USF Libraries
USF Digital Collections

The moderating role of meaning and defense mechanisms in the association between child sexual abuse and romantic relatio...

MISSING IMAGE

Material Information

Title:
The moderating role of meaning and defense mechanisms in the association between child sexual abuse and romantic relationship dysfunction
Physical Description:
Book
Language:
English
Creator:
Fairweather, Angela
Publisher:
University of South Florida
Place of Publication:
Tampa, Fla
Publication Date:

Subjects

Subjects / Keywords:
Trauma
Relationship adjustment
Psychological adjustment
Coping
Moderator
Dissertations, Academic -- Psychology -- Doctoral -- USF   ( lcsh )
Genre:
non-fiction   ( marcgt )

Notes

Abstract:
ABSTRACT: The current study investigated whether finding meaning in relation to sexual trauma and using mature defense mechanisms would moderate the association between child sexual abuse (CSA) severity and relationship and psychological adjustment in a sample of undergraduate women with a history of child sexual abuse. CSA severity was measured both objectively (i.e., severity of the abusive event) and subjectively (i.e., self-reported perceptions of the severity of the abusive event). As predicted, the interaction of objective CSA severity and mature defenses uniquely predicted one of four aspects of romantic relationship functioning (i.e., dyadic cohesion or doing joint activities with one's partner), which provides strong support for a moderating effect of mature defenses on relationship adjustment for CSA survivors. In addition, Objective CSA Severity X Meaning and Perceived CSA Severity X Meaning were both significantly correlated with various aspects of psychological functioning. Similarly, Objective CSA Severity X Mature Defenses and Perceived CSA Severity X Mature Defenses were significantly correlated with psychological functioning. These findings provide mild support for a possible moderating effect of meaning and mature defenses on psychological adjustment for CSA survivors. Contrary to hypotheses, the interaction of perceived CSA severity and mature defenses was not significantly related to relationship functioning. Also contrary to hypotheses, the interactions of Perceived CSA Severity X Meaning and Objective CSA Severity X Meaning were not significantly related to relationship functioning. Finally, results did not support the hypothesis that relationship functioning would moderate the association between CSA severity (objective and perceived) and psychological adjustment.
Thesis:
Dissertation (Ph.D.)--University of South Florida, 2008.
Bibliography:
Includes bibliographical references.
System Details:
Mode of access: World Wide Web.
System Details:
System requirements: World Wide Web browser and PDF reader.
Statement of Responsibility:
by Angela Fairweather.
General Note:
Title from PDF of title page.
General Note:
Document formatted into pages; contains 120 pages.
General Note:
Includes vita.

Record Information

Source Institution:
University of South Florida Library
Holding Location:
University of South Florida
Rights Management:
All applicable rights reserved by the source institution and holding location.
Resource Identifier:
aleph - 002000473
oclc - 318989560
usfldc doi - E14-SFE0002495
usfldc handle - e14.2495
System ID:
SFS0026812:00001


This item is only available as the following downloads:


Full Text
xml version 1.0 encoding UTF-8 standalone no
record xmlns http:www.loc.govMARC21slim xmlns:xsi http:www.w3.org2001XMLSchema-instance xsi:schemaLocation http:www.loc.govstandardsmarcxmlschemaMARC21slim.xsd
leader nam Ka
controlfield tag 001 002000473
003 fts
005 20090422135814.0
006 m||||e|||d||||||||
007 cr mnu|||uuuuu
008 090422s2008 flu s 000 0 eng d
datafield ind1 8 ind2 024
subfield code a E14-SFE0002495
035
(OCoLC)318989560
040
FHM
c FHM
049
FHMM
090
BF121 (Online)
1 100
Fairweather, Angela.
4 245
The moderating role of meaning and defense mechanisms in the association between child sexual abuse and romantic relationship dysfunction
h [electronic resource] /
by Angela Fairweather.
260
[Tampa, Fla] :
b University of South Florida,
2008.
500
Title from PDF of title page.
Document formatted into pages; contains 120 pages.
Includes vita.
502
Dissertation (Ph.D.)--University of South Florida, 2008.
504
Includes bibliographical references.
516
Text (Electronic dissertation) in PDF format.
3 520
ABSTRACT: The current study investigated whether finding meaning in relation to sexual trauma and using mature defense mechanisms would moderate the association between child sexual abuse (CSA) severity and relationship and psychological adjustment in a sample of undergraduate women with a history of child sexual abuse. CSA severity was measured both objectively (i.e., severity of the abusive event) and subjectively (i.e., self-reported perceptions of the severity of the abusive event). As predicted, the interaction of objective CSA severity and mature defenses uniquely predicted one of four aspects of romantic relationship functioning (i.e., dyadic cohesion or doing joint activities with one's partner), which provides strong support for a moderating effect of mature defenses on relationship adjustment for CSA survivors. In addition, Objective CSA Severity X Meaning and Perceived CSA Severity X Meaning were both significantly correlated with various aspects of psychological functioning. Similarly, Objective CSA Severity X Mature Defenses and Perceived CSA Severity X Mature Defenses were significantly correlated with psychological functioning. These findings provide mild support for a possible moderating effect of meaning and mature defenses on psychological adjustment for CSA survivors. Contrary to hypotheses, the interaction of perceived CSA severity and mature defenses was not significantly related to relationship functioning. Also contrary to hypotheses, the interactions of Perceived CSA Severity X Meaning and Objective CSA Severity X Meaning were not significantly related to relationship functioning. Finally, results did not support the hypothesis that relationship functioning would moderate the association between CSA severity (objective and perceived) and psychological adjustment.
538
Mode of access: World Wide Web.
System requirements: World Wide Web browser and PDF reader.
590
Advisor: Bill Kinder, Ph.D.
653
Trauma
Relationship adjustment
Psychological adjustment
Coping
Moderator
0 690
Dissertations, Academic
z USF
x Psychology
Doctoral.
773
t USF Electronic Theses and Dissertations.
856
u http://digital.lib.usf.edu/?e14.2495



PAGE 1

The Moderating Role of Meaning and Defens e Mechanisms in the Association between Child Sexual Abuse and Romantic Relationship Dysfunction by Angela Fairweather A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy Department of Psychology College of Arts and Sciences University of South Florida Major Professor: Bill Kinder, Ph.D. Michael Brannick, Ph.D. Vicky Phares, Ph.D. Charles Spielberger, Ph.D. Joseph Vandello, Ph.D. Date of Approval: February 13, 2008 Keywords: trauma, relationship adjustment, psychological adjustment, coping, moderator Copyright 2008, Angela Fairweather

PAGE 2

Dedication This dissertation is dedicated to those courageous and resili ent women who have survived the trauma of childhood sexual abuse. You truly epitomize the strength of the human spirit. It is my sincere wish that this work will inspire new advances in psychological treatment and hope for a better tomorrow.

PAGE 3

Acknowledgements I would like to express my deepest appr eciation to my major professor, Dr. Bill Kinder, for his ubiquitous and invaluable s upport and guidance throughout my graduate school career and especially during the time-consuming process of developing and completing this dissertation. I would also like to express sinc ere gratitude to my dissertation committee members and chai r, all of whom provided tremendous encouragement and insightful feedback that significantly enhanced the quality of my work. Finally, I have to thank my wonderf ul husband, Sean, for being my rock and my inspiration to be more than I ever thought I could.

PAGE 4

i Table of Contents List of Tables ii Abstract v Chapter One 1 Introduction 1 Child Sexual Abuse 1 Positive Illusions and Discovery of Meaning 6 Defense Mechanisms 14 Relationship Functioning 20 Chapter Two 33 The Present Study 33 Hypotheses 34 Chapter Three 36 Method 36 Participants 36 Measures 37 Procedures 42 Chapter Four 43 Results 43 Preliminary Analyses 43 Moderator Analyses 44 Chapter Five 48 Discussion 48 References 94 Appendices 110 Appendix A: Demographics 111 Appendix B: ESE 112 Appendix C: SRG 113 Appendix D: DSQ-40 114 Appendix E: DAS 118

PAGE 5

ii List of Tables Table 1 Descriptive Stat istics for Continuous Variables 61 Table 2 Analysis of Variance between Discrete Child Sexual Abuse & Relationship Functioning 62 Table 3 Analysis of Variance between Discrete Child Sexual Abuse & Psychological Functioning 63 Table 4 Correlations between Child Sexual Abuse Severity & Relationship Functioning 64 Table 5 Correlations between Child Sexual Abuse Severity & Psychological Functioning 65 Table 6 Correlations between Child Sexual Abuse Severity X Meaning & Relationship Functioning 66 Table 7 Correlations between Child Sexual Abuse Severity X Meaning & Psychological Functioning 67 Table 8 Correlations between Child Se xual Abuse X Mature Defenses & Relationship Functioning 68 Table 9 Correlations between Child Sexual Abuse Severity X Mature Defenses & Psychological Fu nctioning 69 Table 10 Hierarchical Regression between Objective Child Sexual Abuse Severity X Meaning & Aff ectional Expression 70 Table 11 Hierarchical Regression between Perceived Child Sexual Abuse Severity X Meaning & Aff ectional Expression 71 Table 12 Hierarchical Regression between Objective Child Sexual Abuse Severity X Meaning & Dyadic Consensus 72 Table 13 Hierarchical Regression between Perceived Child Sexual Abuse Severity X Meaning & Dyadic Consensus 73

PAGE 6

iii Table 14 Hierarchical Regression between Objective Child Sexual Abuse Severity X Meaning & Dyadic Satisfactio n 74 Table 15 Hierarchical Regression between Perceived Child Sexual Abuse Severity X Meaning & Dyadic Satisfactio n 75 Table 16 Hierarchical Regression between Objective Child Sexual Abuse Severity X Meaning & Dyadic Cohesion 76 Table 17 Hierarchical Regression between Perceived Child Sexual Abuse Severity X Meaning & Dyadic Cohesion 77 Table 18 Hierarchical Regression between Objective Child Sexual Abuse Severity X Mature Defenses & Dyadic Consensus 78 Table 19 Hierarchical Regression between Perceived Child Sexual Abuse Severity X Mature Defenses & Dyadic Consensus 79 Table 20 Hierarchical Regression between Objective Child Sexual Abuse Severity X Mature Defenses & Affectional Expression 80 Table 21 Hierarchical Regression between Perceived Child Sexual Abuse Severity X Mature Defenses & Affectional Expression 81 Table 22 Hierarchical Regression between Objective Child Sexual Abuse Severity X Mature Defenses & Dyadic Satisfaction 82 Table 23 Hierarchical Regression between Perceived Child Sexual Abuse Severity X Mature Defenses & Dyadic Satisfaction 83 Table 24 Hierarchical Regression between Objective Child Sexual Abuse Severity X Mature Defenses & Dyadic Cohesion 84 Table 25 Hierarchical Regression between Perceived Child Sexual Abuse Severity X Mature Defenses &Dyadic Cohe sion 85 Table 26 Hierarchical Regression between Objective Child Sexual Abuse Severity X Dyadic Consensus & Global Severity Index 86

PAGE 7

iv Table 27 Hierarchical Regression be tween Perceived Child Sexual Abuse Severity X Dyadic Consensus & Global Severity Index 87 Table 28 Hierarchical Regression between Objective Child Sexual Abuse Severity X Affectional E xpression & Global Severity Index 88 Table 29 Hierarchical Regression between Perceived Child Sexual Abuse Severity X Affectional E xpression & Global Severity Index 89 Table 30 Hierarchical Regression between Objective Child Sexual Abuse Severity X Dyadic Cohesion & Global Severi ty Index 90 Table 31 Hierarchical Regression between Perceived Child Sexual Abuse Severity X Dyadic Cohesion & Global Severi ty Index 91 Table 32 Hierarchical Regression between Objective Child Sexual Abuse Severity X Dyadic Satisfaction & Global Severity Index 92 Table 33 Hierarchical Regression between Perceived Child Sexual Abuse Severity X Dyadic Satisfaction & Global Severity Index 93

PAGE 8

v The Moderating Role of Meaning and Defense Mechanisms in the Association between Child Sexual Abuse and Roman tic Relationship Dysfunction Angela Fairweather ABSTRACT The current study investigated whether finding meaning in relation to sexual trauma and using mature defense mechanisms would moderate the association between child sexual abuse (CSA) severity and relati onship and psychological adjustment in a sample of undergraduate women with a history of child sexual abuse. CSA severity was measured both objectively (i.e., severity of the abusive event) and subj ectively (i.e., selfreported perceptions of the severity of the abus ive event). As predicted, the interaction of objective CSA severity and mature defenses uniquely predicted one of four aspects of romantic relationship functioning (i.e., dyadic cohesion or doing join t activities with one’s partner), which provides strong support fo r a moderating effect of mature defenses on relationship adjustment for CSA survivors. In addition, Objec tive CSA Severity X Meaning and Perceived CSA Severity X Mean ing were both significan tly correlated with various aspects of psychological functioni ng. Similarly, Objective CSA Severity X Mature Defenses and Perceived CSA Severi ty X Mature Defenses were significantly correlated with psychological functioning. These findings provide mild support for a possible moderating effect of meaning and matu re defenses on psyc hological adjustment for CSA survivors. Contrary to hypotheses, the interaction of pe rceived CSA severity

PAGE 9

vi and mature defenses was not significantly related to relationsh ip functioning. Also contrary to hypotheses, the interactions of Perceived CSA Severity X Meaning and Objective CSA Severity X Meaning were not significantly related to relationship functioning. Finally, results did not support the hypothesis th at relationship functioning would moderate the associat ion between CSA severity (objective and perceived) and psychological adjustment.

PAGE 10

1 Chapter One Introduction Child Sexual Abuse Child sexual abuse (CSA) has been define d as the involvement of a child in a sexual activity that he or she does not fully co mprehend; that he or she is unable to give informed consent to; that he or she is not developmentally prepared for and cannot give consent to; and/or that violat es the laws or social taboos of society (World Health Organization, 1999). Furthermore, the perpetrator must be an adult or another child who by developmental age is in a relationship of re sponsibility, trust, or power with the victim, and the sexual activity must be intended to satisfy the needs of the perpetrator (World Health Organization, 1999). Finally, the se xual activity is usually unlawful, and may include fondling, exposure, intercourse, child prostitution, and child pornography (World Health Organization, 1999). Other definitions used in the literature include direct or indirect sexual contact of a child with an adult, whether through force or consent (Friedrich, Urquiza, & Bielke, 1986); sexua l contact between a child under 15 and someone at least 5 years older (Schaa f & McCann, 1998); and any unwanted sexual experience of a child under the age of 12 with someone at least 5 years older (Peters & Range, 1995). Epidemiological studies have s uggested that 12-35 pe rcent of women and 4-9 percent of men in the U.S. report having been sexually abused before the age of 18 (Putnam, 2003).

PAGE 11

2 A large body of research has examined the short and long-term effects of CSA on its survivors. These data i ndicate that child survivors may demonstrate inappropriate sexualized behaviors, anxiet y, depression, low self-esteem, withdrawal, attention and concentration problems, and Post-Trauma tic Stress Disorder (PTSD) symptoms (Koverola, Pound, Heger, & Lytle, 1993; Me rry & Andrews, 1994; Oates, O’Toole, Lynch, Stern, & Cooney, 1994). Similarly, adult survivors have been found to demonstrate anxiety, depressi on, low self-esteem, PTSD sy mptoms, substance abuse, eating disorder symptoms, and personality di sorder symptoms (Hall, Tice, Beresford, Wooley, & Hall, 1989; Neumann, 1994; Neuma nn, Houskamp, Pollock, & Briere, 1996). Medical consequences of CSA have also b een identified. For example, some studies have reported increased risk for gastrointes tinal disorders (e.g., irritable bowel syndrome and chronic abdominal pain) and gynecological disorders (e.g., chronic pelvic pain) in adult survivors of CSA (Drossman, 1992; Fr y, Crisp, Beard, & McGu igan, 1993; Scarinci, McDonald-Haile, Bradley, & Richter, 1994). In addition, deleterious effects on the sympathetic nervous system and the immune system have been observed in sexually abused girls (Putnam & Trickett, 1997). De spite the negative sequelae often associated with CSA, however, the research evidence suggests that there is a relatively large subgroup of survivors who seem to come away relatively unscathed from the experience (Kendall-Tackett, Williams, & Finkelhor, 1993; Runtz & Schallow, 1997; Savell, Kinder, & Young, 2006). As such, researchers have be en interested in id entifying protective factors and coping mechanisms in particular th at are associated with healthy adjustment to CSA.

PAGE 12

3 Some situational variables that have been shown to be protective against the effects of CSA in both the short and long-run include childhood factors, such as parental warmth (Wind & Silvern, 1994); social suppor t (Testa, Miller, Downs, & Panek, 1992); support and belief from a nonoffending parent (Spaccarelli & Kim, 1995); and a positive family environment in general (Esparza, 1993; Spaccarelli et al., 1995). Coping variables associated with better adjustment in both ch ild and adult survivors of CSA are said to include approach strategies (e.g., expressing feelings and seeking social support) and active problem solving (Coffey, Leitenberg, Henning, & Turner, 1996; Himelein & McElrath, 1996). Runtz and Schallow (1997) conducted a st udy in which they employed structural equation modeling (SEM) to investigate wh ether coping and social support would mediate the relation between child maltreatme nt (i.e., sexual and physical abuse) and psychological adjustment in a sample of male and female undergraduates at a Canadian University. The results indicated strong evid ence for the mediation hypothesis, such that the association between child maltreatment a nd adjustment was almost entirely accounted for by the mediating variables (i.e, social s upport and coping). With respect to coping, the strategies that were most significantly related to healthy adjustment were the expression of emotion and active pursuit of ch ange and understanding. On the other hand, self-destructive behaviors (e.g., suicidality, substance abuse) and avoidant be haviors (e.g., trying to forget, ignoring feelings) were most strongly related to poor adjustment. Merrill, Thomsen, Sinclair, Gold, and Milner (2001) conducted a similar study that examined the role s of parental support, coping strategies, and a buse severity in the psychological adjustment of female Navy recruits The results revealed that participants

PAGE 13

4 who reported high levels of pa rental support, including those with and without a history of CSA, had fewer psychological symptoms, wh ereas those who reporte d lower levels of parental support reported more symptoms. Structural equati on models were also tested in order to determine whether coping behaviors mediate the effect of abuse severity and parental support on psychologica l symptoms. A fully mediated model in which parental support and abuse severity were only rela ted to symptoms by way of coping was compared with a partially mediated model in which parental support and abuse severity were related to symptoms both directly and indirectly via coping. The results indicated that both models provided an adequate fit fo r the data. Furthermore, the fully mediated model fit the data as well as the partially me diated model, which suggested strong support for the mediation hypothesis. More specifically, the fully mediated model proposed that parental support led to cons tructive coping, which refers to proactive coping strategies, such as behavioral cha nges, cognitive reframing, and support seeking. On the other hand, abuse severity was proposed to lead to all 3 forms of coping included in the model: constructive coping; self-destruc tive coping (i.e., behavi oral acting out such as substance abuse); and avoi dant coping (i.e., attempts to deny or repress thoughts and feelings associated with the a buse). Finally, these 3 coping stra tegies were said to lead to psychological symptoms, such that constr uctive coping was associated with fewer symptoms, whereas self-destructive and avoi dant coping were associated with more symptoms. Coffey, Leitenberg, Henning, Turner, and Bennett (1996) also conducted a study in which they examined the relationship between coping strategies and psychological adjustment in a group of community women with a history of CSA and a comparison

PAGE 14

5 group with no history of CSA. This study specifically aimed to identify the coping strategies used to deal with CSA (versus t hose used to deal with other stressors) and analyze how these CSA coping strategies woul d be related to adjustment. The results revealed a significant interaction between the type of stressful event (i.e., CSA versus another stressor) and coping method empl oyed by the CSA group. Specifically, CSA participants employed engagement coping (i .e., active efforts to manage oneself and one’s environment, such as talking to others) more ofte n in dealing with non-CSA stressors. On the other hand, they employe d disengagement coping (i.e., attempts to disengage from oneself and one’s environmen t, such as avoiding thinking about the situation) more often in dealing with CSA. It is noteworthy that more severe abuse was related to increased us e of both engagement and disengage ment strategies for coping with the abuse. With respect to adjustment, it was found that disengagement coping specific to CSA and disengagement coping specific to non-CSA events were the only coping methods that uniquely predicted psychologica l adjustment. Specifically, coping with CSA via disengagement methods was associat ed with poorer adjustment. Finally, CSAspecific disengagement coping added significantly to the va riance in adjustment, above and beyond abuse characteristics and methods of coping with non-CSA events. Ullman (1997) investigated how different cognitions about the self, the world, and the abuse experience influence recovery from sexual assault in a sample of adult women from the community. Results showed that gr eater self-worth was associated with fewer self-reported psychological symptoms and highe r self-reported recove ry. On the other hand, external attributions of blame for the abuse were re lated to more self-reported symptoms. Finally, searching for meaning in one’s victimizati on (versus having found

