title: Pathway from child sexual and physical abuse to risky sex among emerging adults: the role of trauma-related intrusions and alcohol problems.
abstract: OBJECTIVE
  Some evidence suggests that risk reduction programming for sexual risk behaviors (SRB) has been minimally effective, which emphasized the need for research on etiological and mechanistic factors that can be addressed in prevention and intervention programming. Childhood sexual and physical abuse have been linked with SRB among older adolescents and emerging adults; however, pathways to SRB remain unclear. This study adds to the literature by testing a model specifying that traumatic intrusions after early abuse may increase risk for alcohol problems, which in turn may increase the likelihood of engaging in various types of SRB.
  
  
  METHODS
  Participants were 1,169 racially diverse college students (72.9% female, 37.6% black/African-American, and 33.6% white) who completed anonymous questionnaires assessing child abuse, traumatic intrusions, alcohol problems, and sexual risk behavior.
  
  
  RESULTS
  The hypothesized path model specifying that traumatic intrusions and alcohol problems account for associations between child abuse and several aspects of SRB was a good fit for the data; however, for men, stronger associations emerged between physical abuse and traumatic intrusions and between traumatic intrusions and alcohol problems, whereas for women, alcohol problems were more strongly associated with intent to engage in risky sex.
  
  
  CONCLUSIONS
  Findings highlight the role of traumatic intrusions and alcohol problems in explaining paths from childhood abuse to SRB in emerging adulthood, and suggest that risk reduction programs may benefit from an integrated focus on traumatic intrusions, alcohol problems, and SRB for individuals with abuse experiences.
authors.affiliation: Department of Epidemiology, Columbia University, New York, New York. Electronic address: klw2153@columbia.edu.
authors.forename: Kate
authors.initials: K
authors.lastname: Walsh
authors.affiliation: Division of Violence Prevention, National Center for Injury Control and Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Natasha E
authors.initials: NE
authors.lastname: Latzman
authors.affiliation: Department of Psychology, Georgia State University, Atlanta, Georgia.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Latzman
mesh_terms: D000293:Adolescent; D000428:Alcohol Drinking; D000437:Alcoholism / Q000209:etiology; D001007:Anxiety / Q000209:etiology; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology*; D003863:Depression / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008960:Models, Psychological; D012309:Risk-Taking; D012725:Sexual Behavior; D055815:Young Adult
keywords: Alcohol problems; Child abuse; Sexual risk behavior; Traumatic intrusions