Attachment style and childhood sexual abuse: A longitudinal examination

Attachment theory was utilized as a conceptual framework through which to better understand the antecedents and consequences of childhood sexual abuse. Attachment styles of 49 sexually abused and 54 comparison females (mean age = 12.01; SD = 2.88) were classified as part of a longitudinal, prospective study of the long-term effects of childhood sexual abuse. Abused participants were more likely to be insecurely attached than comparison participants, and certain attachment styles were associated with distinct patterns of abuse when considering factors such as the child's relationship with the perpetrator, the severity and duration of the abuse, and the degree of violence accompanying the abuse. Attachment style was related to concurrent levels of depression, anxiety, dissociation, confidence, and externalizing difficulties, as well as locus of control and perception of family functioning. Ten years subsequent to disclosure, attachment style was related to levels of anxiety, internalizing difficulties, obsessive-compulsive behavior, social phobia, delinquent behavior, and various forms of eating pathology. Both concurrently and in terms of later psychological functioning, a secure attachment style provided the basis for superior adjustment, whereas an insecure attachment style placed participants at risk for greater difficulties. The degree and type of difficulty experienced varied according to the participants' specific insecure attachment strategies. Attachment style also mediated the concurrent relationship between childhood sexual abuse and levels of depression, confidence, and locus of control, and accounted for the relationship between abuse and levels of overall eating pathology ten years later, including dieting behavior, bulimia and food preoccupation, and oral control, as well as the extent to which the participants experienced subsequent revictimization. Results indicate that attachment style likely accounts for at least some of the diversity of effects experienced by childhood sexual abuse survivors.