Journal of Child Sexual Abuse

ISSN: 1053-8712 (Print) 1547-0679 (Online) Journal homepage: http://www.tandfonline.com/loi/wcsa20

Conflict Resolution Styles as Mediators of Female

Child Sexual Abuse Experience and Heterosexual
Couple Relationship Satisfaction and Stability in
Adulthood

Ashlee E. Knapp, Darin J. Knapp, Cameron C. Brown & Jeffry H. Larson

To cite this article: Ashlee E. Knapp, Darin J. Knapp, Cameron C. Brown & Jeffry H. Larson
(2017) Conflict Resolution Styles as Mediators of Female Child Sexual Abuse Experience and
Heterosexual Couple Relationship Satisfaction and Stability in Adulthood, Journal of Child Sexual
Abuse, 26:1, 58-77, DOI: 10.1080/10538712.2016.1262931

To link to this article: http://dx.doi.org/10.1080/10538712.2016.1262931

Published online: 17 Feb 2017.

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Download by: [Eastern Michigan University] Date: 20 February 2017, At: 08:29
JOURNAL OF CHILD SEXUAL ABUSE
2017, VOL. 26, NO. 1, 58–77
http://dx.doi.org/10.1080/10538712.2016.1262931

Conflict Resolution Styles as Mediators of Female Child

Sexual Abuse Experience and Heterosexual Couple
Relationship Satisfaction and Stability in Adulthood
Ashlee E. Knappa, Darin J. Knappb, Cameron C. Brownb, and Jeffry H. Larsona
a
Department of Marriage and Family Therapy, Brigham Young University, Provo, Utah, USA;
b
Department of Family Studies and Human Services, Kansas State University, Manhattan, Kansas, USA

ABSTRACT ARTICLE HISTORY

Trauma from female incestuous child sexual abuse may result in Received 31 August 2016
negative psychological consequences affecting adult relationships. Revised 22 October 2016
This study explored relational consequences of incestuous child Accepted 22 October 2016
sexual abuse, focusing on conflict resolution styles, relationship KEYWORDS
satisfaction, and relationship stability. Using the RELATionship conflict resolution styles;
Evaluation dataset, 457 heterosexual couples in which female female childhood sexual
partners experienced incestuous child sexual abuse were com- abuse; incest; relationship
pared to a group of 1,827 couples with no sexual abuse history. satisfaction; relationship
Analyses tested differences in the frequencies of reported conflict stability; self and partner
resolution styles for incestuous child sexual abuse and non–inces- report
tuous child sexual abuse groups, the mediating effects of conflict
resolution styles on the relationship between incestuous child
sexual abuse, and self- and partner-reported relationship satisfac-
tion and stability. Significant differences in the reports of types of
conflict resolution styles were found for incestuous child sexual
abuse versus non–incestuous child sexual abuse groups.
Incestuous child sexual abuse and conflict resolution styles were
negatively related to relationship satisfaction and stability and
there was a significant indirect effect between female incestuous
child sexual abuse, female volatility, and relationship instability.
Clinical applications for couple relationships are discussed.

Clinical assessment of incestuous childhood sexual abuse (ICSA) in indivi-

duals presenting for relational therapy is important because the psychological
effects experienced by ICSA survivors may extend beyond the initial trauma
of ICSA into adult functioning and interpersonal relationships (Larson &
Lamont, 2005). Despite its prevalence, clinicians are rarely trained to identify
sexual abuse trauma origins of relational issues being presented in therapy
(Harway & Faulk, 2005; Mohl, 2010).
Research has reported a wide range of percentages of women with childhood
sexual abuse (CSA) experience. Recent studies have found that 13.5% (Molnar,
Buka, & Kessler, 2001), 25% (Dube et al., 2005), and 26.6% (Finkelhor, Shattuck,

CONTACT Ashlee E. Knapp, MS sloanashlee@gmail.com Brigham Young University, School of Family Life,
Marriage and Family Therapy Program, 234 TLRB, Provo, UT, 84602.

© 2017 Taylor & Francis

 JOURNAL OF CHILD SEXUAL ABUSE 59

Turner, & Hamby, 2014) of women experience CSA. International meta-analyses

of female CSA have produced similar results of 18% (Stoltenborgh, Van
Ijzendoorn, Euser, & Bakermans-Kranenburg, 2011) and 19.7% (Pereda, Guilera,
Forns, & Gómez-Benito, 2009). Women are more likely to be abused by a family
member than a non–family member (Finkelhor, 1990). This is particularly dama-
ging because the level of emotional closeness between perpetrator and victim is one
that has a significant influence on psychological trauma (Bronwyn & Halford,
2010; Carlson, Maciol, & Schneider, 2006; Cyr, Wright, McDuff, & Perron, 2002;
Ketring & Feinauer, 1999). One aspect of this trauma is its tendency to affect
survivors’ adult intimate relationships (Dube et al., 2005; Larson & Lamont, 2005).
A common complaint among scholars has been the tendency to neglect adult
interpersonal issues that result from CSA experiences in research (Briere & Elliott,
1994; Davis & Petretic-Jackson, 2000).
Accordingly, our study focused on understanding more about the inter-
personal functioning of ICSA survivors of in the context of conflict with
romantic partners. The purpose of this study was to explore the possible
mediating relationship of Gottman’s (1994) conflict resolution styles (CRS)
between the trauma of female ICSA and relationship satisfaction and stability
in heterosexual adult committed relationships. Our study has increased
awareness and understanding in this area, and our findings can be used to
help educators, clinicians, and researchers understand the specific conflict
resolution needs of this traumatized population and their romantic partners.

Theoretical approach
The post-traumatic stress disorder (PTSD) perspective is the most common and
widely applied model in literature to ICSA. Recent studies have found that children
with CSA experience significantly greater PTSD symptoms than those who have
not (O’Brien, White, Wu, & Killian-Farrell, 2016; Runyon & Kenny, 2002). We
determined to use PTSD theory in framing our study because the framework
suggests that the trauma of experiencing CSA has psychological consequences
generally considered to be long lasting and therefore more likely to affect com-
mitted relationships in adulthood (Larson & Lamont, 2005).
As described by the American Psychiatric Association (2000), PTSD in
children may originate from developmentally inappropriate sexual experiences,
which may result in relational consequences, such as feeling detached from
others, being highly irritable, angry, hypervigilant, avoidant, etc. Through heal-
ing from the trauma, some behaviors and initial reactions may fade over time
while others may become increasingly more potent and complicated (Briere &
Elliott, 1994), mirroring many of the symptoms of PTSD (Harway & Faulk,
2005; Walker, Sheffield, Larson, & Holman, 2011). As our research questions
assess ICSA experiences linked with adult romantic relationship processes, we
conceptualized our study within PTSD theoretical framework.
60 A. E. KNAPP ET AL.

