Elsevier

Child Abuse & Neglect

Volume 28, Issue 4, April 2004, Pages 393-410
Child Abuse & Neglect

Childhood and adult sexual abuse, rumination on sadness, and dysphoria

https://doi.org/10.1016/j.chiabu.2003.05.004Get rights and content

Abstract

Objective: The study addressed the hypothesis that adults reporting sexual abuse are more likely to exhibit a general tendency to ruminate on sadness. The relations between reported abuse, rumination on sadness, and dysphoria were also examined.

Method: Undergraduate students (101 women and 100 men) reported on childhood and adult sexual abuse and instances of intimidation, as well as completing the Rumination on Sadness Scale [Journal of Personality Assessment 75 (2000) 404] and the Beck Depression Inventory [Depression: Clinical, Experimental, and Theoretical Aspects, Harper & Row, New York].

Results: Participants who reported more abuse were more likely to report rumination on sadness. Both reports of abuse and of rumination were linked to dysphoria. Overall, causal modeling indicated that two models were equally effective in accounting for the data: (a) victimization leads to dysphoria, with this relation being partly mediated by rumination and (b) victimization leads to dysphoria, which in turn leads to rumination. Both models are consistent with prior research. For men considered separately, both models were equally effective. For women, model a best accounted for the data.

Conclusion: One of the pathways by which victimization may lead to depression in adulthood is by encouraging the development of a tendency to ruminate on sadness. Alternatively, victimization may lead to depression by other means, and the experienced depression or dysphoria may foster rumination.

Résumé

Objectif: Cette étude concerne l’hypothèse que les adultes qui font état d’abus sexuels ont le plus tendance à présenter une tendance aux ruminations mélancoliques. Les relations entre l’abus rapporté, la rumination mélancolique et la dysphorie ont aussi été examinées.

Méthode: Des étudiants (101 femmes et 100 hommes) on témoigné d’abus sexuels subis dans l’enfance et à l’âge adulte et donné des exemples de menaces. Ils ont également rempli l’échelle “Rumination on Sadness” [Journal of Personality Assessment 75 (2000) 404] et le Beck Depression Inventory [Depression: Clinical, Experimental, and Theoretical Aspects, Harper & Row, New York].

Résultats: Les participants qui ont rapporté le plus d’abus ont aussi rapporté plus de rumination mélancolique. Rapporter abus et rumination étaient liés à la dysphorie. Dans l’ensemble la modélisation pour trouver la cause a montré que deux modèles étaient également efficaces pour rendre compte des données: (a) la victimisation conduit à la dysphorie, relation partiellement médiatisée par la rumination et (b) la victimisation conduit à la dysphorie, qui à son tour mène à la rumination. Les deux modèles sont compatibles avec la recherche antérieure. Si l’on considère les hommes séparément, les deux modèles sont d’une efficacité égale. Pour les femmes, le modèle a rend le mieux compte des données.

Conclusions: L’une des voies par lesquelles la victimisation peut conduire à la dépression à l’âge adulte vient de ce que la tendance à la rumination mélancolique se trouve encouragée. La victimisation peut conduire à la dépression par d’autres moyens et l’expérience de la dépression et de la dysphorie peut nourrir la rumination.

Resumen

Spanish language abstract not available at time of publication.

Introduction

Having been subjected to sexual abuse in childhood or adulthood is likely to lead adults to experience chronic or recurrent bouts of depression (Andrews, 1995; Andrews, Valentine, & Valentine, 1995; Atkeson, Calhoun, Resick, & Ellis, 1982; Beitchman et al., 1992; Bifulco, Brown, & Adler, 1991; Browne & Finkelhor, 1986; Koss, Dinero, Seibel, & Cox, 1988; Nadelson, Notman, Zackson, & Gornick, 1982; Polusny & Follette, 1995). Victims of sexual abuse may also be prone to ruminate on the abuse itself, and such on-going rumination has been associated with more severe long-term distress (Holman & Silver, 1996). Rumination on being sexually abused can be considered a particular instance of the rumination that may occur as a consequence of traumatic experience (Horowitz, 1976; Tait & Silver, 1989).

