Family Environment, Personality, and Psychological Symptoms in

Family Environment, Personality, and Psychological Symptoms in

This article was downloaded by: [Lauren Stokes] On: 19 September 2013, At: 07:56 Publisher: Routledge Informa Ltd Registered in England and Wales Regi...

139KB Sizes 0 Downloads 0 Views

Recommend Documents

Neuropsychiatric Syndromes and Psychological Symptoms in Patients
William Breitbart, MD, Eduardo Bruera, MD, Harvey Chochinov, MD, and. Mary Lynch ... Breitbart et al. Vol. 10 No. ......

Psychiatric symptoms, psychological distress and - Antonio Casella
b University of Geneva, Department of Community Medicine and Primary Care, 9 Avenue de Champel 1211 Geneva, Switzerland

Social Psychological and Personality Science, in press Attentional
Department of Psychology ... gleaned from psychological studies of public speaking. .... after reverse-scoring items suc

Health Insurance Status and Symptoms of Psychological Distress
tain we already knew the answer'' (McArdle. 2010:35). Although numerous ...... Sherbourne, Cathy Donald, Megan Dwight-Jo

Behavioral and Psychological Symptoms of Dementia: Part I
iors, which are more common in moderate-to-severe stages of disease, are seen in 12% to 84% of patients with dementia.13

Psychological Ownership in Family Businesses - Beck-Shop
Familiy Business 5. Psychological Ownership in Family Businesses. Three Essays on Antecedents and Consequences. Bearbeit

Symptoms in the Pharmacy
Jul 7, 2004 - Blackwell Publishing Asia Pty Ltd, 550 Swanston Street, Carlton, Victoria ..... becoming more widespread i

Family Context, Victimization, and Child Trauma Symptoms: Variations
examines variations in ''safe, stable, and nurturing'' relationships (SSNRs), including sev- eral forms of family perpet

LEARNED HELPLESSNESS AND DEPRESSIVE SYMPTOMS IN
And mostly, to my husband, Robert: your unwavering dedication and support guided me thorough ... Thank you to Dr. Rob Ho

Respiratory function and symptoms in workers exposed
May 26, 2017 - exposed simultaneously to jute and hemp. S. H. EL GHAWABI. From the National Institute of Occupational Sa

This article was downloaded by: [Lauren Stokes] On: 19 September 2013, At: 07:56 Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK

Journal of Child Sexual Abuse Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/wcsa20

Family Environment, Personality, and Psychological Symptoms in Adults Sexually Abused as Children a

a

Lauren Drerup Stokes , David McCord & Lydia Aydlett

a

a

Western Carolina University , Cullowhee , North Carolina , USA Published online: 07 Aug 2013.

To cite this article: Lauren Drerup Stokes , David McCord & Lydia Aydlett (2013) Family Environment, Personality, and Psychological Symptoms in Adults Sexually Abused as Children, Journal of Child Sexual Abuse, 22:6, 658-676, DOI: 10.1080/10538712.2013.811142 To link to this article: http://dx.doi.org/10.1080/10538712.2013.811142

PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://www.tandfonline.com/page/termsand-conditions

Journal of Child Sexual Abuse, 22:658–676, 2013 Copyright © Taylor & Francis Group, LLC ISSN: 1053-8712 print/1547-0679 online DOI: 10.1080/10538712.2013.811142

Family Environment, Personality, and Psychological Symptoms in Adults Sexually Abused as Children LAUREN DRERUP STOKES, DAVID McCORD, and LYDIA AYDLETT

Downloaded by [Lauren Stokes] at 07:56 19 September 2013

Western Carolina University, Cullowhee, North Carolina, USA

The current study examined the relationships between family environment characteristics, personality traits, and current psychological symptoms in adults with a history of child sexual abuse. Family environment characteristics, personality traits, and psychological symptoms in 18 abused and 18 nonabused college students were examined using ANOVAs and MANOVAs. Pearson product moment correlations were also performed. Results indicated significantly more dysfunctional family environment characteristics (inflexibility, poor cohesion, family dissatisfaction, and poor family communication) in the abused versus the nonabused group. There were significantly higher levels in the personality traits of neuroticism and openness to experience in the abused group; however, there were no significant differences in psychological symptoms when comparing the two groups. The implications of the results and areas of future research are discussed. KEYWORDS adult survivor, mental health, violence, adjustment, resilience

Research has consistently shown that individuals who have been sexually abused as children have significantly greater psychological symptoms than individuals who do not have histories of child sexual abuse (CSA). Individuals with histories of sexual abuse exhibit significantly greater psychological symptoms such as depression, anxiety, post-traumatic stress disorder, suicidal ideation, sexual dysfunction, and low self-esteem (Molnar, Buka, Received 25 January 2012; revised 25 June 2012; accepted 1 July 2012. Address correspondence to Lauren Drerup Stokes, 1016 Calais Circle, Alexandria, LA 71303. E-mail: [email protected] 658

Downloaded by [Lauren Stokes] at 07:56 19 September 2013

Sexual Abuse, Family Environment, and Personality

659

& Kessler, 2001; Peters & Range, 1995; Sarwer & Durlak, 1996; Whiffen, Thompson & Aube, 2000). These individuals also report dysfunctional family environment characteristics, such as inflexibility, lack of cohesion, and a lack of family structure, all of which are also associated with long-term psychological difficulties (Ray & Jackson, 1997). Furthermore, research indicates that these individuals more often exhibit personality traits associated with maladaptive psychological functioning, such as high levels of neuroticism and low levels of agreeableness, conscientiousness, and openness to experience (Rogosch & Cicchetti, 2004). Thus, the relation between CSA and psychological difficulties is confounded by both family environment and personality characteristics. Although extant research indicates that the majority of abuse victims endorse dysfunctional family environments and maladaptive personality traits, some research indicates that functional environments and adaptive traits are associated with fewer psychological difficulties (Fassler, Amodeo, Griffin, Clay, & Ellis, 2005; Rogosch & Cicchetti, 2004). Thus, these positive characteristics and traits may ultimately buffer or protect against the harmful effects of CSA. The purpose of this study is to investigate the long-term effects of CSA as measured in terms of current psychological symptoms. Family environment and personality characteristics will also be investigated in order to determine to what extent these factors are associated with or influence the effects of abuse. By beginning to understand and disentangle the complex relation between CSA and adult functioning, the field can gain clarity on the specific factors that may promote resilience, such as positive family environment characteristics and adaptive personality traits.

