SEVERITY OF CHILD SEXUAL ABUSE AND REVICTIMIZATION: THE MEDIATING ROLE OF COPING AND TRAUMA SYMPTOMS

Child sexual abuse (CSA) has consistently been associated with the use of avoidant coping; these coping methods have been associated with increased trauma symptoms, which have, in turn, been linked to increased risk for adult sexual revictimization. Given these previous findings, the purpose of the current study was to test a model that conceptualized the relationships among these variables. Specifically, CSA severity was conceptualized as leading to the use of avoidant coping, which was proposed to lead to maintenance of trauma symptoms, which would, in turn, impact severity of revictimization indirectly. This comprehensive model was tested in a cross-sectional study of a large, geographically diverse sample of college women. Participants were 99 female undergraduates classified as having experienced CSA who completed measures of abuse history, coping style, current levels of trauma symptoms, and adult sexual revictimization. Multivariate path analysis indicated that the data fit the hypothesized model for verbally coercive, but not physically aggressive, revictimization. Specifically, increased CSA severity was associated with the use of avoidant coping, which, in turn, predicted greater levels of trauma symptomatology and severity of sexual coercion in adulthood. Although cross-sectional in nature, findings from this study suggest that coping strategies and trauma symptoms may represent modifiable factors that place women at increased risk for verbally coercive sexual revictimization.     

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.     

Exploring the Recovery of Non-offending Parents after a Child’s Sexual Abuse Event

A variety of factors influence a child’s recovery from a child sexual abuse (CSA) event including the non-offending parent’s role in the healing process of their child. The purpose of this study was to gain a better understanding of how non-offending parents recuperate from a CSA occurrence. By better understanding non-offending parents’ perspectives related to the healing process, health professionals can provide effective supports, programs, and services. We recruited and conducted in-depth qualitative interviews with 16 non-offending parents to explore their risk factors, protective factors, stressors, coping strategies, and perceptions of healing following their child’s sexual abuse event. We also invited parents to contribute specific ideas to improve programs and services offered to families of sexual abuse served by a child advocacy center located in an urban pediatric hospital. Our findings included five themes: (1) a variety of emotions are present; (2) family context influences recovery; (3) coping is different for everyone; (4) navigating the justice system is frustrating; and (5) healing is a process. The results of our study revealed that the non-offending parents that were managing their child’s sexual abuse event more productively were further along in the healing process (as compared with their counterparts) and had successfully processed their emotions, described less chaos in their family unit, employed positive coping strategies, and had found a way to move forward and accept a “new normal”. The findings of our study can be used to promote recovery and provide better services to non-offending parents following a CSA event.

     

A qualitative study of childhood sexual abuse survivors in Taiwan: toward a transactional and ecological model of coping

In this study, we aimed to explore the experiences of 10 female Taiwanese childhood sexual abuse (CSA) survivors (age range = 20-39 years) to broaden our understanding of the post-abuse coping process in a Chinese sociocultural context. This investigation was grounded on a feminist paradigm, and the consensual qualitative research method (Hill et al., 2005; Hill, Thompson, & Williams, 1997) was utilized as the strategy of inquiry. The transactional and ecological model of coping that emerged from the data describes the dynamic interplay among (a) intrapersonal, interpersonal, and sociocultural factors and (b) the coping process and outcomes of CSA survivors. Implications for research on CSA recovery and culturally appropriate interventions in a collectivistic sociocultural context are discussed.     

A short-term group treatment model for gay male survivors of childhood sexual abuse living with HIV/AIDS

HIV-positive gay male survivors of childhood sexual abuse (CSA) face three layers of trauma: childhood abuse, homophobic oppression, and HIV/AIDS. Additionally, CSA has been shown to increase HIV risk behavior among gay men, and the trauma of HIV infection often parallels the experience of CSA. Effective coping strategies are particularly important for people living with HIV/AIDS in order to adapt to physical, psychological, and social implications of infection. However, coping strategies once adaptive in the context of CSA may become maladaptive in adulthood. Interventions are needed that enhance coping and address CSA for survivors living with HIV/AIDS to protect their own health and to prevent new transmissions. This article presents a group model found to be efficacious for treating gay male survivors of CSA living with HIV/AIDS.     

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.     

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.     

Nature and Prevalence of Childhood Sexual Abuse Among High School Girls and College Students in Zimbabwe

The study investigated the nature and prevalence of self-reported childhood sexual abuse (CSA) among a sample of Zimbabwean girls and college students. A total of 1059 high school girls and college students with a mean age (M = 18.31, SD = 3.66) participated in study. Overall, a CSA prevalence rate of 41.26% was found. The highest CSA prevalence rate was found among respondents who resided on commercial farms and mines (53%). Respondents who lived with their biological parents during childhood were significantly less likely to be sexually abused than were respondents who lived with non-parents such as uncles and brothers-in-law. Only 7.22% of the perpetrators were strangers. This study shows that sexual abuse of children in Zimbabwe is rampant, multifaceted, and linked to cultural factors that must be addressed as part of efforts to confront this scourge.     

