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.     

Family Functioning Moderating the Effects of Childhood Sexual Abuse on Memory Specificity

The main goal of this study was to investigate if adults sexually abused as children who were raised in a functional family are more able to generate specific autobiographical memories and suffer fewer depressive symptoms than sexually abused adults who were raised in a dysfunctional family. We found that abused males retrieved fewer specific memories than nonabused males, abused females, and nonabused females. The three latter groups did not differ from each other. Further, childhood sexual abuse did not predict depression among males and females. After accounting for family functioning, there were no group differences regarding memory specificity. Functional families appear to have beneficial effects on the adjustment of male victims of childhood sexual abuse.     

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.     

Impact of Childhood Sexual Abuse on Client Spiritual Development: Counseling Implications

The spiritual development of sexually traumatized clients is an important area of concern for counselors. In this paper, spirituality is defined, and its relevance for counselors who work with childhood sexual abuse survivors is discussed. Impact of abuse on client spirituality is described, and several suggestions are given for assessment and intervention approaches that address spiritual issues as part of the counseling process.     

Moral Principles Underlying the Treatment of Adults With Memories of Childhood Abuse

Ethical decision making measures are widely applied as the principal dependent variable used in studies of research integrity. However, evidence bearing on the internal and external validity of these measures is not available. In this study, ethical decision making measures were administered to 102 graduate students in the biological, health, and social sciences, along with measures examining exposure to ethical breaches and the severity of punishments recommended. The ethical decision making measure was found to be related to exposure to ethical events and the severity of punishments awarded. The implications of these findings for the application of ethical decision making measures are discussed.     

Spirituality and the Current Adjustment of Adult Survivors of Childhood Sexual Abuse

We explore the role of spirituality in the current adjustment of adult survivors of childhood sexual abuse (CSA). A sample of 101 men and women survivors of CSA completed questionnaires on spirituality (relationship with God or higher power), person factors (blame attributions, self-acceptance, hope), and current adjustment (mood, personal growth, resolution of the abuse). Results indicated that relationship with a benevolent God or higher power is related to the experience of less negative mood and a greater sense of personal growth and resolution of the abuse. Also, relationship with a higher power is related to other person factors such as self-acceptance and hope. Relationship with a benevolent God appears to have an indirect link to depressive mood and resolution of abuse through the mediating pathways of hope and self-acceptance. In contrast, relationship with God appears to have a more direct association to the outcome of personal growth for these survivors .     

Suicidal Behavior Outcomes of Childhood Sexual Abuse: Longitudinal Study of Adjudicated Girls

Childhood sexual abuse (CSA) histories are prevalent among adolescent girls in the juvenile justice system (JJS) and may contribute to their high rates of suicidal behavior. Among 166 JJS girls who participated in an intervention trial, baseline CSA and covariates were examined as predictors of suicide attempt and nonsuicidal self‐injury (NSSI) reported at long‐term follow‐up (7–12 years later). Early forced CSA was related to lifetime suicide attempt and NSSI history and (marginally) to postbaseline attempt; effects were not mediated by anxiety or depressive symptoms. Findings suggest that earlier victimization and younger entry into JJS are linked with suicide attempt and NSSI.     

Hierarchical Relationships in Dependency Grids: Explorations in Survivors of Childhood Sexual Abuse

A methodology for representing the patterns of dependency in a dependency grid using partial order scalogram analysis by coordinates (POSAC) is presented. The technique, devised by Shye (1985) Shye, S. 1985. Multiple scaling: The theory and application of partial order scalogram analysis, Amsterdam: North Holland.  [Google Scholar], shows these patterns as hierarchical relationships that indicate superordinate and subordinate resources. An index of depth of resource support is calculated in addition to an index of breadth of resource (which is shown to correspond to an index of dispersion of dependency). The procedure was applied to data from 54 survivors of child sexual abuse and a similar number of control subjects who all completed both an adult and child dependency grid. There was significantly less breadth of resource in the abuse group, more so for the child version than the adult, but there was significantly more depth of resource in the dependency grids from the child sexual abuse survivors.     