OVERVIEW OF CSA Research has supported no clear consensus on a universal definition of CSA (Bolen, 2001), and, as a result, incidence and prevalence rates differ dramatically. For example, when only sexual penetration is considered abuse, estimates have ranged from 1.3% to 28.7% of females and 1.1 to 14.1% of males. However, when noncontact abuse is included estimates range from 8% to 62.1% of females and 3% to 29% of males (Fergusson & Mullen, 1999). In a review of the literature by Bolen (2001), the mean prevalence rate of CSA from national surveys was 19% for females and 9% for males. Prevalence rates for females are 3 to 5 times higher than males, but this may be due to the underreporting of male abuse cases (Koenig, Doll, O’Leary, & Pequegnat, 2004).

SHORT-TERM EFFECTS OF CSA Research has extensively documented short-term effects that are associated with the occurrence of CSA. Effects are considered to be short-term if they

660

L. Drerup Stokes et al.

occur within two years of the cessation of abuse (Browne & Finkelhor, 1986). In a review of the literature, Kendall-Tackett, Williams, and Finkelhor (1993) found in most studies that sexually abused children were more symptomatic than nonabused children. These symptoms include fear, nightmares, posttraumatic stress disorder, general behavior problems, self-injurious behaviors, sexualized behaviors, internalizing behaviors (e.g., withdrawal, depression, fearfulness, inhibition, and overcontrol), and externalizing behaviors (e.g., aggression, antisocial behavior, and undercontrolled behavior). These results suggest that the occurrence of sexual abuse is strongly associated with a variety of psychological symptoms.

Downloaded by [Lauren Stokes] at 07:56 19 September 2013

ASYMPTOMATIC SEXUALLY ABUSED CHILDREN While the majority of studies indicate that there are many short-term effects associated with sexual abuse, studies also find a significant number of children with few or no symptoms. Finkelhor (1990) found that findings ranged from approximately 25% to 36% of children with few or no symptoms. Kendall-Tackett and colleagues (1993) found a broader range with as many as 21% to 49% as asymptomatic. A variety of hypotheses have been offered to explain why some abused children are found to be asymptomatic. One possible explanation is that asymptomatic children were less likely to have been seriously abused. Research has found that these children were more likely to have been abused for a shorter duration, with less force or violence, and without penetration. In addition, it was less likely that the abuser was a father figure (Browne & Finkelhor, 1986). However, asymptomatic children may actually be less affected by the abuse. These children may be more resilient and possess certain psychological characteristics or social and treatment resources that may aid in their coping with the abuse (KendallTackett et al., 1993). It can also be argued that other factors moderate the abused children’s psychological outcomes. It is possible that the abused children brought in for treatment have a supportive family environment, a factor shown to moderate the effects of abuse, whereas those who never disclosed the abuse or did not have a supportive family display more psychological symptoms.

LONG-TERM EFFECTS OF CSA Research has also investigated later psychological adjustment in adults with a history of CSA. In a nationally representative population study of individuals aged 15 to 54 years old, Molnar and colleagues (2001) found the prevalence of psychiatric disorders was higher in individuals who reported a history of CSA compared to nonabused individuals, even after controlling for the abuse variables of CSA type, chronicity of abuse, and other childhood adversities.

Downloaded by [Lauren Stokes] at 07:56 19 September 2013

Sexual Abuse, Family Environment, and Personality

661

Significant associations were found for females with sexual abuse histories, including mood disorders (depression, dysthymia, and mania), anxiety disorders (agoraphobia, panic attacks, panic disorder, posttraumatic stress disorder, and social phobia), and substance abuse and dependence disorders. Significant associations were found for males including post-traumatic stress disorder, substance dependence, and substance abuse. Studies have also shown that individuals with histories of CSA have significantly greater suicidal ideation than nonabused individuals (Peters & Range, 1995). Those individuals who experienced contact abuse were significantly more suicidal than those who experienced noncontact abuse or no abuse. Whiffen and colleagues (2000) found men and women with a history of CSA experienced significantly more interpersonal difficulties than nonabused individuals, such as difficulties being assertive, sociable, intimate, submissive, responsible, and controlling. Women with a more severe abuse history had greater difficulties with mistrust and estrangement from others, while males had greater difficulties with lacking assertiveness and taking on too much responsibility in their interpersonal relationships. Thus, females may have difficulties actually forming relationships, where males may have difficulties maintaining their relationships. In addition, Sarwer and Durlak (1996) found that a greater percentage of women reporting sexual dysfunction had histories of CSA compared to nonabused individuals.

FAMILY ENVIRONMENT IN SEXUALLY ABUSED INDIVIDUALS One of the more difficult areas in the study of CSA is that in addition to an association with psychological symptoms, maladaptive childhood family environments are also associated with CSA. The fact that CSA is significantly related to both psychological symptoms and to family dysfunction causes an even more difficult matrix of childhood influences on psychopathology that researchers are trying to tease apart. Individuals with a history of CSA tend to recall a significantly different family environment than individuals without a history of CSA (Hulsey & Sexton, 1992). Abused individuals described their family environment as lacking integration and involvement in social groups. Additional characteristics included an authoritarian parenting style, a disconnection between family members, isolation, chaos, and a lack of autonomy. Based on these results, the researchers concluded that the associated effects of CSA are embedded within the context of a dysfunctional family environment and that it is this interaction that determines later psychological outcomes of abuse rather than a direct, causal relationship. Additional research by Fassler and colleagues (2005) found that when family environment characteristics of conflict, expressiveness, and cohesion were included with CSA status, it significantly increased the explained

662

L. Drerup Stokes et al.

variance in psychological outcomes by two to four times, compared to the variance explained by just CSA. Higher family conflict was found to be associated with poorer adult outcomes, and higher family expressiveness and cohesion were significantly associated with better adult psychological outcomes. These results suggest that not only are certain family environment characteristics associated with victims of CSA but that certain family environments are associated with more adaptive and healthy psychological functioning, even within the context of CSA.

