The role of traumagenic dynamics on the psychological adjustment of survivors of child sexual abuse

The aim of this study was to analyse the consequences of child sexual abuse (CSA) on the psychological adjustment of survivors, as well as to determine the role of the feelings provoked by the abuse, following Finkelhor and Browne's traumagenic dynamics model (1985), on the adjustment of CSA victims. The sample of the study comprised 182 survivors of CSA, and another 182 participants selected as a comparison group. Results showed that CSA survivors, in contrast with the group of non-victims of CSA, had significantly higher scores on state anxiety, trait anxiety and depression, and lower on self-esteem. With regard to the role of traumagenic dynamics, feelings of powerlessness, self-blame, traumatic sexualization and, to a lesser extent, betrayal, predicted the scores of the CSA survivors in the four psychological adjustment variables assessed. To summarize, the results confirm the relation between CSA and the development of psychological problems in adulthood, explaining the survivors' feelings to a substantial extent the variability of adjustment.     

Context matters: the benefits and costs of expressing positive emotion among survivors of childhood sexual abuse

Positive emotions promote adjustment to aversive life events. However, evolutionary theory and empirical research on trauma disclosure suggest that in the context of stigmatized events, expressing positive emotions might incur social costs. To test this thesis, the authors coded genuine (Duchenne) smiling and laughter and also non-Duchenne smiling from videotapes of late-adolescent and young adult women, approximately half with documented histories of childhood sexual abuse (CSA), as they described the most distressing event of their lives. Consistent with previous studies, genuine positive emotional expression was generally associated with better social adjustment two years later. However, as anticipated, CSA survivors who expressed positive emotion in the context of describing a past CSA experience had poorer long-term social adjustment, whereas CSA survivors who expressed positive emotion while describing a nonabuse experience had improved social adjustment. These findings suggest that the benefits of positive emotional expression may often be context specific.     

Traumatic stress and psychological adjustment in treatment-seeking women sexually abused in childhood: A follow-up

The objective of this study was to assess post-traumatic stress disorder (PTSD), psychological distress, and risk factors among women sexually abused in childhood (CSA) after six months in therapy. Thirty in-treatment CSA survivors reported their abuse history and filled out several questionnaires. Comparisons were made to a non-CSA in-treatment sample. Although, 50% of the CSA women still had PTSD, there was a remarkable decrease in PTSD symptoms (Cohen's d = 1.06). A considerable change in self-worth and in attachment styles was found. It was concluded that CSA survivors benefit much from 6 months of weekly treatment. However, it is recommended that treatment should continue for a still longer period.     

Sorrow,shame, and self-esteem: Perception of self and others in groups for women survivors of child sexual abuse

Despite evidence that exists about the severity of impact of child sexual abuse (CSA), less has been published about treatment options. Much CSA is enshrouded in secrecy in the context of dysfunctional family dynamics, therefore group work is often recommended as a method of treatment. Although long- and short-term groups are seen as being equally effective, there are few published studies of long-term analytic groups for survivors of CSA. This study was designed to analyse the process of one long-term group. A case is made for using Core Conflictual Relationship Theme (CCRT), a method designed to analyse individual therapy, with reference to group theory. Shifts in self-perception and in relation to others are analysed from the beginning to the end of therapy.     

The impact of child sexual abuse on adult interpersonal functioning: A review and synthesis of the empirical literature

The many studies that have examined the long-term impact of child sexual abuse (CSA) on adult functioning have primarily focused on the personal distress of survivors, largely ignoring the impact of CSA on interpersonal relationships. This article reviews empirical findings concerning the interpersonal distress of survivors as expressed in their intimate and sexual relationships. First, current conceptualizations of the relationship between CSA and interpersonal relationships are reviewed, with a focus on the theoretical models that appear to have implications for the long-term interpersonal sequelae associated with CSA. This is followed by a review of the research conducted on intimacy within the area of social psychology and a summary of the empirical findings related to intimacy functioning in CSA survivors. A hypothesized typology of intimacy functioning for survivors is suggested. The effects of CSA on three components of sexuality—sexual dysfunctions, underlying psychological components of sexuality, and sexual orientation—are discussed. Finally, the interpersonal issues believed to be most salient for CSA survivors in the therapeutic setting are discussed, along with implications for the client–therapist relationship. Methodological, assessment, and conceptual issues are discussed throughout. Recommendations for future research and clinical endeavors are suggested.     

Childhood Sexual Abuse and Intimate Relationships: A Support Group for Male Partners

Individual and group therapy modalities are common approaches to treating survivors of child sexual abuse (CSA). Survivors have identified a number of interpersonal problems that they experience with romantic partners but little is known about the partner’s perspective. Additionally, partners of abuse survivors are generally excluded from the treatment process. A short-term support group for the partners of adult survivors of sexual abuse was conducted concurrently with an Incest Resolution Group. The goal of the Partner’s Support Group was to gain greater understanding of the interpersonal relational problems as experienced by the partners, and to provide support, insight, and education regarding the impact of CSA. Clinical implications are discussed.     