Child sexual abuse coping and long term psychological adjustment

The aim of the study was to analyze the consequences of Child Sexual Abuse (CSA) on the psychological adjustment of university students, as well as the way in which several avoidance and approach coping strategies affect that adjustment. The sample comprised 1162 students from the University of Granada. Data about CSA was obtained from a questionnaire developed with this aim. We used the How I Deal with Things Scale of Burt and Katz to evaluate coping strategies, whereas depression and self-esteem were assessed with the Beck Depression Inventory and the Rosenberg Self-Esteem Scale, respectively. Subjects who were victims of CSA showed significantly higher scores on depression and lower scores on self-esteem. An analysis of coping strategies revealed that only the use of avoidance strategies was related to psychological adjustment. Subjects who used these strategies obtained higher scores on depression and lower scores on self-esteem. These results confirm the idea of CSA as a risk experience that can affect victims' psychological adjustment, to a greater or lesser extent, according to the coping strategy employed.     

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.     

Unresolved Childhood Sexual Abuse and Older Adults: Late-Life Vulnerabilities

Several long-term correlates of childhood sexual abuse (CSA) have been identified, including depression, fear, anxiety, guilt, anger, and poor interpersonal functioning (e.g., Browne and Finkelhor, 1986). However, little is know about how CSA survivors fare in old age. This article addresses the impact of unresolved CSA on late-life (emotional, cognitive, and behavioral) functioning. Three case studies of older adults ages 60 and older who were struggling with unresolved CSA are presented. Two observed stressors (loss of social support and declining health) and one developmental task (reminiscence or life-review) appear to be linked to exacerbated vulnerabilities in older survivors. Specifically, because CSA may arrest specific childhood developmental tasks (e.g., ability to form secure attachments, autonomy) or facilitate development of coping strategies that are maladaptive when outside of an abusive environment (e.g., generalized interpersonal distrust, avoidance, dissociation), the survivor may be at risk for developmental vulnerabilities for dysfunction in adulthood. These vulnerabilities may exacerbate unresolved CSA, particularly when the adult encounters stressors or developmental tasks that exceed his or her capacity for adaptive coping. Recommendations for mental health professionals and future research are suggested.     

Developing Culturally Responsive Evidence-Based Practice: A Game-Based Group Therapy Program for Child Sexual Abuse (CSA)

The American Psychological Association has called for the development and dissemination of evidence-based practices (EBPs) that are culturally responsive to ethnically and socioeconomically diverse groups. Delivering culturally responsive EBPs is essential for mental health practitioners working within racially, culturally, and ethnically diverse settings and across a variety of disorders. Child sexual abuse (CSA) affects people from diverse backgrounds and results in a myriad of difficulties impacting children and families. Therefore, effective treatment for CSA must take cultural factors into consideration. The authors describe the culturally congruent elements of a Game-Based Cognitive-Behavioral Group Therapy (GB-CBT) model for CSA, which was developed within a center serving predominantly urban, economically disadvantaged, African-American and Latino families. Lessons learned from families served through the GB-CBT program are incorporated and illustrate the ongoing and dynamic process of improving cultural competence in clinical practice. Cultural and socioeconomic considerations and obstacles to treatment are discussed along with strategies and recommendations for delivering EBPs for CSA in a culturally informed manner.     

Child sexual abuse, early family risk, and childhood parentification: pathways to current psychosocial adjustment.

In this study, the authors examined the role of parentification (children assuming adult-like roles in the family) as it relates to family risk (parental psychopathology, parental illness, and domestic violence), child sexual abuse (CSA), and psychosocial adjustment in 499 college women. Structural equation modeling was used to test a model of direct, indirect, and mediational pathways through which CSA, family risk, and parentification contributed to later psychosocial maladjustment. Results indicate that CSA and family risk independently and directly predicted higher levels of maladjustment, but only family risk positively predicted parentification in childhood. Parentification was unexpectedly related to less maladjustment. Parentification failed to mediate the relation between early family risk and maladjustment. Findings suggest that family risk factors may contribute to parentification and that parentification is not always related to poorer psychosocial outcomes. Future research should examine the impact of parentification on other aspects of functioning and should assess how individual, familial, and cultural variables (e.g., age, gender, duration, perceived fairness, ethnicity, and family support) moderate the impact of parentification on long-term adjustment.     