Downloaded by [Lauren Stokes] at 07:56 19 September 2013

FAMILY ENVIRONMENT, CSA, AND PSYCHOLOGICAL SYMPTOMS These studies illustrate the difficulties in researching CSA. There are other factors that coincide with the occurrence of sexual abuse making it quite difficult to determine the extent to which certain variables contribute to the psychological functioning of individuals with histories of CSA. Recent emphasis has been placed not only on identifying additional variables but also examining the interaction of these variables and their influence on later psychological functioning. The apex of these studies was with Rind, Tromovitch, and Bauserman’s (1998) controversial and highly criticized study. They conducted a meta-analysis of 59 studies that investigated long-term effects of CSA in college student populations. It was found that CSA accounted for less than 1% of the variance in psychological symptoms, thus suggesting that CSA effects for college students are not intense, and abused college students are only slightly less well adjusted than nonabused college students. The researchers then investigated the role of family environment characteristics as a confound in the association between CSA and symptomatology. The results of this study indicated that family environment was a better predictor of symptoms than CSA, and statistical control of family environment eliminated significant associations between CSA and symptoms. Criticism of the study focused on the appropriateness of the statistical analyses utilized by the meta-analysis, the exclusive use of a nonrepresentative population (i.e., college sample), and lack of definitional consensus (Dallam et al., 2001). Since the publication of this controversial article, many researchers have sought to reinvestigate the idea that family environment is more predictive of adult psychological adjustment than histories of CSA. When individual studies are examined rather than a meta-analysis it has been found that histories of CSA make a significantly unique contribution to some aspects of adult psychological adjustment, even after accounting for family environment characteristics. For example, Peleikis, Mykletun, & Dahl (2004) found that a history of CSA was a greater risk factor than family background for post-traumatic stress disorder and self-injurious behaviors; however, results were not significant for CSA influences on

Downloaded by [Lauren Stokes] at 07:56 19 September 2013

Sexual Abuse, Family Environment, and Personality

663

major depression and dysthymia when adjusted for by family background characteristics. Molnar and colleagues (2001) investigated the strength of the relationship between CSA and psychiatric disorders. After other childhood adversities (e.g., mother and/or father verbal or physical abuse, mother and/or father psychopathology, and mother and/or father substance abuse and antisocial behaviors) were accounted for, statistically significant relationships were found between the majority of mood, anxiety, substance disorders, and CSA, thus indicating that CSA had significant influences on psychopathology, independent of other adversities. In addition, results indicated that CSA was a significant predictor of psychopathology among individuals who did not report other childhood adversities. These findings imply that CSA still has negative consequences for individuals with relatively healthy families. Research has demonstrated that significant associations between histories of CSA and later psychological symptoms are not eliminated when family environment characteristics are taken into account. In fact, these relationships remain statistically significant. However, research has also shown that there is a significant relationship between current psychological symptoms and previous family environment characteristics. This raises the question of whether family environment characteristics can influence current psychological symptoms. To what extent does having a healthy family environment alleviate some long-term psychological symptoms? Does having an unhealthy, maladaptive family environment exacerbate long-term psychological symptoms associated with histories of CSA?

PERSONALITY AND CSA Studies have also investigated the associations between histories of CSA and internal factors, such as personality traits. Personality traits that have been investigated include those from the five factor model such as extraversion (an individual’s quality and intensity of interpersonal interaction), neuroticism (an individual’s adjustment as opposed to emotional instability), openness to experience (an individual’s active seeking and appreciation of experience), agreeableness (the quality of an individual’s interpersonal orientation), and conscientiousness (an individual’s motivation, organization, and goal-directed behavior; Costa & McRae, 1992). Pickering, Farmer, and McGuffin (2004) investigated personality characteristics in individuals with a diagnosis of depression who had histories of child abuse and neglect. They found that sexual abuse was significantly positively correlated with extraversion and psychoticism (a combination of agreeableness and conscientiousness) scores. Sexual abuse was a significant

Downloaded by [Lauren Stokes] at 07:56 19 September 2013

664

L. Drerup Stokes et al.

predictor of extraversion scores. These findings suggest that sexually abused individuals were more likely to be described as adventurous and sensationseeking as well as cold and reckless compared to individuals reporting other types of child abuse. Sexually abused individuals also had significantly lower Lie scale scores, suggesting that they may be described as less likely to conform to societal standards. Roy (2002) found significant positive correlations for neuroticism with individuals with a history of sexual abuse. The study’s findings suggest it is possible that childhood trauma may be associated with a predisposition to psychiatric disorders and suicidal behavior due to higher neuroticism personality factors. Rogosch and Cicchetti (2004) compared the personality development of maltreated and nonmaltreated school-age children. Results indicated that as a group, maltreated children had significantly lower scores on measures of agreeableness, conscientiousness, and openness to experience than nonmaltreated children. They also had significantly higher levels of neuroticism. These scores indicated less adaptive functioning. There were no differences found on the measure of extraversion. Results also indicated that approximately 70% of maltreated children had personalities that were less adaptive; however, it is clear that a significant proportion of maltreated children had adaptive personalities. These results indicate that maltreated children may be more likely to develop maladaptive personalities even though some maltreated children do develop adaptive personalities. This leads to the question of whether adaptive personalities serve to influence the relation between CSA and psychological outcomes. Can some traits lessen the degree of psychological trauma associated with CSA, and can some traits exacerbate psychological trauma? Can some children be more resilient and possess certain psychological characteristics that may aid in their coping with the abuse (Kendall-Tackett et al., 1993)?

