Adult male survivors of childhood sexual abuse

This paper outlines the conclusions drawn from a qualitative research study which involved in-depth interviews with 2.5 adult males who had been sexually abused during childhood. The full findings have been described in Adult Male Survivors of Childhood Sexual Abuse published by Pitman (1995). The book includes many of the men's first person accounts of their experiences of abuse.     

Sex differences in childhood sexual abuse and suicide-related behaviors

Child sexual abuse and suicide-related behaviors are associated, but it remains unclear if the strength of this association differs in boys and girls. In a systematic review of this association in children and youth, we identified 16 relevant studies, all cross-sectional surveys of students. The association is stronger in boys specific to suicide attempt(s). Adjustments for potential confounding variables explained some, but not all of this sex difference. While additional research would strengthen causal inferences, this sex difference may be influenced by the nature and timing of child sexual abuse as well as the sex of the perpetrator, which in turn shapes the disclosure of these events.     

Borderline Personality Disorder and childhood sexual abuse: a meta-analytic study.

A meta-analysis of the published literature was performed to evaluate the common effect size (r) of the association between childhood sexual abuse (CSA) and Borderline Personality Disorder (BPD). An online search from 1980 to 1995 was used to gather published papers. r coefficient was used as an effect size measure, and 21 studies were retrieved. A moderate pooled r (.279) for the association between CSA and BPD was observed. Pooled effect size estimates were also obtained for CSA parameters. No significant effect of moderators was evidenced. The results of this study did not support the hypothesis that CSA is a major psychological risk factor or a causal antecedent of BPD.     

The relationship between childhood sexual abuse and sexual health practices of homeless adolescents

This study explored the gender differences in sexual self-concept, personal resources for sexual health, safe sex behaviors, and risky sexual behaviors among homeless adolescents with and without histories of sexual abuse. Data for this secondary analysis were collected in 2003 to 2004 in the first phase of a larger repeated-measures sexual health intervention study; 371 homeless youth between 16 and 23 years of age (M = 19.26, SD = 1.83) were recruited from a street outreach center. The majority (64.6%) of participants were males. Self-report instruments were completed at the outreach center via audio computer-assisted self-interview (A-CASI) format. It was found that female participants were better off than males on numerous measures of sexual health behaviors and attitudes. Sexually abused participants had significantly less future time perspective (p = .05), fewer sexual self-care behaviors (p = .04), and less social support than nonabused participants (p = .01) and almost significantly more sexual risk-taking (p = .08). However, no significant differences were found between abused and nonabused participants on sexual self-concept, self-efficacy or intention to use condoms, safe sex behaviors, AIDS knowledge, assertive communication, or self-efficacy to perform testicular/ breast self-exams. Overall, participants who did not report a history of sexual abuse had significantly more sexual health resources and engaged in fewer sex-risk behaviors than those who reported having been abused. These differences have notable implications for screening adolescents for a history of sexual abuse. Adolescents who report sexual abuse should receive risk counseling and be screened regularly for the development of sexual risk behaviors.     

Responsivity to stress in chronic posttraumatic stress disorder due to childhood sexual abuse

The purpose of this study was to investigate psychological, cardiovascular, and neuroendocrine reactivity to standardized stress tests (orthostatic challenge, Stroop Color Word Test) in drug-free adult women with chronic PTSD due to repetitive childhood sexual abuse. At baseline, the 11 patients showed significantly higher mean scores on the Symptom Check List-90 and the Profile of Mood States than 13 healthy female controls, whereas baseline cardiovascular or hormonal parameters showed no differences between the groups. Also, no significant differences were found between the two groups in cardiovascular and hormonal responsivity to the stress tests. Thus, in the presence of robust psychological differences, the patients with chronic PTSD due to childhood sexual abuse did not show alterations in baseline values of neurobiological parameters, nor did they react differently to a physical and mental stress test when compared to healthy controls.     