ICSA and psychological effects

Psychological effects of CSA may be due to the disruption of normative
psychological development from abuse trauma (Fleming, Mullen, & Bammer,
1997; Kendler et al., 2000), such as a sense of security in trusting adults. If
that security is impaired or violated, children may feel betrayed. Davis and
Petretic-Jackson (2000) further explained that betrayal by a primary caregiver
translates into distorted expectations of future committed relationships, with
those who have experienced this betrayal displaying increased emotional
sensitivity, heightened loss of trust in others, and strong reactions to valida-
tion of this expectation with anger, thus negatively impacting capacity to
develop healthy relationships later on. Psychological repercussions of ICSA
have been found in survivors across familial perpetrator groups, such as
sibling, father, or stepfather (Cyr et al., 2002), although the levels of effects
may vary across groups (Stroebel et al., 2013). Therefore, females who survive
ICSA, due to the emotional closeness of the familial perpetrator, bear the
highest risk for issues in adult romantic relationships as compared to those
perpetrated by a stranger or friend (Bronwyn & Halford, 2010).

ICSA and adult relationships

Larson and Lamont (2005) indicated that female ICSA survivors may wait
one and a half years longer on average than non–ICSA survivors to marry
due to developed expectations that marriage will be difficult, unsatisfactory,
and present with high levels of conflict. Compared to a community sample,
ICSA survivors often perceived their committed relationships as more poorly
adjusted (Feinauer, Callahan, & Hilton, 1996).
As a result of skewed perceptions of relationships from ICSA trauma, these
women often reported being less satisfied and stable in romantic relation-
ships compared to non–ICSA survivors (DiLillo, 2001; Hunter, 1991; Nelson
& Wampler, 2000). ICSA survivors and their partners report higher levels of
emotional intensity (Nelson & Wampler, 2002) as well as greater contempt
and defensiveness in their relationships (Walker et al., 2011). Female ICSA
survivors tend to perceive partners as more controlling, uncaring, neurotic,
and conflict prone than non-ICSA women (Busby, Walker, & Holman, 2011;
Mullen, Martin, Anderson, Romans, & Herbison, 1994). ICSA experience is
also related to more relationship risk taking, including pre-developmentally
appropriate cohabitation and repeating relationships with abusive partners
(Friesen, Woodward, Horwood, & Fergusson, 2010). ICSA survivors have
also been found to separate or divorce more than those without a history of
ICSA (DiLillo, 2001).
 JOURNAL OF CHILD SEXUAL ABUSE 61

ICSA and adult relationship conflict sources

Female CSA survivors are at greater risk of conflict in adult romantic relation-
ships (Godbout, Sabourin, & Lussier, 2009). For example, Mullen and collea-
gues (1994) found that ICSA victims often report lower rates of meaningful
communication with their partners in comparison to non-abused women.
Female CSA survivors often report feelings of shame related to the trauma
of abuse, which increases risk of marital distress as well (Kim, Talbot, &
Cicchetti, 2009). Partners of survivors also report issues including feelings of
isolation, pain, anger, frustration, dissatisfaction (Reid, Mathews, & Liss, 1995),
resentment, or powerlessness (Harway & Faulk, 2005) in their relationships, all
of which are potential sources of conflict. Barcus (1997) found that husbands
of female ICSA survivors felt rage and confusion linked to spousal mood
swings as well as decreased sexual interest. Because the link between ICSA
and potential relationship conflicts stems from trauma-based experiences and
behaviors, it is important to explore factors that influence conflict behaviors
among this population. In our study, we examined conflict resolution within
ICSA couples in order to understand more about how these men and women
deal with spillover from previous trauma as it affects their conflicts.

Conflict resolution styles: A brief explanation

Gottman (1994) explained that there are four conflict resolution styles used
by couples. Three of these are regulated (stable) styles of conflict resolution,
and one is unregulated (unstable). The three regulated conflict styles are:
validating, volatile, and conflict-avoidant. The unregulated conflict style is
hostility. Gottman determined that regulated relationships were the most
stable because they maintained a healthy ratio of positive to negative inter-
actions, whereas the unregulated were least stable and more prone to stone-
walling and defensiveness.

Conflict resolution styles as mediators of ICSA and relationship satisfaction

Holman and Jarvis (2003) found that conflict resolution style is linked to
relationship satisfaction, with the lowest satisfaction among hostile couples,
the next lowest satisfaction reported by volatile couples, then avoidant
couples, with validating style couples indicating the highest relationship
satisfaction. Walker and colleagues (2011) found that a CSA survivor in a
marital relationship will tend to report greater marital distress as well as
increased likelihood that they will report the spouse to have contempt or a
defensive communication style. Busby and Holman (2009) also studied
marital mismatches of conflict style types, finding support for a one is enough
idea: if one spouse is considered hostile, there is a drop in relationship
62 A. E. KNAPP ET AL.

satisfaction. Similarly, if one spouse is perceived as validating, relationship

satisfaction was reported higher by both partners. These scholars also deter-
mined that couples with matched validating styles were more satisfied, more
stable, and reported fewer problems in their relationships.

The present study

Researchers have yet to explore all facets of the impact of female ICSA
experience on committed relationships in adulthood. Conceptually, the
PTSD framework and previous research has led us to posit that traumatic
experiences of female ICSA are linked with problems in adult romantic
relationships. We determined that it is important to examine how couples
with ICSA experiences use conflict resolution to navigate these potentially
problematic relationships and examine those behaviors in our current study
by answering the following research questions:

(1) What are female ICSA survivors’ self-reports of their conflict resolu-
tion styles (i.e. avoidant, validating, volatile, or hostile) compared to
females with no ICSA background, and what are male partner’s self-
report of their conflict resolution?
(2) What do female ICSA survivors report their male partners’ conflict
resolution styles to be as compared to women with no ICSA back-
ground, and what are the male partners’ report of their female part-
ner’s conflict style?
(3) Does conflict resolution style (as reported by the partner) significantly
mediate the relationship between ICSA experience and self-reported
relationship satisfaction and stability?

