Original article
Pathway From Child Sexual and Physical Abuse to Risky Sex Among Emerging Adults: The Role of Trauma-Related Intrusions and Alcohol Problems

https://doi.org/10.1016/j.jadohealth.2013.09.020Get rights and content

Abstract

Purpose

Some evidence suggests that risk reduction programming for sexual risk behaviors (SRB) has been minimally effective, which emphasized the need for research on etiological and mechanistic factors that can be addressed in prevention and intervention programming. Childhood sexual and physical abuse have been linked with SRB among older adolescents and emerging adults; however, pathways to SRB remain unclear. This study adds to the literature by testing a model specifying that traumatic intrusions after early abuse may increase risk for alcohol problems, which in turn may increase the likelihood of engaging in various types of SRB.

Methods

Participants were 1,169 racially diverse college students (72.9% female, 37.6% black/African-American, and 33.6% white) who completed anonymous questionnaires assessing child abuse, traumatic intrusions, alcohol problems, and sexual risk behavior.

Results

The hypothesized path model specifying that traumatic intrusions and alcohol problems account for associations between child abuse and several aspects of SRB was a good fit for the data; however, for men, stronger associations emerged between physical abuse and traumatic intrusions and between traumatic intrusions and alcohol problems, whereas for women, alcohol problems were more strongly associated with intent to engage in risky sex.

Conclusions

Findings highlight the role of traumatic intrusions and alcohol problems in explaining paths from childhood abuse to SRB in emerging adulthood, and suggest that risk reduction programs may benefit from an integrated focus on traumatic intrusions, alcohol problems, and SRB for individuals with abuse experiences.

Section snippets

Participants

Participants were 1,169 racially diverse college students (72.9% female) at a large, public, urban Southeastern university where most of the student body (64%) is ethnic minority. More than 90% of students receive some financial aid and more than 50% receive needs-based grants or scholarships. The average age was 20.7 (standard deviation, 4.65). Of the sample, 37.6% (n = 439) were black/African-American, 33.6% (n = 393) were white, and 14.5% (n = 169) were Asian/Asian-American.

Childhood Trauma Questionnaire

The Childhood

Results

Table 1 presents descriptive information overall and by gender. Skewness for the SRB variables ranged from 1.1 to 3.8; a base-10 log transformation was applied to the four subscales with skewness between 1.1 and 2.9; an inverse transformation was applied to the fifth subscale, which had a skewness value of 3.8. Approximately 32% (n = 374) of participants screened positive for CSA and 41.5% (n = 483) screened positive for physical abuse. The sexual abuse item “Someone tried to touch me in a

Discussion

The current study is the first, of which the authors are aware, to test a path model specifying that traumatic intrusions and alcohol problems help to explain relationships between child physical and sexual abuse and various forms of SRB in a sample of male and female college students. Unique aspects of this study included a racially diverse sample of male and female college students and assessment of sexual and physical abuse experiences, as well as a variety of SRB in relation to both

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    Disclaimer: The findings and conclusions of this manuscript are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

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