Who's in Control? Sexual Trauma, Lack of Control, and Depression Severity

Background and Purpose: One in 4 adult women will have experienced sexual trauma in their lifetime. Sexual trauma has deleterious affects in adulthood including increased risk for mental health disorders, poorer physical health outcomes, higher rates of substance abuse, and reduced self-esteem and social functioning. There are many documented mediators for the relationship between sexual trauma and depression such as substance use, income, socioeconomic status, and race. Similarly, perceptions of control have been researched as coping mechanisms for survivors of sexual trauma and higher perception of control is found to reduce psychological distress and eating disorders among survivors. However, to this date, no investigation has been done on the mediating effect of perception of control on depression for survivors of sexual trauma. This study sought to investigate the mediating effect of perception of control on the relationship between sexual trauma and depression.

Methods: Data and samples: Data for this study comes from the New Family Structures Study (NFSS) conducted in 2012. The study surveyed 15,000 adults between the ages of 18 and 39 on a range of social, mental health, and educational outcomes and familial structures.

Measures: The independent variable for this study was sexual trauma and was derived from four questions regarding experiences with sexual trauma. The dependent variable was depression, derived from an 11-question scale which was reliable (α= .89). The mediating variable was perception of control which was measured from a one-item question “I have little control in my life” which was answered on a scale from 0= never or rarely to 4= most of the time. Control variables included race, income, gender, and substance use.

Results: Hierarchical regression analysis was conducted using PROCESS (v2.16.3) in SPSS and found all paths of the proposed mediation model to be significant. Sexual trauma was a significant predictor of (lack of) perception of control (β= .0741, t= 2.187, p=.029). Lack of perception of control was also a significant predictor of depression (β=2.64, t= 16.98, p<.000). As assumed, sexual trauma was a significant predictor of depression (β=1.91, t= 7.23, p<.000). As hypothesized, the association between sexual trauma and depression was increased by lack of perception of control when controlling for race, income, gender and substance use, indicating a mediating effect (β=2.11, t= 7.76, p<.000). The Sobel test statistic confirmed that a lack of control is a partially mediating factor between sexual trauma and depression (z= 2.17, p=.03).

Conclusions and Implications: A lack of feeling in control accounts for some of the depression survivors of sexual trauma experience, even when controlling for race, income, and gender. As such, interventions for sexual trauma should focus on perceptions of control in addition to ensuring the victim has control over their treatment. Furthermore, involvement in health care and the criminal justice system for survivors of sexual trauma should also allow for the victim to control their situation. Further research investigating the relationship between perceptions of control during birthing for survivors of sexual trauma and postpartum depression could be a valuable endeavor.