Association between Identity Dimensions and History Sexual Abuse among Rwandan Adolescents: A Case-Control Study.

Background: Adolescent sexual abuse can profoundly impact psychological development, including identity formation, yet there is limited research in African contexts. This study aimed to explore how different levels of identity dimensions (low, moderate, high) are associated with the likelihood of reporting a history of sexual abuse. Methods: A case-control study design was conducted with 746 girls aged 10-19 years, evenly divided between sexually abused (case group) and non-sexually abused adolescents (control group). Cases were selected from Isange One-Stop Centres, and controls were recruited from secondary schools in Rwanda. Data on socio-demographics and identity dimensions were collected. Group differences were analysed using Chi-Square test; and logistic regression was employed to determine independent association's predictor variables. Results: No significant group differences were observed in socio-demographic variables (p>0.05). Teen motherhoods was reported exclusively in the case group (22.9%), with 1.9% of the case group pregnant and 5.4% reporting a history of abortion. Adolescents with a history of sexual abuse were more likely to score high on identity diffusion (AOR =7.55, 95% CI: 5.11-13.92), foreclosure (AOR = 4.81, 95% CI: 2.87-7.95), and moratorium (AOR=2.21, 95%CI: 1.30-3.93). They were also more likely to report moderate or high levels of exploration in depth, commitment making, and identification with commitment. Conclusion: Sexual abuse is significantly associated with disruptions in identity development, including heightened diffusion, foreclosure, and altered exploration processes. Adolescents with a history of sexual abuse exhibit a premature identity characterized by commitment without sufficient exploration. These findings underscore the need for targeted interventions to support identity development and address the psychological impacts of trauma in adolescents.