PAGE 15

6 such meaning) was associated with more self-rated symptoms and lower self-rated recovery. The role of positive illusions and discovery of meaning in adjustment to trauma and CSA in particular will now be discussed. Positive Illusions and Di scovery of Meaning For several decades now, the mental health community has emphasized the importance of rational and accura te thinking for psychological health. Recently, however, there has been a growing body of research exam ining the potentially be neficial effects of so-called positive illusions (Mazur, Wolc hik, Virdin, Sandler, & West, 1999; Taylor, 1989; Taylor, Kemeny, Reed, Bower, & Gruene wald, 2000). Positive illusions refer to beliefs that represent mild positive distortions of reality (Fiske & Taylor, 1991). The social cognition literature has demonstrated considerable evidence that these unrealistic positive beliefs may actually be a normal part of human cognition (Fiske & Taylor, 1991; Taylor & Brown, 1988). Specifically, three types of positive illusions have been consistently identified as characterizing normal thought processes: self-enhancement, unrealistic optimism, and an exaggerated se nse of personal cont rol (Taylor & Brown, 1988). Self-enhancement involves the holding of positively biased beliefs about oneself, including biases about physical appearance, pe rsonality traits, and a variety of abilities. Unrealistic optimism refers to the holding of positive expectations in the face of negative situations from which positive outcomes may be unlikely. Lastly, an exaggerated sense of personal control refers to unr ealistic beliefs about one’s ability to control a situation or stressor that is heavily influe nced by external factors. Anot her concept related to positive illusions has to do with the discovery of meaning in relation to negative events and experiences. It has been suggest ed that positive illusions may facilitate the reappraisal of

PAGE 16

7 negative events, such that individuals come to view these events as catalysts to the discovery of new values and a fresh perspec tive on life (Taylor, 1983). In other words, individuals find meaning relative to the negative event. At first glance, positive i llusions may appear to be another form of avoidant coping, whereby individuals deal with stre ssors by ignoring or denying the objective reality of a situation. Howeve r, denial responses tend to in crease as the magnitude of a stressor increases (Taylor et al., 1996), which restricts the incorporation of any negative information. On the other hand, positive illusions do allow for the acknowledgement of negative information because the distortions involved tend to be relatively mild in nature (Taylor, 1989). Another di stinction between positive i llusions and avoidant coping mechanisms is that positive illusions re present people’s beli efs about their own characteristics, abilities, and future circum stances, while denial tends to be primarily concerned with external circumstances (T aylor et al., 1996). Finally, the research literature has actually shown th at individuals who hold positiv e illusions are more likely to utilize active coping strategies involvi ng proactive steps to deal with stressors (Aspinwall & Taylor, 1997). Taylor and Armor (1996) attempted to explain the mechanisms by which positive illusions operate. As was mentioned earli er, positive illusions are believed to characterize normal human cogni tion (e.g., Fiske & Taylor, 1 991). According to Taylor et al. (1996), negative or threat ening events challenge positiv e illusions, and this causes people to make efforts to protect and enha nce these illusions. Indeed, research has demonstrated that negative events result in increases in affective, physiological, cognitive, and behavioral activities compared to neut ral or positive events (Taylor, 1991). More

PAGE 17

8 specifically, people may develop even greater self-enhancement, unr ealistic optimism, and perceptions of personal control when faced with threats to these beliefs (Taylor et al., 1996). For instance, breast cancer patients (Taylor, Lichtman, & Wood, 1984) and heart disease patients (Taylor, Helgeson, Reed, & S kokan, 1991) often believe that they have a high degree of control over their illness, despite compelling medical evidence to the contrary. People dealing with stressful even ts may also make downward comparisons in an effort to increase self-enhancement (Aspinwall & Taylor, 1993). For example, the aforementioned study on breast cancer patients revealed that 70 of the 72 women in the sample believed that they were doing better than other women with breast cancer (Taylor et al., 1984). Despite the fact that positiv e illusions represent a distorted version of objective reality, however, Taylor et al (1996) emphasized that the dist ortions are kept in check by external feedback, such as feedback from one’s friends and family (Taylor & Brown, 1988). Another important point made by Taylor et al. (1996) about the workings of positive illusions was that these belie fs seem to be more active during the implementation of decisions aimed at dealing with stressors and problems, rather than during the deliberation process. This is perhaps because decisionmaking requires more realistic information processing, whereas deci sion implementation may benefit from the exaggeration and enhanced self-efficacy charact erized by positive illusions (Taylor et al., 1996). Consistent with this position, a study by Gollwitzer and Kinney (1989) found that individuals in the implementation condition of a task were more likely to demonstrate an illusion of control over an uncontrollable apparatus when compared to individuals in the deliberation condition for the same task/decisi on. Finally, there is the question of what happens when positive illusions are di sconfirmed by deteriorating events or

PAGE 18

9 circumstances. Taylor et al., (1996) actually suggested th at people with an optimistic outlook may be more flexible in their use of coping mechanisms and can, therefore, modify their cognitions and strategies effectively in order to deal with a worsening reality. Data collected from HIV seropositive gay and bisexual men indeed confirmed that dispositional optimism was not associated with psychological maladjustment when positive expectations were shat tered (Neter, Taylor, & Kemeny, 1995). At this juncture, research findings on the effects of positive illusions on adjustment to illness, stress, and trauma will be discussed. Thereafter, the research literature on the relationship between positive illusions and adjustment to child sexual abuse in particular will be reviewed. Recent studies have investigated the role of positive illusions and the discovery of meaning in physical health and disease outcome s. For example, Segerstrom, Taylor, and Fahey (1998) found a positive association be tween optimism and the number of CD4 (helper) T cells, which are important for eff ective immune system functioning, in stressed law school students. Similarly, a study by Ta ylor, Lerner, Sherman, Sage, and McDowell (2003) examined the association between self-enhancement and physiological (i.e., autonomic and hypothalamic-pituitary-adrenocor tical [HPA]) responses to stress in 92 adults affiliated with the University of California (Los Angeles). While these physiological responses are generally believed to be adaptive in the short term because of prompting the “fight or flight” reaction, it is well established that recurrent activation of the autonomic and HPA systems can result in adverse consequences (e.g., coronary disease) for health (McEwen, 1998). As such, Taylor et al. (2003) hypothesized that selfenhancement would be associated with signi ficantly less activation of the body’s stress regulatory systems in response to psychologi cal stressors. Consistent with this

PAGE 19

10 hypothesis, results indicated th at high self-enhancers had lo wer systolic blood pressure and a lower heart rate than low self-enhancer s when confronted with stressful tasks. Although high self-enhancers showed lower co rtisol levels which suggests lower physiological arousal than low self-enhancer s at baseline, there was no difference in cortisol levels between the two groups when performing stressful activities. The researchers also tested whether psychol ogical distress, psychological health, and psychological resources (e.g., adaptive coping) mediated the relationship between selfenhancement and physiological arousal. Wh ile none of these vari ables were found to mediate the association between self-enhancement and either h eart rate or systolic blood pressure, psychological resources did mediat e the path between self-enhancement and baseline cortisol levels. This suggests that high self-enhancers were able to maintain lower cortisol levels, which is one indicator of lower physiol ogical reactivity, as a result of having more psychological resources (e.g., e ffective coping skills), (Taylor et al., 2003). Taylor, Kemeny, Reed, Bower, and Gruene wald (2000) also investigated the association between positive illusions and phys ical health. More specifically, these researchers examined whether unrealistic op timism, a belief in personal control, and having a sense of meaning would predict the course of illness for 78 homosexual men infected with HIV. HIV was believed to be an ideal model for understanding the influence of these positive cognitions because seropositive individuals could be followed from the time of diagnosis when many of them are asymptomatic through symptom manifestation and death. Results showed that the men who were high on realistic acceptance of their own death died an average of 9 months earlier than those who were

PAGE 20

11 low on realistic acceptance, even when c ontrolling for potential confounds (e.g., age, time since diagnosis, number of AIDS-related symptoms, level of CD4 T helper cells, psychological distress, depression, suicidal ideation, and use of the AIDS medication zidovudine – i.e., AZT). Furthermore, ne gative HIV-specific expectancies were predictive of the onset of AIDS-related symptoms, especially amongst seropositive men who were experiencing bereavement from the loss of a close friend or romantic partner. This finding remained stable even when mood and health habits were controlled. It was also investigated whether th e course of illness for seropositive participants who were bereaved was related to cognitive processing (defined as verbal statements indicative of effortful or long-lasting thoughts about the de ath of one’s loved one) and finding a sense of meaning (defined as a majo r shift in values or perspec tive in response to the loss of one’s loved one. Sixty-five percent of these participants were high on cognitive processing, while 40 percent were high on findi ng meaning. The vast majority of those who were high on finding meaning were also high on cognitive processing; however, only some of those who were high on cogniti ve processing were hi gh on finding a sense of meaning. Primary analyses indicated th at only the men who had found a sense of meaning in their loss maintained their CD4 T helper cells over the follow-up period (i.e., 4-9 months), after controlling for other pred ictors of HIV progre ssion (e.g., number of HIV-related symptoms, initial CD 4 T helper cell levels health habits, and affect). In addition, only 3 of the 16 men who had found a sense of meaning died during the follow up period, whereas half of the 24 who had not found meaning died during this period. This study, therefore, provides compelling evid ence of the beneficial effects of positive illusions on the course of terminal disease. Other studies of individuals infected with

PAGE 21

12 HIV and AIDS have also revealed that thos e persons who held unr ealistically optimistic views about the course of their illness showed slower disease progression (Reed, Kemeny, Taylor, & Visscher, 1999) and greater longevity (Reed, Kemeny, Taylor, Wang, & Visscher, 1994) than those who di d not hold such optimistic views. Studies have also investigated the imp act of positive illusions and meaning on adjustment to external stressors. For exam ple, the research literature on divorce has sought to identify various risk and protective fa ctors that predict children’s adjustment to this stressful event. One of the most wide ly studied variables re lated to post-divorce outcomes for children is cognitive appr aisal (e.g., Lazarus, 1991; Meichenbaum & Fitzpatrick, 1993). Numerous st udies have shown that nega tive cognitive errors of children are positively associated with psyc hological (Cole & Turner, 1993; Laurent & Stark, 1993; Mazur, Wolchik, & Sandler, 1992) and behavioral prob lems (Mazur et al., 1992). In contrast, Mazur et al. (1992) found that having a sense of meaning in relation to hypothetical divorce events were related to lower levels of aggression in children. Similarly, Krantz, Clark, Pruyn, and Usher (1985 ) demonstrated that positive appraisals of divorce were associated with parental reports of fewer be havioral problems in boys. A recent study conducted by Mazur et al. (1999) examined the impact of negative cognitive errors and meaning on interna lizing and externalizing symptoms of children experiencing divorce-related stress. In a ddition, these researchers expl ored whether gender and age moderated the effects of negative cognitive er rors and meaning. Results indicated that negative cognitive errors were significantly positively correlated with both child and maternal reports of internalizing and extern alizing problems. On the other hand, finding a sense of meaning in the divorce was signifi cantly negatively correlated with child and

PAGE 22

13 maternal reports of internalizing problems a nd child reports of externalizing problems. Interaction analyses indicated that the effect of meaning and negative cognitive errors on adjustment problems differed depending on the age and gender of children. That is, the positive relationship between negative cogniti ve errors and adjustment problems was found to be stronger in boys (v ersus girls) and older children (versus younger children). Furthermore, the negative association between meaning and depression was stronger for girls than boys, while the negative associ ation between meaning and conduct problems only held for older children. Relatively few studies have evaluated the use of positive illusions and discovery of meaning as a coping mechanism for su rvivors of child sexual abuse (CSA). Nonetheless, the findings of existing studies have been promising. For instance, Silver, Boon, and Stones (1983) conducted a study in wh ich they looked at the strategy of searching for meaning in a sample of adult incest survivors. They found that the women who reported having found meaning relative to the abuse event (e.g., viewing the experience as having made them emotionally stronger) had less psychological symptoms, higher self-esteem, and better social functioni ng than those who were not successful in their search for meaning (Silver et al., 1983). In addition, Moran and Eckenrode (1992) found that having a sense of personal control or internal locus of control for positive events was a protective factor for adolescent survivors of child ma ltreatment, including sexual abuse. Another study by Himelein and McElrath (1996) investigated cognitive mechanisms associated with resilience in a nonclinical sample of CSA survivors. In particular, they examined whether the CSA group differed from a control group in their level of overall adjustment (as indicated by measures of psychological health,

PAGE 23

14 psychological distress, and life satisfaction) and their tendency to employ perceptions of personal control and unrealistic optimism. Secondly, they lo oked at whether the use of these positive illusions was associated w ith overall adjustment for both the CSA and control groups. Preliminary analyses showed that the two groups did not differ in overall adjustment or in their reported use of pos itive illusion as a general coping strategy. Consistent with the hypothesis that positive illusion use would be related to better adjustment, results indicated that nearly all of the variance in adjustment for both groups was accounted for by the illusion variables (i.e ., sense of personal control and unrealistic optimism). These findings suggest that posi tive illusions can serve as a very powerful coping technique, even in the face of a severe traumatic stressor like sexual abuse. Like positive illusions, defense mechanisms are another means by which individuals sometimes cope with trauma. As such, a discussion of the role of these defense mechanisms in adjustment to trauma and CSA will now be presented. Defense Mechanisms Sigmund Freud was the first to introduce th e idea that indivi duals distort their perceptions of reality in orde r to minimize negative psychological effects, especially anxiety (Kassin, 1998). The distortions are said to o ccur unconsciously in most instances, but at times may occur at th e conscious level (Newman, 2001). Freud identified six major defense mechanisms that characterize human behavior and cognition. A brief description of these defense mechanisms follows. First, repression refers to the “forgetting” or uncons cious suppression of anxietyprovoking thoughts, memories, and feelings (K assin, 1998). For example, survivors of traumatic events sometimes report that they ha ve little or no recollec tion of the event.

PAGE 24

15 Denial is a related defense that involves automatic exclusion from consciousness of threatening aspects of reality or the inability to acknowledge th e true significance of such situations or events (White & Gilliland, 1975). In the case of a trauma survivor, minimizing the abusive experience might c onstitute denial. Projection involves projecting one’s own unacceptable impulses or c ognitions unto others, such that another person, rather than the self, is perceived as having those impulses or cognitions (Kassin, 1998). For instance, a man who is attracted to his brother’s wife ma y begin to perceive that his brother’s wife is at tracted to him rather than to accept his own inappropriate thoughts and feelings. Reaction formation is another defense mechanism and it refers to the conversion of unacceptable feelings or c ognitions into its opposite (White & Gilliland, 1975). A mother who smothers an unwanted an d resented child with affection can be said to be demonstrating reaction formation. Rationalization involve s creating alternative explanations for one’s misfortunes because th e true explanation is too threatening to accept (Kassin, 1998). For example, a failing st udent who blames the instructor for his bad grades, rather than acknowledge his lack of preparation, may be rationalizing. Lastly, Freud described sublimation as the channeli ng of unacceptable impulses or feelings into more socially acceptable outlets (Kassin, 1998). An example of this might be a male who satisfies his inappropriate aggressive urge s by engaging in a more socially acceptable activity, such as joining the police force. Additional defense mechanisms have also been identified in the literature. Displacement involves the transferring of inte nse feelings from one situation where such feelings cannot be expressed safely to anothe r situation where they can. For example, an employee cannot express anger toward his boss, so he displaces the anger and expresses

PAGE 25

16 it toward his family at home instead. Next, in tellectualization refers to efforts to focus on factual or rational aspects of a stressful or traumatic event rather than on the emotional aspects. For instance, a wife whose husband ha s died from a terminal illness may tend to dwell on the biological intricacies of the i llness in order to avoid dealing with the emotional pain associated with the loss. Re gression is yet another defense and it involves returning to an earlier stage of development in order to reduce anxiet y and distress. An example of this would be an adult woman w ho curls up in the corner of her room like a child when experiencing extreme distress becaus e this was something that used to bring her comfort as a child. Finally, dissociation re fers to the act of se parating oneself from reality by way of a temporary alteration in consciousness or identity. For instance, theorists would suggest that someone who has endured a traumatic event may develop multiple personalities to separate themselves from the event. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychological Association, 2000) classified de fense mechanisms and other coping styles into different levels according to how adaptiv e or dysfunctional they were assessed to be. Of the defenses described above, sublimati on (i.e., channeling unacceptable impulses into more socially acceptable outlets) is the only one classified as being highly adaptive because it involves a balance be tween gratification and cons cious awareness of thoughts, feelings, and their consequences. Displ acement (i.e., redirecting inappropriate or negative emotions toward a safer target), disso ciation (i.e., separating oneself from reality by altering consciousness or identity), inte llectualization (i.e., focusing on the rational rather than emotional aspects of a stressful event), reaction formation (i.e., expressing behaviors that are the opposite of one’s internal de sires or feelings), and repression (i.e.,

PAGE 26

17 forgetting important aspects of an adverse event) are classifi ed as mental inhibitions and considered to be less adaptive because th ey keep certain cognitions, feelings, and impulses out of conscious awareness. Denial (i .e., failure to become aware of a negative event), projection (i.e., perceiving that ot hers hold one’s own unacceptable thoughts and impulses), and rationalization (i .e., developing alternative expl anations for inadequacies or wrongdoings) are classified as being in the disavowal level of functioning. This level is said to be even less adaptive than me ntal inhibitions because it not only involves keeping unpleasant or unacceptable thoughts, fee lings, etc. out of awareness, but it may also include misattributing thes e thoughts and feelings to ex ternal causes. Lastly, the DSM-IV classified extreme forms of projecti on (termed delusional pr ojection) and denial (termed psychotic denial) as being at the level of defensive dysregulation. This level is described as being the most dysfunctional be cause regulatory mechanisms fail to keep defensive reactions “in check”, which lead s to a profound break from objective reality. Despite these classifications provided by the DSM-IV, there has been very little empirical investigation into th e role of defense mechanisms in adjustment to stress and trauma. As such, it is not clear whether thes e defenses (or which defenses) are generally protective against maladjustment, harmful, or both. The few existi ng studies that have looked at the association be tween defense mechanisms and adjustment, especially psychological symptoms, will now be discussed in detail. Punamaki, Kanninen, Qouta, & El-Sarraj (2002) conducted a study in which they looked at the relationship between defense m echanisms and PTSD symptoms in a sample of Palestinian political ex-prisoners who re ported being tortured dur ing their detention. First, they analyzed the factor structure of a variety of de fense mechanisms. Thereafter,

PAGE 27

18 they directly examined the relationships between defenses and PTSD symptoms and between severity of torture and defenses. Fi nally, the researchers investigated whether defense mechanisms would moderate the asso ciation between severi ty of torture and PTSD symptoms. In other words, they were interested in whether defense mechanisms would serve as a protective factor against PT SD symptoms. Results revealed that a fourfactor solution comprised of two immature defenses (i.e., defenses that develop in childhood and are unconscious for the most part) and two mature defenses (i.e., defenses that develop later in life and are conscious for the most part) provided the best fit for the defense mechanisms. Factor I was labeled immature reality-distorting defenses because it was comprised of immature defenses that were said to produce distortions in reality (e.g., displa cement). Factor II was labeled mature reality-based defenses because it included mature defenses that were said to be grounded in reality (e.g., sublimation). Factor III wa s described as consciousness-limiting defenses (mature) because these defenses were said to involve mental inhibition via internal manipulations and limiting conscious access to r eality (e.g., denial). Lastly, Factor IV was labeled immature reality-escaping defens es because it included immature defenses that surround escaping reality (e.g., projection). With respec t to the main effect of defense mechanisms on PTSD symptoms, it wa s found that the immature defenses were associated with high levels of PTSD symptoms whereas mature defenses were associated with low levels of PTSD symptoms. Resu lts also indicated a significant relationship between severity of torture and defenses, wher eby high levels of tort ure were associated with low levels of mature reality-based defens es. Moderator analyses revealed that more severe torture was related to more PTSD symptoms for men who frequently used