Child Sexual Abuse History and Feminine Gender-Role Identity

The association between child sexual abuse (CSA) and feminine gender-role identity was examined among 75 women with and 107 without a history of CSA. Undergraduates and hospital employees from a university in the Southern United States completed questionnaires on the internet. Three aspects of feminine identity were assessed, including how much participants identified with feminine versus masculine traits, endorsed stereotypes about women, and viewed themselves as meeting feminine self-standards. Participants with a history of CSA reported greater feminine self-discrepancy and endorsed more derogatory stereotypes about women than the comparison group. CSA was also linked to identifying with more feminine than masculine traits, but only among hospital employees. Results suggest that feminine identity is a meaningful construct to consider in the adjustment of CSA survivors.     

When the face reveals what words do not: facial expressions of emotion,smiling, and the willingness to disclose childhood sexual abuse

For survivors of childhood sexual abuse (CSA), verbal disclosure is often complex and painful. The authors examined the voluntary disclosure-nondisclosure of CSA in relation to nonverbal expressions of emotion in the face. Consistent with hypotheses derived from recent theorizing about the moral nature of emotion, CSA survivors who did not voluntarily disclose CSA showed greater facial expressions of shame, whereas CSA survivors who voluntarily disclosed CSA expressed greater disgust. Expressions of disgust also signaled sexual abuse accompanied by violence. Consistent with recent theorizing about smiling behavior, CSA nondisclosers made more polite smiles, whereas nonabused participants expressed greater genuine positive emotion. Discussion addressed the implications of these findings for the study of disclosure of traumatic events, facial expression, and the links between morality and emotion.     

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.     

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 .     

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.     

Psychological assessment of adult survivors of childhood sexual abuse within a naturalistic clinical sample

This study investigates the long-term effects of childhood sexual abuse (CSA). Differences between abused and nonabused individuals in psychiatric symptomatology, interpersonal functioning, social and occupational functioning, personality dynamics, and therapeutic alliance were examined. The relationship between abuse severity and long-term effects was also analyzed. Data were gathered from 51 patients seeking individual psychotherapy at a community outpatient clinic. Findings suggested that CSA survivors tend to experience greater psychiatric distress and poorer interpersonal functioning than nonabused clinical controls. No significant differences were found in social and occupational functioning or in alliance developed by the end of the therapeutic assessment process. Abuse severity was significantly related to increased symptomatology and poorer interpersonal functioning. Findings support and extend existing literature and are especially useful for clinicians working with abuse survivors.     

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.     

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.     

Using Narrative Therapy in the Treatment of Adult Survivors of Childhood Sexual Abuse in the Context of Couple Therapy

Abstract

Childhood Sexual Abuse (CSA) is a prevalent social issue. Many theoretical approaches have been applied to the treatment of CSA, these approaches predominately focus on the treatment of children and adolescents, failing to address adulthood and couples’ relations. This limited focus fails to address long-lasting relational implications CSA survivors face. This paper proposes the application of a systemic therapeutic modality, Narrative therapy when treating adult survivors of CSA in couple therapy. The treatment of CSA in the context of couple therapy will be discussed. Clinical vignettes will be used. Implications for clinical practice and future research will be discussed.     

Childhood Sexual Abuse and the Perpetration of Violence: The Moderating Role of Gender

This study sought to increase specificity in our knowledge of links among child sexual abuse (CSA), aggression, and physical intimate partner violence (IPV) perpetration by criminal offenders, with particular interest in gender. Participants were 202 men and 72 women (N = 274), who were recruited from an urban pretrial supervision program. Women reported higher rates of CSA than men. After controlling for relevant covariates, CSA was associated with general aggression and severe IPV. We found a gender by CSA interaction; CSA was associated with aggression and severe IPV for women, but not men. Findings provide preliminary evidence that CSA impacts aggression and IPV perpetration differently for female offenders compared to male offenders and gender-specific treatment might be warranted in pretrial settings.     

THE SEXUAL WELL-BEING OF WOMEN WHO HAVE EXPERIENCED CHILD SEXUAL ABUSE

The present study examined the association between child sexual abuse (CSA) and a range of positive and negative aspects of women's sexual well-being. We also investigated the extent to which women's cognitive-affective sexual appraisals mediated these relationships. Participants were 272 female community college and university students. CSA involving fondling only was generally not associated with adverse sexual outcomes. However, the women who had experienced CSA involving sexual penetration or attempted sexual penetration were (a) more likely to be sexually revictimized in adulthood; (b) more likely to have engaged in casual sex, unprotected sex, and voluntary sexual abstinence; and (c) reported fewer sexual rewards, more sexual costs, and lower sexual self-esteem. These findings held over and above the effects of nonsexual abuse in childhood, and as predicted, sexual self-esteem partially or fully mediated most of these relationships. Nonsexual abuse in childhood and adult sexual victimization were also uniquely associated with a number of adverse sexual outcomes. However, outcomes were not worse for women who had experienced CSA involving actual or attempted sexual penetration and sexual assault in adulthood. The results highlight the fact that CSA is a serious and widespread problem with significant implications for adult women's sexual functioning.     

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.     

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.