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.     

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.     

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.     

The credibility of sexual abuse allegations: Child sexual abuse, adult rape, and sexual harassment

Allegations and denials of sexual abuse often occur in a context in which there is rarely decisive evidence. The present study investigated the credibility of allegations of three kinds of sexual abuse—child sexual abuse, adult rape, and sexual harassment—that also contained a denial by the alleged perpetrator. Perceptions of fair punishment were investigated for the perpetrator if he did actually commit these acts and for the accuser if she was lying. Results indicated that allegations were generally rated in the credible direction. Allegations of child sexual abuse were rated more credible than allegations of rape or sexual harassment. Females found all allegations more credible than males. Males were more likely to believe allegations in the child sexual abuse condition than either the rape or sexual harassment conditions. Females were more likely to believe sexual harassment allegations. Punishments were generally the most severe for child sexual abuse, and psychotherapy was a popular disposition for both perpetrators and those making false allegations.     

Transgenerational processes and the trauma of sexual abuse

The process of the unconscious transmission of trauma between generations has been written about within the psychoanalytic field since Freud. the concept was further developed by psychoanalysts in their work with second generation survivors of the Holocaust. the particular characteristic is that it is a transmission that takes place silently and in secret, but actively. It is especially found in families where there is an inhibition against thinking. It is suggested in this paper that the concept could be usefully considered in families where a parent is a survivor of child sexual abuse but has kept the trauma a secret. Clinical examples illustrate how children in such families may carry the unconscious dynamics which can emerge into consciousness through symptomatology in the child.     

Broken mirror: The intertwining of therapist and client stories of childhood sexual abuse (CSA)

In recent years, there has been a great deal of attention given to the potential increased risk of vicarious traumatisation (VT) for clinicians with a history of childhood sexual abuse.

I am curious about whether the silencing, which has been ubiquitous within society, is also prevalent within the therapeutic profession. I wonder if therapists with a history of abuse feel they have to bracket their experience, and if this limits the potential for positive transformation.

In this paper, I draw upon my narrative study of therapists with a history of abuse. The methodology followed was narrative inquiry with two therapists in addition to an autoethnography. I used ‘narrative analysis’ to analyse the data. The findings of the study covered themes of transgenerational trauma, ‘the wounded healer’, caregivers’ responsibility in communal cultures and dissociation.

In this paper, I will consider the part dissociation plays when there is a shared history of trauma, and the ways in which dissociative enactments within the consulting room themselves may be part of the mutual healing. For this paper, only extracts from interviews with one of my participants will be included.     

Depressive implicit associations and adults' reports of childhood abuse

Theory and research suggest that negative events in childhood (e.g., childhood abuse) may contribute to the development of a cognitive vulnerability to depression. A limitation of past research, however, is that the majority has focused on explicit cognitions (e.g., attributional style) and it remains unclear whether similar relations would be observed for more implicit measures of depressive cognitions. This study investigated the relation between young adults' reports of childhood abuse and their implicit depressive cognitions, as measured by the Implicit Association Test. As hypothesised, young adults reporting a history of childhood abuse exhibited stronger implicit associations for depression-relevant stimuli than did individuals with no abuse history. These results were maintained even after statistically controlling for the influence of current depressive symptom levels.     

The role of corroborative evidence in child sexual abuse evaluations

Published studies of forensic child sexual abuse (CSA) evaluations by mental health and medical professionals and paraprofessionals (MHPs) were analysed in order to evaluate two widely held assumptions. These related assumptions are (1) evidence that corroborates children's reports of sexual abuse is rare in forensic CSA evaluations; and (2) in the vast majority of evaluations, MHPs base their judgements about whether or not sexual abuse allegations are true on their assessments of children's reports of sexual abuse and other psychosocial data. Data from five chart review studies of a combined total of 894 forensic CSA evaluations provided sufficient information to assess the validity of these assumptions. Corroborative evidence was present in 36% of the 894 evaluations and in 54% of evaluations in which MHPs judged the allegations likely to be true, contradicting the first assumption. In the evaluations in which corroborative evidence was present, the presence or absence of a child's report of sexual abuse was only weakly associated with MHPs' judgements about the validity of the allegations (allegations in almost all corroborated cases were judged likely to be true, even in the absence of a child's report), partially contradicting the second assumption. Implications of this analysis for research and policy are discussed. Copyright © 2010 John Wiley & Sons, Ltd.     

