Elsevier

Child Abuse & Neglect

Volume 30, Issue 2, February 2006, Pages 127-143
Child Abuse & Neglect

Risk factors and protective factors in relation to subjective health among adult female victims of child sexual abuse

https://doi.org/10.1016/j.chiabu.2005.08.014Get rights and content

Abstract

Objective

To investigate the relationships between risk and protective factors and health outcome in a sample of adult females who had been victims of child sexual abuse.

Method

Both person- and variable-oriented analyses were applied to questionnaire data from a non-clinical group of women (n = 152) reporting sexual abuse during childhood.

Results

Six groups with different patterns of risk and protective factors were found by cluster analysis. Two groups (Good Coping and Support Compensation) had significantly better health than expected in spite of severe abuse. Self-esteem and social support were strong predictors of health in the regression models.

Conclusion

The relationships between risk and protective factors and health may be different in different groups of victims of child sexual abuse. Self-esteem was closely related to health outcome displaying the importance of this concept in clinical practice. Availability of resources seems to be more important for health outcomes than the amount of risk factors.

Résumé

Objectif

Etudier les rapports entre facteurs de risque et facteurs protecteurs sur la perception de leur état de santé dans un groupe de femmes adultes qui ont été victimes d’agression sexuelle dans leur enfance.

Méthode

Des analyses à la fois générales et personnelles ont été appliquées à des réponses de questionnaires provenant d’un groupe de femmes (n = 152) ayant signalé des agressions sexuelles dans l’enfance.

Resultats

Six groupes avec des modèles différents de facteurs de risque et de facteurs protecteurs ont été trouvés par analyse de l’ensemble. Deux groupes (Bonne adaptabilité et soutien de bonne qualité) avaient de façon significative un meilleur état de santé que celui qu’on aurait pu attendre, malgré une maltraitance grave. Bonne estime de soi et soutien ont été des facteurs prédictifs de bonne santé sur les modèles de régression.

Conclusion

Les rapports entre facteurs de risque, facteurs protecteurs et l’état de santé peuvent être différents selon les groupes de victimes d’agression sexuelle infantile. L’estime de soi est fortement corrélée à une évolution vers un état de bonne santé, montrant ainsi l’importance de ce concept en pratique clinique. La disponibilité de possibilités de soutien semble plus importante pour l’évolution de l’état de santé que le niveau des facteurs de risque.

Resumen

Objetivo

Investigar las relaciones entre los factores de riesgo y los de protección y el resultado de salud en una muestra de mujeres adultas que habían sido víctima de abuso sexual en la niñez.

Método

Se le aplicó un análisis orientado a personas y variables, a los datos de un cuestionario completado por mujeres no-clínicas (n = 152) que reportaron abuso sexual durante su niñez.

Resultados

Se encontraron seis grupos con diferentes patrones en los factores de riesgo y los de protección a través de un análisis de grupos. Dos de los grupos (Buena recuperación y Compensación de apoyo) presentaron significativamente mejor salud que lo esperado a pesar del abuso severo. La autoestima y el apoyo social fueron fuertes predictores de salud en los modelos de regresión.

Conclusión

Las relaciones entre los factores de riesgo y los de protección y la salud pueden ser diferente en diferentes grupos de víctimas de abuso sexual en la niñez. La autoestima estuvo muy relacionada con los resultados de salud demostrando la importancia de este concepto en la práctica clínica. La disponibilidad de recursos parece ser más importante para los resultados de salud que el número de factores de riesgo.

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.

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