Internal and external mediators of women's sexual abuse in childhood.

A community sample of 111 women's retrospective reports of childhood sexual abuse was examined in an effort to understand the circumstances and coping strategies that mediated the immediate and lasting effects of those stressful experiences. Aspects of single or multiple abuse incidents were captured in 11 variables, each reflecting 1 of 3 domains: circumstances of abuse, mediators, and outcomes (the negative effects of abuse). Observed variable simultaneous path analysis models revealed several direct and mediated influences on the outcomes. Long-term negative outcomes of abuse were directly affected by a close relationship to the perpetrator and severity of abuse from the circumstance of abuse domain, and immediate negative responses, self-blame, and nondisclosure regarding the incident from the mediational domain. The importance of examining factors that mediate the negative effects of child sexual abuse is discussed.