The psychological outcome for a random community sample of women
who had experienced significant childhood sexual abuse was assessed,
using two outcome measures: (i) psychiatric morbidity (measured with
the short PSE); (ii) self-esteem. Sexual abused women with a good
outcome, i.e. who were not a PSE 'case' or who had high self-esteem
were compared with abused women with a poor outcome. This paper
describes the post-abuse factors that modified the two outcomes. In
general, a range of variables, all correlated with each other in a
complex manner, distinguished good outcome subjects from poor outcome
subjects. Post-abuse adolescent variables included family factors
(poor mother-father and parent-child relationships), high school
factors (poor academic, sporting and social performance) and early
pregnancy. Women who had a good adolescent relationship with their
father did better than expected statistically. Sport emerged as an
alternative at secondary school to academic achievement in catalysing
a good psychological outcome. Adult factors included the quality of
relationship with partner, which was associated with a good outcome on
both measures. Current paid employment was linked to high self-esteem
but not to lowered psychiatric morbidity, while the converse applied
for high socio-economic status. These findings imply that different
processes operate for each outcome measure. A clear recognition by the
school of childhood sexual abuse may help to provide the opportunity
for the girl to experience success in some arena; this in turn may
protect her against the likely adult consequences of low self-esteem
and increased psychiatric morbidity.