Linking thought suppression and recovered memories of childhood sexual abuse

There are two types of recovered memories: those that gradually return in recovered memory therapy and those that are spontaneously recovered outside the context of therapy. In the current study, we employed a thought suppression paradigm, with autobiographical experiences as target thoughts, to test whether individuals reporting spontaneously recovered memories of childhood sexual abuse (CSA) are more adept at suppressing positive and anxious autobiographical thoughts, relative to individuals reporting CSA memories recovered in therapy, relative to individuals with continuous abuse memories, and relative to controls reporting no history of abuse. Results showed that people reporting spontaneously recovered memories are superior in suppressing anxious autobiographical thoughts, both in the short term and long term (7 days). Our findings may partly explain why people with spontaneous CSA memories have the subjective impression that they have "repressed" their CSA memories for many years.     

Factors to consider in assessing adult litigants' complaints of childhood sexual abuse

Based on limited research, clinical and forensic experience and observations, factors hypothesized to be potentially useful in forensic evaluation of claims of decades-delayed discovery of childhood sexual abuse are delineated. Factors considered include: (1) alleged victim factors, (2) memory factors, (3) therapist/examiner factors, (4) external influences on the abuse account, (5) evidential patterns. Differences among a limited sample of cases seen by the author are described. Present knowledge does not provide a basis for reliable determination of whether a specific recollection is true or false, based only upon the claimant's account. At this time, there is no empirically validated method for discriminating valid from invalid cases. Experts testifying for either side must exercise caution and restraint as it may be premature and even unethical in many cases to propound opinions about the validity or invalidity of the memories.     

Evaluating a novel intervention to reduce trauma symptoms and sexual risk taking: qualitative exit interviews with sexual minority men with childhood sexual abuse

Childhood sexual abuse (CSA) continues to affect sexual minority men (SMM) at disproportionate levels and contributes to multiple negative health outcomes, including sexual-risk taking and HIV acquisition. This paper presents qualitative evaluative feedback from SMM (N = 9) who participated in a 10-session Cognitive Behavioral Therapy-Trauma and Sexual Health (CBT-TSH) intervention to reduce CSA-related posttraumatic stress reaction and distress. The treatment was designed to increase accurate sexual risk appraisals and to improve self-care health behaviors related to HIV/STI acquisition. The researchers identified four emerging themes: (1) motivation to participate, (2) response to cognitive therapy, (3) process of change, and (4) considerations for intervention improvement. These qualitative findings provide useful feedback on the acceptability of an innovative program that integrates CBT for trauma related to CSA with sexual risk-reduction counseling.     

People believe it is plausible to have forgotten memories of childhood sexual abuse

Pezdek, Blandon-Gitlin, and Gabbay (2006) found that perceptions of the plausibility of events increase the likelihood that imagination may induce false memories of those events. Using a survey conducted by Gallup, we asked a large sample of the general population how plausible it would be for a person with longstanding emotional problems and a need for psychotherapy to be a victim of childhood sexual abuse, even though the person could not remember the abuse. Only 18% indicated that it was implausible or very implausible, whereas 67% indicated that such an occurrence was either plausible or very plausible. Combined with Pezdek et al.’s findings, and counter to their conclusions, our findings imply that there is a substantial danger of inducing false memories of childhood sexual abuse through imagination in psychotherapy.     

Prevalence of childhood and adolescent sexual abuse among sex offenders.

A simple nonstandardized questionnaire was developed and administered to 150 men convicted of various sexual offenses currently on probation or parole, living in the community, admitting their offenses and attending treatment. The hypothesis that men who engaged in sexual activity as adolescents with women would be at a higher risk of committing statutory rape-type sexual offenses was not substantiated.     

Supervising counsellors who work with survivors of childhood sexual abuse

This paper draws attention to issues for supervisors who support counsellors working with adult survivors of childhood sexual abuse from the perspective of trauma theory. The author describes the effects of vicarious traumatization and the unconscious dynamics that contribute to this experience. A narrative approach is included as another way of supervisors listening to distressing stories, both those of clients and of their counsellors, and reflects on the value of bearing witness to those stories in supervision and of recognizing them as a source of healing.     

Social and emotional outcomes of childhood sexual abuse: A review of recent research

A total of 41 articles examined the social and emotional outcomes of childhood sexual abuse. The outcomes examined included suicide and substance use, gang involvement, pregnancy, running away, post-traumatic stress disorder (PTSD), risky sexual behavior, and behavioral problems. Results for each of these outcomes tended to vary by developmental period. However, problems of internalizing and externalizing behavior appeared to be specific to sexually abused children of all age groups. Some studies found differences in outcome according to gender, race, and age. Although findings related to abuse characteristics were found to vary from study to study, severity of the abuse, use of force, and victim's relationship to the perpetrator were found to be especially important. Other factors, such as family support and parental monitoring, were found to mitigate a negative outcome. Limitations are discussed along with suggestions for future research.     