PAGE 28

19 immature reality-distorting defenses. Cont rary to hypotheses, neither of the mature defenses (i.e., consciousness limiting defenses and mature reality-based defenses) significantly moderated the asso ciation between trauma severity and PTSD symptoms. In fact, for men who reported more severe tort ure, consciousness-limiting defenses were related to more PTSD symptoms. Another study by Shilony and Grossman (1993) examined the role of depersonalization in the psychol ogical adjustment of a samp le of trauma survivors, including survivors of physical abuse, auto accidents, and se xual abuse/assault survivors. Depersonalization is a form of the defe nse mechanism known as dissociation and involves the experiencing of an altered state of reality wherei n the individual feels like an outside onlooker to an assa ult on his/her physical person (Shilony & Grossman, 1993). Results revealed that 60 per cent of the sample reported experiencing depersonalization during their traumatic experi ence(s). Furthermore, the depersonalization trauma group scored significantly lower than the non-depersonaliza tion trauma group on somatization, obsessive-compulsive symptoms, interperso nal sensitivity, depression, anxiety, phobic anxiety, paranoid ideation, and overall psycholog ical symptom severity. This difference between the two groups remained even afte r controlling for trauma severity and time elapsed since the occurrence of the trauma. Lastly, Birmes et al. (2000) investigat ed the association between particular defense styles/mechanisms and risk for PTSD in a sample of trauma survivors, which included survivors of auto accidents, severe bu rns, violent assault, and sexual assault. Specifically, they looked at mature defenses (e.g., sublimation), neur otic defenses (e.g., reaction formation), and immature defenses (e .g., projection, denial, and dissociation) in

PAGE 29

20 the trauma survivors with and without PTSD Results showed that the PTSD and nonPTSD survivors did not signifi cantly differ on their use of ma ture, neurotic, or immature defense mechanisms in general. However, they did differ on one neurotic defense mechanism (i.e., reaction form ation), whereby the PTSD gr oup was more likely to use reaction formation compared to the non-PTSD group. Note th at no existing studies have examined the role of defense mechanism in adjustment to CSA in particular. To summarize, then, positive illusions and defense mechanisms may operate as moderating factors in the asso ciation between trauma, including CSA, and psychological adjustment. Having reviewed the literature on factors related to psychological functioning of trauma and CSA survivors, our discussion will now focus on the importance of studying interpersonal functioning. Relationship Functioning Romantic relationships are central to th e lives of most people. When these relationships are satisfying, indi viduals experience elevated levels of general well-being and life satisfaction (Myers & Diener, 1995). On the other hand, relationship distress and instability can result in increased physical and psychological probl ems for partners as well as children (Glenn, 1990; Grych & Fi ncham, 1990). For instance, Prigerson, Maciejewski, and Rosenheck (1999) found that both marital dissatisfaction and divorce were associated with emotional problems, such as depression, and increased mental health service use by women. Similarly, Hi ntikka, Koskela, Kontula, Koskela, and Viinamaeki (1999) found that men and women in unhappy marriages were at significantly higher risk for co mmon mental disorders as co mpared with those in happy marriages. Taken together, these research find ings indicate that re lationship satisfaction

PAGE 30

21 and outcome can exert a powerful influence on on e’s mental health and quality of life as a whole. It is, therefore, alarming that more than half of all first marriages in the United States experience dissatisfaction and end in divorce (Council on Families in America, 1995). These observations have been the cata lyst of extensive research on variables related to satisfaction and outco me in close relationships. Factors affecting relationship satisfaction and outcome can be divided into two broad categories : individual difference variables and relationship va riables. Individual diffe rence variables refer to characteristics of the individuals within the relationship, such as pe rsonality traits. On the other hand, relationship variab les refer to interpersonal ch aracteristics or processes, such as communication. In this section, a fe w individual difference variables that have been found to influence relationship satisfac tion and outcome will be examined. Several different personal ity traits have been iden tified as being significant predictors of relationship satisfaction and outcome. For instance, self-disclosure and expressiveness (Geist & Gilbert, 1996), hostility (Newton & Kiecolt-Glaser, 1995), dominance (Blum & Mehrabian, 1999), a nd pleasantness (Blum & Mehrabian, 1999) have all been found to account for a significan t amount of the variance in relationship satisfaction. In addition, a numbe r of studies have been done on the Big Five personality traits: neuroticism (emotional instability), extraversion (warm, cheerful, energetic, assertive, and adventurous behavior), conscientiousness (responsibleness), agreeableness (cooperativeness), and openness to experience. Several studies sugge st that individuals who are high on neuroticism (based on particip ant’s self-ratings and partner’s ratings of participant) report gr eater marital dissatisfaction (E yesenck & Wakefield, 1981; Karney & Bradbury, 1995; Karney, Bradbury, Finc ham, & Sullivan, 1994; and Thomsen &

PAGE 31

22 Gilbert, 1998) and are more likely to b ecome divorced over a time span of 40 years (Kelly & Conley, 1987). In addition, the partne rs of individuals hi gh on neuroticism also reported elevated levels of di ssatisfaction in their relations hips (Karney et al., 1994). Watson, Hubbard, and Weise (2000) also looked at the relationship between personality traits and relati onship functioning. They found that conscientiousness and agreeableness, as measured by participant’s self -rating and partner’s rating of participant, were consistent positive predictors of satisfac tion for participants in dating couples. This study also found extraversion, also measured by participant’s self -rating and partner’s rating of participant, to be a strong positive predictor of participants’ marital satisfaction (Watson et al., 2000). Likewise, positive affectivity of participants was positively correlated with participants’ satisfaction, a nd negative affectivity of participants was negatively correlated with both participants ’ and partners’ satisfaction for dating and married couples (Watson et al., 2000). Attachment is another individual differe nce variable that has been linked to relationship functioning. Hazan and Shaver (1987) found that working models formed from child-caretaker attachment are rela ted to corresponding rela tionship styles in adulthood. Their research showed that the pr evalence of the 3 major attachment styles described by Bowlby is similar in infanc y and adulthood: 70 percent show secure attachment (i.e., autonomous yet comfortable with trust a nd intimacy), 20 percent show avoidant attachment (i.e., excessively au tonomous, distrustful, and anxious about intimacy), and 10 percent show anxious-ambiv alent attachment (i.e., eagerly seeking intimacy yet anxious about rejection a nd abandonment), (Hazan & Shaver, 1987). Furthermore, the research literature indicat es a relationship between adult attachment

PAGE 32

23 style and relationship satisfacti on. Individuals who have secu re attachment styles report greater satisfaction in their relationships than do individuals with insecure attachment styles (Hammond & Fletcher 1991; Hendrick & Hendrick, 1989; Senchak & Leonard, 1992). This might be due, in part, to evidence that secure attachment is associated with adaptive behaviors, such as less rejection and more support in marital problem-solving interactions (Kobak & Hazan, 1991) Numerous studies also indicate that people with secure attachment styles desc ribe their relationships as having more positive and less negative emotion, and more emotional involvem ent and stability (Collins & Read, 1990; Feeney & Noller, 1991). In addition, anxiet y about abandonment predicts higher levels of coercive communication, less mutual comm unication, and lower marital quality for both men and women, while comfort with closeness predicts more mutual communication and higher marital quality fo r men (Feeney, Noller, & Callan, 1994). Finally, romantic beliefs of individuals ha ve shown a significant association with relationship satisfaction. According to re searchers, people’s romantic beliefs are important in shaping their leve l of relationship satisfaction. It is important to point out that many romantic beliefs are unrealistic, but some unrealistic beliefs are maladaptive, while others are adaptive. Studies have found that individuals who endorse certain dysfunctional relationship beliefs are less likel y to be satisfied in their relationships (Epstein & Eidelson, 1981). These beliefs include the idea that disagreement is destructive to a relationship, spouses should be able to read each others’ minds, partners cannot change significant aspects of themselv es, sexual performance should be perfect, and men and women have different emotional needs. Such beliefs are also negatively correlated with a couple’s desire to improve their marital relationship (Epstein &

PAGE 33

24 Eidelson, 1981). On the other hand, studies have found that people with strong, idealistic romantic beliefs (e.g., exaggerating the positiv e aspects of one’s pa rtner) generally tend to have higher motivation and persistence in their relationships (Taylor & Brown, 1988), which typically leads to gr eater satisfaction. Along these lines, Jones and Stanton ( 1988) conducted a study to determine whether dysfunctional beliefs specific to roma ntic relationships would have a stronger association with marital dissatisfaction than general dysfunctional beliefs. Results indicated that general dysfunctional beliefs as a whole did not significantly correlate with marital distress, while dysfunctional beliefs related to relationships were significantly associated with dissatisfaction. Specifically, the belief that “disagreement is destructive” emerged as a significant predictor of distress for the individuals who held this belief. Another study looked at the effect of roman ticism on relationship satisfaction (Jones and Cunningham, 1996). Romanticism refers to th e degree to which an individual idealizes his/her partner and relationship. This variable was found to be a sign ificant predictor of relationship satisfaction, whereby males and females holding these beliefs rated their level of relationship satisfacti on significantly higher than those who did not hold them. Furthermore, romanticism on the part of pa rticipants was positively related to the satisfaction of their partners The researchers provided a possible explanation for the relationship between romanticism and satisfact ion: romantic behavior on the part of romanticizing individuals likely results in reciprocation of such behavior by their partners, which serves to increase both pa rtners’ relationship ha ppiness. Relationship variables that predict relationship satisfacti on and outcome will now be discussed.

PAGE 34

25 Communication is one of the most widely cited variables in the relationship satisfaction literature. Numerous theorists and researchers have postulated that deficits in communication skills are a major source of relationship discord (e.g., Noller, 1993; O’Donohue & Crouch, 1996). Furthermore, co mmunication skills have been said to distinguish between happy and distresse d couples (Christiansen & Shenk, 1991). However, a more recent study conducted by Burleson and Denton (1997) sought to advance our understanding of the role of co mmunication in relati onship satisfaction. First, the researchers made a distinction betw een communication skills versus behaviors. They pointed out that previous studies ha ve relied on communicat ion behavior as an indicator of communication skil l and explained that this approach is flawed because behavior is influenced by numerous other factors (e.g., motivation). Burleson & Denton (1997) also investigated how different factors may moderate the association between communication skills and relationship satisfac tion in a sample of 60 married couples. Four broad communication skills were a ssessed in this study: communication effectiveness (i.e., producing messages that have their intended e ffect); perceptual accuracy (i.e., accurate comprehension of the intentions underlying another’s message); predictive accuracy (i.e., accurate anticipati on of how one’s message will affect another); and interpersonal cognitive complexity (i.e., ability to process social information). Preliminary analyses indicated no over all difference between distressed and nondistressed couples on any of these communica tion skills. With respect to satisfaction, couples’ cognitive complexity was associated with more positive feelings toward one’s partner in the overall sample. Couples’ predictive accuracy and perceptual accuracy were

PAGE 35

26 also associated with more positive feeli ngs toward their partner, but only in nondistressed couples. Burleson & Denton (1997) also examined gender differences in the relationship between communication skills a nd satisfaction. It was found that husbands’ perceptual accuracy was a positive pr edictor of their own ma rital satisfaction in nondistressed marriages, but a negative predictor of their satisfaction in distressed marriages. On the other hand, wives’ predictive accuracy was positively associated with their own satisfaction in distressed marriages, but unrelated to satisfaction in nondistressed marriages. It was also examined whether the communication skills of one partner was related to the other partner’s satisfact ion. These analyses showed that in nondistressed couples, wives’ communication skills we re positively related to their husbands’ satisfaction, whereas wives’ skills did not influenc e husbands’ satisfaction in distressed couples. Similar results were found for the impact of husbands’ communication skills on their wives’ satisfaction, though these effects were not as strong. To summarize, then, communication is an important predictor of relati onship satisfaction, but this relationship is heavily influenced by mode rating variables, such as t ype of communication skill and gender. Another relationship variable that has b een consistently linked to relationship satisfaction is interpersonal similarity (Blum & Mehrabian, 1999; White & Hatcher, 1984). For example, Burleson and Denton (1992) conducted a study in which they looked at similarity in social-cognitive and communication skills as it relates to marital satisfaction. Results indicated that similarity in these skills was positively related to marital satisfaction. In fact, low-skilled c ouples were no less happy with their marriages

PAGE 36

27 than high-skilled couples. Furthermore, distressed spouses demonstrated greater dissimilarity in their social -cognitive and communication skill s relative to non-distressed spouses. Belief and attitude similarity have also been consistently linked to relationship satisfaction (e.g., Hendrick, 1981). According to Byrne (1971) people have a desire to hold “correct” attitudes and values. But sin ce attitudes and values cannot be objectively verified, they turn to others for such valid ation. Thus, when peopl e learn that another person shares their beliefs, this becomes a source of positive reinforcement. As learning principles have demonstrated, persons are drawn toward sources of positive reinforcement. Therefore, people are attracted to others with similar attitudes/values. To illustrate this, Jones and Stanton (1988) examined the association between belief similarity and marital satisfac tion. They found that perceived similarity in couples’ belief systems was negatively associated with marita l distress. In addition, marital distress was greatest when belief dissimilarity involv ed dysfunctional relationship beliefs (e.g., disagreement is destructive) he ld by at least one partner. In addition to similarity in cognitive -communication skills and beliefs, some researchers have explored the role of similari ty in couples’ perceptions of events. Beliefs and attitudes refer to preexisting ideas held by individual couple members about a wide variety of issues. In contrast, percepti ons are defined as the interpretations and evaluations couple members make about shared experiences (Deal, Wampler, & Halverson, 1992). Deal et al (1992) found that couples who were satisfied with their marriage were more likely to have similar pe rceptions about their relationship and their family. Furthermore, spouses that had congr uent perceptions rega rding one aspect of

PAGE 37

28 their life (e.g., the marital relationship) also tended to have similar perceptions about other aspects of their common e xperience, such as the childre n. In contrast, spouses in less satisfying relationships did not perceive their marriage and family in the same way. Where one couple member saw something as being positive, the other saw it as negative. Lastly, maintenance behaviors and expect ations for such behaviors have been linked to relationship satisfaction in the li terature. Maintenance behaviors refer to behaviors carried out by dyadic pa rtners to keep their relations hip in a particular state or condition (Dindia & Canary, 1993). According to Stafford and Canary (1991), there are five basic types of maintenance behaviors: po sitivity (cheerful and optimistic behavior), openness (self-disclosure and direct discussion of the relationship), assurances (messages emphasizing commitment to one’s partner and relationship), social networks (reliance on shared friends and affiliations), and sharing tasks (equal responsibility for tasks facing the couple). Numerous studies have indicated that all five strategi es are strong and consistent predictors of satisfaction (Canary & Sta fford, 1992; Dainton, Sta fford, & Canary, 1994; Stafford & Canary, 1991). Dainton (2000) conducted a study to dete rmine whether expectations regarding the use of maintenance behaviors by one’s pa rtner impact one’s level of relationship satisfaction. Results showed a direct associa tion between participants ’ perceptions of the extent to which their partner fulfilled their expectations for maintenance strategies and their level of satisfaction. More specifica lly, perceived fulfillment of expectations for assurances and the sharing of tasks were the strongest predictors of satisfaction. This study also sought to compare the frequency of maintenance behaviors relative to the discrepancy between expectati ons and actual behaviors as differential predictors of

PAGE 38

29 satisfaction. Even though both factors were significantly a ssociated with satisfaction, with greater frequency and lower discrepanc y predicting higher satisfaction, it was found that the frequency of one’s partner’s use of maintenance behaviors was more strongly related to one’s satisfaction than was the discrepancy between one’s expectations for partner’s behavior and partne r’s actual behavior. Finally, findings indicated that over time, perceptions of partner’s use of maintenance strategies declined while expectations remained the same, thus increasing the gap be tween expectations and behavior. This was perhaps because maintenance strategies beco me more difficult to sustain over time and familiarity leads to more negative interac tional styles (Stafford & Dainton, 1994). To summarize, the identification of fact ors that impact satisfaction has been an important focus of research, given the role of romantic relati onship satisfaction in people’s physical and psychological healt h. Having reviewed some of the common predictors of relationship satisfaction, a di scussion of the relevance of relationship functioning to child sexual a buse will now be provided. Few studies have examined the interpersona l sequelae associated with a history of CSA. Existing studies show that survivors of CSA often report si gnificant problems in romantic relationships (Davis & Petret ic-Jackson, 2000; Westerlund, 1992). For instance, it has been shown that incest survi vors often show patterns of avoiding intimate relationships (Jehu, 1989), limiting themselves to casual and transient relationships (Jehu, 1988), and continuously seeking an intimate re lationship that would “make up” for their traumatic abusive experience (Jehu, 1988). In addition, CSA survivors tend to report greater levels of romantic relationship dissatisfaction than nonabused women (DiLillo & Long, 1999; Jehu, 1988). There is also consiste nt evidence of higher rates of separation

PAGE 39

30 and divorce in community samples of CSA survivors (Finkelhor, Hotaling, Lewis, & Smith, 1990; Mullen, Martin, Anderson, Romans, & Herbison, 1994). Given what we know about the important role of relationship satisfaction and stability in mental health outcomes (e.g., Grych & Fincham, 1990), it is clear that relationship functioning should be a major focu s of research on child sexual abuse. Unfortunately, the existing literature has te nded to focus largely on the psychopathology (especially PTSD) that often results from CSA, ignoring impor tant interpersonal outcomes and interpersonal factors that infl uence such outcomes. Despite the relative paucity of research on the association between CSA and interpersonal functioning, however, a few researchers have developed theo retical models to de scribe the process by which CSA may adversely affect interpersona l functioning. Three of these models will now be described along with the ex isting empirical evidence for each. Finkelhor and Browne (1985) proposed an impact model of CSA that includes four dynamics: betrayal, traumatic sexualiz ation, powerlessness, and stigmatization. Betrayal is believed to relate to relationshi p functioning in that children are generally taught to trust adults and exp ect their protection, but sexual a buse destroys this sense of trust and security and may foster feelings of betrayal. These betrayal issues can carry over into adulthood and lead to many adverse interpersonal outcomes. For instance, the survivor’s ability to judge who she can or cannot trust may be compromised or she may embark on a “desperate search for a redeemi ng relationship”. Altern atively, the survivor might become suspicious of intimate relationships and avoid them, or she might develop misdirected anger toward her partner.

PAGE 40

31 The second dynamic of Finklehor & Br own’s (1985) model is traumatic sexualization, which refers to the process in which a child’s identity is shaped in a developmentally inappropriate and interper sonally dysfunctional fa shion due to sexual abuse. This factor can lead to overly sexua lized attitudes and beha viors that may make survivors more vulnerable to later sexual assault and more inclined to oversexualize all relationships. The third dynamic, powerlessn ess, refers to the “process in which the child’s will, desires, and sense of efficacy ar e continually contravened”. This sense of powerlessness may diminish the su rvivor’s ability to be asse rtive in later relationships and make her feel like she has no control ov er her body or what happens to her, which increases the risk of being revictimized. The fourth dynamic of stigmatization may cause the survivor to feel that she is damaged and unworthy, such that she might gi ve her body to others freely or isolate herself from relationships as a result of this negative self-image (Davis et al., 2000). Finkelhor & Brown’s (1985) model has ind eed received empirical support in the literature. Particularly, res earchers have found evidence of relationship avoidance, casual relationships, and a search for redeemi ng relationships amongst CSA survivors (e.g., Jehu, 1989; Westerlund, 1992). Briere (1992) also proposed a model e xplaining the mechanisms underlying the interpersonal impact of CSA. This abbrev iated model holds that immediate cognitive and conditioned responses from the abuse (e.g., distrust of others, low self esteem, and ambivalence about interper sonal closeness) and accommodation responses (e.g., passivity, sexualization) to continued abuse may continue into adulthood and make it difficult for survivors to develop and mainta in healthy relationshi ps. This model has

PAGE 41

32 been partially supported by findings of distru st, ambivalence, and oversexualization in the interpersonal functioni ng of CSA survivors (Blume, 1990; Westerlund, 1992). The most recent model to explain the connection between CSA and relationship functioning was developed by Polusny and Fo llette (1995). Their model emphasizes the role of emotional avoidance in determining the long-term effects of CSA and describes these effects in terms of multi-systemic in teractions (e.g., family, school, etc.). CSA survivors are said to employ va rious coping strategies in an effort to reduce or avoid memories of the abuse, including dissoc iation, substance abus e, casual sexual relationships, and avoidance of intimate rela tionships. While these behaviors may be effective in the short-term, they can result in feelings of social isolation and sexual dysfunction, which are significant interperso nal concerns. This model is supported by studies showing emotional avoidance, substa nce abuse, and sexual promiscuity amongst CSA survivors (Jehu, 1989; Westerlund, 1992). A description of the current study will now be provided.

