The effects of perpetrator age and abuse disclosure on the relationship between feelings provoked by child sexual abuse and posttraumatic stress

The present study examined the relationship between feelings provoked by child sexual abuse (CSA) and posttraumatic stress disorder (PTSD) symptom scores in a sample of 163 female survivors of CSA. Finkelhor and Browne's traumagenic dynamics model was applied. The interactive effects of provoked feelings with perpetrator age and the existence of abuse disclosure were also studied. Results showed an overall relationship between feelings provoked by CSA and PTSD symptom scores. Feelings of stigma, betrayal, and powerlessness as a result of CSA were associated with PTSD symptom score when the entire group of CSA victims was analyzed. The role of traumatic sexualization was relevant only when analyzed in interaction with the age of the perpetrator and disclosure. The relationship between traumatic sexualization and PTSD symptom scores was only significant when the abuse was committed by an adult perpetrator and when a disclosure was made during the time of abuse, or a short time after the abuse had occurred.     

The role of traumagenic dynamics on the psychological adjustment of survivors of child sexual abuse

The aim of this study was to analyse the consequences of child sexual abuse (CSA) on the psychological adjustment of survivors, as well as to determine the role of the feelings provoked by the abuse, following Finkelhor and Browne's traumagenic dynamics model (1985), on the adjustment of CSA victims. The sample of the study comprised 182 survivors of CSA, and another 182 participants selected as a comparison group. Results showed that CSA survivors, in contrast with the group of non-victims of CSA, had significantly higher scores on state anxiety, trait anxiety and depression, and lower on self-esteem. With regard to the role of traumagenic dynamics, feelings of powerlessness, self-blame, traumatic sexualization and, to a lesser extent, betrayal, predicted the scores of the CSA survivors in the four psychological adjustment variables assessed. To summarize, the results confirm the relation between CSA and the development of psychological problems in adulthood, explaining the survivors' feelings to a substantial extent the variability of adjustment.     

A meta-analysis of the published research on the effects of child sexual abuse

A meta-analysis of the published research on the effects of child sexual abuse (CSA) was undertaken for 6 outcomes: posttraumatic stress disorder (PTSD), depression, suicide, sexual promiscuity, victim-perpetrator cycle, and poor academic performance. Thirty-seven studies published between 1981 and 1995 involving 25,367 people were included. Many of the studies were published in 1994 (24; 65%), and most were done in the United States (22; 59%). All six dependent variables were coded, and effect sizes (d) were computed for each outcome. Average unweighted and weighted ds for each of the respective outcome variables were .50 and .40 for PTSD, .63 and .44 for depression, .64 and .44 for suicide, .59 and .29 for sexual promiscuity, .41 and .16 for victim-perpetrator cycle, and .24 and .19 for academic performance. A file drawer analysis indicated that 277 studies with null ds would be required to negate the present findings. The analyses provide clear evidence confirming the link between CSA and subsequent negative short- and long-term effects on development. There were no statistically significant differences on ds when various potentially mediating variables such as gender, socioeconomic status, type of abuse, age when abused, relationship to perpetrator, and number of abuse incidents were assessed. The results of the present meta-analysis support the multifaceted model of traumatization rather than a specific sexual abuse syndrome of CSA.     

Effects of personality traits and characteristics of child sexual abuse on maternal reactions and support

Objective

This study aimed to examine the relationship between maternal and contextual factors including maternal personality traits, the quality of mother–child relationship, the characteristics of sexual abuse and maternal outcomes: (1) maternal reactions including feelings of anger and responsibility, anger and perceptions of responsibility of the child, and (2) maternal support provided to the child following the disclosure of sexual abuse.

创伤暴露程度对青少年物质滥用的影响：创伤后应激障碍与依恋的中介作用

为了考察汶川地震后青少年的创伤暴露程度、创伤后应激障碍（PTSD）、父母依恋和同伴依恋与物质滥用之间的关系,采用创伤暴露程度问卷、儿童创伤后应激障碍症状量表、父母与同伴依恋问卷和物质滥用问卷对汶川县和茂县的1435名中学生进行调查,选取有物质滥用的青少年354名作为本研究的对象。结果发现：创伤暴露程度可以直接正向预测作用物质滥用。不过,在创伤暴露与物质滥用直接关系之间加入PTSD、父母和同伴依恋之后,创伤暴露程度对物质滥用的直接预测作用不再显著,并且创伤暴露程度不能通过同伴依恋预测物质滥用,也不能通过PTSD经同伴依恋对物质滥用发挥多重中介作用;但创伤暴露程度能通过PTSD正向预测物质滥用,可以通过父母依恋负向预测物质滥用,并且创伤暴露程度还可以通过PTSD经过父母依恋对物质滥用发挥正向的多重中介作用。     