Development and Refinement of a Targeted Sexual Risk Reduction Intervention for Women With a History of Childhood Sexual Abuse

Childhood sexual abuse (CSA) is associated with sexual risk behavior in adulthood. Traditional sexual risk reduction interventions do not meet the unique needs of women who have been sexually abused. In the current paper, we describe the four-stage process we followed to develop and refine a targeted sexual risk reduction intervention for this population. First, initial quantitative work revealed that the intervention should address how maladaptive thoughts related to traumatic sexualization, trust, powerlessness, and guilt/shame (traumagenic dynamics constructs) influence current sexual behavior. Second, qualitative interviews with 10 women who reported a history of CSA (M age = 34 years; 90% African American) as well as current sexual risk behavior provided support for targeting maladaptive thoughts associated with these traumagenic dynamics constructs. Third, based on the qualitative and quantitative results, we developed a 5-session, group-delivered intervention to address the maladaptive thoughts that occurred as a result of CSA, as well as the cognitive-behavioral determinants of sexual risk behavior. This intervention drew heavily on cognitive behavioral techniques to address cognitions associated with CSA and the links between these cognitions and current sexual risk behavior. Techniques from trauma-based therapies, as well as motivational techniques, were also incorporated into the intervention. Finally, we refined the intervention with 24 women (M age = 33 years; 79% African American), and assessed feasibility and acceptability. These women reported high levels of satisfaction with the intervention. The resultant intervention is currently being evaluated in a small, randomized controlled trial.     

Contrapower Sexual Harassment: A Survey of Students and Faculty Members

We conducted two studies to shed light on contrapower sexual harassment in an academic setting. In the first study, we surveyed a random sample of 158 college students (83.4% White) concerning their potentially sexually harassing behaviors toward professors, sexist attitudes toward women, and proclivities to harass sexually. Almost one third of the students reported having sexually harassed a professor at least once. Male students were more likely than female students to be the perpetrators. In the second study, all tenured and tenure-track faculty were mailed a survey; 209 professors (88.9% White) completed the survey concerning their experiences with sexual harassment from students as well as their coping responses, definitions of sexual harassment, and reactions to hypothetical scenarios. Over one half of the professors reported having been at least once sexually harassed by students. Although male and female professors experienced similar rates of sexual harassment from students, the psychological outcome was worse for women than for men. Male and female professors defined sexual harassment similarly. However, when more contextual information was provided in the hypothetical scenarios, several gender differences emerged. In addition, men and women used both internal and external coping responses to different types of sexual harassment. Sexual harassment as both a tool and a result of male dominance in society is discussed.     

Priests as Victims of Childhood Sexual Abuse: The Effects of Disclosure on Empathy

This study explores the effects of disclosing a history of childhood sexual abuse on empathy for Roman Catholic priests. The research design randomly selected priests in good standing in the Roman Catholic Church from 10 locations in the United States. Three groups of priests were identified based on self-report: (a) priests who report sexual abuse and no disclosure, (b) priests who report sexual abuse and disclosure, and (c) priests who report no sexual abuse. The three groups were compared using the Interpersonal Reactivity Index dimensions of perspective-taking, empathic concern, and personal distress as the dependent variable. The data was analyzed using hierarchical multiple regression to examine the incremental contributions for the different sets of independent variables. Results indicate that empathy was not exclusively associated with disclosing sexual abuse. The need for earlier intervention, education, and assistance for priests in disclosing childhood sexual abuse is discussed.     

Rational-Emotive Behavior Therapy in the Treatment of Adult Victims of Childhood Sexual Abuse

This study investigated the effectiveness of Rational-emotive behavior therapy in the treatment of adult victims of childhood sexual abuse. A sample of 42 women, seeking help for their psychological distress associated with childhood sexual abuse, was selected by means of an assessment interview and the Trauma Sympton Checklist, and randomly assigned to a treatment (n=28) and a delayed treatment control group (n=14). The treatment group participated in 10 weekly sessions of group Rational-emotive behavior therapy and was followed up 8 weeks after termination of treatment. Repeated measurements were obtained by means of the Beck Depression Inventory, State-Trait Anxiety Scale, State-Trait Anger Scale, Guilt Inventory, Coopersmith Self-Esteem Inventory and Golombok-Rust Inventory of Sexual Satisfaction. Results indicated significant reductions in depression, State anxiety, State anger, State guilt and low self-esteem. These improvements were maintained at follow-up.     

