Date of Award


Document Type

Doctoral Research Project

Degree Name

Doctor of Psychology (PsyD)



First Advisor

Radhika Krishnamurthy, Psy.D., ABAP

Second Advisor

Maria J. Lavooy, Ph.D.

Third Advisor

Ashok Pandit, Ph.D., P.E.

Fourth Advisor

Robert A. Taylor


Sex trafficking is a hidden crime that affects many vulnerable groups such as women and children. Prior research has demonstrated that individuals currently or formerly engaged in sex trafficking experience heightened levels of depression, anxiety, posttraumatic stress disorder (PTSD), and other mental health concerns. Most of these studies relied on structured interviews and, to date, no empirical studies have evaluated the psychological difficulties of sex trafficking victims with an empirically valid measure. The Minnesota Multiphasic Personality Inventory-3 (MMPI-3; Ben-Porath & Tellegen, 2020a) is a personality assessment measure widely used to assess sexual abuse survivors, substance abusers, and various inpatient and outpatient psychiatric populations. The current study investigated the psychological difficulties of a sex-trafficked sample (N = 76) through examination of their MMPI-3 score patterns. Participants consisted of formerly sex-trafficked women currently receiving services in North America. The sample’s mean T score was at least one standard deviation over the normative mean (i.e., in the 60-64 range) on a broad range of 17 substantive scales measuring dysregulated emotional, behavioral, cognitive, somatic, and interpersonal functioning. The Anxiety-Related Experiences (ARX) scale reached the clinical cut score of 65. Comparisons were conducted between survivors of sex trafficking who first engaged in sex trafficking as a minor versus as an adult, those with the presence versus absence of prior sexual abuse, prior physical abuse, involvement with the child welfare system, history of mental health diagnosis, history of drug use, and legal history, and based on length of time involved in sex trafficking and length of time since exiting sex trafficking. Multivariate and univariate analyses of variance (MANOVA, ANOVAs) indicated significant differences in scores between (a) women who entered sex trafficking as a minor versus as an adult on two scales, (b) women with and without a sexual abuse history on 11 scales, (c) women with and without a physical abuse history on one scale, (d) women with and without a prior involvement in the child welfare system on one scale, (e) women with and without a mental health diagnosis on five scales, (f) women with and without a drug use history on six scales, (g) women with and without a legal history on twelve scales, (h) women involved in sex trafficking for nine or fewer years and those involved 10 or more years on six scales, and (i) women who had exited sex trafficking for two or fewer years and those who had exited for three or more years on three scales. Correlations between MMPI-3 and Dispositional Resilience Scale-15 (DRS-15) scale scores showed significant associations in the expected direction. Stepwise multiple regression analysis revealed Emotional/Internalizing (EID), Stress (STR), and Helplessness/Hopelessness (HLP) scales collectively accounted for 50% of the variance in total resilience. Contributions of this study include providing preliminary empirical data on the MMPI-3 score patterns of sex-trafficked women utilizing a North American sample, furnishing evidence of greater psychological disturbance in subgroups of sex-trafficked women with greater adverse life experiences, and showcasing the inverse relationship between psychological difficulties and resilience. Limitations of this study includes its small sample size and reduced statistical power. Future studies should obtain a larger sample, utilize longer versions of the DRS, and conduct longitudinal studies.