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.     

EFFECTS OF ALCOHOL INTOXICATION AND VICTIMIZATION HISTORY ON WOMEN'S SEXUAL ASSAULT RESISTANCE INTENTIONS: THE ROLE OF SECONDARY COGNITIVE APPRAISALS

This study used an experimental paradigm to investigate the role of secondary cognitive appraisals in women's sexual assault resistance and whether these appraisals mediated influences of alcohol and prior victimization. After consuming a beverage (control, placebo, moderate, or high dose), 351 women projected themselves into a simulated interaction with a sexually aggressive man. Four types of secondary appraisals (shock at the man's behavior, concern about his feelings, uncertainty in the situation, conflict about what to do) and three resistance strategies (assertive, polite, passive) were examined. Path modeling revealed that, as expected, intoxication and prior sexual victimization influenced secondary appraisals, which in turn influenced intended resistance. Prior adult sexual assault (ASA) and childhood sexual abuse (CSA) also had direct effects: ASA negatively predicted assertive resistance and CSA positively predicted passivity. Findings suggest that secondary appraisals are key targets for intervention to facilitate effective resistance, thereby reducing the risk of adult sexual victimization.     

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.     

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.     

WHAT INFLUENCES BELIEVING CHILD SEXUAL ABUSE DISCLOSURES? THE ROLES OF DEPICTED MEMORY PERSISTENCE, PARTICIPANT GENDER, TRAUMA HISTORY, AND SEXISM

This vignette study investigated factors that influence believing child sexual abuse disclosures. College student participants ( N = 318) in a university human subject pool completed measures about their own trauma history and responded to questions about sexist attitudes. Participants then read vignettes in which an adult disclosed a history of child sexual abuse, rated disclosures for accuracy and believability, and judged the level of abusiveness. Continuous memories were believed more than recovered memories. Men believed abuse reports less than did women, and people who had not experienced trauma were less likely to believe trauma reports. Gender and personal history interacted such that trauma history did not impact women's judgments but did impact men's judgments. Men with a trauma history responded similarly to women with or without a trauma history. High sexism predicted lower judgments of an event being abusive. Hostile sexism was negatively correlated with believing abuse disclosures. Results are considered in light of myths about child sexual abuse.     

Comparing suicide attempters, suicide ideators, and nonsuicidal homeless and runaway adolescents.

This study considers variables that best distinguish among attempters, ideators, and nonsuicidal youth in a sample of 527 homeless and runaway adolescents from four Midwestern states. Univariate results indicate that attempters are significantly more likely than ideators and nonsuicidal youth to have experienced physical or sexual abuse by an adult caretaker, to have experienced sexual victimization while on their own, and to have a friend who attempted suicide. Multivariate analyses reveal five variables that best distinguish among the three groups: self-esteem, depression, physical abuse, sexual abuse, and having a friend who attempted suicide. Further analysis suggests that the accumulation of these risk factors greatly increases the chance that these youth will engage in suicidal behavior.     

Cognitive mediation of childhood maltreatment and adult depression in recent crime victims

Childhood maltreatment has been linked to adult depressive disorders. However, few studies have examined mechanisms through which childhood maltreatment may contribute to adult depression. Thus, we examined the role of one potential mechanism of this relationship, maladaptive cognitions, in a recently traumatized sample. Participants were adult women who had been recently raped (n = 133) or physically assaulted (n = 73). We examined whether maladaptive self-and other-cognitions mediated relationships between childhood sexual, physical, and emotional abuse and current depression. Relationships between childhood sexual abuse and both current depression symptoms and diagnosis were mediated by maladaptive cognitions about self. Relationships between both childhood sexual abuse and childhood physical abuse and adult depressive symptoms were mediated by maladaptive cognitions about others.     

Sexual trauma and personality: developmental vulnerability and additive effects.

Two types of sexual trauma, sexual abuse in childhood and rape in adulthood, were investigated in terms of possible effects on personality. Four groups of participants were studied: women who had experienced sexual abuse in childhood, women who had experienced rape as adults, women who had experienced both of these sexual traumas, and a control group of women who had experienced no sexual trauma. Personality functioning was assessed using the Dimensional Assessment of Personality Pathology. Groups who had experienced childhood sexual abuse displayed the highest degree of personality disturbance; however, the additive effects of repeated sexual trauma were limited. These findings may reflect the outcome of specific adversity in childhood on the psychobiological constructs underlying personality.     