Method
Sample
The sample represented in the present study consisted of 2,314 heterosexual
couples in which each partner completed the RELATionship Evaluation
(RELATE; see www.relate-institute.org) questionnaire (Busby, Holman, &
Taniguchi, 2001). The 300-item RELATE questionnaire evaluates individual,
relational, and cultural facets of its participants. We used data from two
groups of couples: first, the ICSA group, and second, the non-ICSA group.
Four hundred and fifty-seven couples were included in the ICSA group.
This group consisted of female ICSA survivors in married, engaged, remar-
ried, cohabiting, or serious dating relationships. Couples were selected for the
ICSA group if the female partner self-reported experiencing CSA from a
family member (incest) as defined by immediate blood or step relations,
 JOURNAL OF CHILD SEXUAL ABUSE 63

including extended relatives. Only heterosexual couples in which the female

partner experienced incest in her family of origin were included in this
group. Previous research indicates that couples in which both partners
experienced childhood trauma show an increase in PTSD symptoms, anxiety,
somatization, hostility, phobic anxiety, and depression while simultaneously
showing higher relationship quality, thus suggesting that couples with shared
childhood trauma may have similar interaction patterns and thus be better
matched to their partner (Lev-Wiesel & Amir, 2003). For this reason, only
couples in which the male partner experienced no physical or sexual abuse
were included in this group. The average length of relationship for couples in
the ICSA group was 4.9 years (SD = 2.85). The comparison non-ICSA group
included 1,827 couples in which neither partner self-reported CSA of any
kind. The average length of relationship for non-ICSA couples was 4.5 years
(SD = 2.43). See Tables 1 and 2 for age, education, and racial demographic
data of the couple groups.

Measures
ICSA
Experience of incestuous childhood sexual abuse was assessed using one
question: “From the following list of family members, select the person
who was most sexually abusive toward you.” Response choices included: (a)

Table 1. Demographic Information for ICSA Couples (N = 487 Couples).

Variables Females Males
Age M (SD) Range M (SD) Range
30.24 (9.45) 18–66 32.36 (10.39) 18–71
N % N %
Education
< High School 4 0.8% 5 1.0%
High School Graduate 18 3.6% 36 7.3%
Some College 182 38.8% 173 35.3%
Associate’s Degree 34 7.0% 41 8.4%
Bachelor’s Degree 110 22.6% 122 25.1%
Some Graduate 50 10.3% 28 5.7%
Graduate Degree 82 16.8% 83 17.0%
Total 487 100% 487 100%
Race
African American 29 6.0% 31 6.4%
Asian 21 4.3% 12 2.5%
Caucasian 373 76.6% 402 82.5%
Native American 1 0.2% 2 0.4%
Latino 27 5.5% 18 3.7%
Mixed 26 5.3% 16 3.3%
Other 10 2.1% 6 1.2%
Total 487 100% 487 100%
64 A. E. KNAPP ET AL.

Table 2. Demographic Information for Non-ICSA Couples (N = 1827 Couples).

Variables Females Males
Age M (SD) Range M (SD) Range
27.05 (8.04) 18–79 29.03 (8.98) 18–75
N % N %
Education
< High School 3 0.2% 7 0.4%
High School Graduate 36 2.0% 61 3.3%
Some College 692 37.9% 685 37.5%
Associate’s Degree 98 5.4% 76 4.2%
Bachelor’s Degree 482 26.4% 521 28.5%
Some Graduate 159 8.7% 122 6.7%
Graduate Degree 357 19.5% 355 19.4%
Total 1827 100% 1827 100%
Race
African American 48 2.6% 49 2.7%
Asian 72 3.9% 49 2.7%
Caucasian 1,594 87.2% 1,608 88.0%
Native American 4 0.2% 2 0.1%
Latino 35 1.9% 40 2.2%
Mixed 32 1.8% 43 2.4%
Other 42 2.3% 36 2.0%
Total 1,827 100% 1,827 100%

brother, (b) sister, (c) father, (d) mother, (e) step- or foster father, (f) step- or
foster mother, (g) another relative, (h) or no family member was sexually
abusive toward me. Responses were recoded as 1 a family member sexually
abused me (inclusive of responses 1–7) or 0, no family member sexually
abused me (inclusive of response 8) to create ICSA and non-ICSA groups.

Conflict resolution style

Conflict resolution style was assessed by a single item used in previous
literature (Holman & Jarvis, 2003). Participants selected one of four empiri-
cally common conflict resolution style types identified by Gottman (1994) for
oneself and for one’s partner that best described conflict behaviors. These
styles included avoidant, volatile, validating, and hostile behaviors. These
responses were recoded as to compare the non-validating conflict styles
against the validating ones with 0 validating, 1 avoidant, 2 volatile, and 3
hostile. This was done because validation is generally known to be more
positively associated with relationship satisfaction (Holman & Jarvis, 2003)
and therefore qualified to be our baseline style to compare the other non-
validating styles separately (e.g. hostile, volatile, and avoidant).

Relationship satisfaction
Relationship satisfaction was assessed using a 7-item scale for each partner
ranging from 1 (very dissatisfied) to 5 (very satisfied). Items began with the
stem: “How satisfied are you with the following?” and examples include: “The
 JOURNAL OF CHILD SEXUAL ABUSE 65

physical intimacy you experience,” “The quality of your communication,”

and “Your overall relationship with your partner.” Higher scores indicated
greater relationship satisfaction. Previous research indicates that rating of the
partner’s satisfaction is more indicative of true relationship satisfaction than
self-report, and thus both the actor and partner reports were used in the
present study. Cronbach’s alpha for this scale was .84 for husbands and .86
for wives.

Relationship instability
Relationship instability was assessed in a 3-item scale for each partner
ranging from 1 (never) to 5 (very often). Example questions include, “How
often have you thought your marriage might be in trouble?” and “How often
have you and your partner discussed ending your marriage?” Higher scores
indicated greater relationship instability. Cronbach’s alpha for this scale was
.77 for men and .78 for women.

Controls
Previous research indicates that when evaluating relational dynamics such as
satisfaction and instability, controls need to be applied, such as education
level, race/ethnicity, and relationship length (Charles, Reynolds, & Gatz,
2001). Furthermore, because frequency of ICSA experience impacts the
severity of the psychological response to the trauma of CSA (Briggs &
Joyce, 1997), we also controlled for frequency of ICSA in our study.

