longitudinal study. Journal of Interpersonal Violence, 21(1), 42–57.

48.

Linehan

M. M

. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford.

49.

Litzinger

Gordon

K. C.

(2005). Exploring relationships among communication, sexual satisfaction, and marital satisfaction. Journal of Sex & Marital Therapy, 31(5), 409–424.

50.

Loeb

T. B.

Rivkin

Williams

J. K.

Wyatt

G. E.

Carmona

J. V.

Chin

(2002). Child sexual abuse: Associations with the sexual functioning of adolescents and adults. Annual Review of Sex Research, 13(1), 307–345.

51.

Lussier

Sabourin

Turgeon

(1997). Coping strategies as moderators of the relationship between attachment and marital adjustment. Journal of Social and Personal Relationships, 14(6), 777–791.

52.

Macy

R. J.

(2008). A research agenda for sexual revictimization priority areas and innovative statistical methods. Violence Against Women, 14, 1128–1147.

53.

Marshall

T. C.

(2008). Cultural differences in intimacy: The influence of gender-role ideology and individualism—collectivism. Journal of Social and Personal Relationships, 25(1), 143–168.

54.

Messman-Moore

T. L.

Long

P. J.

Siegfried

N. J.

(2000). The revictimization of child sexual abuse survivors: An examination of the adjustment of college women with child sexual abuse, adult sexual assault, and adult physical abuse. Child Maltreatment, 5(1), 18–27.

55.

Mikulincer

Shaver

P. R.

(2007). Boosting attachment security to promote mental health, prosocial values, and inter-group tolerance. Psychological Inquiry, 18(3), 139–156.

56.

Mikulincer

Shaver

P. R.

Pereg

(2003). Attachment theory and affect regulation: The dynamics, development, and cognitive consequences of attachment-related strategies. Motivation and Emotion, 27(2), 77–102.

57.

Miner

M. H.

Flitter

J. M. K.

Robinson

B. B. E.

(2006). Association of sexual revictimization with sexuality and psychological function. Journal of Interpersonal Violence, 21(4), 503–524.

58.

Noll

J. G.

Guastaferro

Beal

S. J.

Schreier

H. M.

Barnes

Reader

J. M.

Font

S. A.

(2019). Is sexual abuse a unique predictor of sexual risk behaviors, pregnancy, and motherhood in adolescence? Journal of Research on Adolescence, 29(4), 967–983.

59.

Norton

(1983). Measuring marital quality: A critical look at the dependent variable. Journal of Marriage and the Family, 45(1), 141–151.

60.

Paradis

Boucher

(2010). Child maltreatment history and interpersonal problems in adult couple relationships. Journal of Aggression, Maltreatment & Trauma, 19(2), 138–158.

61.

Rellini

A. H.

Vujanovic

A. A.

Gilbert

Zvolensky

M. J.

(2012). Childhood maltreatment and difficulties in emotion regulation: Associations with sexual and relationship satisfaction among young adult women. Journal of Sex Research, 49(5), 434–442.

62.

Robins

L. N.

Helzer

J. E.

Cottler

L. B.

Goldring

(1988). The diagnostic interview schedule, version IIIR. Washington University School of Medicine.

63.

Rosen

Runtz

Eadie

E. M.

Mirotchnick

(2017). Childhood victimization and physical health in women: The mediating role of adult attachment. Journal of Interpersonal Violence. 1–24. https://doi.org/10.1177/0886260517693001

64.

Sánchez-Fuentes

M. D. M.

Santos-Iglesias

Sierra

J. C.

(2014). A systematic review of sexual satisfaction. International Journal of Clinical and Health Psychology, 14(1), 67–75.

65.

Scott-Storey

(2011). Cumulative abuse: Do things add up? An evaluation of the conceptualization, operationalization, and methodological approaches in the study of the phenomenon of cumulative abuse. Trauma, Violence, & Abuse, 12(3), 135–150.

66.

Senn

T. E.

Carey

M. P.

Corey-Doniger

(2012). Mediators of the relation between childhood sexual abuse and women’s sexual risk behavior: A comparison of two theoretical frameworks. Archives of Sexual Behavior, 41(6), 1363–1377.

67.

Smith

Heaven

P. C.

Ciarrochi

(2008). Trait emotional intelligence, conflict communication patterns, and relationship satisfaction. Personality and Individual Differences, 44(6), 1314–1325.

68.

Spanier

G. B.

(1976). Measuring dyadic adjustment: New scales for assessing the quality of marriage and similar dyads. Journal of Marriage and the Family, 38(1), 15–28.

69.

Straus

M. A.

(1979). Measuring intrafamily conflict and violence: The conflict tactics (CT) scales. Journal of Marriage and Family, 41(1), 75–88.

70.

Sullivan

H. S.

(1953). The interpersonal theory of psychiatry. Norton.

71.

Tardif-Williams

C. Y.

Tanaka

Boyle

M. H.

MacMillan

H. L.

(2017). The impact of childhood abuse and current mental health on young adult intimate relationship functioning. Journal of Interpersonal Violence, 32(22), 3420–3447. https://doi.org/10.1177/0886260515599655

72.

Testa

VanZile-Tamsen

Livingston

J. A.

(2005). Childhood sexual abuse, relationship satisfaction, and sexual risk taking in a community sample of women. Journal of Consulting and Clinical Psychology, 73(6), 1116.

73.

Thelen

M. H.

Sherman

M. D.

Borst

T. S.

(1998). Fear of intimacy and attachment among rape survivors. Behavior Modification, 22(1), 108–116.

74.

Tjaden

P. G.

Thoennes

. (2006). Extent, nature, and consequences of rape victimization: Findings from the National Violence Against Women Survey.

75.

Turchik

J. A.

(2012). Sexual victimization among male college students: Assault severity, sexual functioning, and health risk behaviors. Psychology of Men & Masculinity, 13(3), 243–255.

76.

Ullman

S. E.

Filipas

H. H.

(2005). Gender differences in social reactions to abuse disclosures, post-abuse coping, and PTSD of child sexual abuse survivors. Child Abuse & Neglect, 29(7), 767–782.

77.

Walsh

C. A.

MacMillan

H. L.

Trocmé

Jamieson

Boyle

M. H.

(2008). Measurement of victimization in adolescence: Development and validation of the childhood experiences of violence questionnaire. Child Abuse & Neglect, 32(11), 1037–1057.

78.

Weiss

K. G.

(2010). Male sexual victimization: Examining men’s experiences of rape and sexual assault. Men and Masculinities, 12(3), 275–298.

79.

Whisman

M. A.

(2006). Childhood trauma and marital outcomes in adulthood. Personal Relationships, 13(4), 375–386.