The Effectiveness of Therapy with Couples Reporting a History of Childhood Sexual Abuse: An Exploratory Study

The purpose of this pilot study was to explore the impact of childhood sexual abuse (CSA) on couples therapy. Participants were couples seeking therapy who were screened for CSA prior to therapy. Groups were compared using self-report and therapist-rated measures of individual and relational distress. Results indicate that although therapists report significant differences between CSA couples and couples not reporting abuse at the onset of therapy, those differences do not translate into significant differences in the perceived effectiveness of therapy as measured by change scores on therapist rated levels of distress, questions regarding the effectiveness of therapy, dropout, and length of treatment.     

Relationship of Long Term Effects of Childhood Sexual Abuse to Identity of the Offender

Sexual abuse is defined as the involvement of children and adolescents in sexual activities they do not fully comprehend and to which they do not freely consent. The long term effects of these violations of children have been described clinically. This study was initiated to demonstrate differences in emotional distress experienced by childhood victims of sexual abuse and their non-abused counterparts. Clinical records of 311 women were reviewed following termination from psychotherapy. Fifteen (15%) percent of the women indicated that they had been abused by a father, brother, grandfather, stepfather, friend, or stranger.     

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.     

Timing Disclosure Sessions: Adding a Narrative Perspective to Clinical Work with Adult Survivors of Childhood Sexual Abuse

Though the literature on the diagnosis and treatment of survivors of childhood sexual abuse has burgeoned in the last 20 years, relatively little guidance is available in the popular or professional literature to assist clients or therapists about issues of disclosure of this abuse to family members. When authors explicitly focus on disclosure, the timing of such disclosure is usually framed within a psychological and/or interpersonal perspective. In this article, we suggest that attention to characteristics of the sexual abuse narrative itself offers an important additional resource to guide decision making with respect to disclosure. We also describe ways that a narrative approach to disclosure can produce empowering conversational practices. A detailed case example provides the clinical material to illustrate this narrative approach to disclosure.     

Mock Jurors' Evaluations of Child Sexual Abuse: The Impact of Memory Recovery and Therapeutic Intervention

The present research assessed whether mock jurors' decisions in a case involving allegations of child sexual abuse would be influenced by (1) the nature of the plaintiff's memory of the abuse (repressed, nonrepressed) and (2) therapeutic intervention (present, absent). Participants (N=123) were given a trial summary in which the plaintiff's memory and involvement in therapy were systematically varied to produce four conditions. Although verdicts varied only by sex of participant, some judgments of the plaintiff's claim were more favorable to the plaintiff in the non-repressed condition. Female participants were also less likely to believe that the claim involving memory repression was truthful when the woman was in therapy as opposed to not in therapy. Results also indicated that people who were aware of “False Memory Syndrome” were more likely to think the plaintiff was lying and less likely to think she was telling the truth compared to those who were not aware.     

Refusing to be Marginalized: Groupwork in Mental Health Services for Women Survivors of Childhood Sexual Abuse

Childhood sexual abuse is a major aetiological factor in the development of mental health difficulties experienced by women. Although this conclusion is supported by two decades of extensive research, it has had little impact on the provision of mainstream mental health services. It remains exceptional for there to be specialist therapy or counselling provision for women survivors of childhood sexual abuse within statutory mental health services. This represents a serious gap in service provision and, it is argued, results in extended and inappropriate treatment for women survivors using mental health services. In this article, the development of a multi-agency approach to the provision of groupwork for women survivors of childhood sexual abuse within mental health service is described. A women-centred model of groupwork is outlined. Evaluation and funding are discussed. It is argued that, as a time-limited and effective treatment option, groupwork for women survivors of childhood sexual abuse should form a central part of service provision within statutory adult mental health services.     

Recollections of Childhood Sexual Abuse: Complexities of Religious Coping and Muslim Religious and Psychological Adjustment in Afghanistan

Journal of Religion and Health - Religious coping is a double-edged sword. Clarification of the psychological benefits for positive religious coping requires statistical controls for negative...