Analysis
First, two independent groups for comparison were created. The first group
(ICSA) comprises couples in which only the female partner experienced
ICSA. The second group (non-ICSA) includes couples in which the female
partner did not experience abuse in her family of origin. Male partners in
both groups reported no ICSA or violence in their families of origin.
Research questions 1 and 2, exploring actor and partner reports of
conflict resolution styles for both ICSA and non-ICSA groups, were
addressed using a 2 x 4 chi-square analyses. Chi-square is an analysis
tool used to determine a statistically significant relationship between two
nominal variables (McCall, 1975). For research question one, a chi-
square tested for a significant difference in CRS between ICSA survivor
couples and non-ICSA survivor couples. The analysis first considered
how female ICSA survivors rated their own CRS, as compared to females
in the comparison group. Second, analysis explored how female ICSA
survivors rated their partner’s CRS, as compared to non-ICSA females’
ratings of their partners. These two analyses were also conducted to
compare the male partner groups, including reports of self and partner
66 A. E. KNAPP ET AL.

CRS. Once the overall chi-square statistic was obtained, a step-down

analysis was conducted to determine the significance within each group
of comparisons. For research question two, similar to research question
one, chi-square analyses tested for differences between female ICSA and
non-ICSA groups in their report of their perceptions of their male
partner’s CRS. The same procedure was used to test for differences
between male ICSA and non-ICSA groups as to how they perceive
their female partner’s CRS.
To best answer research question 3, exploring mediation of conflict
resolution style, a two-step analysis was used using MPlus 7.0 (Muthén &
Muthén, 2013). First, a confirmatory factor analysis was conducted to
evaluate how well relationship satisfaction and instability were measured
by the observed variables (Anderson & Gerbing, 1988). We compared two
measurement models to examine the measurement invariance of relation-
ship satisfaction and stability between the male and female respondents.
The first model was specified to have the factor loadings freely estimated.
The second model had all the factor loadings constrained to be equal
across the male and female respondents. The Wald chi-square tests
revealed that the majority of the factor loadings were invariant, while a
few were variant as indicated by asterisk in Table 6 (χ2dif = 79.78, dfdif = 5,
p < .001). This second model, in which the majority of the factor loadings
were held invariant, as indicated in Table 6, fit the data well (χ2 = 1387.00,
df = 156, p < .001, CFI = .98, TLI = .98, RMSEA = .06) and was used
throughout the rest of the analysis.
Second, the structural equation model (SEM) was estimated to test the
possible mediating effects of both partners’ CRS between female ICSA
and both partners’ relationship satisfaction as well as stability. Figure 1
offers the conceptual model. The final structural equation model esti-
mated had good model fit (χ2 = 1720.83, df = 483, p < .001; TLI = .95;
CFI = .96; RMSEA = .05). During this two-step process, missing data
was accounted for using maximum likelihood estimation with robust
standard errors (MLR).

Relationship
Conflict
Satisfaction
Resolution Style
Female Incestuous
Childhood Sexual Avoidance
Abuse Volatility
Hostility Relationship
Instability

Figure 1. Conceptual model.

 JOURNAL OF CHILD SEXUAL ABUSE 67

Results
Research question 1
What are female ICSA survivors’ self-reports of their conflict resolution styles
(i.e. avoidant, validating, volatile, or hostile) compared with females with no
ICSA background, and what are male partner’s self-report of their conflict
resolution?
For females, analysis illustrated an overall significant difference in self-
reported conflict styles between ICSA and non-ICSA groups, χ2 (3,
N = 2314) = 17.42, p < .001. Step-down analyses revealed significant differ-
ences in two conflict style groups when comparing the ICSA and non-ICSA
groups: volatile, χ2(1, N = 872) = 4.54, p < .05, and hostile, χ2(1,
N = 436) = 5.36, p < .05. For males, analysis also showed a significant
difference in conflict styles between ICSA and non-ICSA groups by male
self-report of CRS, χ2(3, N = 2314) = 13.68, p < .05. Step down analysis
revealed that they were significantly more likely than non-CSA males to
report a hostile style of CRS, χ2(1, N = 1464) = 12.69, p < .001. These
analyses showed that frequencies of female self-report of conflict resolution
style appear to be different between ICSA and non-ICSA groups, in that they
are more volatile and hostile. Frequencies of ICSA male self-report conflict
resolution styles were significantly different from non-ICSA males in that
they more frequently reported hostility (see Table 3).

Research question 2
What do female ICSA survivors report their male partners’ conflict resolution
styles to be as compared to women with no ICSA background, and what are
the male partners’ report of their female partner’s conflict style?
For females, there was a significant difference in reported partner conflict
styles between ICSA and non-ICSA groups, χ2(3, N = 2314) = 10.87, p < .05.

Table 3. Chi-square Analysis of Male and Female Self-perceptions of Types of Conflict Resolution
Styles.
Non-ICSA ICSA
Types of CRS N % N % Test Statistic df p
Female
Avoidant 153 8.4 32 6.6
Validating 973 53.3 218 44.8 χ 2 = 17.42 3 < .001
Volatile 517 28.3 170 34.9
Hostile 184 10.1 67 13.8
Male
Avoidant 245 13.4 74 15.2
Validating 1,060 58 258 53.0 χ 2 = 13.68 3 .003
Volatile 423 23.2 108 22.2
Hostile 99 5.4 47 9.7
68 A. E. KNAPP ET AL.

Step-down analysis revealed that significantly higher percentages of ICSA

women report their male partners to have hostile conflict styles, χ2(1,
N = 1441) = 9.82, p < .01, than non-ICSA women. Findings were similar
for men, with analysis illustrating a significant difference in conflict styles
between groups, χ2(3, N = 2314) = 15.67, p < .01. Step-down analysis revealed
that significantly higher percentages of men in committed relationship with
ICSA women reported their ICSA partners to have hostile conflict styles, χ2
(1, N = 1412) = 15.39, p < .001. Overall, frequencies of female and male
reports of partner conflict resolution styles were significantly different across
ICSA and non-ICSA groups in that ICSA couples reported higher frequen-
cies of hostile conflict styles (see Table 4).

Research question 3
Does conflict resolution style (as reported by the partner) significantly med-
iate the relationship between ICSA experience and self-reported relationship
satisfaction and stability?
An examination of mean scores between groups showed that ICSA groups
on average had lower relationship satisfaction than non-ICSA groups. ICSA
groups had more instability than non-ICSA groups. As a total sample, most
couples reported being satisfied and stable in their relationship (see Table 5).

