Risk factors and protective factors in relation to subjective health among adult female victims of child sexual abuse☆
Section snippets
Participants
Participants were recruited by advertisements in a membership magazine published by a national organization for sexually abused women (providing activities for support and healing), as well as in-staff magazines for municipal employees in the Stockholm area. A total of 175 women responded to our invitation, 145 from the organization, and 30 municipal employees. Four women did not meet the inclusion criteria (sexually abused by someone close before the age of 18), and 19 women later chose not to
Person-oriented approach
Methods for grouping individuals. Cluster analysis was used to group the individuals by identifying different patterns of risk factors (sexual abuse, physical abuse, and negative life events) and protective factors (social support, self-esteem, and coping). The aim of this statistical method is to find groups where individuals within each cluster are more closely related to one another than objects assigned to different clusters. Similarity between subjects is frequently measured by the squared
Results
The residue procedure resulted in the exclusion of 13 outliers. The six-cluster solution was chosen because it presented clear and interpretable patterns, although the explained variance by the classification was only moderate, 46%. Table 1 presents the mean scores and standard deviations for the six clusters on the three risk and three protective factors used in the classification analysis. The clusters were characterized according to the scoring on risk factors and protective factors:
Discussion
The main finding in this study is that even in a sample of women reporting severe child sexual abuse, individuals with a positive outcome can still be found. Results from both the person-oriented and the variable-oriented methods indicate that it is the presence of resources – especially social support – that seems to be more important for health than the quantity of risk factors. Self-esteem was closely related to health outcome displaying the importance of this concept in clinical practice.
Conclusions
This study is one of the first to apply cluster analyses on a sample of adult child sexual abuse victims. The person-oriented approach proved to be a good method to show that the relationship between self-esteem, social support and health may be different in different subgroups of survivors. Resources seem to be more important for health outcome than the amount of risk factors, a conclusion drawn from considering the results of both statistical methods. Prospective studies on the concept of
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The authors would like to acknowledge the Crime Victim Fund, Queen Silvia's Jubilee Foundation, Clas Groschinsky's Foundation, and Herbert & Karin Jacobsson's Foundation for their financial support to the project.