CURRENT STUDY Exploratory analyses were performed to examine the relationships between family environment and personality traits with psychological symptoms of abused adults in order to investigate the potential effects of personality and family environment. Based on the literature review, it was hypothesized that individuals with a history of CSA will have significantly more psychological symptoms and more dysfunctional family environment characteristics than individuals who have not been sexually abused. In addition, it was hypothesized that individuals with a history of CSA will have significantly lower ratings on agreeableness, conscientiousness, and openness to experience and higher ratings on neuroticism personality domains than those without a history of sexual abuse.

665

Sexual Abuse, Family Environment, and Personality

Downloaded by [Lauren Stokes] at 07:56 19 September 2013

METHOD Participants included 239 college students currently enrolled in psychology and sociology courses at a regionally comprehensive, Southeastern university. Out of the 239 participants, 18 (7.53%) were considered abused as determined by the abuse definition set prior to data collection. Participants were considered to have a history of CSA if the individuals were younger than 18 years of age at the time of abuse and there was a 5 year age difference between the child and the perpetrator. Eighteen participants were randomly selected from the remaining 211 nonabused participants to compose the nonabused control group. The current study’s sample consisted primarily of Caucasian, female students (86%). The remaining 14% of the sample was African American (2.8%), Hawaiian or Pacific Islander (2.8%), Hispanic/Latino (5.6%), and mixed race (2.8%). The sample consisted of 86% females and 14% males. The mean age of the participants was 21.03, with approximately 78% between the ages of 18 to 20 years. Regarding the abused group, the mean age was 22.72 years old, with approximately 94% females. Eighty-nine percent of the participants were Caucasian and approximately 67% were single. Approximately 28% lived alone, approximately 68% lived with their two biological parents, and approximately one-third were the second child in their family. There were 6 categories of abuse types. Each abused participant endorsed at least one abuse experience. The mean was 2.28 of different types of abuse, with a maximum of 6. See Table 1 for abuse variable descriptions. Regarding the nonabused group, the mean age was 19.33, with approximately 78% males, 83% Caucasian, and 94% single participants. Approximately 17% lived alone, approximately 56% lived with their two biological parents, and 39% were the only child in their family. TABLE 1 Descriptive Statistics of Abuse Variables Abuse Type Hugging/Kissing Sexual Touching: Child to Adult Sexual Touching: Adult to Child Oral Sex: Child to Adult Oral Sex: Adult to Child Sexual Intercourse

Percent

M child

M adult

Force

61.10 44.40

10.00 8.50

27.73 27.25

72.70 87.50

61.10

8.00

29.90

63.60

16.70

7.33

26.33

100.00

11.10

9.00

45.00

100.00

16.70

8.00

35.00

100.00

Note. Percent = percentage of individuals who endorsed abuse type. M child = mean age of child during abuse. M adult = mean age of perpetrator during abuse. Force = percentage of individuals who reported being forced or threatened during abuse.

666

L. Drerup Stokes et al.

Measures

Downloaded by [Lauren Stokes] at 07:56 19 September 2013

CHILDHOOD SEXUAL ABUSE QUESTIONNAIRE This is a measure modified from Finkelhor’s Sexual Experiences Questionnaire (1979) to measure participants’ histories of CSA. On this measure, CSA is defined as any unwanted physical sexual contact before the age of 18 with the perpetrator at least 5 years or older than the individual. Physical sexual experiences range from sexual kissing and touching to forced intercourse. Items are arranged hierarchically by type of sexual experience. Items are followed by prompts to provide more information concerning perpetrator’s identity and age, victim’s age, duration and frequency of the abuse, victim’s relationship to the perpetrator, and whether force or coercion were used. Individuals were classified as abused if they responded yes to any of the abuse categories. SYMPTOM CHECKLIST-90-REVISED (SCL-90-R) The SCL-90-R is an instrument designed to assess a wide range of psychological problems and symptoms of psychopathology (Derogatis, 1977). The SCL-90-R includes nine primary symptom scales: Somatization, ObsessiveCompulsive, Interpersonal Sensitivity, Depression, Anxiety, Hostility, Phobia, Paranoia, and Psychoticism. In addition, the SCL-90-R provides three global indexes: Global Severity Index (GSI), Positive Symptom Distress Index (PSDI), and Positive Symptom Total (PST). For this study, participants were asked to indicate the extent to which each item has caused them distress. Directions were modified from “distress in the past 7 days” to “distress in the past 6 months” in order to assess a longer time period of symptoms. Items are rated on a Likert scale from 0 (not at all) to 5 (extremely). A higher score on the subscales indicates a greater level of psychological distress, and t-scores at or above 65 indicate clinically significant problems. The SCL-90-R has been used extensively in research studies and has internal consistency coefficients ranging from .79 to .90. FAMILY ADAPTABILITY

AND

COHESION EVALUATION SCALE (FACES-IV)

FACES-IV is a self-report instrument designed to assess key concepts for understanding family functioning (Olson & Gorall, 2003). This instrument is based on the circumplex model of marital and family systems. Key concepts include balanced (healthy) and unbalanced (unhealthy) aspects of family functioning. There are six subscales in the new edition, whereas there were two in previous editions. Subscales include: Balanced Cohesion (e.g., closeness, support, and involvement), Balanced Flexibility (e.g., adaptability, fairness, and clear rules), Enmeshed (e.g., interdependence and overreliance on one another), Disengaged (e.g., avoidance of one another and lack of

Sexual Abuse, Family Environment, and Personality

667

family problem-solving), Chaotic (e.g., disorganization and lack of leadership), Rigid (e.g., family’s rules, consequences, and organization), Family Satisfaction (e.g., overall satisfaction with aspects of their family), and Family Communication (e.g., feelings about the quality and quantity of their family communication). Participants are asked to rate their responses to items on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Subscale raw scores range from 7 to 35 and are converted to percentiles with higher scores indicating greater possession of that trait. Reliability coefficients range from .77 to .90, and validity coefficients range from .91 to .93.