PAGE 42

33 Chapter Two The Present Study Psychological sequelae associated with the experience of CSA is perhaps the most widely studied topic in the se xual abuse literature. As such, it is well established that CSA is related to increased risk for vari ous psychological concerns and disorders, including depression, PTSD, and substan ce abuse (Hall et al., 1989; Neumann, 1994; Neumann, et al., 1996). In this effort to unde rstand the impact of CSA on psychological functioning, however, the abuse literature has neglected a nother important area of functioning that is often advers ely affected by CSA: interpers onal functioning. In light of the robust association between relationship functioning and ment al health outcomes, this represents a serious limitation in the abuse l iterature, given that in terpersonal functioning could potentially put CSA survi vors at even higher risk for mental health problems. The proposed study, therefore, seeks to further the understanding of the association between CSA and romantic relationship functioning. This will be accomplished in two ways. First, the associ ation between CSA and a number of romantic relationship outcomes will be examined directl y. The relationship variables that will be analyzed are dyadic satisfac tion, dyadic cohesion, affec tional expression, and dyadic consensus, which are subscales of a widely used relationship satisfaction measure. CSA will be measured both dichotomously (i.e., sexually abused or not) and continuously in terms of severity. With respect to severi ty, this variable will be measured both

PAGE 43

34 objectively and subjectively. Th at is to say, participants wi ll be rated on the severity of their abusive experience base d on objective criteria, whic h will include the type and number of sexual act(s) perpet rated and presence or absenc e of force. In addition, participants will be asked to provide a subjec tive rating of the degree of severity of their abusive experience. Next, it will be invest igated whether mature defense mechanisms and having a sense of meaning moderate th e association between sexual abuse and the relationship outcome variables. Finall y, the current study will examine whether relationship functioning moderates the re lationship between CSA and psychological functioning. Hypotheses It is hypothesized that: 1. Discrete CSA (i.e., abused versus non-abused) will be significantly negatively related to relationship functioning (i .e., affectional expression, dyadic consensus, dyadic cohesion, and dyadic satisfaction). 2. Objective CSA severity (i.e., severity based on objective criteria, such as type of sexual contact) will be significantly negatively related to relationship functioning. 3. Perceived CSA severity (i.e., severity ba sed on the survivor’s subjective appraisal) will be significantly related negatively related to relationship functioning. 4. The interaction of o bjective CSA severity and meaning will significantly predict relationship functioning.

PAGE 44

35 5. The interaction of perceived CSA severity and meaning will significantly predict relationship functioning. 6. The interaction of objective CSA severity and mature defenses will significantly predict re lationship functioning. 7. The interaction of perceived CSA severity and mature defenses will significantly predict re lationship functioning. 8. The interaction of objective CSA severity and relationship functioning will significantly predict ps ychological functioning. 9. The interaction of perceived CSA severity and relationship functioning will significantly predict ps ychological functioning.

PAGE 45

36 Chapter Three Method Participants A total of 287 female participants who were involved in a heterosexual dating relationship at the time of th e study were recruited from the undergraduate participant pool at the University of South Florida. Pa rticipants volunteered in exchange for course credit. The age range of the participants was 18-46 years (M = 21, SD = 3.37). With respect to ethnicity, the majority of th e sample was Caucasian (53.8%), 18.8% were African American, 18.4% were Latina, 5.9% were Asian, and the remaining 3% were from other ethnic groups. Most of the wome n (73.3%) lived in close proximity to their mate, while 26.7% considered themselves to be in a long-distance re lationship. The vast majority of participants were single (94.8%), 3.8 % were divorced, and the remaining 1% were either married or separated. The major ity of participants (54.9%) reported being in their relationship between 1-5 years; 22.6% re ported being in their relationship between 6-12 months; 14.6% reported being in their re lationship less than 6 months; and 8% of the sample reported being in their re lationship for more than 5 years. Of the 287 participants, 192 women (67%) reported an absence of child sexual abuse, while 95 women (33%) reported a history of child sexual abuse. The mean age of onset of abuse was 13.5 years. The frequenc ies of each abuse item endorsed by the abuse sample are as follows: victim touching abuser ’s genitals = 27; abus er touching victim’s

PAGE 46

37 breasts or genitals = 43; oral sex = 12; vagi nal intercourse = 11; anal intercourse = 2; forcible genital manipulation = 28; forcible or al sex = 10; forcible anal intercourse = 3; feeling sexually violated by someone’s touc h = 74; and unwanted sexual activity under the influence of alcoho l or drugs = 16. Nine ty two percent of the abuse sample rated the subjective severity of their abus ive experiences as mild to mode rate (i.e., a rating of 5 or less out of a possible rating of 10 on each pe rceived severity item), while 18 percent subjectively rated their abusive experiences as moderate to severe (i .e., a rating of more than 5 out of a possible rating of 10 on each pe rceived severity item). Nine participants or 3 percent of the sample reported receivi ng psychological treatment for their abusive experiences. Measures Demographics: Demographics were determined using a demographic data sheet asking participants to indicat e their gender and pa rtner’s gender, age, race, romantic relationship status, marital stat us, length of current relationship, and whether their current relationship is a “long distance” one. Relationship Functioning: Relationship functioning (i.e ., affectional expression, dyadic cohesion, dyadic consensus, and dyadi c satisfaction) was measured using a modified version of the Dyadic Adjustment Scale (DAS; Spanier, 1976). The DAS is comprised of four subscales (i.e., aff ectional expression, dyadic cohesion, dyadic consensus, and dyadic satisfaction) and co ntains items asking respondents to rate different aspects of their rela tionship on a five-point Likert scale. Different items on the DAS have different response la bels, but all range from 1 to 5, such as 1 (“always disagree”) to 5 (“always agree”) and 1 (“a ll the time”) to 5 (“never”). Scores on the

PAGE 47

38 affectional expression subscale range from 4-20, dyadic cohesion scores range from 5-25, dyadic consensus scores range from 9-45, and dy adic satisfaction scores range from 9-45. Lower scores indicate poorer functioning in each area while higher scores indicate higher functioning. Subscale scores w ill be used in analyzing th is variable. Modifications involved making the measure more relevant to dating couples as opposed to married couples and standardizing all re sponses on a five-point scale. A total of five items were deleted from the original measure, making the total number of items on the modified scale 27. It is believed that the modificati ons were justified because the DAS has been used in a number of studies on dating couples (e.g., Shapiro & Kroeger, 1991; Zak, Collins, Harper, & Masher, 1998). Internal consistency of the DAS is good, with values ranging from .70 for the 4-item Affectional Expression subscale to .95 for the complete instrument (Carey, Spector, Lantinga, & Krauss, 1993). Furthermore, the DAS demonstrates convergent validity with the Ma rtial Adjustment Scale with a value of .87, and it demonstrates divergent validity with th e Marital Disaffection Scale with a value of .79 (Lem & Ivey, 2000). Internal consis tency for the current study was 0.83. Childhood Sexual Abuse: For the purposes of the pr esent study, childhood sexual abuse (CSA) was defined as any sexual cont act 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. This definition was selected because it is the definition most commonly used in the CSA literature. CSA was measured using a modified version of the Early Sexual Experien ces Survey (ESE; Bartoi & Kinder, 1998). The ESE is a 12-item measure that asks res pondents to indicate whether or not they experienced various types of sexual encounter s before the age of 16. Response options

PAGE 48

39 for each item are 0 (“no”) or 1 (“yes”). A “yes” response to any of the first ten items on this scale was treated as meeting criteria for a history of CSA. Absence of a “yes” response to any of the first ten items was tr eated as having no history of CSA. For participants with a history of CSA, the number of “yes” responses was totaled to produce an objective CSA severity score ranging from 1-10, with 1 being the least severe and 10 being the most severe. The modifications ma de to the ESE involved the addition of two items at the end asking respondents who endorse d “yes” on any of the first ten items to rate the negative impact and degree of distre ss associated with the endorsed experience(s) on an 11-point scale, with 0 indicating no ne gative impact or distress and 10 indicating the most severe negative impact or distress Responses to these items were summed to produce a perceived CSA severity score. Item 9 was also modified in order to specify that it applies to experiences of a sexual nature. Lastly, an item was added asking respondents to indicate how old they were when they had the first sexual experience endorsed. The ESE has demonstrated adequate reliability with internal consistency values around .79 (e.g., Young, Harford, Kinder, & Savell, 2007). Internal consistency for the present study was 0.70 for the first 10 items (i.e., objective CSA severity) and 0.93 for the last 2 items (i.e., pe rceived CSA severity). Meaning: The degree to which participants ha ve a sense of meaning associated with adverse experiences was measured us ing the short form of the Stress Related Growth Scale (SRGS; Park, Cohen, & Murc h, 1996). The SRGS (short form) is a 15item self-report measure that assesses positive cognitions and changes following traumatic events. Respondents are asked to rate items on a 3-point Likert scale going from 0 (“not at all”) to 2 (“a great deal”). Scores on the SRGS range from 0 – 45, with

PAGE 49

40 lower scores indicating lowe r levels of meaning and hi gher scores indicating higher levels of meaning. Internal consistency values for the short form of the SRGS are between .90 and .95 (Frazier, St eward, & Mortensen, 2004). Inte rnal consistency for the current study was 0.92. Defense Mechanisms: Defense mechanisms were assessed using the 40-item version of the Defense Style Questionna ire (DSQ-40; Andrews, Singh, & Bond, 1993). The DSQ-40 is a self-report measure that asks respondents to rate statements corresponding to 20 different defense mechan isms on a 9-point Likert scale. These defense mechanisms are broadly categorized into three broad defense factors: mature, immature, or neurotic defenses. The ma ture defenses include suppression (i.e., consciously pushing threatening cognitions a nd feelings out of consciousness), humor (i.e., focusing on amusing aspects of a threat ening situation), rati onalization, anticipation (i.e., experiencing emotional reactions prior to possible future events and considering realistic alternative re sponses or solutions for such even ts), and sublimation. Immature defenses include projection, acting out (i.e., re sorting to physical acti ons/behaviors rather than thinking about and discussing threaten ing thoughts and feelings ), isolation (i.e., separating thoughts from the feelings orig inally accompanying them and focusing on those cognitions rather than the feelings) devaluation (i .e., attributing exaggerated negative qualities to oneself or others), autistic fantasy (i.e ., excessive daydreaming as a substitute for relationships and action), deni al, displacement, dissoci ation, splitting (i.e., failure to integrate negative and positive aspect s of the self and othe rs, thereby alternating between polar opposite thoughts and feelings, su ch as love and hate), and somatization (i.e., experiencing physical symptoms in respons e to threatening thought s and situations).

PAGE 50

41 Neurotic defenses include undoing, pseudoaltru ism, idealization, r eaction formation, and passive aggression. Subscale scores for each of the three defensive factors were used in analyses. The DSQ-40 has been validated in Western (Elklit, 1998) as well as MiddleEastern (Andersen, 1998) and Asian populations (Ho & Shiu, 1995). Internal consistency values range from .58 .80 and test-retest re liability over a 4-week period ranges from .75 to .85 for the three defensive factors (C ramer, 2000). In addition, the DSQ-40 has been shown to discriminate between anxi ous/depressed patients and normal controls (Sammallahti, Holi, Komulainen, & Aalberg, 19 96). Internal consistency for the present study was 0.79. Psychological Functioning: Psychological functioning was measured using the abbreviated form of the Brief Symptom Inventory (B SI; Derogatis, 1982). The abbreviated BSI is a 53-item self-re port measure designed to assess common psychological symptoms. Respondents are aske d to rate the extent to which each item/problem has distressed them over the past seven days on a 5-poi nt Likert scale going from “not at all” to “extremely”. The BSI consists of nine subscales: depression, interpersonal sensitivity, anxiety, phobic anxiety, pa ranoid ideation, somatization, obsessive-compulsive, hostility, and psychoticism. Both subs cale scores and total scores (i.e., global severity index) were used in analyses. The BSI has demonstrated good reliability, with internal consistency values ranging from .71 (psychoticism subscale) to .83 (obsessive-compulsive subscale) for the subs cales and test-retest re liability values of above .80 for the global severity index (M ental Measurements Yearbook, 1990). In addition, the measure has been shown to have good concurrent validity with the Wiggins content scales and the Tryon cluster scores on the Minnesota Multiphasic Personality

PAGE 51

42 Inventory (MMPI), with correlations rangi ng from .30 to .72 (Mental Measurements Yearbook, 1990). The BSI has been used in both clinical and nonc linical samples, including college samples (Boulet & Boss, 1991; Cochran & Hale, 1985). Internal consistency for the present study was 0.96. Procedures Participants completed informed consent forms followed by self-report measures of demographics, relationshi p functioning, positive illusions, defense mechanisms, and psychological functioning in a single session. Demographic measures always came first in the questionnaire packet and the SRGS al ways followed the ESE. The order of the other questionnaires was randomized usi ng a Latin square procedure. Although participants completed the questionnaire pack et in a group setting (i.e ., other participants were completing measures simultaneously in the same room), they were appropriately spaced in the room in order to ensure individual privacy when completing questionnaires). Informed consent forms a nd completed questionnair e packets were kept separate from each other in order to ensure anonymity of participants. Furthermore, one set of materials (i.e., informed consent or questionnaire packets) was always shuffled after each participant turned in her packet. After completing the measures, participants were thanked and debriefed. All procedures were approved by the Institutional Review Board of the University of South Florida. Participants were provided with referral resources in the event of adverse r eactions to study participation.

PAGE 52

43 Chapter Four Results Preliminary Analyses The means, standard deviations, and range s of the primary vari ables analyzed in the current study are presented in Table 1. Results of the anal yses examining the relationship between discrete child sexual a buse and the primary cr iterion variables are shown in Tables 2 and 3. As hypothesized, anal yses of variance indi cated that discrete abuse was significantly related to dyadic c onsensus, F (1, 284) = 4.49, p < .05, such that women without a history of abuse reported higher dya dic consensus in their relationships than women with a history of abuse. Contrary to hypotheses, however, discrete abuse was not significantly related to affectional expression, F (1, 282) = 0.77, p > .05; dyadic satisfaction, F (1, 236) = 3.64, p > .05; or dyadic cohesion, F (1, 282) = 0.96, p > .05. Additional analyses of variance revealed th at discrete sexual abuse was significantly related to most of the psychol ogical functioning variables. More specifically, discrete abuse was related to somatization, F (1, 279) = 9.26, p < .01, interpersonal sensitivity, F (1, 276) = 4.72, p < .01, depression, F (1, 279) = 4.64, p < .05, anxiety, F (1, 279) = 8.57, p < .01, hostility, F (1, 276) = 11.49, p < .01, phobic anxiety, F (1, 277) = 9.44, p < .01, paranoid ideation, F (1, 279) = 10.03, p < .01, psychoticism, F (1, 278) = 8.52, p < .01, and the global severity index, F (1, 263) = 8.35, p < .01, whereby women with a history of child sexual abuse reported significantly high er levels of these psychological problems compared to women without a history of abuse. Contra ry to predictions, correlation

PAGE 53

44 analyses examining the relationship between sexual abuse severity and relationship functioning revealed that neither objectiv e (r = 0.02, p > .05; r = -0.12, p > .05; r = 0.12, p > .05; r = -0.09, p > .05) nor perceived sever ity (r = 0.04, p > .05; r = 0.13, p > .05; r = 0.02, p > .05; r = -0.03, p > .05) was significantly related to the relationship functioning variables (i.e., dyadic cohesion, affectiona l expression, dyadic consensus, and dyadic satisfaction, respectively). These results are presented in Table 4. However, additional correlation analyses showed that sexual abuse severity was positively related to all of the psychological f unctioning variables. Table 5 depicts these results. Specifically, perceived sexual abus e severity and objective sexual abuse severity, respectively, were significantly related to somatization (r = 0.33, p < .01; r = 0.25, p < .01); interpersonal sensitivity (r = 0.36, p < .01; p < .01); obsessivenesscompulsiveness (r = 0.29, p < .01; r = 0.19, p < .01); depression (r = 0.37, p < .01; r = 0.21, p < .01); anxiety (r = 0.34, p < .01; r = 0.25, p < .01); hostility (r = 0.34, p < .01; r = 0.27, p < .01); phobic anxiety (r = 0.36, p < .01; r = 0.29, p < .01); paranoid ideation ( r = 0.45, p < .01; r = 0.25, p < .01); psychoticism (r = 0.33, p < .01; r = 0.21, p < .01); and the global severity index (r = 0.38, p < .01; r = 0.26, p < .01). Moderator Analyses Moderator analyses (i.e., all interaction analyses) we re performed solely on the abuse sample, which was comprised of 95 partic ipants or 33 percent of the total sample. Correlation analyses were performed in or der to test whether Child Sexual Abuse Severity X Meaning would be related to rela tionship functioning. The results of these analyses are presented in Table 6. Contrary to expectations, re sults showed that neither Perceived Child Sexual Abuse Severity X Meaning (r = 0.08, p > .05; r = 0.09, p > .05; r

PAGE 54

45 = -0.01, p > 05; r = -0.02, p > .05) nor Object ive Child Sexual Abuse Severity X Meaning (r = 0.02, p > .05; r = 0.03, > .05; r = 0.10, p > .05; r = -0.02, p > .05) was significantly related to the relationship functioning vari ables (i.e., dyadic cohe sion, dyadic consensus, affectional expression, and dya dic satisfaction, respectivel y). Additonal correlation analyses were also performed in order to examine the relationship between the Child Sexual Abuse Severity X Meaning interac tions and the psychological functioning variables. Table 7 presents these results. Both Perceived Child Sexual Abuse Severity X Meaning and Objective Child Sexual Abuse Severity X Meaning, respectively, were significantly positively related to somati zation (r = .26, p < .05; r = .23, p < .05), obsessiveness-compulsiveness (r = .29, p < .01; r = .30, p < .01), interpersonal sensitivity (r = .28, p < .01; r = .24, p < .05), depression (r = .34, p < .01; r = .28, p < .01), anxiety (r = .32, p < .01; r = .29, p < .01), hostility (r = .28, p < .01; r = .23, p < .05), phobic anxiety (r = .31, p < .01; r = .31, p < .01), pa ranoid ideation (r = .36, p < .01; r = .26, p < .05), psychoticism (r = .28, p < .05; r = .22, p < .05), and the global severity index (r = .32, p < .01; r = .27, p < .01). Correlation analyses were th ereafter performed in order to examine whether Child Sexual Abuse Severity X Mature Defenses would be significantly related to the relationship functioning variables. The results of these analyses are presented in Table 8. Contrary to hypotheses, results indicated that neither Perceived Child Sexual Abuse Severity X Mature Defenses (r = 0.08, p > .08; r = 0.10, p > .05; r = -0.01, p > .05; r = 0.06, p > .05) nor Objective Child Sexual Abus e Severity X Mature Defenses (r = 0.02, p > .05; r = 0.03, p > .05; r = 0.10, p > .05, r = -0. 02, p > .05) was signifi cantly related to the relationship functioning variables (i.e., dya dic cohesion, dyadic consensus, affectional

PAGE 55

46 expression, and dyadic satisfaction, respectivel y). Additional correlation analyses were performed in order to determine the relati onship between Child Sexual Abuse Severity X Mature Defenses and psychological functioning. These results are pr esented in Table 9. It was found that both Perceived Child Sexua l Abuse Severity X Mature Defenses and Objective Child Sexual Abuse Severity X Mature Defenses, respectively, were significantly positively related to somati zation (r = .27, p < .05; r = .21, p < .05), obsessiveness-compulsiveness (r = .25, p < .05; r = .24, p < .05), depression (r = .34, p < .01; r = .23, p < .05), anxiety (r = .29, p < .01; r = .21, p < .05) phobic anxiety (r = .30, p < .01; r = .27, p < .01), and the global seve rity index (r = .33, p < .01; r = .24, p < .05). In addition, Perceived Child Sexual Abuse Seve rity X Mature Defenses was significantly positively related to interpersonal sensitivity (r = .30, p < .01), hostility (r = .26, p < .01), paranoid ideation (r = .40, p < .01), a nd psychoticism (r = .29, p < .05). In order to test whether Child Sexual Abuse Severity X Meaning would uniquely predict relationship functioni ng, hierarchical regression pr ocedures were performed between the Sexual Abuse Severity X Meani ng variables (i.e, Perceived Child Sexual Abuse Severity X Meaning and Objective Ch ild Sexual Abuse Severity X Meaning) and each of the relationship functioning variables. These results are shown in Tables 10-17. Contrary to hypotheses, neither Perceived Child Sexual Abuse Severity X Meaning (R2 = 0.01, p > .05; R2 = 0.02, p > .05; R2 = 0.01, p > .05; R2 = 0.01, p > .05) nor Objective Child Sexual Abus e Severity X Meaning (R2 = 0.01, p > .05; R2 = 0.03, p > .05; R2 = 0.00, p > .05; R2 = 0.02, p > .05) uniquely predicted any of the relationship functioning variables.

