The Role of Incest in Developmental Theory and Treatment of Women Diagnosed with Borderline Personality Disorder

The incidence of incest in the histories of women diagnosed with borderline personality disorder (BPD) has been noted recently by a number of clinicians (e.g., Barnard & Hirsch, 1985; Herman, Perry, & van der Kolk, 1989). However, the experience of child sexual abuse is virtually ignored in the developmental theory of the borderline syndrome. This paper presents a critical review of theoretical and clinical literature on child sexual abuse and BPD to explore three major goals: to describe the overlapping clinical picture of adult female survivors of incest and of women diagnosed with BPD, to examine the ways in which mother-blaming in psychoanalytic thought has contributed to the neglect of this experience in borderline clients, and to integrate treatment strategies from the child sexual abuse literature, traditional object relations theory, and feminist clinical theory.     

Teacher reported types of sexual abuse of learners with intellectual disability in a South African school setting

This study investigated prevalent types of sexual abuse of learners with intellectual disability, as reported by teachers. Participants were 28 teachers from special educational needs schools in Gauteng Province, South Africa (females = 80%, age range = 30 to 55 years). The teachers participated in a focus group discussion on prevalent types of sexual abuse they were aware of that occurred to learners with intellectual disabilities. Thematic analysis of the data suggested five forms of sexual abuse of learners with intellectual disability: incest, rape by the members of the community, sexual harassment, child prostitution, and exposure to adult sexual encounters. Future research should focus on the ways to mitigate in-school sexual abuse of learners with intellectual disability; prioritising which forms of interventions would be effected.     

Attachment style as a piedictor of sexual attitudes and behavior in late Adolescence

Abstract

This research applied attachment theory to the study of sexual attitudes and behaviors in a sample of late adolescents. Four hundred and seventy heterosexual undergraduate students completed questionnaires assessing attachment (discomfort with closeness; anxiety over relationships). relationship history, communication about sex. sexual self-efficacy and locus of control, and attitudes to condoms. Eight weeks later, participants reported on sexual behaviors occurring during the eight-week interval. and perceived risk of these activities. Both discomfort with closeness and anxiety over relationships were associated with external locus of control for sexual outcomes, and with use of drugs before sexual contact. Anxiety over relationships was linked to unsafe sex and to negative attitudes to condoms, but discomfort with closeness was associated with a more cautious approach to sexual risk-taking. Some results were qualified by gender differences. and by differences between the full sample and those who were sexually active. The findings arc discussed in terms of attachment style and its links with communication and affect regulation.

SUMMARY AND CONCLUSIONS

This study indicates that attachment dimensions are reliably related to many aspects of sexual attitudes and behaviors among late adolescents. Insecure attachment was linked to increased drug use before sexual contact. Anxiety over relationships was also linked to less safe sexual practice, but discomfort with closeness was associated with a tendency for males to be cautious about sexual risk-taking. The results support the utility of the attachment perspective on adolescent sexuality, but also highlight the complex relations between attachment dimensions and sexual outcomes. Future research would benefit from more detailed investigations of the attitudes, emotions, and cognitions which may mediate the link between attachment style and sexual behavior. For example, those who are highly anxious about their relationships may engage in more risky sexual practices because they fear that non-compliance with partners' wishes will jeopardize their relationship; the tendency to engage in drug use before sexual cpntact may reflect their attempts to boost self-confidence or to manage negative mood states. Research into these issues has the potential to explain how attachment insecurity is played out in patterns of sexual activity.     

Cultural Adaptation and Sexual Harassment in the Lives of Asian American Women

ABSTRACT

Despite the prevalence of both historical and current race- and gender-based stereotyping of Asian American women, little is known about their experiences and attitudes regarding sexual harassment. In this study, 109 Asian American women enrolled in a state university or a 2-year community college responded to questionnaires about cultural orientation, experiences of sexual harassment, and sexual harassment attitudes. Asian cultural orientation was associated with sexual harassment attitudes. Specifically, among women with low White cultural orientation, there was a statistically significant positive association between Asian cultural orientation and acceptance of sexual harassment. Results from this study have important implications for clinical practice with Asian American women, including issues of migration, cultural orientation, and the intersection of racism and sexism in the United States.     