Downloaded by [Lauren Stokes] at 07:56 19 September 2013

M5-50 QUESTIONNAIRE This is a measure of personality traits based on the five-factor model of personality (Socha, Cooper, & McCord, 2010). Personality items included were taken from the International Personality Item Pool (Goldberg et al., 2006), and this specific item set has shown good reliability and validity when compared to the NEO-Personality Inventory-Revised (NEO-PI-R; Costa & McCrae, 1992). Participants were asked to rate their responses to items on a 5-point Likert scale ranging from 1 (inaccurate) to 5 (accurate). A total score was calculated for each of the five domains (Extraversion, Neuroticism, Agreeableness, Openness to Experience, and Conscientiousness). Numerous studies have established the validity of the M5-50 Questionnaire (e.g., Donnelan, Oswald, Baird, & Lucas, 2006; Lim & Ployhart, 2006).

Procedure Participants were undergraduate students enrolled in psychology and sociology courses. Participants were informed of the study and asked to volunteer. They received course credit for their participation. The students completed a consent form that provided the instructions and answered common questions about research participation. The consent form also contained contact information for the university counseling center for those students who wished to address concerns about any of the experiences asked about in the surveys. Students then completed a battery of questionnaires titled “Childhood Experiences, Intimate Relationships, Current Psychological Characteristics, and Personality Traits.” After data collection, the abused and nonabused individuals were separated into different groups.

Analyses As a result of the small sample size, more sophisticated statistical techniques such as moderation were not utilized. Multivariate analyses of variance (MANOVA) were used to test for differences in psychological symptoms, family environment characteristics, and personality traits between abused

668

L. Drerup Stokes et al.

and nonabused individuals. Pearson product moment correlations were used to investigate the relationships between family environment and personality characteristics with psychological symptoms of those adults with histories of CSA (exploratory analyses).

Downloaded by [Lauren Stokes] at 07:56 19 September 2013

RESULTS Hypothesis 1 stated that individuals with a history of CSA will have significantly more psychological symptoms than individuals who have not been sexually abused. A one-way between-groups multivariate analysis of variance was performed to investigate abused and nonabused group differences in psychological symptoms. Nine dependent variables were used: Somatization, Obsessive Compulsive, Interpersonal Sensitivity, Depression, Anxiety, Hostility, Phobic Anxiety, Paranoia, and Psychoticism. The independent variable was abuse status. There was no statistically significant difference between abused and nonabused individuals: F(9,26) = 1.74, p = 0.130; Wilks’ lambda = .62; η2 = .38. See Table 2 for descriptive statistics for the scales. Hypothesis 2 stated that individuals with a history of CSA will report significantly more dysfunctional family environment characteristics. A one-way between-groups MANOVA was performed to investigate abused and nonabused group differences in family environment characteristics. Eight dependent variables were used: Cohesion, Flexibility, Disengaged, TABLE 2 Descriptive Statistics for the Scales of the SCL-90-R Scale Somatization Obsessive-Compulsive Interpersonal Sensitivity Depression Anxiety Hostility Phobic Anxiety Paranoia Psychoticism Global Severity Index

Abused

Nonabused

1.06 (0.85) 1.43 (0.85) 1.35 (1.06) 1.25 (0.98) 0.94 (0.86) 0.94 (0.87) 0.24 (0.29) 1.31 (1.11) 0.83 (0.75) 1.06 (0.73)

0.77 (0.71) 0.99 (0.81) 0.71 (0.62) 0.86 (0.74) 0.62 (0.59) 0.80 (0.89) 0.28 (0.41) 0.74 (0.71) 0.43 (0.60) 0.72 (0.59)

Note. Standard deviations are in parentheses.

Downloaded by [Lauren Stokes] at 07:56 19 September 2013

Sexual Abuse, Family Environment, and Personality

669

Enmeshed, Rigid, Chaotic, Family Communication, and Family Satisfaction. The independent variable was abuse status. There were no statistically significant differences between abused and nonabused individuals: F(8,27) = 1.32, p = 0.277; Wilks’ lambda = .72; η2 = .28. Despite the lack of statistical significance for the family environment scores, the mean scores were in the hypothesized direction for all of the scales (See Table 3). In addition, results indicated that Cohesion (p = .02), Flexibility (p = .01), Family Communication (p = .01), and Family Satisfaction (p = .01) were statistically different between the two groups, even with the lack of overall statistical significance. Hypothesis 3 stated that individuals with a history of CSA will have significantly lower ratings on Agreeableness, Conscientiousness, and Openness to Experience and higher ratings on Neuroticism personality domains than those without a history of CSA. A one-way betweengroups MANOVA was performed to investigate abused and nonabused group differences in personality characteristics. Five dependent variables were used: Agreeableness, Conscientiousness, Openness to Experience, Extraversion, and Neuroticism. The independent variable was abuse status. There were statistically significant differences between abused and nonabused individuals: F(5,28) = 2.92, p = 0.03; Wilks’ Lambda = .66; η2 = .34. There were significant differences between groups for Neuroticism (p = .013) and Openness to Experience (p = .002), with participants in the abused group having a higher mean score for both characteristics. Despite the lack of statistical significance for Agreeableness and Conscientiousness, the mean scores were in the hypothesized direction See Table 4. TABLE 3 Descriptive Statistics for the Scales of the FACES-IV Scale

Abused

Nonabused

Cohesion

27.56 (5.34) 23.83 (4.95) 15.67 (6.16) 13.72 (4.99) 22.39 (4.53) 14.39 (4.30) 35.00 (7.59) 31.28 (8.01)

30.94 (2.24) 27.50 (3.31) 13.50 (3.63) 12.72 (2.78) 20.83 (3.13) 12.50 (3.75) 40.72 (5.13) 38.50 (6.61)

Flexibility Disengaged Enmeshed Rigid Chaotic Family Communication Family Satisfaction

Note. Standard deviations are in parentheses.

