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.     

Current Treatment Strategies for Sexually Abused Children

SUMMARY

Given the disturbingly high prevalence of child sexual abuse, the expertise of medical and mental health professionals in treating child sexual abuse victims is essential. Relevant issues in treating these children include the mindfulness of developmental considerations, incorporation of a multi-modal therapeutic evaluation approach, clarification of treatment goals, appropriate use of and integration of various treatment modalities, and effective treatment termination. This article provides an introduction aid overview of treatment of sexually abused children of all ages, from preschoolers to adolescents, with special emphasis on the importance of developmentally linked evaluation and treatment strategies. Treatment is discussed in terms of goals, stages from evaluation to termination, and formats and modalities including individual psychotherapy, family psychotherapy, group psychotherapy and hypnotherapy, to provide a comprehensive overview of current treatment strategies for sexually abused children.     

Current Treatment Strategies for Dissociative Identity Disorders in Adult Sexual Abuse Survivors

SUMMARY

During the past decade, increasing numbers of clinicians and researchers have suggested that the dissociative disorders, including dissociative identity disorder (DID), may be more prevalent than previously hypothesized. The “rediscovery” of DID is due, in part, to the recognition that early childhood trauma in conjunction with the propensity to dissociate, are etiologic factors for the development of DID. The purpose of this article is to raise clinical consciousness regarding DID, discuss the definition and etiology of the dissociative disorders, their assessment, and an approach to treatment of the sexual abuse survivor who has DID. This treatment program, while integrating some of the techniques recommended by others, is unique in its step-by-step flexible organization as well as its multifaceted format. The author's experience to date suggests that the sooner that a dissociative disorder can be identified in the adult sexual abuse survivor client, the more rapid the therapeutic progress.     

God,Sex and Power

Abstract

After twenty years of reform, most church leaders can give an ethical analysis about why clergy sexual abuse is bad. Yet when many churches respond to complaints, committees are frequently inept in holding clergy abusers accountable, and clergy leaders are still likely to abuse their power over others. This article focuses on understanding clergy sexual abuse as a tangle of pathologies of theology, power and sexuality.     

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.     

An Analysis of the Impact of Prison on Women Survivors of Childhood Sexual Abuse

Summary

The prevalence of child abuse histories among incarcerated women has fundamental implications for understanding women's well-being during incarceration. This review of the literature on child sexual abuse and women in prison suggests that incarcerated survivors are likely to be frequently reexposed to the powerful traumatizing processes associated with their early abuse, including traumatic sexualization, powerlessness, stigmatization, and betrayal (Finkelhor & Browne, 1985). Reexposure to these traumagenic dynamics has the potential to trigger traumatic reJivings of imprisoned survivors' pasts, to which survivors respond with a variety of coping strategies often seen in prison, including substance abuse, violence, self-injury, and suicide. The implications of these dynamics and women's responses to them for those who work with incarcerated women, for prison policy, and for research are discussed.     

Sibling Child Sexual Abuse Research Review and Clinical Implications

SUMMARY

Although sex play is a part of normal childhood development, some sexual activity may be coerced or forced and may have negative long-term consequences and, thus, be considered abusive. However, childhood sexual abuse perpetrated by siblings, cousins, or peers receives relatively little attention from either researchers or practitioners. In the present article, the literature on sibling child sexual abuse is critically reviewed, and particular attention is focused on defining sibling sexual abuse, and determining its scope and effects. Clinical Implications are derived as well. Although the article focuses on sibling sexual abuse, the concepts considered here also apply to other forms of same-age (or near same-age) child sexual relationships.     

The Retarded Child. A Guide for Parents,Teachers and Social Workers by Herta Loewy

Abstract

Emotional abuse in childhood, in contrast to physical or sexual abuse, is a form of maltreatment which has been slow to receive widespread discussion. Categorizing emotional abuse highlights the ongoing realities of emotionally abused individuals. The five categories introduced here help to classify developmental problems, create treatment plans, and identify preventive opportunities. After a discussion of these categories, representative case histories from therapy groups are presented. These case histories are then traced through major phases of group therapy conducted within a structured setting and occurring on a time-limited basis.     

