Arlynn T. Revell
Doctoral students in Family and Sexuality Studies
Masters degree in Family and Sexuality Studies (MA) and
Masters degree in Human Ecology (MA)
Institute for Family and Sexuality Studies,
Faculty of Medicine, U.Z.
Catholic University of Leuven Kapucijnenvoer 35 B-3000 Leuven Belgium
atrevell @yahoo.com
Prof. Alfons Vansteenwegen
Institute for Family and Sexuality Studies, Faculty of Medicine, U.Z.
Catholic University of Leuven Kapucijnenvoer 35 B-3000 Leuven Belgium
Prof. Lionel J. Nicholas
Department of Psychology, University of Fort Hare, East London, 5201 South Africa
Prof. Kitty Dumont
Department of Psychology, University of Fort Hare, East London, 5201 South Africa
This study examined the association between unwanted early sexual experiences (UESE also referred to as “child sexual abuse” (CSA)) and relationship adjustment among first year students (South Africans = 1,081 and Belgians = 2,608) and the association of the severity of the experience with relationship adjustment. Of South African women 31.3% (231) and 14.2% (226) of Belgian women reported UESE. Of South African men 56.4% (189) and 12.3% (125) of Belgian men reported UESE. Of these respondents 39.6% (1464) were in a committed relationship and of these respondents 20.1 % (n = 295) reported UESE. No statistically significant differences were found between those students with less severe experiences vs. more severe experiences with regard to the relationship adjustment.
Davis and Petretic-Jackson (2000) point out that many studies that have examined the long-term impact of child sexual abuse (CSA) on adult functioning have primarily focused on the personal distress of survivors and have neglected the impact of CSA on interpersonal relationships. They therefore reviewed what they consider to be the most important empirical and clinical findings in the past 15 years about the impact of CSA on intimate relationships. They reported that CSA survivors had difficulties associated with relationships, but that the specific nature and course of the impact of CSA on interpersonal relationships are unclear, since survivors of CSA report considerable variability in both the range and severity of reported symptomatology.
Rind, Tromovitch, & Bauserman (1998) found i n a meta-analysis of 59 studies of over 15, 000 college students, that the relation between self-reported CSA and psychopathology was weak and even weaker when CSA was considered to be consensual, particularly for men. They furthermore reported that 11% of women and 37% of men indicated that their short-term reaction to the CSA was positive. Rind and Tromovitch (1997) also reported, in their meta-analytic review of seven national samples of psychological correlates of CSA, that only a small proportion of individuals with CSA experiences are permanently harmed. They contended that while psychological adjustment measures suggest that CSA is related to poorer adjustment in the general population, confounding variables prevent such attribution of causal effects of CSA.
Davis, Petretic-Jackson and Ting (2001) surveyed relationships among interpersonal functioning, symptomatology and CSA among 315 university women students and found that women reporting CSA had lower quality of past interpersonal relationships, greater fear of intimacy and greater trauma symptomatology than non-abused women. Rumstein-McKean and Hunsley (2001) reviewed empirical literature on interpersonal and family functioning of female survivors of CSA and reported converging evidence in both clinical and non-clinical community samples that compared to other women, female CSA survivors experience more relationship problems. Mullen, Martin, Anderson, Romans and Herbison (1994) reported an association between CSA and disruption of intimate relationships including difficulties with trust and a propensity to perceive their partners as uncaring and over-controlling. They found that women show low satisfaction with their relationships and that those with a history of abuse were significantly more likely than controls to have difficulties confiding in and discussing personal concerns with their partners.
Fleming, Mullen, Sibthorpe, and Bammer (1999) in their cross sectional study on the long-term impact of CSA in women, found that those reporting CSA perceived their partners as significantly less caring but that there were no significant differences in the perceived levels of intrusive or inappropriate control by partners. Women reporting CSA significantly predicted dissatisfaction with current relationships but no significant effects were found on the level of the emotional support they experienced.
