Childhood sexual abuse (CSA) has been consistently associated with long-term difficulties in affective development, particularly in adult attachment and the capacity for intimacy. This study compared adult attachment patterns and intimacy levels between individuals with and without a self-reported history of CSA, using a sample of 587 Spanish-speaking adults, 161 of whom reported experiencing CSA. Participants completed validated measures of attachment and intimacy, and group differences were analyzed using MANOVAs. Multiple mediation analyses were conducted to explore whether attachment dimensions explained the link between CSA and intimacy outcomes, controlling for gender. Results showed that survivors of CSA exhibited significantly higher levels of attachment anxiety and avoidance, and lower socio-emotional competence. They also reported reduced intimacy and self-disclosure, particularly in relation to their personality and body. Mediation analyses indicated that attachment avoidance and low emotional competence mediated the relationship between CSA and all intimacy indicators. Interestingly, attachment anxiety was positively related to general intimacy but negatively associated with bodily self-disclosure. These findings highlight the indirect impact of CSA on adult intimacy through maladaptive attachment patterns. They suggest the need for trauma-informed interventions that go beyond memory processing to foster relational skills and embodied forms of safe intimacy—crucial elements for emotional healing in adulthood.
Pastor-Cerezo et al. (2026) studied this question.