WORLDVIEW AS A PREDICTOR OF HEALTH RISK BEHAVIOR FOLLOWING SEXUAL VICTIMIZATION: MODERATED MEDIATION IN AN ETHNICALLY DIVERSE COMMUNITY SAMPLE

Abstract

Sexual victimization has been associated with many adverse health outcomes including substance dependence, reproductive health issues, and increased somatic complaints, as well as risk for re-victimization. Engagement in health risk behaviors such as risky sexual behaviors and hazardous drinking has been proposed as one means by which sexual victimization leads to these adverse outcomes, but work remains to be done in understanding the factors which influence victims' engagement in these risk behaviors. The assumptive worlds theory posits that loss of a positive worldview (i.e. the way an individual perceives other people, the world, and themselves) can be devastating to adjustment and may be the most important construct in how people make sense of and navigate through life. Therefore, the current study examined the worldview dimensions of self-worth and benevolence as predictors of engagement in health risk behaviors (specifically, drinking, number of sexual partners, and one-time sexual encounters) in a sample of 594 ethnically diverse, primarily lower income community women recruited from an OB-GYN waiting room. A moderated mediation model was tested with depression mediating the relationship between worldviews and risk behaviors. Sexual victimization history and ethnicity were examined as moderators of this mediated relationship. Analyses supported that depression mediated the relationship between both dimensions of worldview and hazardous drinking, as well as the relationship between benevolence and number of past year sexual partners. Depression did not mediate the relationship between either worldview dimension and past year one-time sexual encounters. Having a history of sexual victimization significantly moderated the relationship between self-worth and depressive symptoms. Ethnicity did not emerge as a significant moderator. Results suggest that aspects of one's worldview, particularly self-worth, and depressive symptoms are two variables important for understanding health risk behavior. The current study supports the importance of worldview and depression in predicting risk behavior, and highlights that victims of sexual violence may be especially vulnerable to depressive symptoms in response to holding a negative self-view, increasing their vulnerability to health risk behaviors as well.