DiLillo and Long (1999) surveyed 166 college women about their perceptions of couple functioning among female survivors of CSA and found that sexually abused women reported lower levels of relationship satisfaction and poor communication in their committed relationships in comparison to non-abused women. They found that CSA survivors placed less emotional trust in their partners and have less confidence that significant others can be counted upon to perform important supportive behaviors for them.
DiLillo (2001) cites several studies involving interpersonal functioning among women with a history of CSA, which reported a set of intensely ambivalent feelings (e.g., disillusionment, mistrust, idealization, devaluation, and hostility) about men in general. When compared to non-abused women they also experience less satisfaction in platonic interaction with men. He cites a number of clinical studies of CSA survivors reporting patterns of dysfunction in survivors’ marital and couple relationships. He reported a general pattern of dissatisfaction with couple relationships, with survivors reporting greater levels of overall marital discord, generalized fear of partners and husbands, and moderate to severe conflict with partners, including feelings of fear, mistrust and hostility in their relationship with men. He concluded that the increased risk of revictimization was not surprising in that male partners of sexually abused women are frequently characterized as less well-adjusted and less supportive in comparison to partners of non-abused women. He cited a number of studies where male partners were described as being overly dependent, insecure, immature and exploitative.
Holmes and Slap (1998) in their comprehensive review of 166 North American studies concluded that sexual abuse of boys is under reported, under recognized and under treated. Negative responses to CSA were associated with the use of force and a larger perpetrator-victim age difference. CSA by an older perpetrator and a younger victim were reported by 15% to 39% of male victims. They also reported that when comparing men with a history of CSA to men with no CSA history, they had more fears about intimate relationships with both men and women. They furthermore reported that men with a history of CSA, compared to men with no such history, were up to five times more likely to report sexuality-related problems, being hypersexual, having difficulty controlling sexual feelings and had more fears about intimate relationships. They also reported increased rates of post-traumatic stress disorder, aggressive behavior and sexuality-related problems in clinical samples. Positive responses to CSA were associated with female perpetration with 88% exposed to CSA viewing the perpetrations positively and when the incident happened after the age of 12 years. A longer duration of perpetrations and that 91% recalled the events as physically pleasurable were also listed as positive CSA experiences. Madu’s (2001) South African survey which included 244 university men students, reported a CSA prevalence rate of 21.7% for men, 83% of whom did not perceive themselves as having been sexually abused. In the same study Madu found a CSA rate of 22.7% for women in a sample of 722 undergraduate students, of whom (68.2%) perceived themselves not to have been abused.
Loeb et al. (2002) reviewed research on the relationship between CSA and adult sexual functioning and reported that CSA presents a violation of an intimate bond and that survivors of CSA may experience difficulties in their intimate relationships in adulthood. When comparing women with a history of CSA to a control group, women with CSA reported that they were more anxious about their relationships and had lower levels of intimacy. They also reported that long-term effects of CSA in males include drug and alcohol problems and relationship problems. They noted that abuse incidents are unlikely to affect all children uniformly and that the child’s age, severity and frequency of abuse and the perpetrator would play a role.
Najman, Dunne, Purdue, Boyle, and Coxeter (2005) reported on CSA of an Australian national probability survey of 1,793 participants and found that CSA had a greater impact on the sexual functioning of women than men, but about half of the women they surveyed who reported sexual dysfunction had not experienced CSA.
Miller, Johnson and Johnson (1991) surveyed college students and unwanted sexual experiences before the age of 16 and contend that self-report biases and definitional problems permeate CSA research. They developed an Early Sexual Experience Checklist (ESEC), which sought to avoid such problems, and argued that, because the ESEC assesses an explicit variety of non-coital responses and provides a non-restrictive response to format. They requested respondents to report the occurrence of specific overt unwanted sexual behaviors before the age of 16 without requiring them to make distinctions about whether an unwanted sexual experience constituted ‘abuse’ or ‘molestation’. They intended that respondents’ own definitions of the desirability of the experiences govern their self-reports and expected a greater prevalence of distressing sexual experiences than methods that required self-nominations of abuse. Such experiences therefore constitute CSA as broadly conceptualised in the CSA literature.