The relationship between childhood abuse and depression in a sample of Chinese people who use methamphetamine

Background/ObjectivePrevious studies have shown that childhood abuse is associated with symptoms of depression. This study aims to examine the prevalence of childhood abuse or neglect and its correlation with depression among a sample of Chinese people who use methamphetamine.MethodPeople who use methamphetamine (MA) (N = 1,173) were recruited from government-operated drug rehabilitation centres in Anhui province, China. Participants were assessed using the short form of Childhood Trauma Questionnaire and the Beck Depression Inventory-II for childhood abuse or neglect and depression symptoms.ResultsA total of 44.6% of people who use MA reported moderate/severe childhood abuse or neglect, and 56.9% of this sample were diagnosed with depression. Emotional abuse, sexual abuse, emotional neglect and physical neglect were revealed to increase the risk of depression. Multivariable regression analyses showed that depression scores were significantly predicted by gender, duration of drug use, sexual abuse and emotional neglect (model R² = .08, p < .001). The interaction between emotional neglect and duration of drug use on the depression was statistically significant.ConclusionsThese analyses indicate that sexual abuse and emotional neglect increase the severity of depression in individuals who use MA in drug rehabilitation centres of China.     

Childhood Sexual Abuse and Revictimization In Adolescence and Adulthood

Abstract

Childhood sexual abuse must be seen as a pervasive risk factor in children's lives: No demographic or family characteristics have as yet been identified to rule out the possibility that a child will be or has been sexually abused (Finkelhor, 1993). The adverse consequences of sexual abuse, both immediate and long term, have been documented by a large body of research. After a summary of the main findings from this research, the main objective of the present chapter is to examine the impact of childhood sexual abuse on a particular aspect of psychological functioning: the development of sexual behavior and sexual relationships. In this analysis, special consideration is given to the question of whether individuals who were sexually abused as children are at greater risk of experiencing sexual victimization in later life than individuals without experience of abuse. This question has generated a substantial body of evidence (see Messman & Long, 1996, for a review), and researchers are beginning to understand pathways from the experience of abuse in childhood to revictimization in adolescence and adulthood.     

Child Sexual Abuse within Educational Settings: A Qualitative Study on Female Teachers Who Sexually Abuse Their Students

ABSTRACT

Despite growing interest, research on female sex offenders has been limited. Previous research on female sex offenders has focused on understanding behaviors, patterns, and motivations of female sex offenders overall, but only a handful of studies have specifically focused on teachers who are convicted of sexually abusing underaged students. For the present study, we examined the nature of child sexual abuse among a sample of female teachers, focusing specifically on the onset, situational context, and conclusion of these sexual abuses. We examined interviews conducted with 35 female sex offenders who used their position as a teacher to engage in a sexual abuse of underage students from 1995 to 2016 in a southern state. Based on the narratives of both victims and offenders, our findings indicated several categories of female teacher offenders including predatory, sexual friendship, and emotionally dependent. We hope the findings of the current study will help inform educational policy in efforts to prevent the occurrence of these abuses in the future.     

The Roles of Childhood Maltreatment and Psychopathy in Sexual Recidivism of Treated Sex Offenders

Abstract

The Intensive Treatment Program for Sexual Offenders (ITPSO) at the Correctional Service of Canada (CSC) provides cognitive-behavioral group treatment to federally incarcerated sex offenders. Follow-up data for 81 of these men were examined, looking at psychopathy and childhood maltreatment history as potential predictors of recidivism using Survival Analysis. Offenders who had been placed in foster care as a child were more likely to recidivate; however when PCL-R Factor 2 scores (a history of antisocial behavior) were entered, they predicted over and above foster care history. Childhood physical abuse predicted sexual recidivism; however, childhood sexual abuse and PCL-R scores did not predict sexual recidivism. PCL-R Factor 2 scores predicted violent recidivism.     

Hardiness as a Moderator of Shame Associated with Childhood Sexual Abuse

An adult female sample of childhood sexual abuse survivors (n = 195) were surveyed to determine if hardiness was effective in moderating the negative effects of the perceived trauma and severity of the sexual abuse and internalized shame on relationship intimacy. The results indicated that perception of abuse, severity of abuse, and shame were significantly and negatively related to hardiness. Hardiness was found to have a significant moderating effect on the negative impact of internalized shame and severity of abuse on marital/relationship intimacy.     