Direct effects
Figure 2 illustrates the results of all paths of the present mediating model
controlling for relationship length, education level, race, and frequency of
ICSA. The full model accounted for 47.5% (p < .001) of the variance in male
relationship satisfaction and 41.2% (p < .001) of the variance in male
relationship instability. The model also accounted for 51.5% (p < .001) of
the variance in female relationship satisfaction and 35.2% (p < .001) of female
relationship instability. Direct effects worth noting include that female ICSA

Table 4. Chi-square Analysis of Male and Female Reports of Partner’s Types of Conflict Resolution
Style by ICSA Categories.
Non-ICSA ICSA
Types of CRS N % N % Test Statistic df p
Female
Avoidant 359 19.6 106 21.8
Validating 985 53.9 236 48.5 χ 2 = 10.873 3 .012
Volatile 326 17.8 82 16.8
Hostile 157 8.6 63 12.9
Male
Avoidant 291 15.9 73 15
Validating 954 52.2 226 46.4 χ 2 = 15.67 3 < .001
Volatile 421 23 117 24
Hostile 161 8.8 71 14.6
 JOURNAL OF CHILD SEXUAL ABUSE 69

Table 5. Mean Scores and Standard Deviations of Dependent Variables for ICSA and non-ICSA
Groups and Combined Sample.
Females
R. Satisfaction
Groups N M
ICSAa 487 3.92
Non-ICSA 1827 4.16
Combined 2314 4.11
a
Note: ICSA groups include couples in which only the female partner was self-reported to have experienced
ICSA. Non-ICSA groups are couples in which neither partner reported experienced ICSA. The combined
group includes all participants in this study without differentiation of ICSA or non-ICSA experience.
b
Note: Higher scores indicate more instability in the relationship.

Female -.12*** (-.21)

Avoidance

Female -.05** (-.09) .11*** (.12)

.17 (.08) .32* (.16)
Volatility
Male
.17*** (.19)
Relationship
Satisfaction
.22 (.10) -.30*** (-.56)
Female
Hostility
.51*** (.56)

-.18* (-.15) Male

Incestuous Relationship
.25 (.13)
child Sexual Instability
Abuse -.18* (-.17)

.25 (.13)
Female
-.42 (-.21) Relationship
-.12*** (-.23)
Satisfaction
Male
Avoidance .11*** (.12)

.32* (.16) -.05** (-.09)

Male .07 (.07) Female
.22 (.10) Volatility Relationship
.51*** (.55) Instability
-.30*** (-.61)

Male
Hostility

Figure 2. Unstandardized (standardized) coefficients of the model including controls.Note:

*p < .05, **p < .01, ***p < .001.

experience was significantly negatively related to male and female relation-

ship satisfaction. Furthermore, female ICSA experience was also significantly
directly related to male and female reports of partner volatility. Female ICSA
experience was not significantly directly related to either hostile or avoidant
conflict styles.
Each of the three conflict resolution styles was directly negatively related to
relationship satisfaction and positively related to instability, with one excep-
tion: the relationship between female report of partner volatility and her self-
reported relationship instability, which was non-significant. Furthermore,
70 A. E. KNAPP ET AL.

Table 6. Mean, Standard Deviations, and Standardized Factor Loadings for the Independent
Variables.
Females Males
M SD Factor Loadings M SD Factor Loadings
Relationship Satisfaction Scalea
179. Physical intimacy 4.09 .98 .56 4.06 .99 .59
180. Love 4.56 .76 .81* 4.54 .72 .81*
181. Conflicts resolved 3.71 1.08 .69 3.75 1.02 .71
182. Relationship quality 4.32 .89 .79* 4.28 .82 .74*
183. Time together 3.68 1.12 .40* 3.67 1.09 .30*
184. Quality of communication 3.91 1.04 .76 3.93 .97 .74
185. Overall relationship 4.51 .76 .88* 4.51 .72 .87*
Total relationship satisfaction scale 4.11 .70 4.10 .65
Relationship Stability Scaleb
248. Thought the relationship was in trouble 2.10 .97 .91 2.07 .93 .87
249. Discussed ending the relationship 1.68 .87 .76* 1.66 .84 .78*
250. Broken up or separated 1.36 .71 .47 1.35 .68 .47
Total Relationship Stability 1.72 .71 1.69 .68
a
Note: Responses include: 1 = very dissatisfied, 2 = dissatisfied, 3 = neutral, 4 = satisfied, 5 = very satisfied.
b
Note: Responses include: 1 = never, 2 = rarely, 3 = sometimes, 4 = often, 5 = very often.
*Note: Invariant factor loadings as indicated by Wald chi-square test.

hostility had significant and larger effect sizes related to relationship satisfac-
tion and instability than the other conflict resolution styles by both partners.
Male report of female partner hostility was negatively related to male report
of relationship satisfaction (B = –.30, p < .001, β = –.56) and positively related
to instability (B = .51, p < .001; β = .56). Female report of male partner
hostility also had large effect sizes with female report of relationship satisfac-
tion (B = –.30, p < .001; β = –.61) and instability (B = .51, p < .001; β = .55).

Indirect effects
One significant indirect effect was found in the analysis of CRS as a mediator
between female ICSA experience and both partners’ relationship satisfaction
and instability. This indirect effect was the female ICSA→male report of
female volatility→male relationship instability (B = .06, p < .05; β = .03). As
seen in Figure 2, there was no direct effect between ICSA and male relation-
ship instability. All other indirect effects were non-significant.

Discussion
Previous research has suggested that female ICSA survivors are likely to
experience relational consequences of the trauma in adulthood (Briggs &
Joyce, 1997; Mullen et al., 1994). Our study supports previous research that
has found female ICSA experience to be a risk factor for relationship
satisfaction in heterosexual couples (DiLillo, 2001; Friesen et al., 2010;
Hunter, 1991; Nelson & Wampler, 2000; Walker et al., 2011), but it does
not support the idea that ICSA is directly associated with relationship
 JOURNAL OF CHILD SEXUAL ABUSE 71