A prospective study of memory for child sexual abuse: new findings relevant to the repressed-memory controversy

Previous research indicates that many adults (nearly 40%) fail to report their own documented child sexual abuse (CSA) when asked about their childhood experiences. These controversial results could reflect lack of consciously accessible recollection, thus bolstering claims that traumatic memories may be repressed. In the present study, 175 individuals with documented CSA histories were interviewed regarding their childhood trauma. Unlike in previous studies, the majority of participants (81%) in our study reported the documented abuse. Older age when the abuse ended, maternal support following disclosure of the abuse, and more severe abuse were associated with an increased likelihood of disclosure. Ethnicity and dissociation also played a role. Failure to report CSA should not necessarily be interpreted as evidence that the abuse is inaccessible to memory, although inaccessibility or forgetting cannot be ruled out in a subset of cases.     

Childhood Sexual Assault,Quality of Life,and Psychiatric Comorbidity in Veterans With Military and Civilian Sexual Trauma

Veterans with military sexual trauma (MST) are at risk for a variety of psychiatric conditions, including posttraumatic stress disorder (PTSD) and depression. Survivors of MST are also likely to experience diminished quality of life (QoL). Individuals with higher lifetime incidence of sexual trauma may also be at increased risk for poorer outcomes in QoL and psychiatric symptomatology. The differences in psychological sequelae among those who have experienced sexual trauma as children, and those whose sexual trauma exposure is limited to adulthood are relatively understudied. The majority of sexual trauma literature has focused primarily on civilian trauma, and comparatively few studies have specifically examined psychosocial sequelae (e.g., QoL) in veterans with MST. This study examined how childhood sexual abuse (CSA) affects overall QoL as well as severity of PTSD and depressive symptoms. Veterans who reported CSA had significantly greater depression symptom severity than veterans who did not. No significant differences in PTSD symptom severity or QoL were found between veterans who did and did not report CSA. Results highlight the need for further examination of the relationship between CSA and depression in veterans with MST-related PTSD who also report CSA.     

Social and emotional outcomes of childhood sexual abuse: A review of recent research

A total of 41 articles examined the social and emotional outcomes of childhood sexual abuse. The outcomes examined included suicide and substance use, gang involvement, pregnancy, running away, post-traumatic stress disorder (PTSD), risky sexual behavior, and behavioral problems. Results for each of these outcomes tended to vary by developmental period. However, problems of internalizing and externalizing behavior appeared to be specific to sexually abused children of all age groups. Some studies found differences in outcome according to gender, race, and age. Although findings related to abuse characteristics were found to vary from study to study, severity of the abuse, use of force, and victim's relationship to the perpetrator were found to be especially important. Other factors, such as family support and parental monitoring, were found to mitigate a negative outcome. Limitations are discussed along with suggestions for future research.     

Patterns in Blame Attributions in Maltreated Youth: Association with Psychopathology and Interpersonal Functioning

This investigation explored patterns of blame attributions in 128 youth, primarily (87%) female, with maltreatment histories. Second, the study also evaluated the relative variance in posttraumatic stress disorder (PTSD) symptom severity, emotional distress, and interpersonal functioning outcomes, accounted for by age, abuse characteristics, and blame attribution patterns. Cluster analyses revealed distinctive blame profiles: high perpetrator blame, moderate perpetrator blame, high self-blame, high perpetrator/high self-blame, and low perpetrator/low self-blame. Regression analyses yielded significant models, accounting for 15% to 34% of the variance of outcomes. Most notably, youth endorsing a high perpetrator/high self-blame (i.e., compounded blame) attribution pattern reported poorer outcomes as compared to youth presenting with other blame profiles. Maltreatment type and age differences were not demonstrated across clusters. Implications and limitations are discussed.     