Autobiographical Memory Disturbances in Childhood Abuse Survivors

Summary

Clinicians have noted that childhood abuse survivors frequently report that they have forgotten large parts of their childhood. While memory for abusive experiences has attracted a great deal of attention from researchers, other types of memory disturbances may also accompany a history of childhood trauma. Many clinicians report that certain types of sexual abuse, and abuse at certain developmental stages, is more likely to result in reports of gaps in memory for the abuse. However, because information has been mainly collected in clinical populations, the possibility of confounding between abusive experiences and psychological disturbances cannot be ruled out. This article reports on data gathered from a large, epidemiologic study conducted within a health maintenance organization. A history of childhood physical or sexual abuse doubled the prevalence of general autobiographical memory loss for women, while for men, the rate increased 1.5 times over those with no abuse history. Higher rates of autobiographical memory loss were noted where both types of abuse were reported. Further, multiple incidents of sexual abuse, sexual abuse by a relative, and more severe sexual abuse increased reports of autobiographical memory loss. Theoretical perspectives on changes in the memory system that may affect trauma survivors are discussed.     

Abusive interactions and burnout: Examining occupation,gender, and the mediating role of community

Abstract

Two studies examined the association of gender and occupational group (nursing versus non-nursing) with perceived risk of abuse (sexual harassment and verbal and physical abuse) as well as the relationship of perceived abuse risk with burnout and sense of community. Study 1, comprising of two settings (tertiary care hospital, N = 3,062; psychiatric hospital, N = 383), found gender and occupational group associated with perceived risk of abuse (women felt greater risk than men; nurses felt greater risk than non-nurses). It also found a gender/occupational group interaction. Study 2, conducted at an Irish tertiary care hospital (N = 892), found nurses felt at greater risk for all three types of abuse than did non-nurses. Further, women perceived themselves at greater risk for sexual harassment and verbal abuse than did men; the study found no gender difference regarding physical abuse. The analysis identified a gender/occupational group interaction for sexual harassment. The study considers methods of reducing perceived risk in regard to the research literature on abuse at work.     

Child Sexual Abuse

Summary

Children who are recent victims of sexual abuse may initially present to their primary care health provider. Often, the outward manifestations of sexual abuse are somatic complaints or nonspecific behavioral changes. Retrospective reports of adults suggest that about 20-30% of women were sexually abused as children, with figures for men ranging from 10-15%. Interview guidelines for children and adolescents emphasize the need for sensitivity to cognitive development and emotional issues while simultaneously being focused on eliciting specific behavioral data. The use of anatomically detailed dolls, in the context of a comprehensive assessment, is discussed. Health care providers are mandated reporters and must disclose suspected child sexual abuse to the state's child protective service department. Guidelines for reporting as well as addressing this issue with parents are discussed.     

Memory retrieval in treating adult survivors of sexual abuse

Abstract

Therapists working with adult survivors of sexual abuse must be sensitive to the powerful ambivalence such clients have toward addressing their victimization. They fear experiencing the significant emotional turmoil which occurs in therapy and the powerful loyalty conflicts they encounter in their families-of-origin. Establishing rapport and allowing clients to set the pace for disclosing and addressing their abuse are critical components of the therapy process. The authors describe effective Ericksonian approaches for establishing these critical treatment elements. Ericksonian techniques for utilizing the client's internal resources and retrieving repressed memories are also discussed, followed by case examples illustrating specific hypnotic methods.     

Sandtray Play with Traumatized Children

Summary

The patterns of play in latency age males were examined to determine how play influenced by sexual abuse trauma differs from other types of traumatic play. Three groups of five boys each were assessed using sandtray play. The first were victims of sexual abuse, the second were being treated for chronic or terminal health conditions and the third had no known trauma. Although the number of subjects was small, the findings reflected distinct patterns in the groups examined including differences in the average number of figures used, organization in their trays, whether they were chosen deliberately or randomly, the central figure and the ability to find resolution.