Recovering substance abusers with a history of childhood sexual abuse (n=69) or no history of childhood sexual abuse (n=68) completed the Toronto Alexithymia Scale (TAS) and a background survey that assessed demographic data and (in the case of sexually abused respondents) parameters of the childhood abuse experienced. The sexually abused group scored significantly higher than the non-abused group on the TAS. Within the abused group, measured alexithymic symptomatology was found to be related positively to the duration of the abuse. Alexithymia was significantly higher when the sexual abuse first occurred after the victim had reached the age of 12; when a perpetrator of the sexual abuse was a father or stepfather; and when the abuse involved oral, vaginal, and/or anal penetration. Results were interpreted as indicating that the development of alexithymic symptoms may represent another defense victims use to insulate themselves from painful affect, along with dissociative symptoms and substance abuse, which have been shown previously to characterize adult survivors of child sexual abuse. 2 tables and 52 references