670

L. Drerup Stokes et al. TABLE 4 Descriptive Statistics for the Scales of the M5-50 Scale

Abused

Nonabused

Agreeableness

37.38 (7.55) 36.44 (7.34) 41.75 (4.92) 39.19 (7.04) 27.13 (8.53)

37.83 (4.67) 38.17 (5.02) 33.72 (8.56) 40.67 (4.46) 21.06 (4.52)

Conscientiousness Openness to Experience Extraversion Neuroticism

Downloaded by [Lauren Stokes] at 07:56 19 September 2013

Note. Standard deviations are in parentheses.

Exploratory analyses were conducted to examine the relationships between the family environment and personality scales with the psychological symptoms of those who were sexually abused. The family environment and personality scales used were those that had been found to have statistically significant group differences (i.e., Neuroticism and Openness to Experience). In addition, despite no overall statistical significance in the MANOVA for family environment traits, the scales of Flexibility, Cohesion, Family Communication, and Family Satisfaction were explored as exploratory post hoc investigations indicated that there were group differences for these scales. The GSI was used as an overall measure of psychological symptoms. The relationships between personality and psychological symptoms were investigated using Pearson product-moment correlation coefficients. Family Satisfaction was significantly negatively associated with psychological difficulties, and neuroticism was significantly positively associated with psychological difficulties. Results are presented in Tables 5 and 6.

DISCUSSION Research has also shown that family environment traits contribute to later psychological functioning in adulthood (Ray & Jackson, 1997), thus TABLE 5 Intercorrelations between FACES-IV Scales and the GSI for Abused Adults Scale 1. 2. 3. 4. 5. ∗

1

Flexibility Cohesion Communication Satisfaction GSI

p < .05.

∗∗

p < .01.

— 0.76∗∗ 0.79∗∗ 0.81∗∗ −0.36

2

3 ∗∗

0.76 — 0.83∗∗ 0.57∗ −0.26

4 ∗∗

0.79 0.83∗∗ — 0.72∗∗ −0.42

5 ∗∗

0.81 0.57∗ 0.72∗∗ — −0.46∗

−0.36 −0.26 −0.42 −0.46∗ —

671

Sexual Abuse, Family Environment, and Personality TABLE 6 Intercorrelations between M5-50 Scales for Abused Adults Scale 1. Neuroticism 2. Openness 3. GSI

Downloaded by [Lauren Stokes] at 07:56 19 September 2013



p < .05.

∗∗

1

2

3

— 0.35 0.76∗∗

0.35 — −0.38

0.76∗∗ −0.38 —

p < .01.

suggesting a confounding role of family environment in the relationship between CSA and psychological symptoms. Moreover, studies have shown that abused and nonabused children and adults have significant differences in their personality traits. As such, the current study investigated the contributing influences of family environment and personality to the psychological symptoms of adults who have histories of CSA. It was hypothesized that adults with histories of CSA would have significantly more psychological symptoms compared to the control group of nonabused adults. While this hypothesis was not supported by reaching statistical significance, the results indicated that the mean scores of psychological symptoms were in the predicted direction for all nine scales, except phobic anxiety. Adults with a history of CSA had higher mean scores, though this difference did not reach statistical significance. In addition, these results support previous research findings of a relationship between psychological symptoms and CSA but not a direct, causal link. Therefore, these results seem to indicate that there are other complex factors influencing this relationship. It was also hypothesized that adults with histories of CSA would have significantly more dysfunctional family environment characteristics. Although the overall MANOVA indicated that there were no significant differences between the two groups, exploratory investigations of individual scales indicate that the abused group had significantly more dysfunctional family environment characteristics of cohesion, flexibility, family communication, and family satisfaction. Abused adults tended to report that their families were less supportive, less close to one another, spent less time together, had less clear rules and leadership, used unfair discipline, and had more difficulty adjusting to change than nonabused adults. The abused group was also significantly less satisfied with their family and their family communication than the nonabused group. In addition, it was hypothesized that abused adults would have significantly different personality traits than nonabused adults. This hypothesis was partially supported. Individuals with a history of CSA had significantly higher ratings of neuroticism than nonabused individuals. They tended to be more worrisome, emotional, nervous, and insecure than nonabused individuals. It was hypothesized that abused individuals would have significantly lower ratings on openness to experience; however, the results indicate the

Downloaded by [Lauren Stokes] at 07:56 19 September 2013

672

L. Drerup Stokes et al.

opposite was true. Abused individuals tended to be more curious, creative, untraditional, and imaginative than nonabused individuals. Previous research found that women who were abused by a parent scored lower on openness to experience traits than those who were not abused by a parent (Talbot, Duberstein, King, Cox, & Giles, 2000). Due to the small sample size, the relationship of the perpetrator to the victim was not a grouping variable; therefore, the current results may reflect this limitation. Results also indicated that extraversion and agreeableness traits were not significantly different when comparing the two groups. While conscientiousness traits were not significantly different, the mean scores were in the predicted direction. Exploratory analyses were performed to investigate the relationship of family environment and personality with psychological symptoms in abused adults. The small sample size limited the use of more sophisticated statistical analyses; therefore, Pearson product moment correlations were used. Of the family environment characteristics examined, medium-size correlations were found between flexibility, family communication, and family satisfaction with psychological symptoms. The more dissatisfied adults were with their family and family communication, the higher their level of psychological symptoms. In addition, the more inflexible and less supportive the family was, the higher the current psychological symptoms of the adults. Similar results were found for the personality traits of neuroticism and openness to experience. There was a large, statistically significant relationship between neuroticism and psychological symptoms. The higher the level of neuroticism reported by an abused adult, the greater the psychological symptoms. Contrary to the hypothesis, it was found that abused individuals had significantly higher levels of openness to experience than nonabused adults. A medium-size correlation was also found between openness to experience and psychological symptoms. Therefore, abused adults with higher levels of openness to experience had fewer psychological symptoms. This finding may partially explain the lack of significant results found when investigating the relationship of abuse and psychological symptoms. This particular sample of abused individuals exhibited significantly more adaptive personality characteristics (i.e., openness to experience) than the nonabused sample, possibly resulting in fewer psychological symptoms. While abused individuals were found to have significantly different levels of satisfaction with their family communication, the mean scores of the abused adults were quite similar to the normative scores of the instrument. The normative mean score for family communication was 36.20 (Olson, Gorall, & Tiesel, 2006), and the mean score for the abused adults was 35.00. A hypothesized explanation of this finding is that this particular sample of abused individuals reported an average or normative level of satisfaction with their family communication, which may have possibly influenced more adaptive psychological functioning, as indicated in the level of psychological symptoms.