Flashback phenomena in survivors of childhood sexual abuse: A four-stage treatment model

There has been a growing awareness of Post-Traumatic Stress Disorder (PTSD) as a consequence of childhood sexual trauma. Central to this diagnosis is the flashback experience. Flashbacks are essentially memories which have not been integrated into everyday consciousness and return as intrusive symptoms, usually accompanied by dread and panic. This article presents a treatment strategy based on a four-stage model. The model includes (1) education; (2) assisting clients in identifying their flashback patterns; (3) designing coping strategies; and (4) processing the flashback. The goal is to assist the client with the management and integration of traumatic memory.This article is based on a paper practical guidelines to treating incest survivors' flashbacks presented at the World Congress of Cognitive Therapy, Toronto, June 1992.     

Tonic immobility and childhood sexual abuse: a preliminary report evaluating the sequela of rape-induced paralysis

The present study examined tonic immobility (TI) in victims of childhood sexual abuse (CSA). Female undergraduates (n=39) and female psychiatric inpatients (n=41) who experienced CSA completed a series of questionnaires assessing aspects of their victimization history, psychological functioning, and TI symptoms. Over fifty-two percent of all participants reported TI in response to CSA. Episodes of CSA involving attempted or completed penile/vaginal penetration were more likely to be associated with an increased likelihood of experiencing TI, and report of TI was associated with greater current psychological impairment. The implications of these findings are discussed, and suggestions for future research are offered.     

False memories in women with self-reported childhood sexual abuse: an empirical study

Although controversy exists about the validity of memories of childhood abuse, little is known about memory function in individuals reporting childhood abuse. This study assessed memories for previously presented words, including the capacity for false memory of critical lures not actually present in the word list, in 63 subjects, including abused women with posttraumatic stress disorder (PTSD), abused women without PTSD, and men and women without abuse or PTSD. Abused women with PTSD had a higher frequency of false recognition memory of critical lures (95%) than abused women without PTSD (78%), nonabused women without PTSD (79%), or nonabused men without PTSD (86%). PTSD women also showed poorer memory for studied words and increased insertions of non-studied words other than critical lures. These findings are consistent with a broad range of memory alterations in abused women with PTSD.     

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.     

Emotions and suicidal ideation among depressed women with childhood sexual abuse histories

Depressed women with sexual abuse histories have a heightened risk of suicidal ideation (SI), which may be only in part attributable to psychiatric symptoms of depression and posttraumatic stress disorder (PTSD). Emotions and SI were studied among 106 women with histories of childhood sexual abuse enrolled in treatment trials for major depression. Assessments were conducted at baseline, 10, 24, and 36 weeks. Sadness, guilt, and shame-proneness were associated with self-reported and observer-rated SI across time after adjusting for depressive and PTSD symptoms, suicide attempt history, and sociodemographic characteristics associated with SI. These findings highlight the need for clinical attention to self-directed negative emotions to potentially reduce suicide-related risk.     

The reality of recovered memories: corroborating continuous and discontinuous memories of childhood sexual abuse

Although controversy surrounds the relative authenticity of discontinuous versus continuous memories of childhood sexual abuse (CSA), little is known about whether such memories differ in their likelihood of corroborative evidence. Individuals reporting CSA memories were interviewed, and two independent raters attempted to find corroborative information for the allegations. Continuous CSA memories and discontinuous memories that were unexpectedly recalled outside therapy were more likely to be corroborated than anticipated discontinuous memories recovered in therapy. Evidence that suggestion during therapy possibly mediates these differences comes from the additional finding that individuals who recalled the memories outside therapy were markedly more surprised at the existence of their memories than were individuals who initially recalled the memories in therapy. These results indicate that discontinuous CSA memories spontaneously retrieved outside of therapy may be accurate, while implicating expectations arising from suggestions during therapy in producing false CSA memories.