Heiman, Verhulst and Heard-Davison (2003) refer to a number of studies involving undergraduate students and adult sexual relationships which reported that women with a history of CSA might experience more relationship stress. They contended that little is known about how much continuity there is or should be between childhood sexuality and adult sexual relationships. They concluded that there is a necessity to locate human sexuality in multiple levels of influence with many pathways to both sexually functional or satisfying and sexually troubled adult relationships.
The authors had potential access to both South African and Belgian students at universities in these countries, and an examination of the UESE research failed to find any UESE studies on these two populations. Given the complexities of the role of CSA in relational functioning (Loeb et al., 2002) and the need for more cross-cultural research (Finkelhor, 1994) this study sought to assess the potential correlation between unwanted early sexual experiences (UESE) and relationship adjustment among Belgian and South African students in a committed relationship as well as the role of severity of UESE in such adjustment.
Participants
Participants in this present study were 3,689 first year students (Belgians N = 2,608 and South Africans: N = 1,081). Of the 2,608 Belgians 60.9% (n = 1,587) were women (mean age 18.2, SD = 0.96) and 39.1% (n = 1,017) were men (mean age 18.3, SD = 1.63). Of the 1,081 South African students 68.8% (n = 739) were women (mean age 19.6, SD = 4.10) and 31.2% (n = 335) were men (mean age 19.3, SD = 3.40).
Table 1:
|
Belgium |
South Africa |
| Men | n = 1,017 (39.1%) |
n = 335 (31.2%) |
Women |
n = 1,587 (60.9%) |
n = 739 (68.8%) |
Instruments
CSA measure
The Early Sexual Experience Checklist (ESEC) consists of nine multiple choice items that list explicit sexual behaviors and two additional items that allow participants either to describe a further sexual event or to select ‘none of the above’. Respondents were requested to respond to these questions on a yes/no basis and were informed to select any sexual behaviors that were unwanted (occurred when the respondents did not want them to) and occurred before the age of 16. Sexual behavior in this study refers to specific behaviors such as “flashing”, being touched on the genitals, touching someone’s genitals, oral/vaginal/anal sexual intercourse (Miller et al., 1991). Participants who indicated at least one ‘yes’ were considered to have experienced CSA. The ESEC is a straightforward mechanical checklist method, which eschews evaluative or pejorative terminology and is relatively non-invasive (Miller et al., 1991). The ESEC asks respondents to check any overt sexual experiences that occurred when they did not want them to e.g.: “Another person showed his or her sex organs to you”, ‘You showed your sex organs to another at his or her request”, “Someone touched or fondled your sex organs”, “You touched or fondled another person’s sex organs at his or her request”, “Another person had sexual intercourse with you”, “Another person performed oral sex on you”, “You performed oral sex on another person”, “Someone told you to engage in sexual activity so that he or she can watch” and “You engaged in anal sex with another person”. The checklist includes (a) respondent’s age, (b) respondent’s age at the time of the event, (c) age and (d) identity of the other person involved, (e) frequency and duration of the experience, and (f) presence and type of any coercion. Items using a Likert-style format (1 (not at all) to 7 (extremely) also obtain various ratings of the most bothersome event (e.g., ‘How much did it bother you then?’ and ‘How much does it bother you now?’). Miller and Johnson (1998) found a one-month test retest reliability of .92, for the ESEC, using Cohen’s kappa (Cited in Davis, Yarber, Bauserman, Schreer & David, 1998). Given the wide variability in the results of CSA studies Miller et al. (1991) attempted to avoid conceptual and definitional problems of past studies by asking respondents to report specific sexual behaviors that occurred when they did not want them to, without requiring them to make a distinction about whether the event constituted abuse or molestation. They concluded that their method: (1) operationalized CSA in a broad manner that fit the most widely held definitions of CSA, (2) promised to provide less biased reporting than asking about abuse, (3) could be used effectively and inexpensively in large prevalence studies. Miller et al. (1991) advocated distinguishing between less severe events such as exhibitionism and touching of sexual organs and more severe events such as anal/vaginal intercourse and oral-genital contact, because greater severity of experience was associated with greater hypothesised trauma in their pilot study. Najman, Dunne and Boyle (2007) make the point that quite different outcomes would result depending on the severity of the CSA experience.