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.     

Prevention of child abuse and neglect

With the dramatic increase in recent reports of physical and sexual child abuse and neglect, professionals are well as the public are increasingly concerned about the prevention of child abuse. This article provides an overview of existing child abuse prevention programs (physical abuse and sexual abuse programs are treated separately). Five computerized data bases (psychology, social work, criminal justice, education, and social sciences) were searched for literature published between 1982 and 1991. We also call attention to critical issues that need to be considered in the development and planning of future prevention efforts and evaluations.     

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.     

Childhood sexual abuse and impulsive personality traits: Mixed evidence for moderation by DRD4 genotype

This project examines associations between childhood sexual abuse (CSA) and two dimensions of impulsivity (sensation seeking and premeditation), and tests whether CSA-personality associations are moderated by the DRD4 exon III VNTR polymorphism. Sample 1 is from a longitudinal study of university students measured at 10 waves over ages 18–24 years (n = 500). Sample 2 is from a national sample of young adult sibling pairs, ages 18–24, from the National Longitudinal Study of Adolescent Health (n = 2559). In both samples, CSA was associated with elevated sensation seeking. In Sample 1, the association between CSA and sensation seeking was moderated by DRD4 genotype; this gene × environment interaction effect, however, was not replicated in Sample 2. Results suggest new avenues for research on CSA in the area of normal-range personality variation.     

Deliberate self-harm and sexual abuse in adolescence

Helping a young person to render repeated self-injury redundant as a solution to problems connected with having been sexually abused requires a containing context which both supports autonomic healing in the patient and provides an experiential model for the restoration of relationship with adults as a safe (non-abusive) activity. In this paper a case study is presented and some treatment issues for individual psychotherapeutic work are addressed. These include ensuring that the power balance between patient and therapist is acknowledged by emphasizing the patient's self-determination, recognizing patterns of re-enactment within sessions, and addressing here-and-now behaviour and its link with the original trauma. This paper also examines the changing function of self-injurious behaviour and how it can be perceived as addictive after the establishment of a proper alliance between patient and therapist. the circular logic involved in avoiding identification with the abuse-perpetrator by way of self-injury is explored. the therapeutic relationship as an alternative to this is discussed.     

Photography as a therapeutic tool for substance abuse clients who have a history of sexual abuse

Symptoms of sexual abuse among persons in substance abuse treatment facilities may be difficult to recognise since presenting symptoms frequently mirror those associated with substance abuse. Additionally, treatment may be difficult due to a lack of previous verbal processing and shared negative defence mechanisms that are resistant to traditional talking therapy. The use of photography is presented here as a method of treatment initiation and exploration for substance abuse clients who have a history of sexual abuse. The paper reviews rationale, advantages, current applications and practitioner concerns associated with the use of photography as a therapeutic tool.     

The effects of perpetrator age and abuse disclosure on the relationship between feelings provoked by child sexual abuse and posttraumatic stress

Abstract

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.     

Dynamics of verbal interaction between interviewer and child in interviews with alleged victims of child sexual abuse

A number (n = 27) of investigative interviews with children were analyzed with a view to explore the verbal dynamics between interviewer and child. Different types of interviewer utterances and child responses were defined, and the interrelationships between these were explored. The effectiveness of different interviewer utterances in eliciting information from children as well as the type of utterance the interviewer used to follow up an informative answer by the child were investigated. Option-posing and suggestive utterances made up for more than 50% of interviewer utterances, the proportion of invitations being only 2%. Invitations and directive utterances were associated with an increase in informative responses by the child, the adverse being true for option-posing and suggestive utterances. Interestingly, even after the child had provided an informative answer, interviewers continued to rely on focused and leading interviewing methods--in spite of a slight improvement in interviewing behavior.