Childhood Sexual Assault,Quality of Life,and Psychiatric Comorbidity in Veterans With Military and Civilian Sexual Trauma

Veterans with military sexual trauma (MST) are at risk for a variety of psychiatric conditions, including posttraumatic stress disorder (PTSD) and depression. Survivors of MST are also likely to experience diminished quality of life (QoL). Individuals with higher lifetime incidence of sexual trauma may also be at increased risk for poorer outcomes in QoL and psychiatric symptomatology. The differences in psychological sequelae among those who have experienced sexual trauma as children, and those whose sexual trauma exposure is limited to adulthood are relatively understudied. The majority of sexual trauma literature has focused primarily on civilian trauma, and comparatively few studies have specifically examined psychosocial sequelae (e.g., QoL) in veterans with MST. This study examined how childhood sexual abuse (CSA) affects overall QoL as well as severity of PTSD and depressive symptoms. Veterans who reported CSA had significantly greater depression symptom severity than veterans who did not. No significant differences in PTSD symptom severity or QoL were found between veterans who did and did not report CSA. Results highlight the need for further examination of the relationship between CSA and depression in veterans with MST-related PTSD who also report CSA.     

WOMEN'S SOCIAL BEHAVIOR WHEN MEETING NEW MEN: THE INFLUENCE OF ALCOHOL AND CHILDHOOD SEXUAL ABUSE

Heavy alcohol consumption ( Testa & Parks, 1996 ) and childhood sexual abuse (CSA; Messman-Moore & Long, 2003 ) have been associated with adult sexual victimization. We examined the social behavior of 42 women under two alcohol conditions (high dose and low dose) in a bar laboratory. Women were videotaped interacting with a man they had just met. Women in the higher dose condition engaged in more open body position and talked, stood, and walked more than women in the lower dose condition. These behaviors are consistent with signs of intoxication or romantic interest. The women in the high-dose condition also frowned more than women in the low-dose condition. An increase in frowning could indicate less comfort or may be considered consistent with an increase in animation during the social interaction given the concomitant increase in other behaviors. Thus, the nonverbal behavior of women in the high-dose condition could be interpreted as mixed signals. CSA victims exhibited fewer head movements (e.g., nods), were less animated, and frowned more than non-CSA victims. These behaviors convey reticence or possibly even anxiety or discomfort during the social interaction. Thus, the nonverbal behavior of women with a history of CSA may convey an unease that could be viewed by a potential perpetrator as vulnerability. Our findings suggest that both acute alcohol consumption and history of CSA may influence nonverbal social behavior and may influence risk for sexual assault by sending mixed cues of romantic interest or signs of vulnerability to potential perpetrators.     

Mediators of the relationship between childhood sexual abuse and suicidal behavior in borderline personality disorder

A history of childhood sexual abuse (CSA) increases the risk of suicidal behavior and the lifetime number of suicide attempts in adults with BPD. Despite a strong association, specific variables mediating the relationship between CSA and adult suicidal behavior in BPD have not been identified. This study examined risk factors for suicidal behavior as potential mediators of the relationship between CSA and suicide attempts in 151 men and women with BPD. Diagnostic, clinical, and psychosocial risk factors, as well as CSA, and suicidal behaviors, were assessed by standardized interviews or self-rated measures. Psychotic and schizotypal symptoms, and poor social adjustment, were associated with both CSA and suicidal behavior, and partially mediated the relationship between CSA and attempter status. Psychotic and schizotypal symptoms in BPD define a vulnerability to cognitive and perceptual distortions under stress. They increase the likelihood of suicidal behavior in BPD, especially in the absence of mitigating social support. A theoretical model for suicidal behavior in BPD is presented which integrates direct, mediated, and moderated pathways between childhood sexual abuse and temperament, adolescent and adult risk factors, and suicidal behavior.     

SUSPECTED REPRESSED CHILDHOOD SEXUAL ABUSE

This article explores therapists' responses to clients' suspicions that they have repressed memories of childhood sexual abuse (CSA). Each participant was randomly assigned one of two vignettes, varied for gender, each concerning a client who suspects that he/she is a victim of CSA. Following the vignette, a series of questions regarding the client assesses the participants' ratings of diagnoses, treatment goals, treatment plans, appropriate responses, and validity of suspicions. Participants were significantly more likely to endorse a diagnosis of borderline personality disorder and endorse treatments focusing on present symptoms over treatments focusing on the client's past. Participants were unlikely to endorse controversial treatments, suggestive statements, or strong opinions regarding the client's suspicions of CSA. The client's gender had a significant effect on diagnoses only. These results do not support reports that many therapists neglect clients' current symptoms and instead focus on memories, use controversial techniques, make suggestive statements regarding abuse, or immediately assume that their clients have repressed memories.     

Testing Posttraumatic Stress as a Mediator of Childhood Trauma and Adult Intimate Partner Violence Victimization

This study examined whether potential posttraumatic stress disorder (PTSD) mediated the relationships between different forms of childhood trauma (sexual abuse, physical abuse, violence between caregivers) and intimate partner violence (IPV) victimization (psychological, physical, sexual). Participants were 1,150 female nurses and nursing personnel. Path analytic findings revealed potential PTSD partially mediated the relationships between childhood sexual abuse and psychological IPV and childhood sexual abuse and sexual IPV. Potential PTSD did not mediate the relationship between other types of childhood trauma and IPV. This study adds to the literature indicating PTSD as a risk factor for revictimization in the form of adult IPV among women. Screening for and treatment of PTSD among female child sexual abuse survivors could prevent future IPV victimization.     