PAGE 56

47 Regression analyses were next conducte d in order to examine whether Child Sexual Abuse Severity X Mature Defenses would uniquely predict relationship functioning. These results can be found in Tables 18-25. As hypothesized, results revealed that Objective Child Sexual Abus e Severity X Mature Defenses uniquely predicted dyadic cohesion (R2 = .04, p = .05), which indicates a moderating effect. However, Objective Child Sexual Abus e Severity X Mature Defenses (R2 = 0.00, p > .05; R2 = 0.03, p > .05; R2 = 0.04, p > .05) did not uni quely predict any of the other relationship variables (i.e., dyadic cons ensus, affectional expression, and dyadic satisfaction, respectively). Also contrary to hypotheses, Perceived Child Sexual Abuse Severity X Mature Defenses (R2 = 0.00, p > .05; R2 = 0.00, p > .05; R2 = 0.00, p > .05; R2 = 0.01, p > .05) did not uniquely predic t any of the relationship functioning variables (i.e., dyadic cohesion, dyadic cons ensus, affectional expression, and dyadic satisfaction, respectively). Lastly, hierarchical regressi on analyses were conducted in order to test whether Child Sexual Abuse Severity X Relations hip Functioning would uniquely predict psychological functioning. Tables 26-33 present these results. Contrary to hypotheses, neither Perceived Child Sexual Abuse Severity (R2 = 0.00, p > .05; R2 = 0.01, p > .05; R2 = 0.00, p > .05; R2 = 0.02, p > .05) nor Objective Child Sexual Abuse Severity (R2 = 0.01, p > .05; R2 = 0.02, p > .05; R2 = 0.00, p > .05; R2 = 0.02, p > .05) interacted with any of the four relationship variables (i .e., dyadic cohesion, dyadic consensus, affectional expr ession, and dyadic satisfaction, respectively) to uniquely predict psychological functioning as indi cated by the global severity index.

PAGE 57

48 Chapter Five Discussion The research literature has consistently shown that child sexual abuse (CSA) is related to a myriad of psychological and phys iological sequelae for adult survivors (e.g., Neumann et al., 1996; Scarin ci et al., 1995). However, only a few studies have investigated the negative interpersonal sequel ae associated with CSA. As such, one of the purposes of the current study was to fu rther the understandi ng of interpersonal sequelae related to CSA by examining the relationship between CSA(including both presence of abuse and severity of abuse) and four aspects of romantic relationship functioning (i.e., dyadic consensus, dyadic cohesion, affectional expression, and dyadic satisfaction) in a sample of adult female survivors. Despite the negative outcomes frequently associated with CSA, the research literature has also demonstrated that a larg e number of survivors are able to adjust effectively following the trauma (e.g., Runtz & Schallow, 1997). As a result, recent studies have been interested in identifyi ng specific coping mechanisms that protect against the risk of maladaptive outcomes fo r CSA survivors. However, existing studies have generally focused on psychological adjustment and consequently, protective variables related to healthy re lationship adjustment have not been identified. The current study, therefore, sought to advance the unders tanding of protective factors related to healthy adjustment by investigating whether finding meaning in relation to the abusive

PAGE 58

49 event(s) and utilizing mature defense m echanisms would moderate the association between CSA and the four relations hip variables mentioned earlier. Finally, given the well-established associ ation between relationship dissatisfaction and psychological problems (e.g., Prigerson et al., 1999), the current study tested whether relationship satisfaction would moderate the association between CSA and psychological maladjustment. Results found partial support for the hypothesi s that discrete a buse (i.e., presence vs. absence of abuse history) would be si gnificantly negatively related to relationship functioning. Specifically, disc rete abuse was found to be negatively related to dyadic consensus, such that women with a histor y of CSA reported lower consensus in their relationships than women without a history of CSA. These findings are consistent with previous studies that have shown a significan t association between a history of CSA and lower relationship satisfaction (e.g., Davis & Petretic-Jackson, 2000). Discrete abuse was not significantly related to dyadic cohesion, a ffectional expression, or dyadic satisfaction. Perhaps consensus was significantly related to abuse history because agreement with one’s partner is one of the relationship areas that is most severely affected by CSA compared to other aspects of relationship functioning, such as cohesion (i.e., joint activities), affection, and globa l satisfaction. In this case, it might be important for psychological treatment of surv ivors to provide social skil ls training that emphasizes interpersonal agreement as a criterion for mate sele ction and communication and problem-solving skills training that emphasi ze consensus building and attainment. Another explanation for the non-significan t relationship between discrete abuse and dyadic cohesion, affectional expression, and global satisfacti on is that the effect size

PAGE 59

50 of the relationship between discrete abuse and these ot her aspects of relationship functioning is a small one, which may not have been detected by the current study due to insufficient power. Additional analyses showed that discrete abuse was also significantly positively related to nine of the ten psychological pr oblems analyzed in the current study (i.e., somatization, depression, anxiety, hostility, interpersonal sensitivity, phobias, paranoia, psychosis, and global psychopathology). These results are consistent with the existing literature, which has consistently demonstrat ed a positive relationship between a history of CSA and psychological maladjustment (e.g., Neumann, 1994). Results did not support the hypotheses that objective and perceived CSA severity would be significantly related to dyadi c consensus, dyadic cohesion, affectional expression, and dyadic satisfac tion. These findings are not consistent with previous studies (e.g., DiLillo & Long, 1999; Jehu, 1988), which have shown a significant association between CSA and relationship f unctioning. Again, it is possible that these relationships are small effects th at could not be dete cted by the power of the current study, which could only detect a me dium or large effect. Additional analyses did reveal, however that both objective and perceived CSA severity were significantly positively rela ted to all ten of the psychological problems analyzed in the current study (i.e., somati zation, interpersonal sensitivity, obsessivecompulsive symptoms, depression, anxiety, hostility, phobias, paranoia, psychosis, and global psychopathology). While the moderate correlation between objective CSA severity and perceived CSA severity does suggest some overlap between these two variables, the fact th at the correlation only corresponds to a small effect indicates that

PAGE 60

51 objective and perceived severity at least part ially tap into different constructs. This notion is further supported by the finding that the correlations between perceived severity and psychological functioning were consistently larger than the correlations between objective CSA severity and psychological f unctioning. The positive relationship between objective abuse severity and psychological pr oblems is well documented in the CSA literature (Merrill et al., 2001) On the other hand, only one study (Martinez, 2006) to date, an unpublished manuscript, has examin ed and confirmed a significant relationship between subjective appraisals of CSA severity and psychological adjustment to CSA. Therefore, the finding of the current study that perceived abuse seve rity can significantly influence adjustment to abusive events, perhaps more so than objective severity, represents a major advancement in the CSA lite rature that has important implications for CSA survivors who are referred for psychologi cal treatment. Specifically, assessment of survivors’ appraisals of th eir abusive experiences and a ppropriate modification of any maladaptive cognitions may prove to be an effective focus of treatment. With respect to the moderator hypothes es, there was partial support for the hypothesis that the interaction of CSA sever ity and mature defense mechanisms would significantly predict relations hip functioning. Specifically, Objective CSA Severity X Mature Defenses was found to be a unique predictor of dyadic cohesion, which is consistent with the postulation that mature defenses moderates the association between CSA and relationship functioning. This findi ng represents anothe r major advancement in the CSA literature because it demonstrates that using mature defenses to cope with CSA can protect against advers e relationship outcomes for CS A survivors, such as an absence of regular joint activities with thei r partner in intimate relationships. These

PAGE 61

52 findings also suggest that clinicians might want to assess the defense mechanisms of clients with a history of CSA in order to re place maladaptive defenses (e.g., dissociation, projection, and denial) with more adaptive de fenses (i.e., mature defenses), such as humor, anticipation, and sublimation. This would, of course, involve extensive clinical work because maladaptive defenses often de velop in childhood (Punamaki et al., 2002) and have, therefore, become quite deep-seate d by adulthood. Furthermore, maladaptive defenses tend to operate at the unconsci ous level (Punamaki et al., 2002), which can make them more difficult to identify. Contrary to predictions, Objective CSA Severity X Mature Defenses was not significantly related to dyadic consensus, affectional expression, or dyadic satisfaction, nor was Perceived CSA Severity X Mature Defe nses significantly related to any of the four relationship variables. Also contra ry to predictions, the hypothesis that the interaction of CSA severity (objective and perceived) and having a sense of meaning related to CSA events would significantly predict relationshi p functioning was not supported. Like other non-signi ficant findings discussed abov e, it is possible that the relationship between CSA Severity X Meani ng and relationship functioning is a small effect that could not be detected by the current study due to insufficient power. Additional analyses did show, however, that both Objective CSA Severity X Meaning and Perceived CSA Severity X Meanin g were significantly positively related to all ten of the psychological functioning va riables (i.e., somatiz ation, interpersonal sensitivity, depression, anxiety, hostility, phobias, paranoia, obsessive-compulsive symptoms, psychosis, and overall psychopat hology). Furthermore, Objective CSA Severity X Mature Defenses and Perceive d CSA Severity X Mature Defenses were

PAGE 62

53 significantly positively related to somati zation, obsessive-compulsive symptoms, depression, anxiety, phobias, and overall ps ychopathology. Percei ved CSA Severity X Mature Defenses was also significantly posit ively related to interpersonal sensitivity, hostility, paranoia, and psychosis It is notable that the correlations between the CSA Severity X Meaning and CSA Severity X Mature Defenses interactions and psychological symptoms were all lower than those of the main effects, which is consistent with a possible moderating eff ect of meaning and mature defenses in psychological adjustment for CSA survivors. These results are consistent with previous studies that have shown that finding meaning and using mature defenses can moderate the relationship between trau matic events and psychological adjustment (e.g., Punamaki et al., 2002; Silver et al., 1983). Despite promising findings, the current st udy had important limitations that must be mentioned. First, the sample was compri sed solely of undergraduate females, which may not be representative of the general popula tion of CSA survivors in terms of severity of abuse and overall adjustment. Consequentl y, it is not clear whet her the results of the current study would generalize to other CSA populations, such as community and clinical samples. Furthermore, most of the partic ipants were unmarried and, therefore, it is uncertain whether similar results would be found in a primarily married sample. Unfortunately, these sampling problems are not unique to the current study. Sampling issues have been a source of concer n in terms of understanding and interpreting findings in the CSA literature as a whole. Three of the major sampling techniques that have been observed in the CSA literature include random sampling, nonprobability sampling of college students (i.e., the method employed in the present study), and

PAGE 63

54 requesting volunteers from the population (Gol dman & Padayachi, 2000). Results of any study may vary depending upon the sample used because each type of sample may be composed of survivors with a particular background and a particular pattern in their abuse history, which are fact ors that could certainly in fluence outcomes that are measured (e.g., Spaccarelli & Kim, 1995). For example, some studies have often found lower rates of CSA inciden ce in college populations (e.g., 12% of females and 5% of males per Haugaard & Emery, 1989) compared to community (e.g., 20% of females and 5-10% of males per Finkelhor, 1994) and clini cal samples (e.g., 50% of females and 16% of males per Callahan, Price, & Hilsenroth, 2003). Furthermore, college samples are generally composed of indivi duals with higher socioeconomi c and educational levels as well as better overall psychologica l health (Goldman & Padayachi, 2000). As a result, it is reasonable to expect that findings from one type of CSA sample may not generalize to other CSA samples. An excellent example of this generaliz ation problem can be found in the metaanalysis conducted by Rind et al. (1998), which investigated the long term outcomes of CSA. The authors concluded that overall, CSA was not signi ficantly related to adverse psychological outcomes as was previously c ontended. These findings were naturally very startling and raised serious questions about whether CSA was as important to psychological functioning and general wellbei ng as the research community believed. However, there was one important factor in Rind et al.’s (1998) meta-analysis which jeopardized their major conclusions: they onl y examined studies using college samples! In contrast to their findings other studies have found a r obust relationship between CSA and psychological maladjustment in clinic al samples (e.g., Good man, Dutton, & Harris,

PAGE 64

55 1995). Clearly, then, the results from any study on CSA has to be interpreted within the context of the particular sample used. Another sampling issue in the CSA literatur e has to do with sample heterogeneity (Saywitz, Mannarino, Berliner, & Cohen, 2000). Within any sample of CSA survivors whether college, community, or clinical – there is often tremendous variability in the abusive experiences of these individuals (Sayw itz et al., 2000). Neve rtheless, researchers frequently treat CSA as a discre te construct and classify indi viduals with vastly different abusive experiences into one generic CSA group (Haugaard, 2000). Outcome data from such a group would, therefore, be the result of an overall mean that is not sensitive enough to detect unique patterns in particular subgroups of participants. For instance, contact sexual abuse has been associated with poorer psychologi cal outcomes than noncontact sexual abuse (e.g., Ke ndler, Bulik, Silberg, Hettema, Myers, & Prescott, 2000). Use of force and having a closer relationship to the offender are also consistent predictors of psychological symptoms (Spaccarelli, 1994). In addition to sampling issues, the curre nt study had limitations with respect to power. More specifically, the sample si ze was only large enough to detect a medium effect with a power of .80. A larger sample of abused women w ould have provided the power to detect smaller effects. For in stance, the moderating effect of meaning on relationship adjustment may be a small one. Similarly relationshi p functioning may be a small moderator of psychological ad justment for CSA survivors. Instrumentation represents yet another limitation of the current study. Because perceived severity was assessed solely on the basis of two items created for the purposes of the study, it is possible that participants’ perceptions of CSA severity were not fully

PAGE 65

56 tapped. Perhaps additional items would have yielded a more accurate measure of perceived severity. Like other issues discussed earlier, instrumentation also poses a challenge in the wider CSA literature. Many studies have re lied on unstandardized CSA measures, such as the one used to measure CSA severity in the present study, whose reliability and validity have not been well verified (Briere, 1992 ). Part of the problem is that only few standardized measures exist th at were developed specifically for use with CSA survivors, which has caused researcher s to rely on generic and/or unstandardized instruments (Mannon & Leitschuh, 2002). In a review of methodological issues in CSA research, Mannon & Leitschuh (2002) identifie d 41 different measures of CSA used in the existing literature, 24 of which were uns tandardized. It is also importa nt to mention that measures that use few (e.g., less than 4) and broa d CSA screening questions yield much lower rates of CSA than those that use more que stions and more specific questions (Wyatt, 1985; Wyatt & Peters, 1986). Needless to sa y, the findings studies using unstandardized measures that have not been validate d must be interpreted with caution. Another important limitation of the curre nt study, and the CSA literature in general, relates to the defin ition of child sexual abuse itsel f. The present study defined CSA as any sexual contact between a child unde r 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. However, it seems like every word in the term child sexual abuse has been defined differently by different researchers (Haugaard, 2000). For instance, some researchers have defined child as being a person under the age of 18 (e.g., Wyatt, 1985), whereas others have set the cuto ff at under 16 (e.g., Wurr & Partridge, 1996).

PAGE 66

57 With respect to the sexual component, ther e is also some degree of ambiguity and inconsistency regarding which behaviors are a nd are not considered to be sexual. For example, some researchers might argue that a father who bathes his 7 year old daughter is engaging in sexual behavior, while others mi ght disagree. What constitutes abuse is another source of debate amongst CSA resear chers. Many have contended that abuse requires the presence of some observabl e harm (e.g., Rind, Tromovitch, & Bauserman, 1998), but others would insist th at certain acts are abusive, wh ether or not they result in demonstrable harm (Haugaard, 2000). As one might imagine, combining thes e varied conceptualizations of the component parts of CSA has resulted in a numbe r of different definitions of CSA as was mentioned earlier. For example, Friedrich et al. (1986) defined CSA as direct or indirect sexual contact of a child with an adult, whet her through force or consent (notice that the authors did not include any age limits in th eir definition). Schaaf and McCann (1998), on the other hand, defined CSA as any type of sexual contact between a child under 15 and someone at least 5 years older. Peters and Range (1995) had a similar definition but used the cutoff age of 12 as opposed to 15 to define a child. Finkelhor (1979) had yet another definition of CSA: sexual activity between a child and an older person, including simulated, attempted or actual intercourse, kissing, hugging or fondling in a sexual manner, sexual overtures and exhibitionism occurring between a child of 12 or under and an adult over 18; or between a child of 12 or under and a person more than 5 years older than the child; or between an adolescent and an adult at leas t 10 or more years older than the adolescent.

PAGE 67

58 As a result of these variations in how CSA has been defined by researchers, the samples of CSA survivors from existing studies have been markedly different in terms of their age and their abusive experience s (Haugaard, 2000). Furthermore, the epidemiology of CSA has been difficult to de termine because depending on the definition of CSA employed, a different ra te of incidence is obtained. For example, previous studies have found that 12 percent of women in college samples report a history of CSA (e.g., Haugaard & Emery, 1989), whereas the curr ent study found a rate of 33 percent in the undergraduate women sampled. Conseque ntly, it has been difficult to compare different studies in an effort to make globa l interpretations and de velop a reliable and comprehensive body of knowledge on CSA. Another methodological concern in the pr esent study and many other CSA studies is the reliance on retrosp ective reports of CSA (Hulme, 2004). This methodology is inherently fraught with problems surrounding th e accuracy of survivors’ memories of their abusive experiences, give n that adult survivors are trying to recall the details of incident(s) that occurred several years earlier Consequently, the results generated from these retrospective studies have limited reliability and validity. Finally, internal validity is a major limitation of th e current study and the CSA literature as a whole. Although many importa nt risk, protective, and mediating factors associated with CSA outcomes have been identified, most studies have used nonexperimental designs that do not fulfill the 3 necessary criteria for inferring causality between variables: covariation between va riables, time-order relationship between variables, and elimination of alternative explanations for findings (Kazdin, 2003). As such, it is difficult to infer causal links betw een CSA and these variables. CSA studies

PAGE 68

59 have generally used cross-sectional, longit udinal/prospective, and retrospective designs (Briere, 1992), which are correl ational designs that can only reveal the degree to which variables are related (Trochim, 2005). Cro ss-sectional and retrospective designs only satisfy the first requisite condition for causali ty, which is covaria tion between variables (Kazdin, 2003). Longitudinal or prospectiv e designs offer some advantage over these two designs in that they can establish a time-order relationship between CSA and predictor or outcome variable s, in addition to simply s howing covariation (Trochim, 2005). However, the absence of random assignment to groups or levels of the independent variable (IV) pr ecludes the inference that th e IV caused changes in the dependent variable (DV) because alternat ive explanations could have caused those changes (Kazdin, 2003). As such, longitudinal de signs fail to fulfill the third criterion for causality (i.e., ruling out a lternative explanations). It is important to note that the lack of in ternal validity in the CSA literature is due in large part to ethical constraints. That is, it would be unethical in most instances to implement experimental designs using random as signment in an effort to identify factors that cause CSA and adverse outcomes associ ated with it. Fo r example, it would obviously be unethical (as well as illegal) to randomly assign individuals to a CSA condition in order to determine whether CS A is causally related to psychological adjustment. Limitations notwithstanding, the current study has elucidated several areas in which research on the moderating effects of mature defenses and meaning on CSA adjustment might be advanced. For instance, it would be important to investigate the moderating role of meaning and mature defens es on interpersonal adju stment of different

PAGE 69

60 populations of CSA survivors, su ch as clinical samples, community samples, and married samples. In addition, longitudinal studies that follow CSA survivors over time would help to elucidate whether the effect of m eaning and defense mechanisms on adjustment differs over time. Finally, it would be useful to further explore the moderating role of meaning and mature defenses on psychologi cal adjustment of CSA survivors.

