The goal of this thesis is to explore the mechanisms underlying the association between women's experiences of child sexual abuse (CSA) and substance use in adulthood. Specifically, I evaluated the role of CSA, adult sexual victimization (ASA), and psychological distress including symptoms of depression, perceived stress, and PTSD on substance use. Research has shown that individuals who experience CSA are more likely to experience ASA, which results in psychological distress. Individuals may engage in substance use to cope with psychological distress from CSA and ASA, consistent with the self-medication hypothesis. Women (N = 225) were recruited from Mechanical Turk (MTurk) and completed an online survey. Results indicate positive correlations between CSA, ASA, psychological distress, problem drinking, and drug use. Further, there was an indirect effect of CSA on substance use through ASA, but not psychological distress. Results highlight the importance of trauma informed care for women's psychological distress and problem substance use.

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