instability for either sex. This research also supports previous findings that
most couples, regardless of ICSA experience, report themselves and their
partners to be validating (Holman & Jarvis, 2003).
Building on previous research, there were several important findings in this
study. First, we found that ICSA couples were significantly different from
comparison couples in only one self-reported conflict resolution style: hostility.
In addition, female ICSA survivors self-reported significantly more use of
hostility and more volatility than non-ICSA women. These results are contrary
to previous research that suggested ICSA survivors may be more likely to be
avoidant and hostile than comparison groups (Davins-Pujols, Pérez-Testor,
Salamero-Baró, & Castillo-Garayoa, 2012; Finkelhor & Browne, 1985). One
explanation may be that female ICSA survivors may feel distrust toward their
partners (Davis & Petretic-Jackson, 2000). This may indicate that females who
have experienced the trauma of ICSA may be more likely to adopt hostile or
volatile CRS instead of avoidance.
One of our other important findings showed that CRS is directly nega-
tively related to relationship satisfaction and stability. Non-validating CRS is
linked to lower reports of relationship satisfaction and stability. Hostility is
more strongly negatively related to relationship satisfaction and stability for
men and women than any other non-validating conflict resolution styles, a
finding supported by previous research (Holman & Jarvis, 2003).
We found, with one exception, conflict resolution styles were not major
mediators between female ICSA experience and reported relationship satis-
faction and instability. Male report of female partner volatility was negatively
related to his reported relationship stability. The significance of female
volatility as reported by the male partner may add to Busby and Holman’s
(2009) “one is enough” idea—meaning that even if only one partner is
hostile, both partners report lower relationship satisfaction. This principle
may be applicable to ICSA couples in regard to female volatility. If the male
perceives his ICSA partner to be volatile, it alone may decrease his reported
relationship stability than with any other reported conflict resolution style.
There were fewer (N = 452) participants in the hostile group than the
volatile group (N = 946). Therefore, in this model, if there were higher counts
of participants in the hostile group, it may have been likely that a significant
path would have been found between ICSA and hostility. This is important to
note, as Gottman (1994) suggested that volatility may escalate into hostility.
He also suggested that emotional flooding and intense behaviors are asso-
ciated with hostility and volatility. Therefore, volatility is not a safe way to
communicate, as it may change into hostility.
The findings in this study indicated that conflict resolution style may not
be primarily a result of ICSA experience, but perhaps a combination of other
related ICSA experiences, (e.g. family of origin conflict styles, adult relation-
ship experiences, and trust and power issues in adulthood). As such,
72 A. E. KNAPP ET AL.

relationship satisfaction and instability may not be as impacted by ICSA

experience as they are CRS in adulthood. This may be due to other factors in
the relationship altered by ICSA experience, such as relationship trust.

Clinical implications
Our results have several implications for clinicians. We found that CRS has a
much more proximal effect on relationship satisfaction, whereas ICSA
experience has a more distal effect. Therefore, clinicians may consider treat-
ing the CRS as a first priority in couple’s therapy and ICSA experience
secondarily. Although there is great benefit in utilizing the couple to help
the CSA survivor process her trauma using therapeutic methods such as
witnessing (Nasim & Nadan, 2013), couple’s therapy focusing on the here
and now may make greater strides toward improving relationship satisfaction
and stability. Working on the proximal factor of conflict resolution style may
help decrease some of the psychological symptoms of the CSA trauma. For
example, Feinauer and colleagues (1996) found that for married female ICSA
survivors with depressive symptoms, a positive intimate relationship
decreased their reported symptoms of depression, suggesting that a healthy
couple relationship may help mitigate the normative interpersonal issues an
ICSA survivor may experience. For effective assessment and treatment of
CRS, clinicians might consider having couples fill out a conflict style ques-
tionnaire for themselves and for their partner. It would be especially impor-
tant to include partner perceptions, as we found partner perception of
conflict style to be strongly linked to relationship satisfaction and stability.
The presence of volatility in a couple may be an important issue to address
clinically. We found that female partner volatility strongly impacted male
relationship stability when the female partner experienced ICSA. Gottman
and Silver (1995) explain that because volatile couples value honesty and
independence in their relationships, they are less likely to filter negative
comments about their relationships and share these feelings openly.
Although this leads to an open and passionate relationship, it may lead to
hostility if the couple lets their negative communication consume their
relationship. Our study showed that of all the conflict styles measured,
hostility is most strongly related to lower relationship satisfaction and higher
instability as reported by both genders. Therefore, it would be important to
address volatility in a clinically present couple to prevent communication
from transitioning into hostility.

Limitations and future direction

Notwithstanding how this study adds depth and clarity to previous research
on previous female ICSA’s part in later romantic relationships, this research
 JOURNAL OF CHILD SEXUAL ABUSE 73

does have several limitations that should be accounted in order to interpret

our results in context. Our analysis did not illustrate how conflict resolution
style and relationship satisfaction and instability might change based on race,
culture, identity, sexual orientation, or socioeconomic status. The effects of
ICSA on communication in adult committed relationships may take a dif-
ferent form in different cultures, as different cultural groups may value
different types of coping strategies that would impact relationships in differ-
ent ways (Bardi & Guerra, 2010). Culture-specific research about the effects
of CSA has demonstrated that cultural values and views about the roles of
women has influenced coping behaviors, including desired relationship attri-
butes in future/current romantic partners (Ligiéro, Fassinger, McCauley,
Moore, & Lyytinen, 2009). Cultural values of both ICSA survivors and
their partners likely influence the couple relationship in profound ways and
warrant further examination.
Also, participants in this study were in the early years of their rela-
tionships (average between 4.5–4.9 years). Perhaps the development of
non-validating CRS did not have sufficient time to develop in a short
relationship span. Furthermore, our sample mostly included satisfied
couples with stable relationships who self-recruited to participation.
Our participants may represent inaccurate frequencies of those who
use avoidant conflict styles in their relationships. Avoidant female
ICSA survivors may not seek out relational assistance or choose to stay
out of committed relationships with males. Therefore, our findings
should be used tentatively in application to a general population. In
addition, this study is from cross-sectional data rather than multiple
time points. To best understand the role that ICSA plays within roman-
tic relationships, longitudinal methodologies need to be used. This
would offer insight on how direct and indirect effects of ICSA and the
CRS may change over various stages or experiences of the relationship.
Due to our limitations, we suggest several routes for continuation of
future research. First, researchers could focus on clinically distressed
couples to gain a better understanding of more troubled relationships
dealing with ICSA and conflict. Second, identifying cultural values and
beliefs for ICSA survivors and partners seems to be a necessary part of
furthering knowledge in this area. Third, future research could further
explore associations of ICSA and CRS with relationship outcomes such
as relationship safety and relational coping. Fourth, future work could
consider broader systemic relationships relevant to ICSA survivors such
as those with children and parents. Last, additional research could
consider how CRS may change the relationship between ICSA experi-
ences and relational outcomes as a moderating variable.
74 A. E. KNAPP ET AL.

Conclusion
Previous research had not explored the impact of female ICSA experience on
conflict resolution styles present in adult committed relationships. This study
found that compared to non-ICSA women, ICSA survivors more frequently
reported use of hostile conflict styles than their non-ICSA counterparts. Also,
female ICSA survivors were not different from their non-ICSA counterparts
in reports of using validation. This is a finding startling to many who may
have assumed that women ICSA survivors would likely be more avoidant.
This study reminds clinicians of the importance of working with both
partners on effective conflict resolution skills and for helping female ICSA
survivors process their trauma. Treatment quality may suffer if only indivi-
dual therapy for ICSA is done because CRS were found to be much more
influential on relationship satisfaction and stability than ICSA experience.

