Psychological distress in adult survivors of childhood sexual abuse : the role of shame, self-esteem and blame

Research shows that individuals who report a history of childhood sexual abuse (CSA) are more likely to develop a range of psychological difficulties in adulthood than those who report no early experiences of CSA. The concept of CSA as a risk factor for developing psychological distress is no longer in question, but the causal mechanisms that underlie these associations are still not well understood. The feelings of shame, responsibility, and low levels of self-esteem that are commonly found in presentations of psychological distress in female survivors may implicate these characteristics as mediating risk factors in the sequelae of CSA. A literature review was carried out to explore the theoretical knowledge of CSA, and to examine the evidence of its relationship with psychopathology, and the role of contributory features of shame, self-esteem and attributions of blame. One hundred and fifty nine undergraduates (thirty two of whom reported a history of CSA) completed questionnaires requesting information on a history of CSA, shame, self-esteem, and attributions of blame and responsibility. The expected association between CSA distress and psychopathology was not found and this precluded mediation analysis. However, differences were found between the Abused and Non-Abused groups on the psychopathology subtests, most notably psychoticism. Compared to the Non-abused group, the Abused group also showed higher levels of Shame and a non-significant trend towards lower Self-esteem. Shame ii and Self-esteem were found to correlate with psychopathology and CSA distress correlated with Perpetrator Blame and Family Blame. Finally, the last section of the thesis discusses implications for clinical practice, the limitations of the empirical study, and ideas for further researc