PAGE 70

61 Table1 Descriptive Statistics for Continuous Variables __________________________________________________________________________ Variable Mean SD Range ___________________________________________________________________________________ CSA Severity Objective 0.81 1.44 0.00-7.00 CSA Severity Perceived 6.35 5.82 0.00-18.00 Dyadic Consensus 35.72 4.76 16.00-64.00 Affectional Expression 12.36 1.56 7.00-17.00 Dyadic Cohesion 19.76 2.62 11.00-25.00 Dyadic Satisfaction 31.64 2.95 22.00-38.00 Somatization 0.96 0.92 0.00-5.43 Obsessiveness-Compulsiveness 1.71 1.35 0.00-9.50 Interpersonal Sensitivity 1.69 1. 43 0.00-7.50 Depression 1.19 1.14 0.00-5.83 Anxiety 1.20 1.08 0.00-5.67 Hostility 1.35 1.10 0.00-7.00 Phobic Anxiety 0.92 0.95 0.00-6.00 Paranoid Ideation 1.38 1.13 0.00-6.20 Psychoticism 1.11 1.10 0.00-6.60 Global Severity Index 0.21 0.18 0.00-1.05 Meaning 18.21 8.86 0.00-31.00 Mature Defenses 5.70 1.16 1.50-8.63 ___________________________________________________________________________ CSA = Child Sexual Abuse

PAGE 71

62 Table 2 Analysis of Variance between Discrete Child Sexual Abuse and Relationship Functioning _____________________________________________________________________________ Variable Group N Mean SD F Cohen’s d _____________________________________________________________________________ Dyadic Consensus Abused 94 34.86 4.53 4.49* -0.27 Non-Abused 192 36.13 4.83 Dyadic Cohesion Abused 95 19.97 3.06 0.96 0.12 Non-Abused 189 19.65 2.37 Affectional Expression Abused 95 12.48 1.57 0.77 0.11 Non-Abused 189 12.31 1.56 Dyadic Satisfaction Abused 79 31.13 3.42 3.64 -0.25 Non-Abused 159 31.90 2.67 _________________________________________________________________ *p .05

PAGE 72

63 Table 3 Analysis of Variance between Discrete Child Sexual Abuse and Psychological Functioning __________________________________________________________________ Variable Group N Mean SD F Cohen’s d _______________________________________________________________________________________ Somatization Abused 92 1.20 1.04 9.23** 0.37 Non-Abused 189 0.85 0.83 Obsessive-Compulsive Abused 93 1.91 1.48 2.83 0.21 Non-Abused 189 1.62 1.28 Interpersonal Sensitivity Abused 92 1.95 1.54 4.72* 0.27 Non-Abused 186 1.56 1.35 Depression Abused 93 1.40 1.25 4.64* 0.27 Non-Abused 188 1.09 1.07 Anxiety Abused 92 1.47 1.26 8.57** 0.36 Non-Abused 189 1.07 0.96 Hostility Abused 93 1.66 1.30 11.49** 0.40 Non-Abused 185 1.20 0.95 Phobic Anxiety Abused 93 1.16 1.18 9.4** 0.18 Non-Abused 186 0.80 0.78 Paranoid Ideation Abused 93 1.68 1.29 10.03** 0.39 Non-Abused 188 1.23 1.02 Psychoticism Abused 92 1.38 1.21 8.52** 0.36 Non-Abused 188 0.98 1.02 Global Severity Index Abused 89 0.26 0.21 8.40** 0.37 Non-Abused 176 0.19 0.16 ______________________________________________________________________________________ *p .05, **p .01 Table 4

PAGE 73

64 Correlations between Child Sexual Abuse Seve rity and Relationship Functioning Variables ___________________________________________________________________ Variable Perc Obj Dyadic Dyad ic Affection Dyadic Sev Sev Consen Cohesion Expression Satisfaction ________________________________________________________________________________ Perceived Severity 1.00 0.43** -0.02 0.04 0.13 -0.03 Objective Severity 1.00 -0.12 0.02 0.12 -0.09 Dyadic Consensus 1.00 0.43** 0.01 0.39** Dyadic Cohesion 1.00 0.07 0.37** Affectional Expression 1.00 -0.07 Dyadic Satisfaction 1.00 ________________________________________________________________________________ **p .01 Perc Sev = Perceived Child Sexual Abuse Severity Obj Sev = Objective Child Sexual Abuse Severity Dyadic Consen = Dyadic Consensus

PAGE 74

65 Table 5 Correlations between Child Sexual Abuse Seve rity and Psychological Functioning Variables ______________________________________________________________________________________________________ Variable Perc Sev Obj Sev Som ObsessInterpers Dep Anx Host Phob ic Para Psych GSI Comp Sensitivity Anx Idea _______________________________________________________________________________________________________________________________ _________ Perc Sev 1.00 0.43** 0.33** 0.29** 0.37** 0.34** 0.34** 0.34** 0.36** 0.45** 0.33** 0.38** Obj Sev 1.00 0.25** 0.21** 0.19** 0.21** 0.25** 0.27** 0.29** 0.25** 0.21** 0.26** Somatization 1.00 0.77** 0.77** 0.84** 0.86** 0.81* 0.82** 0.75** 0.82** 0.89** Obsess-Comp 1.00 0.78** 0.79** 0.79** 0.78** 0.76** 0.74** 0.77** 0.87** Interpers Sens 1.00 0.88** 0.88** 0.87* 0.87** 0.88** 0.88** 0.94** Depression 1.00 0.88** 0.86** 0.86** 0.85** 0.93** 0.95** Anxiety 1.00 0.87** 0.88** 0.83** 0.89** 0.95** Hostility 1.00 0.87** 0.85** 0.87** 0.93** Phobic Anx 1.00 0.83** 0.86** 0.93** Paranoid Ideation 1.00 0.87** 0.92** Psychoticism 1.00 0.95** GSI 1.00 _______________________________________________________________________________________________________________________________ _________ **p .01 Perc Sev = Perceived Seve rity Anx = Anxiety Obj Sev = Objective Severity Host = Hostility Som = Somatization Phobic Anx = Phobic Anxiety Obsess-Comp = Obsessiveness-Compulsivene ss Para Idea = Paranoid Ideation Interpers Sensitivity = Interpersonal Sensitivity Psych = Psychoticism Dep = Depression GSI – Global Severity Index

PAGE 75

66 Table 6 Correlations between Child Sexual Abuse Severity X Meaning and Relationship Functioning Variables ___________________________________________________________________________________ Variable Perc Sev Obj Sev Dyadic Dyadic Affection Dyadic X Mean X Mean Cons Cohes Exp Sat ___________________________________________________________________________________________________ Perc Sev X Mean 1.00 0.54** 0.09 0.08 -0.01 -0.02 Obj Sev X Mean 1.00 0.03 0. 02 0.10 -0.02 Dyadic Consensus 1.00 0.43** 0.01 0.39** Dyadic Cohesion 1.00 0.07 0.37** Affection Exp 1.00 -0.07 Dyadic Sat 1.00 ___________________________________________________________________________________ **p .01 Dyadic Cons = Dyadic Consensus Dyadic Cohes = Dyadic Cohesion Affection Exp = Affectional Expression Dyadic Sat = Dyadic Satisfaction Perc Sev = Perceived Severity Obj Sev = Objective Severity Mean = Meaning

PAGE 76

67 Table 7 Correlations between Child Sexual Abuse Severity X Meaning and Psychological Functioning Variables _____________________________________________________________________________________________________ Variable Perc Sev Obj Sev Som ObsessInterpers Dep Anx Host Phobic Para Psych GSI X Mean X Mean Comp Sens Anx Idea _________________________________________________________________________________________________________________________ Perc Sev X Mean 1.00 0.54** 0.26* 0.29** 0.28** 0.34** 0.32** 0.28** 0.31** 0.36** 0.28** 0.32** Obj Sev X Mean 1.00 0.23* 0.30** 0.24* 0.28** 0.29** 0.23* 0. 31** 0.26* 0.22* 0.27** Somatization 1.00 0.77** 0.77** 0.84** 0.86** 0 .81** 0.82** 0.75** 0.82** 0.89** Obsess-Comp 1.00 0.78** 0.79** 0.79** 0. 78** 0.76** 0.74** 0.77** 0.87** Interpers Sens 1.00 0.88** 0.88** 0.87** 0.87** 0.88** 0.88** 0.94** Depression 1.00 0.88** 0.86** 0.86** 0.85** 0.93** 0.95** Anxiety 1.00 0.87** 0.88** 0.83** 0.89** 0.95** Hostility 1.00 0.87** 0.85** 0.87** 0.93** Phobic Anx 1.00 0.83** 0.86** 0.93** Paranoid Ideation 1.00 0.87** 0.92** Psychoticism 1.00 0.95** GSI 1.00 ______________________________________________________________________________________________________ *p .05, ** p .01 Host = Hostility Som = Somatization Phobic Anx = Phobic Anxiety Obsess-Comp = Obsessiveness-Compulsiveness Para Idea = Parnoid Ideation Interpers Sens = Interpersonal Se nsitivity Psych = Psychoticism Dep = Depression Anx = Anxiety Perc Sev = Perceived Severity GSI = Global Severity Index Obj Sev = Objective Severity Mean = Meaning

PAGE 77

68 Table 8 Correlations between Child Sexual Abuse Severity X Ma ture Defenses and Relatio nship Functioning Variables _____________________________________________________________________________________ Variable Perc Sev Obj Sev Dyadic Dyadic Affection Dyadic X Mat Def X Mat Def Cons Cohes Exp Sat _____________________________________________________________________________________________________ Perc Sev X Mat Def 1.00 0.30** 0.10 0.08 -0.01 0.06 Obj Sev X Mat Def 1.00 0.03 0. 02 0.10 -0.02 Dyadic Consensus 1.00 0.43** 0.01 0.39** Dyadic Cohesion 1.00 0.07 0.37** Affectional Expression 1.00 -0.07 Dyadic Sat 1.00 ____________________________________________________________________________________ **p .01 Dyadic Cons = Dyadic Consensus Dyadic Cohes = Dyadic Cohesion Affection Exp = Affectional Expression Dyadic Sat = Dyadic Satisfaction Perc Sev = Perceived Severity Obj Sev = Objective Severity Mat Def = Mature Defenses

PAGE 78

69 Table 9 Correlations between Child Sexual Abuse Severity X Matu re Defenses and Psycholog ical Functioning Variables ______________________________________________________________________________________________________ Variable Perc Sev Obj Sev Som ObsessInterpers Dep Anx Host P hobic Para Psych GSI X Mat Def X Mat Def Comp Sens Anx Idea __________________________________________________________________________________________________________________________ Perc Sev X Mat Def 1.00 0.30* 0.27* 0.25* 0.30** 0.34** 0.29** 0.26* 0.30** 0.40** 0.29** 0.33** Obj Sev X Mat Def 1.00 0.21* 0.24* 0.20 0.23* 0.21* 0.19 0.27** 0.21 0.14 0.24 Somatization 1.00 0.77** 0.77** 0.84** 0.86** 0 .81** 0.82** 0.75** 0.82** 0.89** Obsess-Comp 1.00 0.78** 0.79** 0.79** 0.7 8** 0.76** 0.74** 0.77** 0.87** Interpers Sens 1.00 0.88** 0.88** 0.87* 0.87** 0.88** 0.88** 0.94** Depression 1.00 0.88** 0.86** 0.86** 0.85** 0.93** 0.95** Anxiety 1.00 0.87** 0.88** 0.83** 0.89** 0.95** Hostility 1.00 0.87** 0.85** 0.87** 0.93** Phobic Anx 1.00 0.83** 0.86** 0.93** Paranoid Ideation 1.00 0.87** 0.92** Psychoticism 1.00 0.95** GSI 1.00 __________________________________________________________________________________________________________________________ *p .05, p .01 Mat Def = Mature Defenses Som = Somatization Phobic Anx = Phobic Anxiety Obsess-Comp = Obsessiveness-Compulsivene ss Para Idea = Paranoid Ideation Interpers Sens = Interpersonal Se nsitivity Psych = Psychoticism Dep = Depression GSI = Global Severity Index Anx = Anxiety Perc Sev = Perceived Severity Host = Hostility Obj Sev = Objective Severity

PAGE 79

70 Table 10 Hierarchical Multiple Regression Analysis between Objectiv e Child Sexual Abuse Severity X Meaning and Affectional Expression ________________________________________________________________________________________________________________________ Variable Beta t Sig R2 Sig ____________________________________________________________________________________________________ Step 1 Objective CSA Severity 0.22 2.14 0.04 0.05 0.09 Meaning -0.08 -0.75 0.46 Step 2 Obj CSA Sev X Meaning -0.10 -0.32 0.75 0.00 0.75 _________________________________________________________________________________________________________________________ Obj CSA Sev = Objective Child Sexual Abuse Severity

PAGE 80

71 Table 11 Hierarchical Multiple Regression Analysis between Perceive d Child Sexual Abuse Severity X Meaning and Affectional Expression _________________________________________________________________________________________________________________________ Variable Beta t Sig R2 Sig _____________________________________________________________________________________________________ Step 1 Perceived CSA Severity 0.10 0.98 0.33 0.01 0.54 Meaning -0.07 -0.68 0.50 Step 2 Perc CSA Sev X Meaning -0.30 -1.15 0.26 0.01 0.26 _____________________________________________________________________________________________________ Perc CSA Sev = Perceived Child Sexual Abuse Severity

PAGE 81

72 Table 12 Hierarchical Multiple Regression Analysis between Object ive Child Sexual Abuse Severity X Meaning and Dyadic Consensus _________________________________________________________________________________________________________________________ Variable Beta t Sig R2 Sig _____________________________________________________________________________________________________ Step 1 Objective CSA Severity -0.05 -0.50 0.62 0.00 0.87 Meaning 0.02 0.20 0.84 Step 2 Obj CSA Sev X Meaning 0.47 1.54 0.13 0.03 0.13 _____________________________________________________________________________________________________ Obj CSA Sev = Objective Child Sexual Abuse Severity

PAGE 82

73 Table 13 Hierarchical Multiple Regression Analysis between Perceived Child Sexual Abuse Severity X Meaning and Dyadic Consensus _______________________________________________________________________________________________________________________ Variable Beta t Sig R2 Sig ___________________________________________________________________________________________________ Step 1 Perceived CSA Severity 0.03 0.30 0.77 0.00 0.95 Meaning 0.01 0.10 0.92 Step 2 Perc CSA Sev X Meaning 0.36 1.36 0.18 0.02 0.18 ____________________________________________________________________________________________________ Perc CSA Sev = Perceived Child Sexual Abuse Severity

PAGE 83

74 Table 14 Hierarchical Multiple Regression Analysis between Object ive Child Sexual Abuse Severity X Meaning and Dyadic Satisfaction ________________________________________________________________________________________________________________________ Variable Beta t Sig R2 Sig ____________________________________________________________________________________________________ Step 1 Objective CSA Severity 0.02 0.18 0.86 0.00 0.96 Meaning 0.03 0.21 0.83 Step 2 Obj CSA Sev X Meaning -0.41 -1.22 0.23 0.02 0.23 ____________________________________________________________________________________________________ Obj CSA Sev = Objective Child Sexual Abuse Severity

PAGE 84

75 Table 15 Hierarchical Multiple Regression Analysis between Perceived Child Sexual Abuse Severity X Meaning and Dyadic Satisfaction ________________________________________________________________________________________________________________________ Variable Beta t Sig R2 Sig ____________________________________________________________________________________________________ Step 1 Perceived CSA Severity 0.01 0.12 0.91 0.00 0.96 Meaning 0.03 0.24 0.81 Step 2 Perc CSA Sev X Meaning -0.28 -0.98 0.33 0.01 0.33 _____________________________________________________________________________________________________ Perc CSA Sev = Perceived Child Sexual Abuse Severity

PAGE 85

76 Table 16 Hierarchical Multiple Regression Analysis between Objective Child Sexual Abuse Severity X Meaning and Dyadic Cohesion _______________________________________________________________________________________________________________________ Variable Beta t Sig R2 Sig Step 1 Objective CSA Severity -0.08 -0.73 0.47 0.03 0.25 Meaning 0.16 1.59 0.12 Step 2 Obj CSA Sev X Meaning -0.27 -0.87 0.38 0.01 0.38 ____________________________________________________________________________________________________ Obj CSA Sev = Objective Child Sexual Abuse Severity

PAGE 86

77 Table 17 Hierarchical Multiple Regression Analysis between Perceived Child Sexual Abuse Severity X Meaning and Dyadic Cohesion ________________________________________________________________________________________________________________________ Variable Beta t Sig R2 Sig ____________________________________________________________________________________________________ Step 1 Perceived CSA Severity 0.04 0.34 0.73 0.03 0.31 Meaning 0.15 1.44 0.15 Step 2 Perc CSA Sev X Meaning -0.23 -0.87 0.39 0.01 0.39 ____________________________________________________________________________________________________ Perc CSA Sev = Perceived Child Sexual Abuse Severity

PAGE 87

78 Table 18 Hierarchical Multiple Regression Analysis between Objective Child Sexual Abuse Severity X Mature Defenses and Dyadic Consensus _______________________________________________________________________________________________________________________ Variable Beta t Sig R2 Sig ___________________________________________________________________________________________________ Step 1 Objective CSA Severity -0.03 -0.32 0.75 0.05 0.09 Mature Defenses 0.23 2.23 0.03 Step 2 Obj CSA Sev X Mat Def -0.11 -0.21 0.83 0.00 0.83 ____________________________________________________________________________________________________ Obj CSA Sev = Objective Child Sexual Abuse Severity Mat Def = Mature Defenses

PAGE 88

79 Table 19 Hierarchical Multiple Regression Analysis between Perceived Child Sexual Abuse Severity X Mature Defenses and Dyadic Consensus _____________________________________________________________________________________________________ Variable Beta t Sig R2 Sig _____________________________________________________________________________________________________ Step 1 Perceived CSA Severity 0.04 0.41 0.68 0.06 0.08 Mature Defenses 0.23 2.21 0.03 Step 2 Perc CSA Sev X Mat Def -0.18 -0.34 0.74 0.00 0.74 ______________________________________________________________________________________________________ Perc CSA Sev = Perceived Child Sexual Abuse Severity Mat Def = Mature Defenses

PAGE 89

80 Table 20 Hierarchical Multiple Regression Analysis between Objective Child Sexual Abuse Severity X Mature Defenses and Affectional Expression ____________________________________________________________________________________________________ Variable Beta t Sig R2 Sig ____________________________________________________________________________________________________ Step 1 Objective CSA Severity 0.20 2.08 0.04 0.16 0.00 Mature Defenses -0.35 -3.57 0.00 Step 2 Obj CSA Sev X Mat Def 0.84 1.73 0.09 0.03 0.09 ____________________________________________________________________________________________________ Obj CSA Sev = Objective Child Sexual Abuse Severity Mat Def = Mature Defenses

PAGE 90

81 Table 21 Hierarchical Multiple Regression Analysis between Perceived Child Sexual Abuse Severity X Mature Defenses and Affectional Expression _____________________________________________________________________________________________________ Variable Beta t Sig R2 Sig _____________________________________________________________________________________________________ Step 1 Perceived CSA Severity 0.10 1.02 0.31 0.14 0.00 Mature Defenses -0.36 -3.59 0.00 Step 2 Perc CSA Sev X Mat Def -0.20 -0.38 0.70 0.00 0.70 ___________________________________________________________________________________________________ Perc CSA Sev = Perceived Child Sexual Abuse Severity Mat Def = Mature Defenses

PAGE 91

82 Table 22 Hierarchical Multiple Regression Analysis between Objective Child Sexual Abuse Severity X Mature Defenses and Dyadic Satisfaction ____________________________________________________________________________________________________ Variable Beta t Sig R2 Sig ____________________________________________________________________________________________________ Step 1 Objective CSA Severity 0.04 0.35 0.73 0.04 0.19 Mature Defenses 0.21 1.80 0.08 Step 2 Obj CSA Sev X Mat Def -1.00 -1.66 0.10 0.04 0.10 ____________________________________________________________________________________________________ Obj CSA Sev = Objective Child Sexual Abuse Severity Mat Def = Mature Defenses

PAGE 92

83 Table 23 Hierarchical Multiple Regression Analysis between Perceived Child Sexual Abuse Severity X Mature Defenses and Dyadic Satisfaction ____________________________________________________________________________________________________ Variable Beta t Sig R2 Sig ____________________________________________________________________________________________________ Step 1 Perceived CSA Severity 0.04 0.37 0.71 0.05 0.19 Mature Defenses 0.21 1.82 0.07 Step 2 Perc CSA Sev X Mat Def -0.52 -0.86 0.40 0.01 0.40 _____________________________________________________________________________________________________

PAGE 93

84 Table 24 Hierarchical Multiple Regression Analysis between Objective Ch ild Sexual Abuse Severity X Mature Defenses and Dyadic Cohesion ____________________________________________________________________________________________________ Variable Beta t Sig R2 Sig ____________________________________________________________________________________________________ Step 1 Objective CSA Severity -0.07 -0.65 0.52 0.01 0.57 Mature Defenses 0.09 0.83 0.41 Step 2 Obj CSA Sev X Mat Def -1.06 -2.02 0.05 0.04* 0.05* _____________________________________________________________________________________________________ *p .05 Obj CSA Sev = Objective Child Sexual Abuse Severity Mat Def = Mature Defenses

PAGE 94

85 Table 25 Hierarchical Multiple Regression Analysis between Perceived Child Sexual Abuse Severity X Mature Defenses and Dyadic Cohesion ____________________________________________________________________________________________________ Variable Beta t Sig R2 Sig ____________________________________________________________________________________________________ Step 1 Perceived CSA Severity 0.06 0.55 0.58 0.01 0.60 Mature Defenses 0.09 0.83 0.41 Step 2 Perc CSA Sev X Mat Def -0.10 -0.18 0.86 0.00 0.86 _____________________________________________________________________________________________________ Perc CSA Sev = Perceived Child Sexual Abuse Severity Mat Def = Mature Defenses