Additive impact of childhood emotional,physical, and sexual abuse on suicide attempts among low-income African American women

This study examines the association between exposures to multiple forms of childhood abuse (emotional, physical, sexual) and adult suicidal behavior in a sample of low-income, African American women. We hypothesized a linear relation between childhood abuse and risk for making a suicide attempt, such that the more forms of childhood abuse to which a woman was exposed, the greater her risk would be to make a suicide attempt. Logistic regression analyses revealed that, compared to women who did not report any experiences of childhood abuse, women who experienced one, two, or three forms of abuse were 1.83, 2.29, or 7.75 times more likely to attempt suicide, respectively (all statistically significant). Furthermore, compared to women who reported one or two types of abuse, women who reported all three types of abuse were statistically more likely to attempt suicide. These findings have implications for clinicians working with African American women who report either childhood abuse or exhibit suicidal behavior.     

The Influence of Religion on Victims of Childhood Sexual Abuse

Survey responses of 5,417 women were studied to obtain information about childhood sexual abuse, religion, and mental health. There were 653 (13%) who reported being sexually abused while growing up. When studying those who were sexually abused, it was found that this childhood experience was associated with less emotional maturity, lower self-esteem, more instability in their relationships with partners, and higher levels of depression. The highest scores on the mental health indicators were found for women who were not abused and highly religious, then highly religious and abused, and the lower scores for no abuse and low religiosity, low religiosity and abuse, and medium religiosity and abuse. These findings were interpreted as demon- strating that religion could help ameliorate negative mental health outcomes associ- ated with childhood sexual abuse.     

Childhood sexual and physical abuse and the 1-year prevalence of medical problems in the National Comorbidity Survey.

In a population sample (N=5,877; ages 15 to 54), the authors found childhood sexual and physical abuse to be associated with the 1-year prevalence of serious health problems for both men and women. The authors also found that participants' psychiatric disorders partially mediated the effects of physical and sexual abuse on adult health. However, childhood abuse continued to independently influence health status after the authors controlled for psychiatric disorders. Contrary to expectations, individuals who experienced a combination of sexual and physical abuse did not have a higher frequency of health problems than those who experienced either type of abuse alone. Implications for these findings are discussed, including possible mechanisms that may account for the association between childhood abuse and adult health problems.     

Autobiographical memory specificity in adults reporting repressed,recovered, or continuous memories of childhood sexual abuse

Some psychotherapists believe that adult survivors of childhood sexual abuse (CSA) are characterised by memory deficits for their childhood. Using the Autobiographical Memory Test (AMT), we asked nonabused control participants and participants who reported either continuous, recovered, or repressed memories of CSA to retrieve a specific personal memory in response to either positive or negative cue words from either childhood or adolescence/adulthood. The results indicated that participants who believed they harboured repressed memories of abuse tended to exhibit the greatest difficulty retrieving specific memories from their childhood. Neither posttraumatic stress disorder (PTSD) nor major depression was related to diminished memory specificity.     

HIV/STD Risk Factors for Women with Violent Male Partners

This study compared 167 women, categorized as nonabused, emotionally abused, or physically abused in their primary relationships, on sexual risk factors. Physically abused women differed in several ways: greater STD risk, psychosocial distress, and substance use; more traditional gender role beliefs; lower self-esteem; more likely to have been raped and to engage in sex for pay; and less likely to attend the project's STD/HIV risk reduction groups. Within primary relationships, they differed in amount of decision-making power about safer sex, likelihood of nonmonogamy, use of substances before sex, and self-efficacy about initiating condom use. African American women reported higher rates of emotional abuse than White women, a finding related mainly to their lower socioeconomic status in this sample.     

CHILDHOOD SEXUAL ABUSE, CULTURE, AND COPING: A QUALITATIVE STUDY OF LATINAS

The purpose of this study was to articulate a model of how Latinas cope with childhood sexual abuse (CSA) and the ways in which personal and cultural variables influence their coping strategies. Nine women who identified as Latina and as survivors of CSA participated in an in-depth interview. The data were analyzed using a grounded theory methodology. Results suggested that participants' coping efforts were influenced by a variety of cultural factors and that they engaged in a wide range of coping behaviors, all of which served two main functions: (1) seeking relief from negative emotions and (2) protecting one's self from further abuse.     

Victimization of Lesbian,Gay, and Bisexual People in Childhood: Associations with Attempted Suicide

Higher rates of attempted suicide have been documented among people who identify themselves as gay, lesbian, and bisexual (LGB) compared with heterosexuals. This study sought to ascertain the association between childhood abuse and neglect and attempted suicide, comparing LGBs and heterosexuals. Childhood sexual abuse among men and childhood sexual and physical abuse among women were found to mediate the association between LGB identity and attempted suicide. The experience of childhood abuse likely plays a significant role in the relationship between LGB identity and attempted suicide, but other factors such as experience of discrimination are also important.