Modeling the relationship between sexual victimization and physical health
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Recent investigations have documented that sexual victimization is related to long-term physical health. Using Structural Equation Modeling (SEM), this study examined pathways by which this relationship exists. Data collected from 737 college women (110 sexually victimized women and 627 nonvictimized women) were analyzed. The model included psychological and behavioral processes that have each been linked to both sexual victimization and health outcome (i.e., perceived stress, depression, locus of control, maladaptive coping, sleep quality, alcohol use, and sexual risk taking). The role of family of origin conflict was also investigated. Tests of overall model fit suggest that the implied model fit the data reasonably well. The total indirect path between sexual victimization and health outcome was significant. There was also a significant indirect effect for sexual victimization on depression through perceived stress, maladaptive coping, and external locus of control. Perceived stress appeared to be largely responsible for this effect. A significant indirect effect was also found for depression on physical health outcome through increased alcohol use, sexual risk taking, and poor sleep quality. Specifically, alcohol use and poor sleep quality were primarily responsible for this mediated effect. Family conflict and sexual victimization were significantly correlated. The present study generally supports pathways proposed within Schnurr and Green’s (2004) theoretical model. It also highlights the usefulness of an integrated model of care. Implications of the present findings include the importance of considering mental health conditions, such as depression, when evaluating physical health problems even among young trauma survivors. Early mental health intervention could help prevent chronic psychological conditions from developing, thereby lessening the impact on physical health as well as health care cost and utilization.