Traumatic impact predicts long-term memory for documented child sexual abuse

Prospective studies of adults' memories of documented child sexual abuse (CSA) reveal that the majority of individuals remember their victimization. However, the accuracy of these memories has rarely been investigated scientifically. The present study examined predictors of memory accuracy and errors 12 to 21 years after abuse ended for individuals with legal experiences resulting from documented CSA. Severity of posttraumatic stress disorder (PTSD) symptomatology was positively associated with memory accuracy. However, individuals nominating CSA as their most traumatic life event exhibited relatively accurate memory regardless of indicators of PTSD. Predictors of memory errors were also identified (e.g., less maternal support). These results indicate that, in addition to understanding the role of traditional cognitive factors, understanding an event's traumatic impact is important for predicting the accuracy of long-term memory for reported CSA.     

Measuring Abuse Sequelae: Validating and Extending the Trauma Symptom Checklist–40

This study used the Trauma Symptom Checklist–40 (TSC–40) to index both childhood sexual abuse (CSA) and childhood physical abuse (CPA) in a college student sample of both men and women (N = 441). Although the TSC–40 was designed as a measure of CSA trauma, this study concludes the measure is appropriately reliable for indexing the traumatic sequelae of CPA as well as CSA in nonclinical samples. This study also explored the effects of gender and abuse severity on resulting symptomatology, finding that women and severely abused individuals report the most negative sequelae. Both CSA and CPA emerged as significant explanatory variables in TSC–40 scale scores beyond gender, supporting its validity for indexing traumatic sequelae in nonclinical samples.     

When the face reveals what words do not: facial expressions of emotion,smiling, and the willingness to disclose childhood sexual abuse

For survivors of childhood sexual abuse (CSA), verbal disclosure is often complex and painful. The authors examined the voluntary disclosure-nondisclosure of CSA in relation to nonverbal expressions of emotion in the face. Consistent with hypotheses derived from recent theorizing about the moral nature of emotion, CSA survivors who did not voluntarily disclose CSA showed greater facial expressions of shame, whereas CSA survivors who voluntarily disclosed CSA expressed greater disgust. Expressions of disgust also signaled sexual abuse accompanied by violence. Consistent with recent theorizing about smiling behavior, CSA nondisclosers made more polite smiles, whereas nonabused participants expressed greater genuine positive emotion. Discussion addressed the implications of these findings for the study of disclosure of traumatic events, facial expression, and the links between morality and emotion.     

Treating the Sexual Concerns of Adult Incest Survivors and Their Partners

SUMMARY

Negative attitudes about sex and sexuality and many types of sexual dysfunction are common aftereffects of sexual child abuse and incest. The traumatic sexualization and the aversive sexual conditioning resulting from childhood abuse have long gone unrecognized, however. This article presents research findings regarding the impact of incest on sexual attitudes and functioning along with treatment recommendations.     

Review of the contemporary literature on how children report sexual abuse to others: findings, methodological issues, and implications for forensic interviewers

Methods used during forensic interviews with children are driven by beliefs about how children recall and report child sexual abuse (CSA) to others. Summit (1983) proposed a theory (Child Sexual Abuse Accommodation Syndrome) contending that, due to the specific traumatic characteristics of CSA, children will often delay disclosing abuse or altogether fail to disclose during childhood, deny abuse when asked, and often recant abuse allegations. His theory has had a tremendous impact on the field of CSA forensic evaluations, despite its dearth of empirical support. In this paper, we review and critique the contemporary literature from two main sources: retrospective accounts from adults reporting CSA experiences and studies of children undergoing forensic evaluation for CSA. We conclude that data support the notion that children often delay abuse disclosure, but that among valid abuse cases undergoing forensic evaluation, denial and recantation are not common. Methodological issues and implications for forensic interviewers are discussed.     

Why do child sexual abuse victims not tell anyone about their abuse? An exploration of factors that prevent and promote disclosure

Disclosure rates of child sexual abuse (CSA) to both social supports and law enforcement are concerningly low, although more research is needed to understand factors that impact disclosure. Thus, the present study examined rates of informal (i.e., to a social support) and formal (i.e., to law enforcement) disclosure of CSA, as well as victims' self-reported experiences with telling others about their own abuse and their perceptions of the overall advantages and disadvantages of disclosure. In all, 76 undergraduate women (who collectively experienced 105 instances of abuse) participated in a semi-structured interview regarding their history of CSA. Results revealed that approximately 50% of cases involved the victim informally disclosing, and only 10% of cases being formally disclosed to authorities. The quantitative and qualitative data shed light on a number of factors that lead victims to not disclose, as well as the identification of factors that may promote a victim to share their abuse with others. The implications for improved prevention and responses to CSA disclosure are discussed.     

