This study examined the role of internalized shame in mediating the relationship between severity of childhood sexual abuse and adult symptoms in three groups based on attribution of blame. The random community sample of 318 female survivors completed the Trauma Symptom Checklist-40 (Briere, 1996), Internalized Shame Scale (Cook, 2001), questions about frequency of abuse, duration, and specific characteristics (no physical contact to vaginal/anal intercourse with force) and the degree to which they blamed self, fate, or perpetrator. It was hypothesized that severity (measured by abuse characteristics, frequency, and duration) would predict symptoms (measured by subscales of dissociation, anxiety, sexual problems, depression, and sleep disturbance from TSC-40) and that Internalized shame would be a potential mediator in all three groups (blame self, blame fate, or blame perpetrator). Multiple group analysis in Structural Equation Modeling showed that severity and shame were related for all groups and that the relationship was strongest when survivors blamed themselves and weakest when they blamed perpetrators. Shame was a significant predictor of symptoms for all three groups with no significant differences between groups. Severity was a significant predictor of symptoms for the blame self and blame fate groups but not for the blame perpetrator group, with symptoms being the strongest in the blame self-group. Sobel tests showed that shame was a significant mediator for all three groups. Given these findings, therapists treating adult survivors who blame fate or the perpetrator for the abuse should consider addressing the underlying shame. When treating adult survivors that blame themselves, therapists should consider addressing this attribution of blame and its meaning in addition to focusing on shame.



College and Department

Family, Home, and Social Sciences; Family Life; Marriage and Family Therapy



Date Submitted


Document Type





childhood sexual abuse, shame, blame, trauma, post-traumatic stress disorder, symptoms