1. BODY ESTEEM PREDICTS SEXUAL FUNCTIONING STATUS FOR WOMEN REPORTING CHILDHOOD SEXUAL ABUSE Yasisca Pujols & Cindy M. Meston University of Texas at Austin I N T R O D U C T I O N Table 1: Demographics of the Participant Sample R E F E R E N C E S Ta ble 3: M E T H O D S  Questionnaire data was collected from a community- based sample of 171 sexually-active Women, 114 of which reported CSA (M age = 32.4, SD= 10.7). Data from the women with a history of sexual abuse was taken from the first session of a 6-month treatment outcome study for sexual dysfunction among CSA survivors.  Definition of childhood sexual abuse: Involuntary sexual abuse was defined as unwanted sexual activity prior to age 16, and included one or more of the following acts: oral, anal, or vaginal intercourse, penetration of the vagina or anus using objects or digits, or genital touching or fondling.  Participants who did not report incidents of sexual or physical abuse in childhood and no unwanted sexual experiences in adulthood were established as a comparison group (NSA). PARTICIPANTS MEASURES C O N C L U S I O N  This finding suggests that poor body esteem resulting from early sexually abusive experiences may be particularly detrimental to later sexual function – more so that poor self-esteem caused by other life experiences. Childhood is a critical period for the development of body image, which is a product of other’s reactions and cognitions and one’s own feelings about her body during this period 8. Premature exposure to sexual activity may induce negative body image for CSA survivors during this critical developmental period.  Given the documented link between depression and poor body esteem 9-11, it may be that the link between body esteem and sexual function noted in past studies is more a consequence of depressive symptoms than poor body esteem per se. That is, depression may be an important moderator of the relationship between body esteem and sexual functioning. R E F E R E N C E S 1. Browne, A., & Finkelhor, D. (1988). Impact of child sexual abuse: A review of the research. Psychological Bulletin, 99(1), 555 - 584. 2. Gorcey, M., Santiago, J., & McCall-Perez, F. (1986). Psychological consequences for women sexually abused in childhood. Social Psychiatry, 21(3), 129-133. 3. Polusny, M., & Follette, V. (1995). Long-term correlates of child sexual abuse: Theory and review of the empirical literature. Applied & Preventive Psychology, 4(3), 143-166. 4. Eubanks, J., Kenkel, M., & Gardner, R. (2006). Body-size perception, body-esteem, and parenting history in college women reporting a history of child abuse. Perceptual and Motor Skills, 102(2), 485- 497. 5. Jackson, J., Calhoun, K., Amick, A., Maddever, H., Habif, V. L. (1990). Young adult women who report childhood intrafamilial sexual abuse: Subsequent adjustment. Archives of Sexual Behavior, 19(3), 211- 221. 6. Wenninger, K., & Heiman, J. (1998). Relating body image to psychological and sexual functioning in child sexual abuse survivors. Journal of Traumatic Stress, 11(3), 543-562. 7. Smolak, L., & Murnen, S. (2002). A meta-analytic examination of the relationship between child sexual abuse and eating disorders. International Journal of Eating Disorders, 31(2), 136-150. 8. Lerner, R., & Jovanovic, J. (1990). The role of body image in psychosocial development across the life span: A developmental contextual perspective. In T. G Cash & T. Pruzinsky (Eds.), Body images: Development, deviance, and change (pp. 110-127). New York: Guilford Press. 9. Joiner, T., Schmidt, N., & Singh, D. (1994). Waist-to-hip ratio and body dissatisfaction among college women and men: Moderating role of depressed symptoms and gender. International Journal of Eating Disorders, 16(2), 199-203. 10. Keel, P., Mitchell, J., Davis, T., & Crow, S. (2001). Relationship between depression and body dissatisfaction in women diagnosed with bulimia nervosa. International Journal of Eating Disorders, 30(1), 48-56. 11. Taylor, M., & Cooper, P. (1986). Body size overestimation and depressed mood. British Journal of Clinical Psychology, 25(2), 153-154. ACKNOWLEDGEMENTS R E S U L T S  T-tests were performed on the variables under investigation comparing the CSA and NSA groups.  In order to determine the predictive value of body esteem on sexual functioning and sexual satisfaction, multiple regressions were performed separately with sexual functioning and sexual satisfaction as the dependent variables and body esteem as the predictor variable for each group.  