Karen was sexually abused by her father at the age of 5. She developed a severe separation anxiety reaction whenever her mother tried to leave. As an adult, Karen developed a dissociative disorder. This is an example of how the same factor, in this case abuse, can be

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The abuse is a proximal causal factor as it directly led to Karen's separation anxiety reaction as a child. However, it also contributed to her development of a dissociative disorder as an adult, which is a more distal causal factor.

Karen Was Sexually Abused by Her Father at the Age