The present research addressed another type of rumination, that being a general tendency to ruminate on sadness regardless of the particular factors that initiate the sadness. The hypothesis was that adults who report having been sexually abused are generally more likely to ruminate on their feelings of sadness. The rumination would concern their current situation and distress, be of negative content, and would not necessarily relate to earlier abuse. It would include thoughts regarding the antecedents, nature, and consequences of one’s current negative affect. Rumination is not goal-directed and does not lead to plans for remedial action (cf Nolen-Hoeksema, 1991). Rumination is also a solitary activity, and is intrusive if the person is pursuing either self- or situationally-imposed task-oriented goals.

Having been sexually abused may lead to a general tendency to ruminate on sadness for a number of reasons. First, victims of sexual abuse may have less trust and be more withdrawn from others, and may have more problematic interpersonal relationships (Browne & Finkelhor, 1986). Consequently, they may be less likely to turn to others for support, which could foster rumination (cf Bodnar & Kiecolt-Glaser, 1994; Nolen-Hoeksema, Parker, & Larson, 1994; Pennebaker & O’Heeron, 1984). Second, abused individuals may feel powerless (Peterson & Seligman, 1983), discouraging externally-oriented problem solving behavior. Third, abused individuals may generally blame their negative outcomes on their own internal, stable characteristics (Andrews, 1998, Gold, 1986; see Briere & Runtz, 1993, for a review), which may foster rumination (Atlas & Peterson, 1990). Fourth, abused individuals often suffer low self-esteem (Browne & Finkelhor, 1986). As a result, they may overgeneralize the consequences of negative outcomes (Kernis, 1993; Kernis, Brockner, & Frankel, 1989).

Rumination on sadness is significant, in that it may lead sad people to become more dysphoric or depressed (Lyubomirsky & Nolen-Hoeksema, 1993; Morrow & Nolen-Hoeksema, 1990; Nolen-Hoeksema, McBride, & Larson, 1997; Nolen-Hoeksema & Morrow, 1993; Nolen-Hoeksema, Morrow, & Fredrickson, 1993; also see Just & Alloy, 1997). Other research also suggests that rumination leads to dysphoria: Rumination on sadness mediates the effects of neuroticism on dysphoria (Nolan, Roberts, & Gotlib, 1998; Roberts, Gilboa, & Gotlib, 1998). In addition to rumination leading to dysphoria, the reverse causal link may exist. Being dysphoric or depressed may lead individuals to ruminate on their sadness. Depressed individuals report more negative self-referent thoughts (e.g., “I’m a failure” and “I hate myself”; see Hollon & Kendall, 1980), and this correlation between dysphoria and such negative thoughts may be due to dysphoria leading to negative thoughts, or just as well due to negative self-referent thoughts leading to dysphoria (Kwon & Oei, 1992; also see Stiles & Götestam, 1989). Note that measures of automatic negative thoughts and of rumination overlap.

Although the present focus was on sexual abuse, other forms of victimization were also considered as abuse victims often suffer other victimization, such as neglect or maltreatment in the family, violent crimes, and subsequent abusive relationships (Bifulco et al., 1991; Browne & Finkelhor, 1986; Ellis, Atkeson, & Calhoun, 1982; Gidycz, Coble, Latham, & Layman, 1993; Gold, 1986). Some of these other types of victimization may also foster rumination. In the present research, intimidation and humiliation by others as a consequence of one’s gender, sexual orientation, ethnic identity, language spoken (language is a major social concern in Québec), or religion were addressed. Intimidation by others would be another form of victimization suffered by sexual abuse victims, and could occur in the context of abusive intimate relationships, or in other, more transient, social contexts. The expectation in the present research was that people reporting more sexual abuse would also report more intimidation. Being intimidated by others implies powerlessness and may encourage a feeling of stigmatization, both of which may encourage rumination.

In the present research, male and female undergraduate students completed questionnaires in which they reported on their history of sexual abuse in childhood and adulthood, and on experiences of intimidation. They also completed a measure of the degree to which they ruminate when feeling sad (regardless of the particular instigators of this sadness), and the Beck Depression Inventory (Beck, 1967). As noted above, the first hypothesis was that greater reports of experienced abuse are associated with a greater current tendency to ruminate on sadness. Other findings were expected to emerge, in light of prior research: (a) people who report more rumination were also expected to report more severe dysphoria on the BDI; (b) people who report more sexual abuse will also report feeling more depressed; and (c) women will report more sexual abuse, more rumination, and more depression than men. The frequency of sexual abuse is estimated to be twice as high for girls than boys (Cutler & Nolen-Hoeksema, 1991; Dhaliwal, Gauzas, Antonowicz, & Ross, 1996), and is substantially higher for women than men (Browne & Finkelhor, 1986).

