Personality constellations in patients with a history of childhood sexual abuse

Although childhood sexual abuse (CSA) appears to have an impact on personality, it does not affect all survivors the same way. The goal of this study was to identify common personality patterns in women with a history of CSA. A national sample of randomly selected psychologists and psychiatrists described 74 adult female patients with a history of CSA and a comparison group of 74 without CSA using the Shedler–Westen Assessment Procedure-200 (SWAP-200), a Q-sort procedure for assessing personality pathology. Q-factor analysis identified four personality constellations among abuse sur-vivors: Internalizing Dysregulated, High Functioning Internalizing, Externalizing Dysregulated, and Dependent. The four groups differed on diagnostic, adaptive functioning, and developmental history variables, providing initial support for the validity of this classification. The data have potential methodological and treatment implications. A history of childhood sexual abuse (CSA) may have a far-ranging psychological impact and is associ-ated with a number of psychological difficulties in adult-hood, including depressed mood, lowered self-esteem, difficulties with anger, anxiety, dissociation, somatic disorders, suicidal and self-harming behaviors, disor-dered eating, sexual dysfunction, and problems in so-cial functioning (Browne & Finkelhor, 1986; Davis &amp