Attachment buffers against the association between childhood sexual abuse, depression, and substance use problems among transgender women: a moderated-mediation model

K. Marie Sizemore, Ali Talan, Shannon Gray, Nicola Forbes, Hannah Hyejin Park, H. Jonathon Rendina

Research output: Contribution to journalArticlepeer-review

Abstract

Previous research shows a greater prevalence of substance use among childhood sexual abuse (CSA) survivors. Transgender women experience CSA at a significantly higher rate compared to the general population. Previous studies show a high prevalence of substance use and find that CSA predicts increased drug use among transgender women. It is proposed that the process through which CSA influences substance use behaviour, is mediated by depression. Further, research has shown that secure attachment may buffer against these associations.Participants were 213 transgender women participating in a behavioural intervention to reduce sexual risk and substance use. A moderated mediation model, including a three-way interaction, examined the indirect effect of CSA, through depression, on both substance use problems and alcohol use disorder, as well as the protective effect of secure attachment on these pathways. Findings from the moderated mediation analysis provide evidence to support our hypothesis that depression mediates the pathways from CSA to both substance use problems and alcohol use disorder for transgender women. We also observed a significant three-way interaction (e.g. attachment anxiety x attachment avoidance x CSA) indicating that secure attachment buffered against the association between CSA and symptoms of depression, as well as CSA and substance use problems.

Original languageEnglish (US)
Pages (from-to)1319-1335
Number of pages17
JournalPsychology and Sexuality
Volume13
Issue number5
DOIs
StatePublished - 2022

All Science Journal Classification (ASJC) codes

  • Gender Studies
  • Social Psychology
  • Health(social science)
  • Applied Psychology

Keywords

  • CSA
  • Transgender health
  • attachment
  • moderated mediation
  • substance use

Fingerprint

Dive into the research topics of 'Attachment buffers against the association between childhood sexual abuse, depression, and substance use problems among transgender women: a moderated-mediation model'. Together they form a unique fingerprint.

Cite this