Reality monitoring in adults reporting repressed, recovered, or continuous memories of childhood sexual abuse

People who report either repressed or recovered memories of childhood sexual abuse (CSA) may have deficits in reality monitoring--the process whereby one discriminates memories of percepts from memories of images. Using signal detection methods, the authors found that adults reporting either repressed or recovered memories of CSA were less able to discriminate between words they had seen from words they had imagined seeing than were adults reporting either never having forgotten their CSA or adults reporting no history of CSA. Relative deficits in the ability to discriminate percepts from images (i.e., low d') were apparent on only some tests. The groups did not differ in their criterion--response bias--for affirming having seen versus imagined stimuli.     

Childhood physical and sexual abuse,and adult health risk behaviours among university students from 24 countries in Africa,the Americas and Asia

The goal of this study was to retrospectively estimate the prevalence of childhood physical abuse (CPA) and childhood sexual abuse (CSA) in relation to experience of adult violence, poor mental health, addictive behaviour and sexual risk behaviour among university students from 24 countries in Africa, the Americas and Asia. In a cross-sectional survey, data were collected from 18 404 undergraduate university students (mean age 20.7, SD = 2.9, age range of 16–30 years) from 24 countries. Overall, 5.0%, 2.6% and 1.2% of the students reported childhood physical abuse, childhood sexual abuse and childhood physical and sexual abuse, respectively. In the logistic regression models, adjusting for age, sex, study year, family wealth, and country, having experienced CPA and CSA was associated with increased odds of having any adult violence (physical and sexual partner violence victimisation. Having been in a physical fight, and weapon carrying), any poor mental health (post-traumatic stress disorder, depression symptoms and sleeping problems), addictive behaviour (tobacco use, binge drinking, frequent gambling and obesity) and sexual risk-taking was higher with a self-reported history of CPA and CSA.     

Memory for autobiographical facts and events: a comparison of women reporting childhood sexual abuse and non‐abused controls

Although there is evidence that many adult survivors of childhood sexual abuse (CSA) have a period when they forget their abuse, existing research is equivocal about whether such individuals show other autobiographical memory impairments. The present study addressed some of the sampling and measurement problems apparent in previous studies and compared 74 women reporting a history of CSA with 60 non‐abused controls on their ability to recall facts and events from childhood. The results showed that the CSA group did not differ from the controls in the quality of their memories for autobiographical incidents. However, they were significantly less able than controls to recall specific facts about their personal history, such as significant addresses and names of significant individuals, after controlling for educational level, depression and childhood address changes. CSA group participants reporting a period of abuse forgetting appeared more impaired than those with continuous abuse memories in their recall of personal semantic facts, but were similar in their recall of autobiographical incidents. The findings suggest that experiencing a period of abuse forgetting is a more influential factor in predicting the ability to recall personal semantic facts than abuse status alone. Copyright © 2002 John Wiley & Sons, Ltd.     

Inhibiting retrieval of trauma cues in adults reporting histories of childhood sexual abuse

Are people who report having forgotten their childhood sexual abuse (CSA) characterised by superior ability to inhibit retrieval of disturbing material? To test this hypothesis, we asked adults reporting either repressed, recovered, or continuous memories of CSA or no history of CSA to participate in a directed forgetting experiment (list method). They rated the emotionality of two consecutive lists of trauma‐related and positive words. After the first list, the experimenter instructed participants to forget these words, and to continue rating the remaining words. A surprise recall task revealed robust directed forgetting and valence effects: All groups recalled more words from the second list than from the first list, and recalled more trauma words than positive ones. Participants reporting either repressed or recovered memories of CSA did not exhibit superior forgetting of trauma versus positive words relative to the other two groups. Finally, a subsidiary analysis revealed that participants exhibiting a “repressor” coping style (low self‐reported anxiety plus high defensiveness) did not exhibit superior directed forgetting of trauma words.     

Adolescent coping with everyday stressors: A seven-nation study of youth from central,eastern, southern,and northern Europe

The present study compares problem-specific coping strategies and coping styles of European adolescents from seven nations. The sample consisted of 3031 adolescent participants, aged 11 to 20, from Croatia, the Czech Republic, Germany, Italy, Norway, Portugal, and Switzerland. The adolescents completed the Coping Across Situations Questionnaire (CASQ) by indicating which coping strategies (from 20 alternatives) they usually employed in dealing with age-specific problems (covering 8 different domains). The strategies can be collapsed to three coping styles: active coping, internal coping, and withdrawal. Results show that adolescents from all seven nations predominantly employed functional forms of coping, i.e., active coping and internal coping. In addition, the pattern of frequently and rarely applied coping strategies was similar across cultures. Differences in coping style were revealed for some, but not all problem domains, suggesting that cross-cultural similarity in coping exists for specific stressors. Problem-specific analyses helped to clarify where cultural influence is most distinct. Whereas cultural diversity was highest for coping with job-related problems, coping with self- and future-related problems was highly similar among adolescents from all the nations. Despite the considerable traditional, educational, and economic differences among the cultures investigated, the similarities in coping behaviour were impressive. Explanations for cultural universals and differences in adolescent coping are discussed.     

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.