Childhood sexual abuse, marital discord, and marital disruption: Propensity score analyses

Childhood sexual abuse (CSA) is associated with greater relationship discord and a higher likelihood of marital disruption; however, these associations may be confounded by co-occurring childhood adversities and sociodemographic factors. Propensity score methods, which seek to improve comparability between exposed and unexposed groups on observed characteristics, provide a complementary approach to traditional covariate adjustment for addressing measured confounding.

To examine the association between CSA and marital discord and disruption using traditional covariate and propensity score methods.

Participants were from the National Comorbidity Survey Replication, a nationally representative probability sample of United States adults.

Associations between CSA and marital discord and disruption were examined using four approaches: bivariate (unadjusted), traditional covariate-adjusted, propensity score-adjusted, and propensity score matching (PSM) analyses. Covariates included demographic and childhood characteristics. Post-matching models additionally adjusted for covariates with residual absolute standardized differences ≥0.10.

CSA was associated with greater marital discord in the bivariate, traditional covariate-adjusted, propensity score-adjusted, and PSM analyses. After additional post-matching covariate adjustment, the estimated association remained positive and similar in magnitude. CSA was associated with higher odds of marital disruption across all models, including the post-matching covariate-adjusted model.

For both marital outcomes, estimates were consistent in direction and similar in magnitude across traditional covariate-adjusted and propensity score approaches, which address measured confounding differently. Future research should investigate underlying mechanisms using longitudinal and dyadic designs.