Acknowledgments
We note a special thank you to the RELATE Institute for usage of their data set (see www.
relate-institute.org).

Notes on contributors
Ashlee E. Knapp, MS, LMFT, is a graduate from Brigham Young University in Provo, Utah.
Darin J. Knapp, PhD, CFLE, LMFT, is assistant professor of practice at the University of
Arizona, Tucson, Arizona.

Cameron C. Brown, MS, LMFT, is third year PhD student at Kansas State University,
Manhattan, Kansas.
Jeffry H. Larson, PhD, LMFT, is a retired professor from Brigham Young University, Provo,
Utah.

References
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental dis-
orders, 4th ed., text revision. Arlington, VA: American Psychiatric Association.
doi:10.1176/appi.books.9780890423349
Anderson, J. C., & Gerbing, D. W. (1988). Structural equation modeling in practice: A review
and recommended two-step approach. Psychological Bulletin, 103(3), 411–423. doi:10.1037/
0033-2909.103.3.411
Barcus, R. (1997). Partners of survivors of abuse: A men’s therapy group. Psychotherapy:
Theory, Research, Practice, Training, 34(3), 316–323. doi:10.1037/h0087830
Bardi, A., & Guerra, V. M. (2010). Cultural values predict coping using culture as an
individual difference variable in multicultural samples. Journal of Cross-Cultural
Psychology, 42, 908–927. doi:10.1177/0022022110381119
Briere, J., & Elliott, D. (1994). Immediate and long-term impacts of child sexual abuse. The
Future of Children, 4(2), 54–69. doi:10.2307/1602523
 JOURNAL OF CHILD SEXUAL ABUSE 75

Briggs, L., & Joyce, P. R. (1997). What determines post-traumatic stress disorder symptoma-
tology for survivors of childhood sexual abuse?. Child Abuse & Neglect, 21(6), 575–582.
doi:10.1016/S0145-2134(97)00014-8
Bronwyn, W., & Halford, W. K. (2010). Classes of childhood sexual abuse and women’s adult
couple relationships. Violence and Victims, 25(4), 518–535. doi:10.1891/0886-6708.25.4.518
Busby, D. M., & Holman, T. B. (2009). Perceived match or mismatch on the Gottman
Conflict Styles: Associations with relationship outcome variables. Family Process, 48(4),
531–545. doi:10.1111/j.1545-5300.2009.01300.x
Busby, D. M., Holman, T. B., & Taniguchi, N. (2001). RELATE: Relationship evaluation of
the individual, family, cultural, and couple contexts. Family Relations, 50(4), 308–316.
doi:10.1111/j.1741-3729.2001.00308.x
Busby, D. M., Walker, E. C., & Holman, T. B. (2011). The association of childhood trauma
with perceptions of self and the partner in adult romantic relationships. Personal
Relationships, 18(4), 547–561. doi:10.1111/j.1475-6811.2010.01316.x
Carlson, B. E., Maciol, K., & Schneider, J. (2006). Sibling incest: Reports from forty-one
survivors. Journal of Child Sexual Abuse, 15(4), 19–34. doi:10.1300/J070v15n04_02
Charles, S., Reynolds, C. A., & Gatz, M. (2001). Age-related differences and change in positive
and negative affect over 23 years. Journal of Personality and Social Psychology, 80(1), 136–
151. doi:10.1037/0022-3514.80.1.136
Cyr, M., Wright, J., McDuff, P., & Perron, A. (2002). Intrafamilial sexual abuse: Brother–sister
incest does not differ from father–daughter and stepfather–stepdaughter incest. Child
Abuse & Neglect, 26(9), 957–973. doi:10.1016/S0145-2134(02)00365-4
Davins-Pujols, M., Pérez-Testor, C., Salamero-Baró, M., & Castillo-Garayoa, J. A. (2012).
Personality profiles in abused women receiving psychotherapy according to the existence of
childhood abuse. Journal of Family Violence, 27(2), 87–96. doi:10.1007/s10896-011-9407-z
Davis, J. L., & Petretic-Jackson, P. A. (2000). The impact of child sexual abuse on adult
interpersonal functioning: A review and synthesis of the empirical literature. Aggression
and Violent Behavior, 5(3), 291–328. doi:10.1016/S1359-1789(99)00010-5
DiLillo, D. (2001). Interpersonal functioning among women reporting a history of childhood
sexual abuse: Empirical findings and methodological issues. Clinical Psychology Review, 21
(4), 553–576. doi:10.1016/S0272-7358(99)00072-0
Dube, S. R., Anda, R. F., Whitfield, C. L., Brown, D. W., Felitti, V. J., Dong, M., & Giles, W.
H. (2005). Long-term consequences of childhood sexual abuse by gender of victim.
American Journal of Preventive Medicine, 28(5), 430–438. doi:10.1016/j.amepre.2005.01.015
Feinauer, L. L., Callahan, E., & Hilton, H. (1996). Positive intimate relationships decrease
depression in sexually abused women. The American Journal of Family Therapy, 24(2), 99–
106. doi:10.1080/01926189608251023
Finkelhor, D. (1990). Early and long term effects of child sexual abuse: An update.
Professional Psychology: Research and Practice, 21(5), 325–330. doi:10.1037/0735-
7028.21.5.325
Finkelhor, D., & Browne, A. (1985). The traumatic impact of child sexual abuse: A con-
ceptualization. American Journal of Orthopsychiatry, 55(4), 530–541. doi:10.1111/j.1939-
0025.1985.tb02703.x
Finkelhor, D., Shattuck, A., Turner, H. A., & Hamby, S. L. (2014). The lifetime prevalence of
child sexual abuse and sexual assault assessed in late adolescence. Journal of Adolescent
Health, 55(3), 329–333. doi:10.1016/j.jadohealth.2013.12.026
Fleming, J., Mullen, P., & Bammer, G. (1997). A study of potential risk factors for sexual
abuse in childhood. Child Abuse & Neglect, 21(1), 49–58. doi:10.1016/S0145-2134(96)
00126-3
76 A. E. KNAPP ET AL.