Linkages between violence-associated attitudes and psychological,physical, and sexual dating abuse perpetration and victimization among male and female adolescents

Attitudes about violence and sex in dating relationships were related to psychological, physical, and sexual teen dating abuse perpetration and victimization. Data from Wave 4 of the national, randomly selected, Growing up with Media cohort (n = 876 adolescents aged 14-19 years), collected in 2011, were analyzed. Dating youth perceived more peer pressure to have sex and were more accepting of sex in brief or nonmarital relationships than pre-dating youth. Boys had higher levels of rape-supportive attitudes than girls. Among dating youth, the relative odds of involvement in teen dating abuse as a perpetrator or a victim were generally associated with greater acceptance of relationship violence, perceived peer pressure to have sex, and acceptance of sex in brief and/or nonmarital relationships. Rape-supportive attitudes were not significantly associated with any type of teen dating abuse involvement. Programs aimed at preventing dating abuse might benefit from targeting attitudes associated with sexual activity as well as relationship violence.     

Single versus Multi-Type Maltreatment

Abstract

The purpose of the present study was to identify the long-term impacts of different types of child abuse and to assess differential effects of single versus multi-type maltreatment. Three hundred and eighty-four college students completed measures of child abuse history (neglect, emotional, physical, and sexual abuse), depression, suicidality, self-esteem, sexual behavior, drug and alcohol use, and delinquent behavior. The results demonstrate the high rates of co-occurrence of different types of abuse, with few differential effects identified. Rather, all types of abuse were associated with symptoms. Experiencing multiple types of abuse was associated with greater symptoms than experiencing no abuse or a single type of abuse. The results highlight the importance of considering all types of abuse when studying child maltreatment.     

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.     

Therapeutic Work with Trauma,Revictimization, and Perpetration: Bearing Witness,Offering Hope,Embracing Despair

ABSTRACT

This paper offers a case study of a survivor of childhood incest who in adulthood has become a victim of violence in her relationships with chosen partners and is concerned that she herself may be a perpetrator of sexual abuse. It examines selected literature on attachment, dissociation, transference/countertransference, role responsiveness and sadomasochistic therapeutic enactments, the two-system superego model, and the triadic self. The paper focuses on long-term treatment dynamics with survivors of cumulative trauma and explores such psychodynamic psychotherapy issues as the therapist as a perpetrator of violence, the development of sacred space, authenticity, and the importance of both offering hope and embracing despair in this work.     

Maternal Response to Father-Daughter Incest: Experiences of Mothers Following Disclosure

This study explored the impact of the disclosure of sexual abuse of the daughter by the father or father figure on the mother. Data were collected from seven mothers aged between 31 and 48 years whose daughters had a history of sexual abuse by the biological father, stepfather or live-in boyfriend. The children's ages ranged between 5 and 11 years with disclosure having taken place in the last two years before data collection. Data were collected using an interview schedule. The results obtained from the thematic content analysis indicate that the mothers were traumatized by the disclosure of the sexual abuse. The most prevalent symptoms were anger, anxiety, guilty, depression, insomnia, headache and fatigue. It is recommended that mothers be provided with psychological intervention in order to assist them deal with the trauma associated with the disclosure of the father-daughter incest.     

The Nature of Attitude

ABSTRACT

Previous research has shown that acute alcohol consumption is associated with negative responses toward outgroup members such as sexual minorities. However, simple alcohol cue exposure without actually consuming alcohol also influences social behavior. Hence, it was reasoned that priming participants with words related to alcohol (relative to neutral words) would promote prejudiced attitudes toward sexual minorities. In fact, an experiment showed that alcohol cue exposure causally led to more negative implicit attitudes toward lesbians and gay men. In contrast, participants’ explicit attitudes were relatively unaffected by the priming manipulation. Moreover, participants’ typical alcohol use was not related to their attitudes toward lesbians and gay men. In sum, it appears that not only acute alcohol consumption but also the simple exposure of alcohol cues may promote negative views toward lesbians and gay men.     

