Effects of Polyvictimization on Trauma Symptoms, Dissociation, and Income Levels Among Adult Survivors of Child Sexual Abuse

Background and Purpose: The cumulative impact of multiple victimizations during childhood has been found to be highly correlated with detrimental developmental and lifetime impact on the wellbeing and functioning of children, adolescents, and adults, even in comparison to chronic exposure to a single form of victimization. In this retrospective study of adult survivors of child sexual abuse, their experiences of childhood polyvictimization were analyzed as to their predictive effect on trauma symptoms, education, and income levels.

Methods: A cross-sectional survey design was use to collect data from 244 adult survivors of childhood sexual abuse. Data was collected through an anonymous online survey, and distributed through social media platforms of 35 organizations serving adult survivor of child sexual abuse in North America. The CSA Subscale of the Computer Assisted Maltreatment Inventory (CAMI) was used to assess exposure to multiple types of maltreatment. The Trauma Symptom Checklist-40 (TSC-40) was used to assess trauma symptoms. The polyvictimization variable was created using responses to questions from the Brief Betrayal Trauma Survey. Each type of polyvictimization (and the sum total Polyvictimization variable) was treated as a continuous independent variable. When each IV was tested against continuous dependent variables, linear regressions were utilized. Multiple Linear Regressions (MLR) were used to determine the best predictor(s) of trauma symptoms, when controlling for each type polyvictimization. The MLR examined the effects of each type of polyvictimization on three dependent variables: Income, Dissociation, and Total Scores on the TSC-40.

Results: The majority of the sample (87%) experienced some form of childhood polyvictimization in combination with child sexual abuse (CSA), (83%) experiencing emotional abuse (EA-Close) by someone close to them, and (22%) experiencing child physical abuse (CPA-Not Close) by someone with whom they were not close. Multiple linear regressions showed that whereas child physical abuse by someone close (CPA-Close) to the survivor (in combination with CSA) predicted higher total trauma scores, both CPA-Close and EA-Close (in combination with CSA) significantly predicted dissociation. Finally, CPA-Close (in combination with CSA) significantly predicted lower income scores.

Conclusions and Implications: The results of this study suggest that not only is there a high rate of polyvictimization among survivors of child sexual abuse, but also that it has a direct predictive effect on trauma symptoms, dissociation, and in some instances, also on income levels of adult survivors. These findings suggest that clinical work with these survivors should take into account the types of victimizations survived in childhood, and its cumulative impact on adult well-being. Holistic interventions that take into account the complexity of the experiences of the survivors would be more effective in meeting their needs, and ensuring a path towards life-long healing. Future research needs to examine the effect of interventions aimed at treating survivors of polyvictimization, in terms of intervening effects on trauma symptoms, dissociation, and income levels.