Childhood sexual abuse and adult intimacy

It’s not at all surprising that victims of childhood sexual abuse have difficulty in adult romantic relationships. Lassri & Gewirtz-Meydan (2024) published “Breaking the Cycle: Mentalizing moderates and mediates the link between childhood sexual abuse and satisfaction with adult romantic relationships” in Psychological Trauma: Theory, Research, Practice, and Policy. Here are the edited abstract and impact statements:

Childhood sexual abuse (CSA) is a significant risk factor with consistently demonstrated negative implications for satisfaction with adult romantic relationships. Yet, research on risk and protective factors in this context is scarce, particularly among well-functioning adults. Addressing this gap, the present study focused on the potential mediating and moderating roles of mentalizing or reflective functioning, i.e., the capacity to understand oneself and others in terms of intentional mental states. We investigated whether impairments in mentalizing underlie the association between CSA and relationship satisfaction and whether robust mentalizing can buffer the CSA-relationship satisfaction link. A sample of 667 individuals engaged in a meaningful romantic relationship was drawn from a larger sample obtained in an online convenience survey. A mediation and moderation model was examined using PROCESS. The results confirmed our integrative model—the association between CSA and satisfaction with romantic relationships was mediated by impairments in mentalizing (uncertainty about mental states) and was simultaneously moderated by robust mentalizing (certainty about mental states). These effects were shown even when controlling for age, gender, education, and psychopathological symptoms. These findings highlight the importance of mentalizing, a key transdiagnostic factor. Reduced mentalizing is a risk factor for harmful impact of CSA on romantic relationships, while greater mentalizing abilities can be a significant resilience factor protecting CSA survivors. This study supports the potential contribution of mentalization-based interventions with survivors of CSA at risk for dissatisfaction with romantic relationships. 

Childhood sexual abuse (CSA) has been consistently linked with decreased satisfaction with adult romantic relationships. We examined mentalizing as both a vulnerability and a resilience dimension in the association between CSA and adult romantic relationship satisfaction among a nonclinical sample. Mentalizing plays a significant role, not only explaining the link between CSA and dissatisfaction with romantic relationships, but also mitigating the harmful impact of CSA on relationship satisfaction. Identifying resilience mechanisms may support the development of new counseling strategies to prevent the onset and recurrence of difficulties in romantic relationships among CSA survivors. 

The APA Dictionary of Psychology says that mentalizing is “the ability to understand one’s own and others’ mental states, thereby comprehending one’s own and others’ intentions and affects.”  I like this study because it’s a large enough sample that they were able to control for age, gender, education, and psychopathological symptoms, so, although it’s a convenience sample, the results are compelling. This work offers clinicians a vehicle for better understanding how clients may fare in adult relationships when they have been victims of childhood sexual abuse. There are also several assessments of mentalizing that may be helpful to practitioners.