To elucidate the relations between victimization, rumination, and dysphoria, structural equation modeling was applied to the present data. A starting assumption, addressed in the modeling, was that the sexual abuse and intimidation measures could be taken to reflect an underlying victimization construct. For victimization, rumination, and dysphoria, two models were considered. One is Model A: Victimization leads to rumination, which in turn leads to dysphoria. See the ellipses connected by arrows in Figure 1. As well, there would be a direct influence of victimization on dysphoria. The other possibility, referred to as Model B, is that victimization leads to dysphoria, which in turn leads to rumination (see Figure 2).

In addition, structural equation modeling was applied to the data for women and men separately. Different causal models may apply to women and men, as there are a number of relevant gender differences. Women are generally more expressive of their sadness than men (e.g., Conway, Giannopoulos, & Stiefenhofer, 1990), and it has been argued that women are generally more prone to ruminate on sadness (Nolen-Hoeksema, 2001). Whether there are gender differences in reactions to sexual abuse is unclear, however. Kendall-Tackett, Meyer Williams, and Finkelhor (1993) noted in their review that “consistent differences in the reaction of boys and girls to molestation have been found in only a few studies” (p. 170; also see Beitchman et al., 1992, for related points). In their controversial review of research on the effects of sexual abuse with college student samples, Rind, Tromovitch, and Bauserman (1998) concluded that “men reacted much less negatively than women” (p. 22). Yet this difference may be due to women suffering more close family abuse and greater use of force in the reviewed studies (p. 43; for critiques of this review and a rebuttal, see Dallam et al., 2001; Ondersma, Chaffin, Berliner, Cordon, & Goodman, 2001; Rind, Tromovitch, & Bauserman, 2001). Some recent findings suggest that male relative to female victims suffer more depression (Gold, Lucenko, Elhai, Swingle, & Sellers, 1999; Schraedley, Gotlib, & Hayward, 1999).

Section snippets

Participants

Participants were a subset of undergraduate students who approached a booth on the campus of Concordia University. The sign read as follows: “Volunteers Needed; Psychology project; Dr. Conway.” The only other information on the sign was the dollar amount of different prizes to be won in a lottery “for completing questionnaires.” Students who approached the booth completed a packet of questionnaires (unrelated to the present research); the packet began with a consent form and included the short

Results

Means for the raw sum scores for each childhood sexual abuse factor are reported in Table 1, as are the means for the raw sum scores for each adult sexual abuse factor. Scores are reported separately for women and men. Prevalence rates are also reported in Table 1. For example, 43.6% of women reported being touched as children, and 30.2% reported forced attempts when they were adults. Prevalence rates were lower for men, but still quite high. Regarding intimidation, female and male

Discussion

As expected, participants in the present study who reported more childhood and adult sexual abuse also obtained higher scores on the Rumination on Sadness Scale. As such, they are more likely to engage in rumination when feeling sadness, regardless of the particular instigator of these feelings. This rumination does not concern the prior sexual abuse. It was also found, as in much prior research, that reports of abuse were associated with dysphoria, as reflected in higher scores on the Beck

References (72)

  • B.M. Atkeson et al.

    Victims of rape: Repeated assessment of depressive symptoms

    Journal of Consulting and Clinical Psychology

    (1982)
  • Beck, A. T. (1967). Depression: Clinical, experimental, and theoretical aspects. New York: Harper &...
  • A.T. Beck et al.

    Screening depressed patients in family practice: A rapid technique

    Postgraduate Medicine

    (1972)
  • A.T. Beck et al.

    An inventory for measuring depression

    Archives of General Psychiatry

    (1961)
  • A. Bifulco et al.

    Early sexual abuse and clinical depression in adult life

    British Journal of Psychiatry

    (1991)
  • C.J. Bodnar et al.

    Caregiver depression after bereavement: Chronic stress isn’t over when it’s over

    Journal of Psychology and Aging

    (1994)
  • M. Braver et al.

    Childhood abuse and current psychological functioning in a university counseling center population

    Journal of Counseling Psychology

    (1992)
  • C.R. Brewin et al.

    Psychopathology and early experience: A reappraisal of retrospective reports

    Psychological Bulletin

    (1993)
  • Briere, J. N. (1992). Child abuse trauma: Theory and treatment of the lasting effects. Newbury Park, CA:...
  • J.N. Briere et al.