The variability associated with depressive symptom severity was held constant by its inclusion in all regression models. Sexuality Variables  Sexual Satisfaction Scale for Women (SSS-W; Meston & Trapnell, 2005)  Female Sexual Functioning Index (FSFI; Rosen et al., 2000) Body Esteem  Body Esteem Scale (BES; Franzoi & Shields, 1984) Depressive Symptom Severity  Beck Depression Inventory (BDI; Beck, Rush, Shaw, & Emery, 1979) All measures are scored in the positive direction. STATISTICAL ANALYSISHYPOTHESIS  The sexual satisfaction and functioning of women with a history of CSA would be uniquely and significantly impacted by body esteem as compared with nonabused women. ►The Sexual Psychophysiology Laboratory at the University of Texas is funded by Grant Number 5 RO1 HD051676-04 from the National Institute of Child Health and Human Development (NICHD) to Cindy M. Meston. CSA Group Multiple Regressions  Predicting Sexual Functioning: The hypothesized model was significant, F(2, 79) = 11.0, p <.001, and accounted for 22% (R 2 adj = 19.7%) of the variance in sexual functioning. Only body esteem was a significant predictor.  Predicting sexual satisfaction: the model was also significant, F(2, 75) = 7.1, p <.001, and accounted for 16% (R 2 adj = 13.7%) of the variance. Both body esteem and depressive symptom severity were significant predictors. NSA Group Multiple Regressions  Predicting sexual functioning: the hypothesized model was significant, F(2, 43) = 7.9, p <.01, and accounted for 22% (R 2 adj = 18.8%) of the variance. Only depressive symptom severity was a significant predictor.  Predicting sexual satisfaction: The model predicting sexual satisfaction was significant, F(2, 43) = 19.4, p <.001, and accounted for 48% (R 2 adj = 45.0%) of the variance. Depressive symptom severity was a significant predictor of sexual satisfaction; body esteem was only marginally significant. R E S U L T S, con’t.  Research supports a link between a history of childhood sexual abuse (CSA) and poor body image, depression, and sexual dysfunction in adulthood 1-3.  Four studies have found women with a history of CSA have poorer body images than non abused women 4-6. However these studies have focused on comparisons between CSA and nonabused groups.  To date, studies examining the degree to which body image serves as a link between CSA and adult psychological well-being have focused primarily on eating disorder symptomatology 7. To our knowledge, the extent to which body image acts as a psychological mechanism through which CSA impacts sexual functioning and satisfaction has not been examined.  The current literature supports links between CSA, poor body image, depression, and sexual dysfunction and dissatisfaction. The aim of current study is to examine a potential role of body image in the link between CSA and adult sexual dysfunction in a community sample of women. CSANSA N11061 Age (yrs) ns 1 Mean33.430.6 SD10.011.8 Range19 - 6318 - 64 % (n) Education ns 2 Less than high school / GED 2.6 (3) - Completed high school / GED11.4 (13) 9.8 (6) Some college/college degree71.1 (81)68.9 (42) Advanced degree11.4 (13)21.3 (13) Data missing 3.5 (4) - Ethnicity ns 2 White*51.8 (59)62.3 (38) Hispanic/Latina19.3 (22)11.5 (7) Black*10.5 (12)11.5 (7) Mixed race* 7.9 (9) 4.9 (3) Asian or Pacific Islander 1.8 (2) 8.2 (5) American Indian or Alaskan Native 0.9 (1) - Data missing 1.8 (2) 1.6 (1) Relationship Status 0.001. 2 Single, not dating15.8 (18)24.6 (15) Single, dating 9.6 (11)26.2 (16) In a committed relationship40.4 (46)41.0 (25) Married29.8 (34) 4.9 (3) Data missing 2.6 (3) 3.3 (2) Note. CSA = Women with a history of childhood sexual abuse, NSA = Women without a history of sexual abuse. *=not of Hispanic origin 1=Mann-Whitney test for group differences 2=t-test for group differences (in a relationship vs single) A I M CSANSA Mean (SD) t Sexual Satisfaction a -5.2*** Contentment 14.2 (4.0) 18.0 (5.1) Communication 19.9 (5.5) 22.7 (5.7) Compatibility 18.4 (6.9) 23.6 (6.3) Relational Concern 15.1 (7.2) 23.5 (7.0) Personal Concern 14.0 (6.2) 22.2 (8.2) Total 82.2 (20.9) 107.7 (27.6) Sexual Functioning b -5.8*** Desire 3.8 (1.6) 4.2 (1.2) Arousal 3.4 (1.6) 4.5 (1.4) Lubrication 3.8 (1.9) 4.6 (2.0) Orgasm 2.9 (1.2) 3.0 (1.4) Satisfaction 3.0 (1.5) 4.4 (1.4) Pain 3.7 (2.3) 4.3 (2.4) Total 22.0 (6.2) 27.5 (4.5) Body Esteem Scale c -4.6*** Weight Concern 42.4 (8.5) 33.0 (9.6) Physical Condition 27.6 (6.8) 31.3 (7.3) Sexual Attractiveness 42.4 (8.5) 48.2 (7.3) Total 96.9 (20.5) 112.5 (21.2) Depressive Symptom Severity d 20.4 (10.5) 11.5 (9.9) 5.4*** Minimal Depression (<10) 14.2 % 50.8 % Minimal to Moderate (10-18) 30.2 % 31.1 % Moderate to Severe (19-29) 34.9 % 11.5 % Severe (>29) 20.8 % 6.6 % Note. CSA = Women with a history of childhood sexual abuse, NSA = Women without a history of sexual abuse. a = SSS-W, b = FSFI, c = BES (Higher scores indicate greater satisfaction, functioning, and body esteem), d = BDI (Higher scores indicate worse depressive symptoms) *** = p <.001; independent samples t-test  The variables under investigation were significantly lower for the CSA group: body esteem (t(157) = -4.6, p <.001), sexual functioning (t(127) = -5.2, p <.001), and sexual satisfaction (t(123) = -5.8, p <.001) (See Table 2). Table 2: Group Means across Body Esteem and Sexuality Variables Figure 1: Multiple Regression of Body Esteem on Sexuality Variables