Briere and Elliott (1994) have reviewed the extensive research linking child sexual abuse (CSA) with adult psychopathology. Despite the potential flaws in retrospective research (Briere, 1992), there is a general consensus that CSA is related to serious problems in adulthood, for example:

1. Depreciated self-concept 2. Unstable personal relationships 3. Self-harm and dangerous lifestyles (e.g., prostitution) 4. Chronic emotional distress and suicidal behavior 5. Substance abuse and addiction 6. Dissociation, conversion, and somatization 7. Sexual dysfunction 8. Revictimization and sexual offending

However, sexual abuse commonly occurs in a matrix of psychosocial adversity involving parental psychopathology, parental substance use, marital discord, domestic violence, parental separation, physical abuse, neglect, and lack of family cohesion. Does sexual abuse increase the risk of psychopathology over and above the risk conveyed by adverse family environment? In the Christchurch

longitudinal study, Fergusson, Horwood, and Lynskey (1996a,b) found that it does.