The influence of childhood sexual abuse, physical abuse, family environment, and gender on the psychological adjustment of adolescentsLori A. Meyerson*,a,1, Patricia J. Longa, Robert Miranda, Jr.a,1, Brian P. MarxbObjective: The primary aim of the current study was to examine the contributions of sexual abuse, physical abuse, family cohesion, and conflict in predicting the psychological functioning of adolescents. Additional analyses were conducted to determine whether adolescent victims of child sexualabuse and physical abuse perceive their family environments as more conflictual and less cohesivethan nonabused adolescents.Method: Participants were 131 male and female adolescents, ages 16 years to 18 years, receiving services at a residential vocational training program. Participants completed well established psychological assessment tools to assess abuse history, family environment characteristics, and current adjustment.Results: Physically abused adolescent females perceived their family environments as more conflictual and less cohesive than females without physical abuse, and sexually abused females perceived their family environments as more conflictual and less cohesive than females without sexual abuse. Physically abused adolescent males reported more conflict than males without physical abuse, but did not differ with regard to cohesion. Adolescent males with and without a sexual abuse history did not differ on the family dimensions. Multiple regression analyses revealed that both conflict and cohesion, in addition to a history of sexual and physical abuse, predicted depression and distress. Separate analyses by gender revealed these variables differentially impact adjustment in male and female adolescents. Results of a power analysis indicated sufficient power to detect these differences.Conclusions: Findings indicate that in addition to child sexual abuse and physical abuse, family conflict and cohesion are risk factors for the development of psychological distress and depression in adolescence. Implications for treatment and directions for future research are discussed. © 2002IntroductionWith nearly three million cases of child abuse and neglect reported in the US each year, child maltreatment has emerged as an urgent national problem (American Humane Association, 1994). Results of investigations conducted in recent decades point to a number of immediate and long-term problems associated with child abuse (e.g., Briere & Runtz, 1988; Browne & Finkelhor, 1986; Polusny & Follette, 1995). To date, however, relatively few studies have examined the effects of child sexual and/or physical abuse within the adolescent population. The unique emotional, social, and physical development occurring during this period suggest that child abuse may differentially affect the psychological functioning of this age cohort as compared to others (Hussey & Singer, 1993; Williamson, Borduin, & Howe,1991).Existing research documenting abuse-related sequelae within the adolescent population has focused primarily on child sexual abuse. Findings have generally demonstrated that adolescents with a sexual abuse history exhibit a wide range of emotional and behavioral problems (Briere & Runtz, 1988). Most notably, investigators have consistently found that adolescent survivors of child sexual abuse report greater depression and general psychological distress, more conductproblems and aggression, lower self-esteem, and more substance abuse problems (Brown, Cohen, Johnson, & Smailes, 1999; Fergusson, Horwood, & Lynskey, 1996; Garnefski & Arends, 1998; Garnefski & Diekstra, 1997; Harrison, Hoffman, & Edwall, 1989; Kendall-Tackett, Williams, & Finkelhor, 1993; Luster & Small, 1997). While the results of such investigations are largely consistent, the heavy reliance on inpatient and treatment samples within this literature limits the generalizability of findings (e.g., Cohen et al., 1996; Harrison et al., 1989; Hart, Madder, Griffith, & De Mendonca, 1989).In comparison to child sexual abuse, fewer studies have examined the effects of childhood physical abuse on adolescent functioning. Those studies available have indicated that adolescents physically abused in childhood show greater overall adjustment difficulties, poorer social competence, decreased language ability, and poorer overall school performance than nonabused adolescents (Flisher, Kramer, Hoven, & Greenwald, 1997). Physically abused adolescents are also more likely to have a variety of psychiatric conditions, including major depression, conduct disorder, and generalized anxiety disorder as compared to nonphysically abused individuals (Briere & Runtz, 1988; Flisher et al., 1997; Kaplan & Pelcovitz, 1982; Kolko, Moser, & Weldy, 1988; Malinosky-Rummell & Hansen, 1993).It is apparent that survivors of physical and sexual abuse often display a wide range of psychological and behavioral problems. Despite these findings, no one type of abuse is associated with a specific pattern of symptomatology. Some studies from the adult literature indicate that sexual and physical abuse result in similar psychological outcomes (Margo & McLees, 1991; Mullen, Martin, Anderson, Romans, & Herbison, 1996; Wind & Silvern, 1992). Other work, however, highlights the differences in symptom expression on the basis of exposure to sexual or physical abuse (Cohen et al., 1996; Hart et al., 1989; Luster & Small, 1997; Schaff & McCanne, 1998). Given the conflicting findings, it is unclear what the unique contribution of physical and sexual abuse may be in predicting later adjustment. A complete understanding of the relationship between abuse and psychopathology may not be adequately achieved until types of abuse are considered together.To further clarify the relationship betweenthe occurrence of abuse and subsequent psychological symptomatology, researchers have expanded their analyses to include contextual variables that may influence psychological functioning. Specifically, numerous investigators have examined the influence of family environment on the development of psychopathology (for reviewsee Draucker, 1996; Hulsey, Sexton, & Nash, 1992). While investigators have only recently begun to unravel the specific relationships between childhood family environment, sexual abuse, and psychological functioning (Hulsey et al., 1992), results of this line of inquiry have consistently shown that survivors of sexual abuse often perceive their family as having high levels of