Friesen, M., Woodward, L., Horwood, L., & Fergusson, D. (2010). Childhood exposure to
sexual abuse and partnership outcomes at age 30. Psychological Medicine, 40(4), 679–688.
doi:10.1017/S0033291709990389
Godbout, N., Sabourin, S., & Lussier, Y. (2009). Child sexual abuse and adult romantic
adjustment: Comparison of single- and multiple-indicator measures. Journal of
Interpersonal Violence, 24(4), 693–705. doi:10.1177/0886260508317179
Gottman, J., & Silver, N. (1995). Why marriages succeed or fail: And how you can make yours
last. New York, New York: Fireside.
Gottman, J. M. (1994). What predicts divorce?: The relationship between marital processes and
marital outcomes. Hillsdale, NJ: Lawrence Erlbaum Associates.
Harway, M., & Faulk, E. (2005). Treating couples with sexual abuse issues. In M. Harway
(Ed.), Handbook of couples therapy (pp. 272–288). Hoboken, NJ: John Wiley & Sons.
Holman, T. B., & Jarvis, M. O. (2003). Hostile, volatile, avoiding, and validating couple-
conflict types: An investigation of Gottman’s couple-conflict types. Personal Relationships,
10(2), 267–282. doi:10.1111/1475-6811.00049
Hunter, J. A. (1991). A comparison of the psychosocial maladjustment of adult males and
females sexually molested as children. Journal of Interpersonal Violence, 6(2), 205–217.
doi:10.1177/088626091006002005
Kendler, K. S., Bulik, C. M., Silberg, J., Hettema, J. M., Myers, J., & Prescott, C. A. (2000).
Childhood sexual abuse and adult psychiatric and substance use disorders in women: An
epidemiological and cotwin control analysis. Archives of General Psychiatry, 57(10), 953–
959. doi:10.1001/archpsyc.57.10.953
Ketring, S. A., & Feinauer, L. L. (1999). Perpetrator–victim relationship: Long-term effects of
sexual abuse for men and women. The American Journal of Family Therapy, 27(2), 109–
120. doi:10.1080/019261899262005
Kim, J., Talbot, N., & Cicchetti, D. (2009). Childhood abuse and current interpersonal
conflict: The role of shame. Child Abuse & Neglect, 33(6), 362–371. doi:10.1016/j.
chiabu.2008.10.003
Larson, J. H., & Lamont, C. (2005). The relationship of childhood sexual abuse to the marital
attitudes and readiness for marriage of single young adult women. Journal of Family Issues,
26(4), 415–430. doi:10.1177/0192513X04270474
Lev-Wiesel, R., & Amir, M. (2003). The effects of similarity versus dissimilarity of spouses’
traumatic childhood events on psychological well-being and marital quality. Journal of
Family Issues, 24(6), 737–752. doi:10.1177/0192513X03255326.
Ligiéro, D. P., Fassinger, R., McCauley, M., Moore, J., & Lyytinen, N. (2009). Childhood
sexual abuse, culture, and coping: A qualitative study of Latinas. Psychology of Women
Quarterly, 33(1), 67–80. doi:10.1111/j.1471-6402.2008.01475.x
McCall, R. (1975). Fundamental statistics for psychology (2nd ed.). New York, New York:
Harcourt Brace Jovanovich.
Mohl, A. (2010). Sexual abuse of the child: A treatment model for the incestuous family. The
Journal of Psychohistory, 38(2), 168–181.
Molnar, B. E., Buka, S. L., & Kessler, R. C. (2001). Child sexual abuse and subsequent
psychopathology: Results from the National Comorbidity Survey. American Journal of
Public Health, 91(5), 753–760. doi:10.2105/AJPH.91.5.753
Mullen, P. E., Martin, J. L., Anderson, J. C., Romans, S. E., & Herbison, G. P. (1994). The
effect of child sexual abuse on social, interpersonal and sexual function in adult life. The
British Journal of Psychiatry, 165(1), 35–47. doi:10.1192/bjp.165.1.35
Muthén, L. K., & Muthén, B. O. (2013). Mplus user’s guide (7th ed.). Los Angeles, CA:
Muthén & Muthén.
 JOURNAL OF CHILD SEXUAL ABUSE 77

Nasim, R., & Nadan, Y. (2013). Couples therapy with childhood sexual abuse survivors (CSA)
and their partners: Establishing a context for witnessing. Family Process, 52(3), 368–377.
doi:10.1111/famp.12026
Nelson, B. S., & Wampler, K. S. (2000). Systemic effects of trauma in clinic couples: An
exploratory study of secondary trauma resulting from childhood abuse. Journal of Marital
and Family Therapy, 26(2), 171–184. doi:10.1111/j.1752-0606.2000.tb00287.x
Nelson, B. S., & Wampler, K. S. (2002). Further understanding the systemic effects of
childhood sexual abuse: A comparison of two groups of clinical couples. Journal of Child
Sexual Abuse: Research, Treatment, & Program Innovations for Victims, Survivors, &
Offenders, 11(3), 85–106. doi:10.1300/J070v11n03_05
O’Brien, J., White, K., Wu, Q., & Killian-Farrell, C. (2016). Mental health and behavioral
outcomes of sexual and nonsexual child maltreatment among child welfare-involved youth.
Journal of Child Sexual Abuse, 25(5), 483–503. doi:10.1080/10538712.2016.1167801
Pereda, N., Guilera, G., Forns, M., & Gómez-Benito, J. (2009). The prevalence of child sexual
abuse in community and student samples: A meta-analysis. Clinical Psychology Review, 29
(4), 328–338. doi:10.1016/j.cpr.2009.02.007
Reid, K., Mathews, G., & Liss, P. (1995). My partner is hurting: Group work with male
partners of adult survivors of sexual abuse. Social Work with Groups: A Journal of
Community and Clinical Practice, 18(1), 81–87. doi:10.1300/J009v18n01_08
Runyon, M. K., & Kenny, M. C. (2002). Relationship of attributional style, depression, and
posttrauma distress among children who suffered physical or sexual abuse. Child
Maltreatment, 7(3), 254–264. doi:10.1177/1077559502007003007
Stoltenborgh, M., Van Ijzendoorn, M. H., Euser, E. M., & Bakermans-Kranenburg, M. J.
(2011). A global perspective on child sexual abuse: Meta-analysis of prevalence around the
world. Child Maltreatment, 16(2), 79–101. doi:10.1177/1077559511403920
Stroebel, S. S., O’Keefe, S. L., Beard, K. W., Kuo, S., Swindell, S., & Stroupe, W. (2013).
Brother–sister incest: Data from anonymous computer-assisted self interviews. Journal of
Child Sexual Abuse, 22(3), 255–276. doi:10.1080/10538712.2013.743952
Walker, E. C., Sheffield, R., Larson, J. H., & Holman, T. B. (2011). Contempt and defensive-
ness in couple relationships related to childhood sexual abuse histories for self and partner.
Journal of Marital and Family Therapy, 37(1), 37–50. doi:10.1111/j.1752-0606.2009.00153.x