Downloaded by [Lauren Stokes] at 07:56 19 September 2013

Sexual Abuse, Family Environment, and Personality

673

Based on the current findings of this study, it is evident that in this sample there are some abused adults who have adaptive personality traits, and there are some abused adults who have healthy family environment characteristics. This finding may possibly account for the fewer psychological symptoms endorsed by the abused adult. However, when taking into account the limited sample size and the finding that the mean scores were in the hypothesized direction, it is possible that there remains a unique relationship between abused adults and psychological symptoms when family environment and personality characteristics are taken into account. There are several limitations for the current study. First, the rate of abuse for the current sample was 7.53%, resulting in the sample size consisting of 18 abused adults and 18 nonabused adults. The sample size greatly limited the statistical power needed to obtain significant results. The analyses performed needed a greater sample size to get meaningful and representative findings. Due to the limitations of the small sample size, results should be interpreted with caution. Had a larger sample size been utilized it is likely that more of the results would have been statistically significant given the effect sizes and mean scores. Another limitation related to the small sample size concerned the procedure for classifying abused participants. Any reported incident was considered abuse as long as it met the preset definition. Therefore, all abuse types and abuse variables were grouped together. Due to the small sample size, it was not possible to group participants by the type of reported abuse experiences. Previous research has shown that the effects and severity of psychological trauma associated with CSA can be contingent on the variables in the abuse experience. While there is no clear consensus on one definitive contributing variable, the literature supports varying degrees of trauma outcomes depending on the severity of the abuse. Research has suggested that certain types of abuse are more traumatic than others, such as physical contact abuse, the occurrence of penetration, abuse by a father figure, level of trust for the perpetrator, the age at the onset of abuse, greater number of sexual abuse incidents, and a greater number of perpetrators (Briere & Elliot, 2003; Browne & Finkelhor, 1986; Rowan, 2006). Finally, another limitation concerned the demographics of the sample. The sample primarily consisted of female, Caucasian college students between the ages of 18 and 20. Finally, the sample was not representative regarding participants’ college student status. Clearly, the current sample was not demographically representative, nor can the results be generalized to the general population. Future research should continue to focus on identifying the myriad of influences in CSA psychological outcomes. It is paramount that researchers obtain a large sample size in order to perform the statistical analyses needed to investigate the relationships between these influences. It is also important to obtain diverse samples including varying ethnicities and ages, while also

674

L. Drerup Stokes et al.

Downloaded by [Lauren Stokes] at 07:56 19 September 2013

accounting for sex differences in abuse rates. If a large sample is obtained, the appropriate categorization of abuse variables can be performed in order to account for the varying degrees of trauma associated with different abuse types. Future research should further investigate the different characteristics of family environments that influence psychological symptoms in abused adults. Based on the results of the current study, some family environment characteristics were more influential than others. In addition, it would be beneficial to investigate the various facets within the five broad domains of personality. For example, there may be some facets of neuroticism and openness to experience that are significantly more associated with psychological symptoms than others.

REFERENCES Bolen, R. M. (2001). Child sexual abuse: Its scope and our failure. New York, NY: Plenum. Briere, J., & Elliott, D. (2003). Prevalence and psychological sequelae of self-reported childhood physical and sexual abuse in a general population sample of men and women. Child Abuse & Neglect, 27, 1205–1222. doi:10.1016/j.chiabu.2003. 09.008 Browne, A., & Finkelhor, D. (1986). Impact of child sexual abuse: A review of the research. Psychological Bulletin, 99, 66–77. doi:10.1037//0033-2909.99.1.66 Costa, P. T., Jr., & McCrae, R. R. (1992). Revised NEO Personality Inventory (NEO-PI-RTM ) and NEO Five-Factor Inventory (NEO-FFI) professional manual. Odessa, FL: Psychological Assessment Resources. Dallam, S. J., Gleaves, D. H., Cepeda-Benito, A., Silber, J. L., Kraemer, H. C., & Spiegel, D. (2001). The effects of child sexual abuse: Comment on Rind, Tromovitch, and Bauserman (1998). Psychological Bulletin, 127, 715–733. doi:10.1037//0033-2909.127.6.715 Derogatis, L. R. (1977). Symptom checklist-90-R: Administration, scoring, and procedures manual (3rd ed.). Minneapolis, MN: National Computer Systems. Donnellan, M. B., Oswald, F. L., Baird, B. M., & Lucas, R. E. (2006). The miniIPIP scales: Tiny-yet-effective measures of the big five factors of personality. Psychological Assessment, 18, 192–203. doi:10.1037/1040-3590.18.2.192 Fassler, I. R., Amodeo, M., Griffin, M. L., Clay, C. M., & Ellis, M. A. (2005). Predicting long term outcomes for women sexually abused in childhood: Contribution of abuse severity versus family environment. Child Abuse & Neglect, 29, 269–284. doi:10.1016/j.chiabu.2004.12.006 Fergusson, D. M., & Mullen, P. E. (1999). Child sexual abuse: An evidence based perspective. Thousand Oaks, CA: Sage. Finkelhor, D. (1979). Sexually victimized children. New York, NY: Free Press. Finkelhor, D. (1990). Early and long-term effects of child sexual abuse: An update. Professional Psychology: Research and Practice, 21, 325–330. doi:10.1037/0735-7028.21.5.325