    Childhood sexual abuse: Long-term sequelae and implications for psychological assessment

    Journal of Interpersonal Violence

    (1993)
  • A. Browne et al.

    Impact of child sexual abuse: A review of the research

    Psychological Bulletin

    (1986)
  • M. Conway et al.

    On assessing individual differences in rumination on sadness

    Journal of Personality Assessment

    (2000)
  • M. Conway et al.

    Response styles to sadness are related to sex and sex-role orientation

    Sex Roles

    (1990)
  • S.E. Cutler et al.

    Accounting for sex differences in depression through female victimization: Childhood sexual abuse

    Sex Roles

    (1991)
  • S.J. Dallam et al.

    The effects of child sexual abuse: Comment on Rind, Tromovitch, and Bauserman (1998)

    Psychological Bulletin

    (2001)
  • K.S. Dobson et al.

    Cognitive assessment of depression: Reliability and validity of three measures

    Journal of Abnormal Psychology

    (1983)
  • E.M. Ellis et al.

    An examination of differences between multiple- and single-incident victims of sexual assault

    Journal of Abnormal Psychology

    (1982)
  • D. Finkelhor et al.

    The traumatic impact of child sexual abuse: A conceptualization

    American Journal of Orthopsychiatry

    (1985)
  • D. Gallagher et al.

    Reliability of the BDI with older adults

    Journal of Consulting and Clinical Psychology

    (1982)
  • C.A. Gidycz et al.

    Sexual assault experience in adulthood and prior victimization experiences: A prospective analysis

    Psychology of Women Quarterly

    (1993)
  • E.R. Gold

    Long-term effects of sexual victimization in childhood: An attributional approach

    Journal of Consulting and Clinical Psychology

    (1986)
  • S.D. Hollon et al.

    Cognitive self-statements in depression: Development of an automatic thoughts questionnaire

    Cognitive Therapy and Research

    (1980)
  • E.A. Holman et al.

    Is it abuse or the aftermath? A stress and coping approach to understanding responses to incest

    Journal of Social and Clinical Psychology

    (1996)
  • Horowitz, M. J. (1976). Stress response syndromes (2nd ed.). New York: Jason...
  • Hoyle, R. H. (1995). The structural equation modeling approach: Basic concepts and fundamental issues. In R. H. Hoyle...
  • J.L. Jackson et al.

    Young adult women who report childhood intrafamilial sexual abuse: Subsequent adjustment

    Archives of Sexual Behavior

    (1990)
  • Cited by (66)

    • Association between childhood adversities and psychopathology onset throughout the lifespan: Findings from a large metropolitan population

      2021, Journal of Psychiatric Research
      Citation Excerpt :

      Interestingly, sexual abuse was only associated with the onset of psychopathology in adulthood, while physical abuse was related to psychopotalogy in childhood and adolescence. One could speculate that such a specific profile may be related to the fact that, since sexual abuse is less reported (and also detected) than physical abuse, it is more likely that individuals who suffered that sort of experience ruminate it for long times (Conway et al., 2004). These specificities seem to be different among different cultures, and while in some countries, as the USA (Green et al., 2010a), almost all ECA are associated with psychiatric disorders in all stages of life, in others, as Japan and Nigeria (Fujiwara et al., 2011; Oladeji et al., 2010), there is almost no association between specific ECA with the onset of mental disorder during some (or even in most) stages of life.

    • Potential mediators of the association between childhood maltreatment and obsessive-compulsive disorder in adulthood

      2020, Journal of Obsessive-Compulsive and Related Disorders
      Citation Excerpt :

      Further, we examined rumination as one particular maladaptive emotion regulation strategy. Earlier research has already suggested that rumination may be an important mediator between CM and later psychopathology (Barnhofer et al., 2006; Conway et al., 2004; Raes & Hermans, 2008; Spasojević & Alloy, 2002). For the first time, our present data show that this could also be the case for OCD, although rumination is not a key symptom of OCD but a more general maladaptive cognitive processing style leading to the maintenance of OCD symptoms (Wahl et al., 2019).

    View all citing articles on Scopus

    The present research was supported by a research grant from the Social Sciences and Humanities Research Council of Canada (SSHRC), and by a grant from the Fonds pour la Formation des Chercheurs et l’Aide à la Recherche (FCAR) of Québec.

    View full text