Understanding the Relationship between Child Internalizing Problems and Familial Cohesion following Child Sexual Abuse: The Moderating Role of Caregiver Abuse History

Due to the heterogeneous nature of symptoms in survivors of child sexual abuse (CSA), extensive research is needed to understand the complexity and further improve intervention practices. This study examined the relationship between risk and outcome factors, specifically caregiver history of emotional abuse and youths’ internalizing problems, and their influence on familial cohesion following CSA. Using a moderation model, it was hypothesized increased child internalizing problems would be related to decreased family cohesion when caregivers have an extensive history of emotional abuse. Participants were 215 non-offending caregivers of sexually abused children attending Project SAFE (Sexual Abuse Family Education), a 12-week cognitive-behavioral treatment program held at a Child Advocacy Center. Caregivers were 23 to 72 years old (M = 37.66, SD = 7.99), 86.9% female, and 85.6% European American. There was a significant interaction between caregiver history of emotional abuse and child internalizing problems as predictors of family cohesion and a regions-of-significance analysis revealed that less family cohesion was only significantly associated with increased child internalizing problems when scores of caregiver emotional abuse history were 9.4 or higher. This suggests that caregiver history of emotional abuse may function as a mechanism that influences how CSA victims’ internalizing problems impact familial cohesion. Given the importance of familial cohesion to the recovery process, this study has meaningful clinical implications such as providing support for interventions that deliver concurrent services to victims as well as their underserved caregivers