PAGE 95

86 Table 26 Hierarchical Multiple Regression Analysis between Objective Ch ild Sexual Abuse Severity X Dyadic Consensus and Global Severity Index ____________________________________________________________________________________________________ Variable Beta t Sig R2 Sig ____________________________________________________________________________________________________ Step 1 Objective CSA Severity 0.29 0.28 0.01 0.15 0.00 Dyadic Consensus -0.25 -2.48 0.02 Step 2 Obj CSA Sev X Dy Cons -1.08 -1.25 0.21 0.02 0.21 ____________________________________________________________________________________________________ Obj CSA Sev = Objective Child Sexual Abuse Severity Dy Cons = Dyadic Consensus

PAGE 96

87 Table 27 Hierarchical Multiple Regression Analysis between Perceived Child Sexual Abuse Severity X Dyadic Consensus and Global Severity Index ____________________________________________________________________________________________________ Variable Beta t Sig R2 Sig ____________________________________________________________________________________________________ Step 1 Perceived CSA Severity 0.38 3.96 0.00 0.22 0.00 Dyadic Consensus -0.29 -2.97 0.00 Step 2 Perc CSA Sev X Dy Cons -0.81 -0.94 0.35 0.01 0.35 ____________________________________________________________________________________________________ Perc CSA Sev = Perceived Child Sexual Abuse Severity Dy Cons = Dyadic Consensus

PAGE 97

88 Table 28 Hierarchical Multiple Regression Analysis between Objective Child Sexual Abuse Severity X Affectional Expression and Global Severity Index _____________________________________________________________________________________________________ Variable Beta t Sig R2 Sig _____________________________________________________________________________________________________ Step 1 Objective CSA Severity 0.26 2.56 0.01 0.12 0.00 Affectional Expression 0.19 1.79 0.08 Step 2 Obj CSA Sev X Aff Exp -0.56 -0.61 0.55 0.00 0.55 _____________________________________________________________________________________________________ Obj CSA Sev = Objective Child Sexual Abuse Severity Aff Exp = Affectional Expression

PAGE 98

89 Table 29 Hierarchical Multiple Regression Analysis between Perceived Child Sexual Abuse Severity X Affectional Expression and Global Severity Index ____________________________________________________________________________________________________ Variable Beta t Sig R2 Sig ____________________________________________________________________________________________________ Step 1 Perceived CSA Severity 0.35 3.51 0.00 0.17 0.00 Affectional Expression 0.20 1.96 0.05 Step 2 Perc CSA Sev X Aff Exp 0.46 0.57 0.57 0.00 0.57 ____________________________________________________________________________________________________ Perc CSA Sev = Perceived Child Sexual Abuse Severity Aff Exp = Affectional Expression

PAGE 99

90 Table 30 Hierarchical Multiple Regression Analysis between Objective Child Sexual Abuse Severity X Dyadic Cohesion and Global Severity Index ____________________________________________________________________________________________________ Variable Beta t Sig R2 Sig ____________________________________________________________________________________________________ Step 1 Objective CSA Severity 0.29 2.88 0.01 0.11 0.01 Dyadic Cohesion -0.15 -1.48 0.14 Step 2 Obj CSA Sev X Dy Cohes -0.76 -1.08 0.29 0.01 0.29 _____________________________________________________________________________________________________ Obj CSA Sev = Objective Child Sexual Abuse Severity Dy Cohes = Dyadic Cohesion

PAGE 100

91 Table 31 Hierarchical Multiple Regression Analysis between Perceived Child Sexual Abuse Severity X Dyadic Cohesion and Global Severity Index ____________________________________________________________________________________________________ Variable Beta t Sig R2 Sig ____________________________________________________________________________________________________ Step 1 Perceived CSA Severity 0.39 3.89 0.00 0.18 0.00 Dyadic Cohesion -0.21 -2.08 0.04 Step 2 Perc CSA Sev X Dy Cohe -0.30 -0.43 0.67 0.00 0.67 ____________________________________________________________________________________________________ Perc CSA Sev = Perceived Child Sexual Abuse Severity Dy Cohe = Dyadic Cohesion

PAGE 101

92 Table 32 Hierarchical Multiple Regression Analysis between Objective Ch ild Sexual Abuse Severity X Dyadic Satisfaction and Global Severity Index ____________________________________________________________________________________________________ Variable Beta t Sig R2 Sig ____________________________________________________________________________________________________ Step 1 Objective CSA Severity 0.35 3.44 0.00 0.25 0.00 Dyadic Satisfaction -0.37 -3.61 0.00 Step 2 Obj CSA Sev X Dy Sat -1.14 -1.38 0.17 0.02 0.17 _____________________________________________________________________________________________________ Obj CSA Sev = Objective Child Sexual Abuse Severity Dy Sat = Dyadic Satisfaction

PAGE 102

93 Table 33 Hierarchical Multiple Regression Analysis between Perceived Ch ild Sexual Abuse Severity X Dyadic Satisfaction and Global Severity Index ____________________________________________________________________________________________________ Variable Beta t Sig R2 Sig ____________________________________________________________________________________________________ Step 1 Perceived CSA Severity 0.37 3.69 0.00 0.27 0.00 Dyadic Satisfaction -0.38 -3.74 0.00 Step 2 Perc CSA Sev X Dyadic Sat -1.19 -1.24 0.22 0.02 0.22 ____________________________________________________________________________________________________ Perc CSA Sev = Perceived Child Sexual Abuse Severity Dyadic Sat = Dyadic Satisfaction

PAGE 103

94 References American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: Ameri can Psychiatric Association. Andersen, M. (unpublished manuscript). Tr aumatic events and their psychological consequences among Israeli youth. Andrews, G., Singh, M., & Bond, M. (1993). The Defence Style Questionnaire. The Journal of Nervous and Mental Disease 181, 246-256. Aspinwall, L. & Taylor, S. (1997). A stitch in time: self regulation and proactive coping. Psychological Bulletin, 121, 417-436 Bartoi, M. & Kinder, B. (1998). Effects of child and adult se xual abuse on adult sexuality. Journal of Sex and Marital Therapy 24, 75-90. Birmes, P., Warner, B., Callahan, S., Sztulm an, Charlet, J., & Schmitt, L. (2000). Defense styles and posttraumatic stress symptoms. Journal of Nervous and Mental Disorders 188, 306-308. Blum, J. & Mehrabian, A. (1999). Personality and temperamental co rrelates of marital satisfaction. Journal of Personality 67, 93-125. Blume, E. (1990). Secret Survivors: Uncovering Inces t and its Aftereffects in Women New York: John Wiley & Sons. Boulet, J. & Boss, M. (1991). Reliability and validity of th e Brief Symptom Inventory. Psychological Assessment 3, 433-437.

PAGE 104

95 Briere, J. (1992). Methodologi cal issues in the study of sexual abuse effects. Journal of Consulting and Clinical Psycholo gy, 60, 196-203. Burleson, B. & Denton, W. (1992). A new look at similarity and attr action in marriage: similarities in social-cognitive and communication skills as predictors of attraction and satisfaction. Communication Monographs 59, 268-287. Byrne, D. (1971). The ubiquitous relationship: attitude similarity and attraction: a crosscultural study. Human Relations 24, 201-207. Callahan, K., Price, J., & Hilsenroth, M. (2003). Psychological assessment of adult survivors of childhood sexual a ssault within a naturalist ic clinical sample. Journal of Personality Assessment 80, 173-184. Canary, D. & Stafford, L. ( 1992). Relational maintenance st rategies and equity in marriage. Communication Monographs 59, 243-267. Carey, M., Spector, I., Lan tinga, L., & Krauss, D. (1993). Re liability of the Dyadic Adjustment Scale. Psychological Assessment 5, 238-240. Christiansen, A. & Shenk, J. (1991). Co mmunication, conflict, and psychological distance in nondistressed, clin ic, and divorcing couples. Journal of Consulting and Clinical Psychology 59, 458-463. Cochran, C. & Hale, D. (1985). Colle ge student norms on the Brief Symptom Inventory. Journal of Clinical Psychology 41, 777-779. Coffey, P., Leitenberg, H., Henning, K., & Tu rner, T. (1996). The relation between methods of coping during a dulthood with a history of childhood sexual abuse and current psychological adjustment. Journal of Consulting & Clinical Psychology 64, 1090-1093.

PAGE 105

96 Cohen, J. (1992). A power primer. Psychological Bulletin 112, 155-159. Cole, D. & Turner, J. (1993). Models of cognitive mediation and moderation in child depression. Journal of Abnormal Psychology 102, 271-281. Collins, N. & Read, S. (1990). Adult att achment, working models, and relationship quality in dating couples. Journal of Personality and Social Psychology 58, 644663. Cramer, P. (2000). Defence mechanism in ps ychology today. Further processes for adaptation. American Psychologist 55, 637-646. Dainton, M. (2000). Maintenance behaviors, expectations for maintenance, and satisfaction: linking comparison levels to relational maintenance strategies. Journal of Social and Personal Relationships 17, 827-842. Dainton, M., Stafford, L., & Ca nary, D. (1994). Maintenanc e strategies and physical affection as predictors of love, liki ng, and satisfaction in marriage. Communication Reports 7, 88-98. Davis, J. & Petretic-Jackson, P. (2000). Th e impact of child se xual abuse on adult interpersonal functioning: a review and s ynthesis of the empiri cal literature. Aggression and Violent Behavior 5, 291-328. Deal, J., Wampler, K., & Halverson, C. (1992) The importance of similarity in the marital relationship. Family Process 31, 369-382. Derogatis, L. (1982). Brief Symptom I nventory: Administra tion, Scoring, and Procedures Manual-II. Minneapolis : NCS Pearson Assessments, Inc. DiLillo, D. & Long, P. (1999). Perceptions of couple functioning among female survivors of child sexual abuse. Journal of Child Sexual Abuse 7, 59-76.

PAGE 106

97 Dindia, K. & Canary, D. (1993). Definitions and theoretical perspectives on maintaining relationships. Journal of Social and Personal Relationships 10, 163-173. Drossman, D. (1992). The link between early abuse and GI diso rders in women. Emergency Medicine 171-175. Elkit, A. (1998). Psychological After-effects in Trauma Patients Aarhus, Denmark: Institute of Psychology, Un iversity of Aarhus. Epstein, N. & Eidelson, R. ( 1981). Unrealistic beliefs of clinical couples: their relationships to expectati ons, goals, and satisfaction. American Journal of Family Therapy 9, 13-22. Esparza, D. (1993). Maternal support and stre ss response in sexually abused girls ages 612. Issues in Mental Health Nursing 14, 85-107. Eysenck, H. & Wakefield, J., Jr. (1981). Psycho logical factors as predictors of marital satisfaction. Advances in Behavior Research Therapy 3, 151-192. Feeney, J. & Noller, P. (1991). Attachment st yle and verbal descrip tions of romantic partners. Journal of Social and Personal Relationships 8, 187-215. Feeney, J., Noller, P., & Callahan, V. (1994) Attachment style, communication and satisfaction in the early years of marriage. Advances in Personal Relationships 5, 269-308. Finkelhor, D. (1979). Sexually Victimized Ch ildren. The Free Press. A division of Macmillan Publishing Co., Inc. Finkelhor, D. (1994). The international epidemiology of child sexual abuse. Child Abuse & Neglect 18, 409-417.

PAGE 107

98 Finkelhor, D. & Browne, A. (1985). The trau matic impact of child sexual abuse: a conceptualization. American Journal of Orthopsychiatry 55, 530-541. Finkelhor, D., Hotaling, G., Lewis, I., & Smit h, C. (1990). Sexual abuse in a national survey of adult men and women: prevalence, characteristics, and risk factors. Child Abuse & Neglect 14, 19-28. Fiske, S. & Taylor, S. (1991). Social Cognition (2nd ed.). New York: McGraw-Hill. Frazier, P., Steward, J., & Mortensen, H. (2004) Perceived control and adjustment to trauma: a comparison across events. Journal of Social and Clinical Psychology 23, 303-324. Friedrich, W., Urquiza, A., & Beilke, R. (1986) Behavior problems in sexually abused young children. Journal of Pediatric Psychology 11, 47-57. Fry, R., Crisp, A., Beard, R., & McGuigan, S. (1 993). Psychosocial aspects of chronic pelvic pain with special reference to sexual abuse. A study of 164 women. Postgraduate Medical Journal 69, 566-574. Geist, R. & Gilbert, D. (1996). Correlates of expressed and felt emotion during marital conflict: satisfaction, personal ity, process, and outcome. Personality and Individual Differences 21, 49-60. Glenn, N.D. (1990). Quantitative research on marital quality in th e 1980’s: a critical review. Journal of Marriage and the Family 52, 818-831. Goldman, J. & Padayachi, U. (2000). So me methodological problems in estimating incidence and prevalence in child sexual abuse research. Journal of Sex Research 37, 305-315.

PAGE 108

99 Gollwitzer, P. & Kinney, R. (1989). Effects of deliberative and implemental mindsets on illusion of control. Journal of Personality and Social Psychology 56, 531-542. Goodman, L., Dutton, M., & Harris, M. (1995) Episodically homeless women with serious mental illness: prevalence of physical and sexual assault. American Journal of Orthopsychiatry 65, 468-478. Grych, J. & Fincham, F. (1990). Marital conf lict and children’s adju stment: a cognitive contextual framework. Psychological Bulletin, 108, 267-290. Hall, R, Tice, L., & Beresford, T. (1989). Se xual abuse in patients with anorexia nervosa and bulimia. Psychosomatics: Journal of Consultation Liaison Psychiatry 30, 7379. Hammond, J.R. & Fletcher, G.J.O. (1991). A ttachment dimensions and relationship satisfaction in the developmen t of close relationships. New Zealand Journal of Psychology 20, 56-62. Haugaard, J. (2000). The challenge of defining child sexual abuse. American Psychologist 55, 1036-1039. Haugaard, J. & Emery, R. (1989). Methodological issues in child sexual abuse research. Child Abuse & Neglect 13, 89-101. Hazan, C. & Shaver, P. (1987). Romantic love co nceptualized as an attachment process. Journal of Personality and Social Psychology 52, 511-524. Hendrick, S.S., Hendrick, C., & Adler, N.L. (1988). Romantic relationships: love, satisfaction, and staying together. Journal of Personality and Social Psychology 54, 980-988.

PAGE 109

100 Himelein, M. & McElrath, J. (1996). Resilien t child sexual abuse survivors: cognitive coping and illusion. Child Abuse & Neglect 20, 747-758. Hintikka, J., Koskela, J., Kontula, O., Kosk ela, K., & Vinamaeki, H. (1999). Men, women, and marriages: are there differences in relations to mental health? Family Therapy 26, 213-218. Ho, S. & Shiu, W. (1995). Death, anxiety, and coping mechanisms of Chinese cancer patients. Omega Journal of Death and Dying 31, 59-65. Hulme, P. (2004). Retrospective measuremen t of childhood sexual abuse: a review of instruments. Child Maltreatment 9, 201-217. Jehu, D. (1988). Beyond Sexual Abuse: Therapy with Women who were Childhood Victims New York: John Wiley & Sons. Jehu, D. (1989). Sexual dysfunctions among wome n client who were sexually abused in childhood. Behavioural Psychotherapy 17, 53-70. Jones, J. & Cunningham, J. (1996). Attach ment styles and other predictors of relationship satisfaction in dating couples. Personal Relationships 3, 387-399. Jones, M. & Stanton, A. (1988). Dysfunctiona l beliefs, belief simila rity, and marital distress a comparison of models. Journal of Social and Clinical Psychology 7, 114. Karney, B. & Bradbury, T. (1995). The long itudinal course of marital quality and stability: a review of th eory, method, and research. Psychological Bulletin 118, 3-34.

PAGE 110

101 Karney, B., Bradbury, T., Fincham, F., & Su llivan, K. (1994). The role of negative affectivity in the association between at tributions and martial satisfaction. Journal of Personality and Social Psychology 66, 413-424. Kassin, S. (1998). Psychology (Second Edition). Upper Saddle River, NJ: Prentice-Hall, Inc. Kazdin, A. (2003). Research Design in Clinical Psychology (Fourth Edition). Boston, Massachusetts: Allyn & Bacon. Kelly, E. & Conley, J. (1987). Personality a nd compatibility: a prospe ctive analysis of marital stability and marital satisfaction. Journal of Personality and Social Psychology 52, 27-40. Kendall-Tackett, K., Williams, L., & Finkelhor, D. (1993). Impact of sexual abuse on children: a review and synthesis of recent empirical studies. Psychological Bulletin 113, 164-180. Kendler, K., Bulik, C., Silberg, J., Hettema, J., Myers, J., & Prescott, C. (2000). Childhood sexual abuse and adult psychiatri c and substance abuse disorders in women. Archives of General Psychiatry 57, 953-959. Kobak, R. & Sceery, A. (1988). Attachment in late adolescence: working models, affect regulation, and representations of self and others. Child Development 59, 135146. Koverola, C., Pound, J., Heger, A., & Lytle, C. (1993). Relationship of child abuse to depression. Child Abuse & Neglect 17, 393-400.

PAGE 111

102 Krantz, S., Clark, J., Clark, J., & Pruyn, J. (1985). Cognition and adjustment among children of separated or divorced parents. Cognitive Therapy and Research 9, 61-77. Laurent, J. & Stark, K. (1993). Tes ting the cognitive content-specificity hypothesis with anxious and depressed youngsters. Journal of Abnormal Psychology 102, 226-237. Lazarus, R. (1991). Emotion and Adaptation New York: Oxford University Press. Lem, B.K. & Ivey, D. (2000). The assessmen t of marital adjustment with Chinese populations: a study of the psychometric pr operties of the Dyadic Adjustment Scale. Contemporary Family Therapy: An International Journal 22, 453-465. Mannon, K. & Leitschuh, G. (2002). Child se xual abuse: a review of definitions, instrumentation, and symptomology. North American Journal of Psychology 4, 149-160. Mazur, E., Wolchik, S., & Sandler, I. (1992) Negative cognitive errors and positive illusions for stressful divorce-related events; predictors of children’s adjustment. Journal of Abnormal Child Psychology 20, 523-542. Mazur, E., Wolchik, S., Virdin, L., Sand ler, I., & West, S. (1999). Cognitive moderators of children’s ad justment to stressful divor ce events: the role of negative cognitive errors and positive illusions. Child Development 70, 231245. McEwen, B. (1998). Protective and dama ging effects of stress mediators. New England Journal of Medicine 338, 171-179.

PAGE 112

103 Meichenbaum, D. & Fitzpatrick, D. (1993). A constructivist narrative perspective on stress and coping: stress inoculation a pplications. In L. Goldberger & S. Breznitz (Eds.), Handbook of Stress: Theoretic al and Clinical Aspects 706723. New York: The Free Press. Mental Measurements Yearbook 10th Edition (1990). Lincoln, Nebraska: Buros Institute of Mental Measurements, University of Ne braska Press. Merrill, L., Thomsen, C., Sinclair, B., Gold, S., & Milner, J. (2001). Journal of Consulting & Clinical Psychology 69, 992-1006. Merry, S. & Andrews, L. (1994). Psychiatri c status of sexually abused children 12 months after disclosure of abuse. Journal of American Academy of Child & Adolescent Psychiatry 33, 939-944. Moran, P & Eckenrode, J. (1992). Protec tive personality characteristics among adolescent victims of maltreatment. Child Abuse and Neglect 16, 743-754. Mullen, P., Martin, J., Anderson, J., Romans, S ., & Herbison, G. (1994). The effect of child sexual abuse on social, interpersona l, and sexual functi on in adult life. British Journal of Psychiatry 165, 35-47. Myers, D. & Diener, E. (1 995). Who is happy? Psychological Science 6, 10-19. Neter, E., Taylor, S., & Kemen y, M. (unpublished manuscript). When the future gets worse: does optimism undermine, sustai n, or buffer psychological adjustment during the progression of HIV? Neumann, D. (1994). Long term correlates of childhood sexual abuse in adult survivors. In J. Briere (ed.), Assessing and Treating Victims of Violence: New Directions for Mental Health Services San Francisco, CA: Jossey-Bass.