Adjustment measure
The Maudsley Marital Questionnaire Relationship Adjustment (MMQR)
Relationship adjustment was measured using the revised and adjusted Relationship adjustment scale, it was derived from the Maudsley Marital Questionnaire ( MMQ) ( Van Bussel, Enzlin, Ruytjens, Van den Berghe & Verhoeven, 2002) and was completed by individuals in a committed relationship. The questions focused on: commitment towards relationship, level of satisfaction regarding relationship, how often quarrels and arguments occur, expressing feelings towards a partner and compassion and understanding received from a partner ( Arrindell, Boebens & Lambert, 1983) . In the MMQR scale, a higher score implies better adjustment and a lower score implies greater adjustment problems. The validity of the Dutch version of the MMQ was established by Arrindell, Emmelkamp and Bast (1983). A Cronbach’s alpha .81 was found for the MMQR in the present study.
Procedure
Permission to conduct the research was obtained from the Human Ethics Committee of each university. Students attending the orientation programmes at a South African and a Belgian university were requested to complete the ESEC. Students completed the self-administered checklist in approximately 10 to 15 minutes in lecture rooms during the first week of the orientation period. The participants were told that the completion of the ESEC was important for determining better counselling services for students at universities. First year university students completed the ESEC under the supervision of senior counsellors. The participants were also encouraged to consult counsellors about the issues raised in the ESEC as well as any other matters of concern in the event that some students might have negative emotional reactions after the recall of their UESE. The ESEC administered to the South African students was in English, while a Dutch translation was completed by the Belgian students. The questionnaire was translated from English into Dutch and back into English in order to ensure that the same measures were being tested. Translations of the questionnaires were done by native English and native Dutch speakers. These were the languages of instruction at the two universities. Participants were given a standard introduction and instructions on how to complete the ESEC and any uncertainties were clarified. Students’ participation in this study was entirely anonymous, voluntary and they were instructed that they could withdraw from the study at any time. Participants were informed that the study was a comparative analysis of South Africa and Belgium. An examination of the returned questionnaires revealed that 19 men respondents (11 Belgian men and 8 South African men) and 68 women respondents (16 Belgian women and 52 South African women) provided insufficient data for analysis and were therefore excluded from this study.
Of South African women respondents, 31.3% (n = 231) reported UESE compared to 14.2% (n = 226) of Belgian women respondents. Of South African men respondents 56.4% (n = 189) indicated that they had an UESE compared to 12.3% (n = 125) of Belgian men respondents.
From the total sample (N = 3689), of respondents 39.6% (n = 1,464) were in a committed relationship. Of these respondents 20.1 % (n = 295) reported having had an UESE (South Africans 37.5%, n = 137: men: n = 48 (50.5%); women: n = 89 (32%) and Belgian students 14.3%, n = 158: men: n = 42 (12.2%); women: n = 116 (15.3%)).
Relationship Adjustment
Belgian women reporting UESE had poorer relationship adjustment than Belgian women reporting no UESE ( M = 6.79, SD = .66 vsM = 6.93, SD = .29 ) but the differences were not statistically significant F(1, 722) = 3.40, p = .06, effect size r = .0699. Similarly South African women reporting UESE had poorer relationship adjustment than South African women reporting no UESE ( M = 6.42, SD = 1.10 vsM = 6.55, SD = .93 ) but the differences were not statistically significant F(1, 248) = .90, p = .34, effect size r = .0603. Belgian men reporting UESE had poorer relationship adjustment than Belgian men reporting no UESE ( M = 6.64, SD = .81 vsM = 6.81, SD = .70 ) but the differences were also not statistically significant F(1, 297) = 1.69, p = .19, effect size r = .0757. Similarly South African men reporting UESE had poorer relationship adjustment than South African men reporting no UESE ( M = 6.41, SD = .96 vsM = 6.43, SD = .99 ) but the differences were not statistically significant F(1, 79) = .006, p = .93, effect size r = .0098.
