Violence against women is epidemic in the United States and results in significant physical and mental health consequences for victims. Women who were sexually abused as children are especially vulnerable to continued interpersonal victimization in adulthood and report a high incidence of rape, battering, and sexual abuse. Such victimizing experiences are associated with increased utilization of health care services (e.g., emergency room visits) and with multiple mental health problems (e.g., depression, substance abuse). The purpose of this study is to test a causal model designed to identify relationships among abuse situation factors and family-of-origin characteristics, coping tasks, and victimization in adulthood in a sample of female sexual abuse survivors. The specific research questions to be addressed are (1) is the degree of powerlessness experienced by children in the abuse situation related to current and past victimization in adulthood and is the relationship between powerlessness and current victimization mediated by the level of accomplishments of three cognitive coping tasks (i.e., finding meaning in the experience, gaining a sense of mastery, and self-enhancement), (2) Is the perceived level of family health in the survivors' families of origin related to current and past victimization in adulthood and is the relationship between family health and current victimization mediated by the level of accomplishment of the self-enhancement coping task, and (3) does the causal model designed to predict victimization account for a significant amount of covariation in the data? This is a cross-sectional field study using survey methodology with a community sample of 200 adult survivors. Structural equation modeling will be used to test the proposed relationships among the variables and to test the goodness of fit of the causal model. If factors that predispose adult survivors of childhood sexual abuse to victimization in adulthood are identified and it can be determined what coping mechanisms mitigate the effects of these factors, health care providers can better identify survivors at risk for further victimization and plan therapeutic interventions to facilitate coping with the abuse, thereby decreasing experiences of victimization and the accompanying health related consequences. A long term goal of this research, therefore, is to develop guidelines for assessing vulnerability to victimization and to plan and test intervention strategies that can be used to effectively decrease the risk of continued abuse in this population.
