Sexual orientation, attachment, and psychopathology among adult inpatient survivors of child abuse

The purpose of the present study was to explore the associations between sexual orientation, adult attachment, and psychopathology outcomes among inpatients with histories of severe childhood emotional and sexual abuse. The data used in the present study was previously collected as part of a comprehensive investigation of adult attachment, personality, psychopathology, and family environment among childhood trauma/abuse survivors in a specialized inpatient program housed within a private psychiatric hospital. Given the high proportion of self-identified sexual minorities within the sample (27.5%), the present research sought to further the analyses presented in two previously published articles by exploring potential differences in psychopathology outcomes between non-heterosexual and heterosexual individuals. The present study hoped to expand the knowledge base regarding sexual minority inpatient populations without contributing to the pathologizing or stigmatizing of sexual minorities that has been historically prevalent in the mental health field.

A series of eight regression analyses examined whether minority sexual orientation, childhood sexual abuse, and childhood emotional abuse by mothers and fathers significantly predicted higher levels of psychopathology. Utilizing data from an extensive battery of instruments, results were primarily non-significant with two exceptions; severe dissociative experiences and attachment avoidance. In both cases childhood sexual abuse was the only significant predictor in the model. Significant findings were consistent with prior research regarding relationships between childhood sexual abuse, psychopathology, and insecure adult attachment: however, the null relationship between minority sexual orientation and psychopathology contradicted prior research among non-clinical populations, as did the lack of ability for emotional abuse by mothers and fathers to predict adverse mental health outcomes. It was suggested that the lack of predictive ability for sexual orientation in the model was reflective of the lack of focus on sexual orientation at the time of original data collection as well as the possibility that when psychopathology is at an acute, severe level, minority sexual orientation no longer differentiates mental health outcomes. Implications for research, training, and practice were discussed. Particularly highlighted was the necessity for treatment approaches that affirm sexual minorities and improve understanding of the adverse effects of sexual orientation stigmatization on mental health.