Sexual dysfunction in women sexually abused as children

Women who were sexually victimized as children report problems in relating to both men and women. Studies have found that victims are less satisfied with their current sexual relationships and with the quality of their relationships with men in general. Fear of sex, arousal dysfunction and desire dysfunction were the most common sexual disturbances found in incest victims.The purpose of this paper was to examine the differences in sexual functioning in abused women who perceived themselves to be adjusted to the trauma of their sexual abuse and those who did not.A sample of 57 nonclinical adult women who had been sexually abused as children was studied. Data were analyzed by means of cross-tabulation, chi square statistics, analysis of variance, and multiple regression.Orgasm was experienced by 63% of the women. There was a significant interaction among ability to be an orgasmic, sexual esteem and adjustment to abuse. Over 56% of the women experienced physical discomfort during intercourse and 36% indicated that they needed sex therapy. The implications of these and other findings are discussed.     

Parenting behaviors of women who were sexually abused as children in their families of origin.

This research explored links between a childhood history of family sexual abuse and current parenting behaviors of mothers of school-age children, using observations of family interaction and interviews with the mothers. Videotaped family interaction tasks, analyzed with Benjamin's Structural Analysis of Social Behavior, showed that women who had been sexually abused in their childhood families were more self-focused, rather than child-focused, compared to nonabused women. In interviews, the women who had been abused gave strong evidence of greater reliance on their children for emotional support. These findings lend support to theoretical and clinical impressions of highly permeable intergenerational boundaries, including parent-child role reversal, in family systems marked by child sexual abuse, even when the abuse occurred in the previous generation.     

A time-limited group therapy model for men sexually abused as children

This article explores the clinical dimensions of male child sexual abuse, and its effects upon these children in their adult lives. The number of men receiving therapeutic help for their sexually abusive past is unknown. Prevalence figures are equally elusive, but reporting of this abuse has steadily increased over the last decade. The majority of these children never tell anyone about their sexual victimization, and enter their adulthoods with long-term psychological difficulties. A short-term psycho/educational model is presented in order that more clinicians will treat this vastly underserved population.This article is dedicated to Marion Dragoon, with special thanks to Len Solomon, James Garland, and the staff of St. Luke's.     

Loneliness in domestically abused women

The qualitative aspects of loneliness in abused women were explored. 80 women, victims of domestic abuse who were staying in shelters, were compared with 84 women from the general population who had no history of abusive relationships. A 30-item loneliness questionnaire, having five qualitative dimensions of loneliness, namely Emotional Distress, Social Inadequacy and Alienation, Growth and Discovery, Interpersonal Isolation, and Self-alienation, was utilized to compare the loneliness in the two samples. Analysis supported the hypothesis that abused women experience loneliness differently from the general population. These abused women scored significantly higher on Emotional Distress, Interpersonal Isolation, and the Self-alienation subscales.     

Treatment for sexually abused children and adolescents

The authors review research demonstrating the variable effects of childhood sexual abuse, the need for intervention, and the effectiveness of available treatment models. The well-controlled treatment-outcome studies reviewed do not focus on sensationalistic fringe treatments that treat sexually abused children as a special class of patients. Instead, studies demonstrate empirical evidence for extending and modifying treatment models from mainstream clinical child psychology to sexually abused children. The authors propose a continuum of interventions to meet the needs of this heterogeneous group. Interventions range from psychoeducation and screening, to short-term, abuse-focused cognitive-behavioral therapy with family involvement, to more comprehensive long-term plans for multiproblem cases. Last discussed are gaps in the research and suggestions for future research to address the pressing dilemmas faced by clinicians and policymakers.     

Adults sexually abused as children: Legal actions and Issues

This article first briefly discusses the problem of delayed memories and long-term effects of child sexual abuse and the current trend to bring civil lawsuits or criminal prosecutions for childhood sexual abuse. The article addresses the primary obstacle to such actions—the statute of limitations—which in most states places a time limit on when legal actions can be commenced. It describes the purpose of the statute of limitations and the need for changing or extending it in child sexual abuse cases; it then summarizes and analyzes the methods used by state legislation and judicial decisions to change or extend the statute of limitations in both criminal and civil actions. The article examines the pros and cons of bringing legal actions for child sexual abuse many years later, and concludes with a discussion regarding the current debate about the accuracy and authenticity of long-term memory and the advisability of legal reforms to extend or eliminate the statute of limitations in this area.     

Depressive characteristics of physically abused children

Physically abused and nonabused children were compared on child-completed measures of depression, hopelessness, self-esteem, and locus of control. Results indicated that, in comparison with nonabused controls, abused children evidenced more depressive symptoms, heightened externality, lower self-esteem, and greater hopelessness about the future. Group differences in depressive symptomatology were not accounted for on the basis of differences in age, sex, race, gender, IQ, or socioeconomic status. Results replicate the results of Kazdin, Moser, Colbus, and Bell (1985) derived from a sample of physically abused psychiatric inpatients and extend the generality of these findings to abused children of nonpatient status. Implications of the findings for clinical interventions, theoretical models of child depression, and future research are discussed.The authors wish to thank Alvin Hadley and the staff of Franklin County Children Services.Appreciation is also extended to Dr. Charles Wenar.     