A model of the effects of child sexual abuse on post-traumatic stress: the mediating role of attributions of blame and avoidance coping

Employing structural equation modeling, the direct and indirect effects of the severity of Child Sexual Abuse (CSA), attributions of blame for the abuse, and coping strategies on Post-traumatic Stress Disorder (PTSD) symptomatology are analyzed. The effects of other types of child maltreatment on PTSD were also controlled. The sample comprised 163 female college students who were victims of CSA. The results suggested that victims of more severe abuse showed higher levels of avoidant coping, self blame, and family blame. Having suffered other kinds of abuse or neglect was also related to higher family blame attributions. Lastly, both attributions of blame scales were indirectly related to PTSD symptomatology through avoidant coping. The strong relationships between attributions of blame, coping strategies, and PTSD suggest that it might be useful to intervene early with children who have suffered CSA in an effort to modify the attributions they make about the abuse and the way they cope with it.     

Coping style and memory specificity in adolescents and adults with histories of child sexual abuse

Individuals with histories of childhood trauma may adopt a nonspecific memory retrieval strategy to avoid unpleasant and intrusive memories. In a sample of 93 adolescents and adults with or without histories of child sexual abuse (CSA), we tested the hypothesis that nonspecific memory retrieval is related to an individual's general tendency to use avoidant (i.e., distancing) coping as a personal problem-solving or coping strategy, especially in victims of CSA. We also examined age differences and other individual differences (e.g., trauma-related psychopathology) as predictors of nonspecific memories. Distancing coping was significantly associated with less specific autobiographical memory. Younger age, lower vocabulary scores, and non-CSA childhood maltreatment (i.e., physical and emotional abuse) also uniquely predicted less autobiographical memory specificity, whereas trauma-related psychopathology was associated with more specific memory. Implications for the development of autobiographical memory retrieval in the context of coping with childhood maltreatment are discussed.     

Fear as a Mediator for the Relationship Between Child Sexual Abuse and Victimization of Relationship Violence

Childhood sexual abuse (CSA) has been identified as a predictor for dating violence victimization; however, the mechanism for this relationship is unexplored. The current study examined whether fearful dating experiences may help explain the relationship between CSA and dating violence victimization. Participants (N =?327 college women) completed self-report measures of CSA, fearful dating experiences, and dating violence. In a mediational model test, CSA was found to be positively associated with fear in dating relationships and with dating violence victimization, fear was associated with dating violence victimization, and the effect of CSA on dating violence victimization scores was reduced after controlling for fear. A Sobel's test showed that fear partially mediated the relationship between CSA and current dating violence victimization.     

Retrieval inhibition of trauma-related words in women reporting repressed or recovered memories of childhood sexual abuse

Several authors have argued that survivors of childhood sexual abuse (CSA) who report to have repressed their traumatic memories are more skilled in forgetting emotional stimuli than survivors who have always remembered the abuse. The current experiment employed a list-wise directed forgetting task to investigate whether women reporting repressed (n = 16) or recovered (n = 23) memories of CSA are better at forgetting disturbing material, relative to women reporting having always remembered their abuse (n = 55) or reporting no history of abuse (n = 20). We found no support for the hypothesis that women reporting repressed or recovered memories of CSA are especially versed in inhibiting retrieval of trauma-related words. Additional analyses revealed that participants characterized by a repressive coping style did not display a superior retrieval inhibition mechanism for negative material.     

Cardiovascular reactions to psychological stress and abuse history: the role of occurrence,frequency, and type of abuse

Background and objectives: Extreme cardiovascular reactions to psychological stress have been associated with traumatic life experiences. Previous studies have focused on the occurrence or frequency of abuse rather than type of abuse. We examined how occurrence, frequency, and the type of abuse history are related to cardiovascular reactivity (CVR) to acute psychological stress. Design: The study consisted of between group and continuous analyses to examine the association between occurrence, type, and frequency of abuse with cardiovascular reactions to acute psychological stress. Methods: Data from 64 participants were collected. Heart rate, systolic blood pressure, and diastolic blood pressure were measured at baseline and during a standard mental arithmetic stress task. Results: Individuals who experienced abuse showed diminished CVR to acute psychological stress; this was driven specifically by the history of sexual abuse. Frequency of abuse did not relate to stress reactions. Conclusions: These findings accord with previous work suggesting a relationship between traumatic life experience and hypoarousal in physiological reactivity and extend previous findings by suggesting the relationship may be driven by sexual abuse.