Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)




A number of studies have linked childhood sexual abuse to problems with alcohol and sexual dysfunction in adult women. Moreover, some researchers suggest temporal sequences in which either (a) early sexual abuse increases women's risks of sexual dysfunction, which in turn leads to increased alcohol use, or (b) the reverse, in which sexual abuse contributes to excessive drinking, which in turn impairs sexual functioning.

Most studies of these issues to date have had serious methodological problems (e.g., small samples, often from clinical populations lacking control groups). Additional limitations have been the limited range of variables measured and the lack of longitudinal data.

This study was designed to overcome many limitations of earlier research. The study attempted, first, to determine if there is an association between childhood sexual abuse and adult alcohol abuse and sexual dysfunction in women, and, second, to test two potential temporal sequences of this relationship using path analysis. Subjects were 143 problem drinkers and 157 nonproblem drinkers from a large national sample of women in the U.S. The longitudinal data were gathered in 1981 and 1986 via structured personal interviews and private questionnaires for information of a more sensitive nature (e.g., sexual experience and sexual abuse).

Results indicate that child sexual abuse predicts adult problem drinking and to a lesser degree sexual dysfunction. However, the temporal sequences among these variables are less clear. Child sexual abuse was a stronger predictor of both 1981 and 1986 problem drinking and 1986 sexual dysfunction among nonproblem drinkers than among problem drinkers. Often lacking a direct effect of its own among problem drinkers, child sexual abuse did predict a number of mediating variables (e.g., depression, suicidal thoughts or attempts, distrust, early sexual relations), some of which led to problem drinking in 1981. A surprising finding was that among problem drinkers, problem drinking in 1981 led to less sexual dysfunction in 1986 rather than more. Differences in predictors of problem drinking onset as compared with chronicity were discussed as a possible explanation for the different patterns among nonproblem and problem drinkers.