PAGE 113

104 Neumann, D., Houskamp, B., Pollock, V., & Brie re, J. (1996). The long term sequelae of childhood sexual abuse in women: a meta-analytic review. Child Maltreatment 1, 6-16. Newman, L. (2001). Coping and de fense: no clear distinction. American Psychologist 760-761. Newton, T. & Kiecolt-Glaser J. (1995) Hostility and erosion of marital quality during early marriage. Journal of Behavioral Medicine 18, 601-619. Noller, P. (1993). Gender and emotional comm unication in marriage: different cultures or differential social power? Journal of Language and Social Psychology 12, 132-152. Oates, K., O’Toole, B., Lynch, D., Stern, A., & Cooney, G. (1994). Stability and change in outcomes for sexually abused children. Journal of American Academy of Child & Adolescent Psychiatry, 33, 945-953. O’Donohue, W. & Crouch, J. (1996). Marital therapy and gender-li nked factors in communication. Journal of Marita l and Family Therapy 22, 87-101. Park, C., Cohen, L. & Murch, R. (1996) Assessment and prediction of stressrelated growth. Journal of Personality, 64 71-105. Peters, D. & Range, L. (1995). Childhood sexual abuse and current suicidality in college women and men. Child Abuse & Neglect 12, 201-208. Polusny, M. & Follette, V. (1995). Long-te rm correlates of childhood sexual abuse: theory and empirical findings. Applied and Preventive Psychology 4, 143-166. Prigerson, H.G., Maciejewski, P.K., & Rosenheck R.A. (1995). The effects of marital dissolution and marital quality on health and health service use among women. Medical Care 37, 858-873.

PAGE 114

105 Punamaki, R. & Kanninen, K. (2002). The role of psyc hological defences in moderating between trauma and post-tra umatic symptoms among Palestinian men. International Journal of Psychology 37, 286-296. Putnam, F. (2003). Ten year research update review: child sexual abuse. Journal of the American Academy of Child & Adolescent Psychiatry 42, 269-278. Putnam, F. & Trickett, P. (1997). The ps ychobiological effects of sexual abuse: a longitudinal study. Annals of the New York Academy of Science, 821, 150-159. Reed, G., Kemeny, M., Taylor, S., Wang, H ., & Visscher, B. ( 1994). Realistic acceptance as a predictor of decreased su rvival time in gay men with AIDS. Health Psychology 13, 299-307. 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. Runtz, M. & Schallow, J. (1997). Social s upport and coping strategies as mediators of adult adjustment following childhood maltreatment. Child Abuse & Neglect 24, 211-226. Sammallahti, P., Holi, M., Komulainen, E., & Aalberg, V. (1996). Comparing two selfreport measures of coping – the Sense of Coherence Scale and the Defense Style Questionnaire. Journal of Clinical Psychology 52, 525-533. Savell, J., Kinder, B., & Young, S. (2006). E ffects of administeri ng sexually explicit questionnaires on anger, anxiety, and depression in sexually abused and nonabused families: implications for risk assessment. Journal of Sex & Marital Therapy 32, 161-172.

PAGE 115

106 Saywitz, K., Mannarino, Berliner, L., & Cohen, J. (2000). Treatment for sexually abused children and adolescents. American Psychologist 55, 1040-1049. Scarinci, A., McDonald-Haile, J., Bradley, L ., & Richter, J. (1994). Altered pain perception and psychosocial features among women with gastrointestinal disorders and history of abus e: a preliminary model. American Journal of Medicine 97, 108-118. Schaaf, K. & McCanne, T. (1998). Relations hip of childhood sexual, physical, and combined sexual and physical abuse to adult victimization and posttraumatic stress disorder. Child Abuse & Neglect 22, 1119-1133. Segerstrom, S., Taylor, S., Keme ny, M., & Fahey, J. (1998). Optimism is associated with mood, coping, and immune change in response to stress. Journal of Personality and Social Psychology, 74, 1646-1655. Senchak, M. & Leonard, K. (1992). Attachment styles and marital adjustment among newlywed couples. Journal of Social and Personal Relationships 9, 51-64. Shapiro, J. & Kroeger, L. (1991). Is life just a romantic novel? The relationship between attitudes about intimate relations hips and the popular media. American Journal of Family Therapy 19, 226-236. Shilony, E. & Grossman, F. ( 1991). Depersonalization as a defense mechanism in survivors of trauma. Journal of Traumatic Stress 6, 119-128. Silver, R., Boon, C., & Stones, M. (1983). Searching for meaning in misfortune: making sense of incest. Journal of Social Issues 39, 81-102. Spaccarelli, S. (1994). Stress, a ppraisal, and coping in child sexual abuse: a theoretical and empirical review. Psychological Bulletin 116, 340-362.

PAGE 116

107 Spaccarelli, S. & Kim, S. (1995). Resilience criteria and factors associated with resilience in sexually abused girls. Child Abuse & Neglect 19, 1171-1182. Spanier, G.B. (1976). Measuring dyadic ad justment: new scales for assessing the quality of marriage and similar dyads. Journal of Marriage and theFamily 38, 15-28. Stafford, L. & Canary, D.J. (1991). Maintenance strategies and romantic relationship type, gender, and relational characteristics. Journal of Social and Personal Relationships 8, 217-242. Taylor, S. (1983). Adjustment to threateni ng events: a theory of cognitive adaptation. American Psychologist 38, 1161-1173. Taylor, S. (1989). Positive Illusions: Creative Se lf-Deception and the Healthy Mind New York: Basic Books. Taylor, S. & Armor, D. (1 996). Positive illusions an d coping with adversity. Journal of Personality 64, 873-898. Taylor, S., & Brown, J. (1988). Illusion and well-being: a social psychological perspective on mental health. Psychological Bulletin 103, 193-210. Taylor, S., Kemeny, M., Reed, G., & Aspinwall, L. (1991) Assault on the self: positive illusions and adjustment to threat ening events. In J. Strauss & G.R. Goethals (Eds.), The Self: Interdisciplinary Approaches New York: SpringerVerlag. Taylor, S., Kemeny, M., R eed, G., Bower, J., & Grue newald, T. (2000). Psychological resources, positiv e illusions, and health. American Psychologist 55, 99-109.

PAGE 117

108 Taylor, S., Lerner, J., Sherman, D., Sage, R., & McDowell, N. (2003). Are selfenhancing cognitions associated with h ealthy or unhealthy biological profiles? Journal of Personality and Social Psychology 85, 605-615. Taylor, S., Lichtman, R., & Wood J. (1984). Attributions, beliefs about control, and adjustment to breast cancer. Journal of Personality and Social Psychology 46, 489-502. Testa, M., Miller, B., Downs, W., & Panek, D. (1992). The moderating impact of social support following childhood sexual abuse. Violence & Victims 7, 173-186. Thomsen, D. & Gilbert, D. (1998). Factors ch aracterizing marital c onflict states and traits: physiological, affectiv e, behavioral, and neurotic variable contributions to marital conflict a nd satisfaction. Personality and Individual Differences 25, 833855. Trochim, W. (2005). Research Methods: the Concise Knowledge Base Cincinnati, Ohio: Atomic Dog Publishing. Ullman, S. (1997). Attributions, world assump tions, and recovery from sexual assault. Journal of Child Sexual Abuse 6, 1-19. Watson, D., Hubbard, B., & Wiese, D. (2000). General traits of personality and affectivity as predictors of satisfaction in intimate relationships: evidence from selfand partner-ratings. Journal of Personality 68, 413-449. Westerlund, E. (1992). Women’s Sexuality after Childhood Incest New York: W.W. Norton & Company. White, R. & Gilliland R. (1975). Elements of Psychopathology: the Mechanisms of Defense NY: Grune & Stratton, Inc.

PAGE 118

109 White, S. & Hatcher, C. (1984). Couple comple mentarity and similarity : a review of the literature. American Journal of Family Therapy 12, 15-25. Wind, T. & Silvern, L. (1994). Parenting and fa mily stress as mediators of the long-term effects of child abuse. Child Abuse & Neglect 18, 439-453. Wurr, C. & Partridge, I. (1996). The prevalen ce of a history of chil dhood sexual abuse in an acute adult inpa tient population. Child Abuse & Neglect 20, 867-872. Wyatt, G. (1985). The sexual abuse of Af ro-American and White-American women in childhood. Child Abuse & Neglect 9, 507-519. Wyatt, G. & Peters, S. (1986). Issues in the definition of child sexua l abuse in prevalence research. Child Abuse & Neglect 10, 231-240. Young, S., Harford, K., Kinder, B., & Savell J. (2007). The re lationship between childhood sexual abuse and ad ult mental health among undergraduates: victim gender doesn’t matter. Journal of Interpersonal Violence 22, 1315-1331. Zak, A., Collins, C., Harper, L., & Masher, M. (1998). Self-reported control over decision-making and its relationshi p to intimate relationships. Psychological Reports 82, 560-562.

PAGE 119

110 Appendices

PAGE 120

111 Appendix A Demographics 1. Are you currently in a romantic relationship with one and only one person? _____ YES _____NO 2. What is your marital status? _____ Married _____ Single (never been married) _____ Separated _____ Divorced 3. Please indicate the length of your relationshi p with your current partner. Check one. _____ less than 6 months _____ 6 – 12 months _____ 1 – 5 years _____ more than 5 years 4. Do you consider yourself to be in a long distance relationship? _____ YES _____ NO 5. What is your gender? _____ MALE _____ FEMALE 6. What is the gender of your partner ? _____ MALE _____ FEMALE 7. What is your age? ___________ 8. Which of the following best describ es your ethnic background? Check one. _____ African American/Black _____ Hispanic/Latino _____ Caucasian _____ Asian _____ Arab _____ Native American

PAGE 121

112 Appendix B ESE We would like to get an idea about the type of sexual experiences you may have had before the age of 16 (15 and younger). Please answer yes or no to the following questions in terms of that time. Before the age of 16 (15 and younger) No Yes 1. Did you ever touch the genitals of someone at least 5 years older than you? 0 1 2. Did someone at least 5 years older than you ever touch your genitals or breasts (besides for a physical ex amination)? 0 1 3. Did you engage in oral sex (cunnilingus and/or fellatio) with someone at least 5 years older than you? 0 1 4. Did you engage in vaginal intercourse with someone at least 5 years older than you? 0 1 5. Did you engage in anal intercourse with some one at least 5 years older than you? 0 1 6. Were you forced into genital manipulation that was unwanted by anyone of any age? 0 1 7. Were you forced into oral sex (cunnilingus and/or fellatio) that was unwanted by anyone of any age? 0 1 8. Were you forced into anal intercourse that was unwanted by anyone of any age? 0 1 9. Were you ever touched in a way that made you feel sexually violated? 0 1 10. Did you engage in any unwanted sexual activity while too intoxicated or 0 1 influenced by drugs to give consent? 11. If you answered yes to ANY of the first 10 questions, how old were you when you first had the experience (if there were multiple experiences, think of the one that occurred when you were youngest)? __________ (write your response here) 12. Have you ever received psychological treatment? 0 1 13. If yes, was sexual abuse one of the issues covered? 0 1 14. If you answered “yes” to ANY of the first 10 questi ons, please rate the extent to which your experience has had a negative impact on your life (0 being no negative impact at all, 5 being a moderate negative impact, and 10 being a severe negative impact; CIRCLE ONE) 0 1 2 3 4 5 6 7 8 9 10 15. If you answered “yes” to ANY of the first 10 ques tions, please rate the extent to which your experience has distressed you (0 being not distressed at a ll, 5 being moderately distressing, and 10 being severely distressing; CIRCLE ONE) 0 1 2 3 4 5 6 7 8 9 10

PAGE 122

113 Appendix C SRG For this questionnaire, please consider th e most stressful sexual experience you endorsed in the previous questionnaire (i f you did not endorse any of the sexual experiences in that questionnaires, then co nsider the most stressful experience you had before age 16) Read the following statements and respond to each item using the scale below: “0” (not at all), “1” (somewhat), or “2” (a great deal). Because of this stressful event: 1. I learned to be nicer to others. 0 1 2 2. I feel freer to make my own decisions. 0 1 2 3. I learned that I have someth ing of value to teach 0 1 2 others about life. 4. I learned to be myself and not try to be what 0 1 2 others want me to be. 5. I learned to work through problems and not just give up. 0 1 2 6. I learned to find more meaning in life. 0 1 2 7. I learned to how to reach out and help others. 0 1 2 8. I learned to be a more confident person. 0 1 2 9. I learned to listen more carefully when others talk to me. 0 1 2 10. I learned to be open to new information and ideas. 0 1 2 11. I learned to communicate more honestly with others. 0 1 2 12. I learned that I want to have some impact on the world. 0 1 2 13. I learned that it’s OK to ask others for help. 0 1 2 14. I learned to stand up for my personal rights. 0 1 2 15. I learned that there are more people who care about me 0 1 2 than I thought.

PAGE 123

114 Appendix D DSQ-40 This questionnaire consists of a number of statements about personal attitudes. There are no right or wrong answers Using the 9-point scale show n below, please indicate how much you agree or disagree with each statement by circling one of the numbers on the scale beside the statement. For example, a score of 5 would indicate that you neither agree nor disagree with th e statement, a score of 3 that you moderately disagree, a score of 9 that you strongly agree. 1 2 3 4 5 6 7 8 9 Strongly Strongly disagree agree 1. I get satisfaction from helping others a nd if this were taken away from me I would get depressed. 1 2 3 4 5 6 7 8 9 2. I’m able to keep a problem out of my mind until I have time to deal with it. 1 2 3 4 5 6 7 8 9 3. I work out my anxiety through doing some thing constructive and creative like painting or woodwork. 1 2 3 4 5 6 7 8 9 4. I am able to find good reasons for everything I do. 1 2 3 4 5 6 7 8 9 5. I’m able to laugh at myself pretty easily. 1 2 3 4 5 6 7 8 9 6. People tend to mistreat me. 1 2 3 4 5 6 7 8 9 7. If someone mugged me and stole my money, I’d rath er he be helped than punished. 1 2 3 4 5 6 7 8 9 8. People say I tend to ignore unpl easant facts as if they didn’t exist. 1 2 3 4 5 6 7 8 9 9. I ignore danger as if I was Superman. 1 2 3 4 5 6 7 8 9 10. I pride myself on my ability to cut people down to size. 1 2 3 4 5 6 7 8 9

PAGE 124

115 Appendix D: (Continued) 11. I often act impulsively when something is bothering me. 1 2 3 4 5 6 7 8 9 12. I get physically ill when thi ngs aren’t going well for me. 1 2 3 4 5 6 7 8 9 13. I’m a very inhibited person. 1 2 3 4 5 6 7 8 9 14. I get more satisfaction from my fant asies than from my real life. 1 2 3 4 5 6 7 8 9 15. I’ve special talents that allow me to go through life with no problems. 1 2 3 4 5 6 7 8 9 16. There are always good reasons when things don’t work out for me. 1 2 3 4 5 6 7 8 9 17. I work more things out in my daydreams than in my real life. 1 2 3 4 5 6 7 8 9 18. I fear nothing. 1 2 3 4 5 6 7 8 9 19. Sometimes I think I’m an angel and other times I think I’m a devil. 1 2 3 4 5 6 7 8 9 20. I get openly aggressive when I feel hurt. 1 2 3 4 5 6 7 8 9 21. I always feel that someone I know is like a guardian angel. 1 2 3 4 5 6 7 8 9 22. As far as I’m concerned, peopl e are either good or bad. 1 2 3 4 5 6 7 8 9 23. If my boss bugged me, I might make a mist ake in my work or work more slowly so as to get back at him. 1 2 3 4 5 6 7 8 9 24. There is someone I know who can do anything and who is absolute ly fair and just. 1 2 3 4 5 6 7 8 9

PAGE 125

116 Appendix D: (Continued) 25. I can keep the lid on my feelings if letting them out would interfere with what I’m doing. 1 2 3 4 5 6 7 8 9 26. I’m usually able to see the funny side of an otherwise painful predicament. 1 2 3 4 5 6 7 8 9 27. I get a headache when I have to do something I don’t like. 1 2 3 4 5 6 7 8 9 28. I often find myself being very nice to people who by all rights I should be angry at. 1 2 3 4 5 6 7 8 9 29. I am sure I get a raw deal from life. 1 2 3 4 5 6 7 8 9 30. When I have to face a difficult situation I try to imagine what it will be like and plan ways to cope with it. 1 2 3 4 5 6 7 8 9 31. Doctors never really understa nd what is wrong with me. 1 2 3 4 5 6 7 8 9 32. After I fight for my rights, I tend to apologize for my assertiveness. 1 2 3 4 5 6 7 8 9 33. When I’m depressed or anxious eating makes me feel better. 1 2 3 4 5 6 7 8 9 34. I’m often told that I don’t show my feelings. 1 2 3 4 5 6 7 8 9 35. If I can predict that I’m going to be sad ahead of time, I can cope better. 1 2 3 4 5 6 7 8 9 36. No matter how much I complain, I never get a satisfactory response. 1 2 3 4 5 6 7 8 9 37. Often I find that I don’t feel anything when the situation would seem to warrant strong emotions. 1 2 3 4 5 6 7 8 9

PAGE 126

117 Appendix D: (Continued) 38. Sticking to the task at hand keeps me from feeling depressed or anxious. 1 2 3 4 5 6 7 8 9 39. If I were in a crisis, I would seek ou t another person who had the same problem. 1 2 3 4 5 6 7 8 9 40. If I have an aggressive thought I feel th e need to do something to compensate for it. 1 2 3 4 5 6 7 8 9 PLEASE CHECK TO SEE THAT Y OU HAVE ANSWERED ALL THE QUESTIONS.

PAGE 127

118 Appendix E DAS Most persons have disagreements in their rela tionships. Please indicate below the appropriate extent of agreement or disagreement between you and your partner for each item on the following list. 5 = Always agree 4 = Frequently agree 3 = Sometimes disagree 2 = Frequently disagree 1 = Always disagree ____ 1. Matters of recreation ____ 2. Religious matters ____ 3. Demonstration of affection ____ 4. Friends ____ 5. Sex relations ____ 6. Conventionality (co rrect or proper behavior) ____ 7. Philosophy of life ____ 8. Aims, goals, and th ings believed important ____ 9. Amount of time spent together ____ 10. Making major decision ____ 11. Leisure time interests Please indicate below approximately how often the following items occur between you and your partner. 1 = All the time 2 = Most of the time 3 = Sometimes 4 = Rarely 5 = Never ____ 12. How often do you discuss or cons idered terminating the relationship? ____ 13. In general, how often do you thin k things between you and your partner are going well? ____ 14. Do you confide in your mate? ____ 15. Do you ever regret entering this relationship? ____ 16. How often do you and your partner quarrel? ____ 17. How often do you and your mate “get on each other’s nerves”? 18. Do you kiss your mate? Every day Almost every day Occasionally Rarely Never 5 4 3 2 1

PAGE 128

119 Appendix E: (Continued) 19. Do you and your mate engage in outside interests together? All of them Most of them Some of them Very few of them None of them 5 4 3 2 1 How often would you say the following events occur between you and your mate? 1 = Never 2 = Less than once a month 3 = Once or twice a month 4 = Once a day 5 = More often ____ 20. Have a stimulating exchange of ideas ____ 21. Laugh together ____ 22. Calmly discuss something ____ 23. Work together on a project There are some things about which couples some times agree and sometim es disagree. Indicate the degree to which each item below caused di fferences of opinions or problems in your relationship during the past few weeks. 1 = Never 2 = Rarely 3 = Sometimes 4 = Frequently 5 = All the time ____ 24. Being too tired for sex ____ 25. Not showing love 26. These numbers represent different degrees of happiness in your relationship. “Happy” represents the degree of happiness of most re lationships. Please circle the number that best describes the degree of happiness, all things considered, of your relationship. 1 = Extremely unhappy 2 = Somewhat unhappy 3 = Slightly unhappy 4 = Happy 5 = Very happy

PAGE 129

120 Appendix E: (Continued) 27. Please circle the number of one of the following statements that best describes how you feel about the future of your relationship. 5 I want very much for my relationship to su cceed, and will do all that I can to see that it does 4 I want very much for my relationship to succeed, and will do my fair share to see that it does. 3 It would be nice if my relationship succeeded, but I can’t do much more than I am doing now to make it succeed. 2 It would be nice if it succeeded, but I refuse to do anymore than I am doing now to keep the relationship going. 1 My relationship can never succeed, and there is no more that I can do to keep the relationship going.

PAGE 130

About the Author Angela Fairweather was born and raised in the country of Belize. She received a Fulbright merit scholarship in 1995 to co mplete her undergraduate education and received her B.A in Liberal Arts and Sciences from the University of Kansas in 1997. In 2001, she received a graduate scholarship from the Organization of American States (OAS) and earned an M.A. in Psychology from the University of Dayton in 2002. Dr. Fairweather entered the Clinical Psychology P h.D. program at the University of South Florida in 2004 and completed he r predoctoral internship at th e University of Medicine & Dentistry of New Jersey in 2008. Dr. Fairweather’s primary research interests are in the relation between romantic relationship functioning and health and in psycho logical factors related to medical illness. She has co-authored two publications and has presented her research at national conferences. Her primary clinical interest s are in behavioral medicine, trauma, and addiction.