“Why would you want to do that work?” The positive impact on therapists of working with child victims of sexual abuse in Ireland: a thematic analysis

Abstract

Research on the impact on psychotherapists of working with trauma has typically focused on negative impact and protective strategies and supports for therapists working in this field, such as self-care strategies and supervision. Yet many clinicians speak of the rewarding and fulfilling experiences of working with those who have been sexually abused. This study explored the positive impact of working with children who have been sexually abused in a sample of psychotherapists in Ireland. Unstructured interviews were conducted with nine female therapists who work in a specialist sexual abuse service with child victims of sexual abuse. An inductive thematic analysis identified four key themes: “the struggle to talk about the positive impact”, “professional satisfaction from helping children”, “learning life lessons from children” and “the magical connection that happens in therapy”. The findings show that, despite therapists’ tendency to think about negative impact, when encouraged to do so they described finding the work professionally rewarding, experiencing an enhancement of their own attitudes and lives through learning from the children they worked with and feeling uplifted within the therapeutic relationship with the child. Suggestions are offered for future research that may provide a broader understanding of the positive impact of this work.     

Beyond Crucifixion: Remaining Christian after Sexual Abuse

Abstract

Christian survivors have frequently likened their experiences of sexual abuse to crucifixion. While it is understandable that many cannot reconcile their experiences within their faith tradition, the question of how it is possible to move forward within a Christian framework which accommodates the experience of sexual abuse has tended to be overlooked. In doing so, this article considers why identifying with the crucified Christ may be an important step in the process of moving forward, and why the terminology "survivor" may be preferable to "victim." The challenge to move forward may require churches and church personnel to consider whether they need to do some things differently. Above all, this requires integrity for the individuals and communities involved rather than a one-size-fits-all approach.     

Personality and sexuality in older adults

Objective: This study explored cross-time associations between personality and multiple components of sexual functioning and behaviour in a large cohort of older adults (n = 5745).

Design: Participants (M_age = 65.57 ± 8.28 years) completed questionnaires in 2010 and 2012.

Main outcome measures: Outcomes explored included sexual attitudes, sexual activity, sexual satisfaction, lifetime sexual partners, sexual orientation and sexual dysfunction.

Results: We found that higher levels of openness and lower levels of agreeableness were related to more liberal attitudes toward sex, a greater number of sexual partners, a higher sex drive, more frequent sexual activity, lower levels of sexual dysfunction and (for women) a greater tendency towards homosexuality. Higher levels of conscientiousness were also related to more conservative attitudes towards sex, lower levels of sexual dysfunction and a greater tendency towards heterosexuality. For sexually active older adults, higher levels of extraversion and lower levels of neuroticism were related to greater sexual satisfaction. Higher levels of extraversion and lower levels of conscientiousness were also related to a greater number of sexual partners in men but not women.

Conclusion: These findings provide evidence that personality is an important correlate of sexual functioning and behaviour in older adults.     

Common Themes in the Experiences of Mother-Daughter Incest Survivors: Implications for Counseling

A qualitative method was used to explore the phenomenon of mother-daughter incest. Common themes were extracted from in-depth interviews with survivors of mother-perpetrated sexual abuse, some of which parallel the experience of survivors of other forms of child sexual abuse, and some of which are more specific to mother-daughter incest. These themes are discussed in detail. Counseling implications are discussed and treatment recommendations are made for therapists working with adult survivors of maternal sexual abuse.     

