The psychological status of sexual abuse victims has long been debated. Recent studies have revealed notable findings common to abuse victims, many of which may either be exacerbated or occur more frequently in chemically dependent populations. This study was conducted to examine correlates of sexual abuse among a sample drawn from 1,824 adolescents who entered inpatient treatment for substance abuse. Subjects consisted of: (1) nonvictims (N=234 girls, 890 boys); (2) extrafamilial abuse victims (N=44 girls, 20 boys); (3) intrafamilial abuse victims (N=41 girls, 28 boys); and (4) intra- and extra-familial abuse victims (N=6 girls, 3 boys). For girls, composite indices of severity suggest substantial disruption of functioning in the sexually abused groups, and particularly in those reporting intrafamilial sexual abuse. For boys, those who reported being victims of sexual abuse seemed to experience a heightened sense of agitation or anxiety and were significantly more likely than other subjects to be frequently troubled by suicidal thoughts. Within this multi-problem, highly stressed population, the sexual abuse victim did appear to show slightly different and often more serious psychopathology, shown in greater incidence of suicidal ideation and attempts, symptoms of agitation, and a sense of shame about the self. The pattern appears to be one of internalization: abused adolescents appear to be at risk for seeing themselves as bad or sick, while normalizing the situation around them. (NB)