Downloaded by [Lauren Stokes] at 07:56 19 September 2013

Sexual Abuse, Family Environment, and Personality

675

Goldberg, L. R., Johnson, J. A., Eber, H. W., Hogan, R., Ashton, M. C., Cloninger, C. R., & Gough, H. G. (2006). The international personality item pool and the future of public-domain personality measures. Journal of Research in Personality, 40(1), 84–96. doi:10.1016/j.jrp.2005.08.007 Hulsey, T., & Sexton, M. (1992). Perceptions of family functioning and the occurrence of childhood sexual abuse. Bulletin of the Menniger Clinic, 56, 438–450. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/1422521 Kendall-Tackett, K. A., Williams, L. M., & Finkelhor, D. (1993). Impact of sexual abuse on children: A review and synthesis of recent empirical studies. Psychological Bulletin, 113, 164–180. doi:10.1037/0033-2909.113.1.164 Koenig, L. J., Doll, L. S., O’Leary, A., & Pequegnat, W. (Eds.). (2004). From child sexual abuse to adult sexual risk: Trauma, revictimization, and intervention. Washington, DC: American Psychological Association. Lim, B., & Ployhart, R. E. (2006). Assessing the convergent and discriminant validity of Goldberg’s international personality item pool: A multitraitmultimethod examination. Organizational Research Methods, 9(1), 29–54. doi:10.1177/1094428105283193 Molnar, B. E., Buka, S. L., & Kessler, R. C. (2001). Child sexual abuse and subsequent psychopathology: Results from the national comorbidity survey. American Journal of Public Health, 91, 753–760. doi:10.2105/AJPH.91.5.753 Olson, D. H., & Gorall, D. M. (2003). Circumplex model of marital and family systems. In F. Walsh (Ed.), Normal family processes (3rd ed., pp. 514–547). New York, NY: Guilford Press. Olson, D. H., Gorall, D. M., & Tiesel, J. W. (2006). FACES-IV package: Administration manual. Minneapolis, MN: Life Innovations. Peleikis, D. E., Mykletun, A., & Dahl, A. A. (2004). The relative influence of childhood sexual abuse and other family background risk factors on adult adversities in female outpatients treated for anxiety disorders and depression. Child Abuse & Neglect, 28, 61–76. doi:10.1016/j.chiabu.2003.08.003 Peters, D. K., & Range, L. M. (1995). Childhood sexual abuse and current suicidality in college women and men. Child Abuse & Neglect, 19, 335–341. doi:10.1016/S0145-2134(94)00133-2 Pickering, A., Farmer, A., & McGuffin, P. (2004). The role of personality in childhood sexual abuse. Personality and Individual Differences, 36, 1295–1303. doi:10.1016/S0191-8869(03)00217-4 Ray, K. C., & Jackson, J. L. (1997). Family environment and childhood sexual victimization. Journal of Interpersonal Violence, 12, 3–17. doi:10.1177/088626097012001001 Rind, B., Tromovitch, P., & Bauserman, R. (1998). A meta-analytic examination of assumed properties of child sexual abuse using college samples. Psychological Bulletin, 124, 22–53. doi:10.1037/0033-2909.124.1.22 Rogosch, F. A., & Cicchetti, D. (2004). Child maltreatment and emergent personality organization: Perspectives from the five-factor model. Journal of Abnormal Child Psychology, 32, 123–145. doi:10.1023/B:JACP.0000019766.47625.40 Rowan, E. L. (2006). Understanding child sexual abuse. Jackson, MI: University Press of Mississippi.

Downloaded by [Lauren Stokes] at 07:56 19 September 2013

676

L. Drerup Stokes et al.

Roy, A. (2002). Childhood trauma and neuroticism as an adult: Possible implication for the development of the common psychiatric disorders and suicidal behavior. Psychological Medicine, 32, 1471–1474. doi:10.1017/S0033291702006566 Sarwer, D. B., & Durlak, J. A. (1996). Childhood sexual abuse as a predictor of adult female sexual dysfunction: A study of couples seeking sex therapy. Child Abuse & Neglect, 20, 963–972. doi:10.1016/0145-2134(96)00085-3 Socha, A., Cooper, C. A., & McCord, D. M. (2010). Confirmatory factor analysis of the M5-50: An implementation of the IPIP item set. Psychological Assessment, 22, 43–49. doi:10.1037/a0017371 Talbot, N. L., Duberstein, P. R., King, D. A., Cox, C., & Giles, D. E. (2000). Personality traits of women with a history of childhood sexual abuse. Comprehensive Psychiatry, 41(2), 130–136. doi:10.1016/S0010-440X(00)90146-9 Whiffen, V. E., Thompson, J. M., & Aube, J. A. (2000). Mediators of the link between childhood sexual abuse and adult depressive symptoms. Journal of Interpersonal Violence, 15, 1100–1120. doi:10.1177/088626000015010006

AUTHOR NOTES Lauren Drerup Stokes, PhD, is a postdoctoral fellow in clinical psychology in Alexandria, Louisiana. She received her MA in clinical psychology from Western Carolina University under the mentorship of David McCord and Lydia Aydlett, and she received her PhD in clinical psychology from the University of Kansas Clinical Child Psychology Program. Her research focuses on mechanisms of resilience in the context of child abuse and exposure to community violence. David McCord, PhD, is currently professor and head of the Department of Psychology at Western Carolina University. He received his BA in psychology from Duke University, his MA in clinical psychology from Western Carolina University, and his PhD in clinical psychology from the University of Alabama. His publications and professional presentations focus generally on personality assessment and personality theory. He serves on the editorial board of Psychological Assessment and is a frequent ad hoc reviewer for other journals. Lydia Aydlett, PhD, is a pediatric psychologist in practice in Sylva, North Carolina. She was formerly an assistant professor at Western Carolina University. She received her MA in school psychology from Western Carolina University. She received her PhD in developmental psychology from the University of North Carolina, Chapel Hill. Her research interests include parenting stress and child abuse.