Perspectives on Memory for Trauma and Cognitive Processes Associated with Dissociative Tendencies

Summary

Cognitive science approaches can inform research in traumatic stress studies by articulating separate scientific issues that may be relevant to understanding alterations in memory and awareness for trauma. This article will first address general issues about disrupted memory and “knowledge isolation” for trauma, as well as introduce specific aspects of “betrayal trauma theory” (Freyd 1994, 1996) that inform our understanding of memory impairment. According to betrayal trauma theory, a potent motivation for knowledge isolation (including amnesia, dissociation, and unawareness) in the face of trauma is to preserve apparently necessary human relationships in which betrayal occurs. Results from three recent laboratory investigations of cognitive processes associated with dissociative tendencies are summarized. These laboratory investigations suggest that the attentional capacities of high dissocators are impaired under conditions of selective attention, but not divided attention. Furthermore, in our laboratory tasks high dissocators have impaired memory for emotionally charged words associated with sexual assault and abuse (e.g., “incest”) but not neutral words, as compared with low dissociators. The findings suggest that high dissociators use divided attention and multi-tasking as a way to control the flow of information. Such a view is consistent with betrayal trauma theory. Though in its infancy, this research draws on cognitive science and observations of traumatic response and offers much promise.     

Experiences of transgender prisoners and their knowledge,attitudes, and practices regarding sexual behaviors and HIV/STIs: A systematic review

Background: Despite transgender people being more visible in prison systems, research suggests they are at higher risk of experiencing sexual violence compared to other prisoners. Research also suggests that transgender prisoners experience harassment, and physical and sexual assault by fellow prisoners, and prison officers who lack transgender-specific health knowledge. There exist no systematic reviews on the experiences of transgender people in prisons. This review aims to fill this research gap. The following question developed in consultation with transgender, sexual health/HIV and corrective services stakeholders has guided the systematic review: What are transgender and gender-diverse prisoners’ experiences in various prison settings and what are their knowledge, attitudes and practices regarding sexual behaviors and HIV/STIs?

Methods: The review followed the PRISMA guidelines and searches were conducted in four databases for the period of January 2007 to August 2017. Studies were assessed against predetermined inclusion and exclusion criteria. Included studies were peer-reviewed, written in English with online full-text availability and reported data on transgender and gender-diverse prisoner experiences relevant to the research question.

Results: Eleven studies (nine qualitative, one quantitative, one mixed-methods; nine in USA, two in Australia) met the criteria for review. Four studies were of high quality, six were of good/acceptable quality, and one study was of modest quality. Transgender and gender-diverse prisoners reported a range of challenges which included sexual assault, discrimination, stigma, harassment, and mistreatment. Information on their sexual health and HIV/STIs knowledge, attitudes, practices is in short supply. Also, their lack of access to gender-affirming, sexual health/STIs and mental health services is commonplace.

Conclusions: The experiences of transgender prisoners as reported in this review are almost uniformly more difficult than other prisoners. Their “otherness” is used as a weapon against them by fellow prisoners through intimidation and violence (including sexual) and by prison officers through neglect and ignorance.     

Knowledge,beliefs, peer norms,and past behaviors as correlates of risky sexual behaviors among college students

Abstract

HIV/AIDS knowledge, age at onset of sexual activity, perceptions of personal risk and peer norms were explored as correlates for risky sexual behaviors among college students. Ninety-nine male and 185 female college students completed a 66-item questionnaire. A majority reported being sexually active with most in mutually monogamous relationships or not currently in a sexual relationship. Multiple regression correlation analyses showed knowledge about HIV/AIDS to be very high but that this knowledge did not independently relate to the extent of risky behaviors. Perceptions of risk were positively related to number of partners and single-time partners but not condom usage. In contrast to previous studies, perceived peer norms did not independently relate to behaviors. Instead, age at first intercourse was found to have substantial overlap with current perceptions, attitudes, and likelihood for engaging in risky behaviors. The necessity for including previous behaviors in analyses of the impact of attitudes and perceived norms on behavioral intentions is discussed.