Childhood sexual abuse, dissociation, and adult self-destructive behavior.

Female college students reporting a history of childhood sexual abuse (N=175) and not reporting a history of childhood sexual abuse (N=260) were compared on indices of six self-destructive behaviors, including drug use, alcohol abuse, binge eating, self-mutilation, risky sex, and suicidality. The samples were also compared on two measures of dissociation, the Trauma Symptom Checklist dissociation subscale and the Dissociative Experiences Scale. The CSA group had significantly higher mean scores on all the indices of self-destructive behavior except self-mutilation (where the mean difference approached significance), and on both measures of dissociation. One or both dissociation measures were related significantly to each index of self-destructive behavior except binge eating. Multiple regression mediation analyses provided support for the hypothesis that dissociation mediates the relationships between CSA and both drug use and alcohol abuse. Dissociation also explained significant variability when added to the regressions of risky sex and suicidality on CSA.