Sexually abused children suffering from post-traumatic stress disorder: assessment and treatment strategies

Child sexual abuse is a highly prevalent problem that frequently occasions the onset of post-traumatic stress disorder in the victimized youngster. This selective review addresses recent advances in the assessment and treatment of sexually abused children with post-traumatic stress disorder. Firstly, we outline the diagnostic criteria for post-traumatic stress disorder and significant moderating variables in the development of post-traumatic stress disorder. Secondly, we address the clinical assessment of post-traumatic stress disorder in sexually abused children, recommending a developmentally sensitive, multi-informant approach. Thirdly, we consider a family-wide cognitive-behavioural treatment framework for sexually abused children with post-traumatic stress disorder that involves both child and non-offending caregivers. Fourthly, we examine the results of recent evaluation studies supportive of cognitive-behavioural therapy in the treatment of sexually abused children. Lastly, we consider conclusions for clinical practice and directions for future research.     

Activities and games for group psychotherapy with sexually abused children

As increasing attention is given to the practice of group psychotherapy with sexually abused children, clinicians are using games and activities designed to address issues related to sexual abuse and its prevention. This paper describes how specific games and activities can be used in group therapy with child victims. These games and activities include: prevention films, role plays, and communication board games. Benefits and risks associated with the use of these resources are also discussed.     

Sexually abused children and post-traumatic stress disorder

Sexually abused children often develop post-traumatic stress disorder, a distressing and debilitating condition that is typically unresponsive to non-directive counselling. Empirically supported abuse-confronting, structured interventions are urgently required for use by counselling psychologists responsible for the management of this challenging clinical population. Given the success of cognitive-behavioural interventions with adult trauma victims, it has been suggested that this treatment approach be applied to sexually abused children. This paper presents a cognitive-behavioural treatment framework comprising two levels of intervention: child therapy and parent training. We selectively review emerging empirical support for the efficacy and acceptability of this treatment approach.     

Comparison of behaviors of suspected sexually abused and nonsexually abused preschool children using anatomical dolls

Using anatomical dolls, the play behaviors of nine sexually abused preschool children (five males, four females), ranging in age from 3 to 5 years, were compared with nine preschool children for whom there was no suspicion of sexual abuse and who were matched on the basis of age, gender, race, family status, and socioeconomic status. There was no significant difference between the two groups on explicit sexual behavior (vaginal, oral, and anal intercourse with thrusting motions between the dolls or between the child and the dolls and masturbation by the child). The groups were significantly [t(8)=2.19, p <.05; Wilcoxon W=6, p <.05) different when behaviors with suspicious sexual implication were combined with explicit sexual behaviors. There were no differences between the groups on measures of nonsexual behavior. The occurrence of the suspicious sexual behaviors is discussed and reviews of previous doll research and physical evidence of child sexual abuse are provided.This project was supported in part by a grant from The Graduate College of Western Michigan University, Kalamazoo, Michigan.     

Group psychotherapy as a technique for assisting ego-impaired children and adolescents

This paper describes an approach to working with egoimpaired children and adolescents. The structure and process of psychotherapy groups within a residential program are discussed. We describe how insight-oriented groups act as a collective superego, thereby encouraging maturation. Functions of the group relating to socialization, milieu issues, peer issues, family relationships, personal issues, selfesteem, empowerment, and special issues are discussed. The focus of the discussion is on the structure and process of the groups. Brief clinical vignettes are utilized to illustrate components of the approach.     

Group therapy for depressed elderly women

We describe and evaluate a group therapy program targeting depression among elderly residents (N=303) of subsidized high-rise apartments in Nashville, TN. This eclectic program was comprised of 12 sessions (a total of 24 hours) that included modules on exercise and preventive health behaviors, cognitive and re-motivation therapy, reminiscence and grief therapy, and social skills development. Our multivariate regression analyses of pre-post measures using the Geriatric Depression Scale (GDS) showed that the effects of the group therapy varied by race, age, and level of initial depression among the participants. The program was effective in reducing depression, but only among Caucasian women who reported at least moderate depression prior to the program, and it yielded greater benefits for women between 55 and 75 years of age.     

Selective attention to facial emotion in physically abused children

The ability to allocate attention to emotional cues in the environment is an important feature of adaptive self-regulation. Existing data suggest that physically abused children overattend to angry expressions, but the attentional mechanisms underlying such behavior are unknown. The authors tested 8-11-year-old physically abused children to determine whether they displayed specific information-processing problems in a selective attention paradigm using emotional faces as cues. Physically abused children demonstrated delayed disengagement when angry faces served as invalid cues. Abused children also demonstrated increased attentional benefits on valid angry trials. Results are discussed in terms of the influence of early adverse experience on children's selective attention to threat-related signals as a mechanism in the development of psychopathology.