Table 2:
|
UESE n |
Controls n |
r |
p |
| Belgian women | 115 |
609 |
.07 |
.06 |
South African women |
81 |
169 |
.06 |
.34 |
Belgian men |
39 |
260 |
.07 |
.19 |
South African men |
43 |
38 |
.01 |
.93 |
Severity of UESE and relationship adjustment
No statistically significant differences were found between the two groups of Belgian women on the MMQR t(206) = -1.14, p = .25, effect size r = .0802 (less severe experiences M = 6.67, SD = .88 vs more severe experiences M = 6.85, SD = .70 ) and the two groups of South African women on the MMQR t(928) = .74, p = .45 , effect size r = .0248 (less severe experiences M = 6.45, SD = .1.25 vs more severe experiences M = 6.25, SD = .1.02 ). Against expectation Belgian women who were exposed to less severe experiences had poorer relational adjustment than those with more severe experiences.
Similarly no statistically significant differences were found between the two groups of Belgian men on the MMQR t(325) = 1.12, p = .27 effect size r = .0612 (less severe experiences M = 6.76, SD = .77 vs more severe experiences M = 6.42, SD = .98) and the two groups of South African men on the MMQR t(998) = .661, p = .51, effect size r = .0209 (less severe experiences M = 6.38, SD = .76 vs more severe experiences M = 6.21, SD = 1.04 ).
Our data were collected retrospectively and relied on self-report measures, which are subject to socially desirable responding, acquiescence, retrospective reconstruction and current levels of psychological adjustment. Generalization of these findings should therefore be made with due caution. Despite the limitations this was the first study to be undertaken among the students of a South African - and a Belgian University regarding the correlation between UESE on the relationship adjustment of students.
The prevalence rates are particularly high for men, however if peer UESE is excluded as is the case in the bulk of CSA literature the percentages are more in line with such literature (Edgardh & Ormstad, 2000; May-Chahal & Herczog, 2003; Bolen & Scannapieco, 1999; Finkelhor, 1994). If one excludes those affected respondents with an age gap of five years or less the UESE prevalence is reduced to South African men 3.8%, Belgian men 1%, South African women 9.5% and Belgian women 4.9%. When both peer and non-peer abuse are included of South African men 56.4%, Belgian men 12.3% South African women 31.3% and Belgian women 14.2% reported such incidences.
No statistically significant correlations were found between UESE and relationship adjustment as measured by the MMQ relationship adjustment subscale for South African and Belgian respondents. Our results do not support the CSA research literature indicating that survivors of CSA experienced more difficulties in their intimate relationships in adulthood (Davis et al., 2001; DiLillo, 2001; Rumstein-Mckean & Hunsley, 2001; Davis & Petretic-Jackson, 2000; Holmes & Slap, 1998). Respondents reporting UESE had poorer relationship adjustment than respondents reporting no UESE, but these differences were not statistically significant. However our findings support R ind et al’s. (1998) and Rind & Tromovitch’s (1997) meta-analyses reporting a low association between CSA and psychopathology. Against expectation Belgian women who were exposed to less severe experiences had poorer relational adjustment than those with more severe experiences. Severity of UESE was therefore not associated with poorer adjustment.
Multiple pathways of development ensure that CSA does not inevitably lead to impaired relationships. It is necessary to locate human sexuality in multiple levels of influence because people are inseparable from their larger contexts where genetic, epigenetic and environmental factors continuously interact. Memories, meanings and consequences of the CSA change as the child matures and are influenced by additional sexual and relational experiences and prevalent cultural values which makes it likely that there is a range of pathways to functional or troubled committed relationships (Heiman et al., 2003).
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