Attachment and object relations: Mediators between child sexual abuse and women's adjustment.

摘要

This study investigated the nature of the relationship among child sexual abuse, interpersonal relationship capacity and psychological adjustment. Interpersonal relationship capacity included the constructs of attachment, measured by the Relationship Questionnaire, and object relations functioning, measured by the Bell Object Relations and Reality Testing Inventory. Psychological adjustment included the constructs of trauma-related symptoms, measured by the Trauma Symptom Inventory and supplemented by the Posttraumatic Sum Diagnostic Scale, and interpersonal problems, measured by the Inventory of Interpersonal Problems. Participants were 118 women from a clinical and community sample, including 58 women who reported a history of child sexual abuse and 60 women who reported no such history. Thirty-three women reported a history of intrafamilial child sexual abuse or both intrafamilial and extrafamilial child sexual abuse and 26 women reported a history of extrafamilial child sexual abuse only.;The pattern of results indicated that child sexual abuse predicted both interpersonal relationship capacity and psychological adjustment and that interpersonal relationship capacity predicted psychological adjustment. In addition, a mediational model in which interpersonal relationship capacity mediates the relationship between child sexual abuse and psychological adjustment was supported. This suggests that relationship capacity may be a process through which the impact of child sexual abuse influences later psychological adjustment. No differences were found between women who had experienced intrafamilial child sexual abuse and women who had experienced extrafamilial child sexual abuse. When the separate components of each construct in the model were considered, attachment mediated the relationship between child sexual abuse and trauma-related symptoms and also mediated the relationship between child sexual abuse and interpersonal problems. Object relations functioning mediated the relationship between child sexual abuse and trauma-related symptoms, but did not mediate the relationship between child sexual abuse and interpersonal problems. Again, no differences were found between women who had experienced intrafamilial child sexual abuse and women who had experienced extrafamilial child sexual abuse. Results are discussed in terms of the implications for appropriate therapy approaches with survivors of child sexual abuse.