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...