Development of Sexuality
Dr. Noll has been involved in a prospective, longitudinal study of the long-term psychobiological effects of substantiated childhood sexual abuse on female development over the past 18 years. Based in the greater Washington DC metropolitan area, this ongoing study has included assessments of abused and comparison females at 3 times during childhood (Times 1-3), twice during adolescence (Times 4 and 5), and, most recently, in young adulthood (Time 6). The study has been funded via several governmental and foundation grants awarded to various combinations of PIs and Co-PIs among a team of the three primary researchers; Penelope K. Trickett, PhD, Frank W. Putnam, MD, and Jennie G. Noll, PhD. Over 96% of the original sample have been available for follow-up assessments and approximately 40 peer-reviewed journal articles have been generated from this longitudinal study reporting on a host of behavioral, psychological, and physiological effects in both childhood and adolescence.
Due to its explicit sexual nature, the impact of childhood sexual abuse likely differs from other forms of child maltreatment in that there are increased possibilities for the development of sexual distortions in adolescence as issues of sexuality and intimacy become increasingly salient. Therefore, an assessment of a host of sexual attitudes and activities was implemented into the procedures of the longitudinal study at the time of the adolescent assessment, approximately 10 years after the disclosure of abuse. Analyses of these data revealed that abused participants were more preoccupied with sex, younger at first voluntary intercourse, and endorsed lower birth control efficacy than comparison participants after controlling for age, SES, minority status, and marital or cohabitation status. Abused females also reported significantly higher rates of teen motherhood (abused = 29%; comparison = 4%).
Psychological functioning earlier in development was examined in order to better understand the developmental sequencing of 3 attitudinal variables defining various aspects of sexual distortion. Results showed that sexual preoccupation was predicted by earlier anxiety; sexual aversion was predicted by sexual behavior problems displayed in childhood, and sexual ambivalence (simultaneous sexual preoccupation and sexual aversion) was predicted by earlier pathological dissociative tendencies. These sexual distortion variables were also shown to be correlated with several concurrent indices of sexual risk-taking behaviors (including age at first voluntary intercourse, number of current sex partners, and HIV risk-behaviors) as well as the occurrence of teenage births.
In other analyses, factors that moderate the relationship between childhood sexual abuse and subsequent sexual distortion were identified. Cross-lag, multiple-group structural models were used to examine relationships between childhood social network variables and later sexual attitudes and activities. For both abused and comparison females, a large number of male peers in childhood networks predicted heightened sexual activity, sexual preoccupation, increased sexual pressure, younger age at first voluntary intercourse, greater numbers of sex partners, and a lack of birth control usage in adolescence. A larger number of non-peer females in childhood networks was predictive of lower sexual permissive attitudes in adolescence. Early sexual relations with boyfriends predicted younger age at first voluntary intercourse. For abused females only, a high quality of relationships with male peers and non-peers in childhood predicted less disturbed sexuality and greater birth control efficacy in adolescence. These results suggest that the emotional depth of a high-quality relationship may be a key component in the cognitive restructuring of relationships with males in terms other than sexual and in the ability to glean emotional, rather than sexual, rewards from romantic attachments. These high-quality relationships may, thus, function to facilitate the reparation of basic trust and the "de-generalization" of all men as abusers.
These analyses suggest that sexual distortion may be a key concept in understanding pregnancy-risk for abused females. They also underscore the importance of ascertaining the quantity and quality of both male and female social network members, as these variables seem to impact the sexual development of both abused and non-abused adolescents.
Future Directions
The link between childhood maltreatment and teen pregnancy is not well understood, but there are several plausible explanations for this high rate; 1) childhood maltreatment is correlated with many of the variables associated with teen pregnancy, and thus, serves to amplify many of these risks, and 2) there are likely unique pathways to teen pregnancy taken by maltreated females that are not necessarily present in non-maltreated teens.
The primary objectives of newly proposed studies are to examine specific pre-pregnancy antecedents associated with teen pregnancy and parenthood in a new cohort of racially and economically diverse maltreated and non-maltreated adolescent females.
Relevant Publications
Noll JG, Trickett PK, Putnam FW. (2003). A prospective investigation of the impact of childhood sexual abuse on the development of sexuality. Journal of Consulting and Clinical Psychology, 71(3), 575-586.
Noll JG, Trickett PK, Putnam FW. (2000). Social network constellation and sexuality of sexually abused and comparison females in childhood and adolescence. Child Maltreatment, Vol 5 (4), 323-337.
Funding Sources
(Noll) Co-Principal Investigator Sexual Abuse of Females: Effects in Young Adulthood, awarded by the Administration on Children, Youth, and Families (ACYF), 90CA1686, $750,000 direct and indirect costs, period covered October, 2001 - December, 2004.
(Noll) Principal Investigator KO1 Research Career Award The Offspring of Maltreated Mothers: Prenatal and Infant Health, K01 HD41402-01, $473,607 direct and indirect costs, period covered March, 2002 - February, 2007.
