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.     

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.     

Play Room as a psychological assessment method in cases of alleged child sexual abuse

This article presents an example of how psychoanalytic theory can be implemented in practice. The aim is to introduce and discuss the semi-projective material ‘Play Room’ which was originally developed to support prevention of sexual abuse among vulnerable children in Denmark. However, a recent study has shown that, when measured with a scale called Ability to Answer, children exposed to sexual abuse talked about the illustrations in Play Room in a significantly different way than did a clinical sample and a normal control group. The finding indicates the potential for expanding the scope of Play Room from prevention into clinical assessment, in cases of alleged child sexual abuse. Taking its starting point in the theory of Jean Laplanche, this article will discuss how psychoanalytic concepts such as seduction, translation, asymmetry, absence, and listening to listening can be used to describe the practice around Play Room. It is argued that, through the use of Play Room, the psychologist can encircle the lack of symbolization and inhibited creation of psychic representations that children exposed to sexual abuse typically convey. The discussion of Play Room’s assessment potential will be further fed by data from interviews with clinical child psychologists.     

Transgenerational transmission of indigestible facts: from trauma,deadly ghosts and mental voids to meaning‐making interpretations

Abstract: In this paper¹ I will discuss clinical material and make some hypotheses on how to work with patients for whom trans‐generational transmission of trauma is an issue. Basing my hypothesis on two clinical cases, I will propose a way of dealing with undigested facts, the fabric of trauma, which generate deadly ghosts and mental voids that are transmitted from one generation to the next. I will propose a way of formulating interpretations for the unthinkable to become thinkable and find a representation in the mind of patients who suffer from transgenerationally transmitted trauma. Some thoughts will be given to the maternal and the paternal transmitters of trauma in relation to child development issues.     

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 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.     

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.     

Recovering memories of trauma: A view from the laboratory

The controversy over the validity of repressed and recovered memories of childhood sexual abuse (CSA) has been extraordinarily bitter. Yet data on cognitive functioning in people reporting repressed and recovered memories of trauma have been strikingly scarce. Recent laboratory studies have been designed to test hypotheses about cognitive mechanisms that ought to be operative if people can repress and recover memories of trauma or if they can form false memories of trauma. Contrary to clinical lore, these studies have shown that people reporting CSA histories are not characterized by a superior ability to forget trauma-related material. Other studies have shown that individuals reporting recovered memories of either CSA or abduction by space aliens are characterized by heightened proneness to form false memories in certain laboratory tasks. Although cognitive psychology methods cannot distinguish true memories from false ones, these methods can illuminate mechanisms for remembering and forgetting among people reporting histories of trauma.     

The transgenerational trauma and resilience genogram

The understanding of trauma within counseling has expanded to include the salience of ecosystemic factors and to acknowledge the importance of multicultural and social justice considerations. Transgenerational trauma and resilience offers a framework that examines trauma across generations, attends to ecosystemic concerns, and adheres to a strengths-based perspective. However, given the complexity of trauma counseling and attending to the multitude of ecosystemic factors, counselors and psychologists may struggle to conduct comprehensive assessments and interventions with their clients. Genograms have long been used to clarify complex family and psychological patterns through visual representations, and are, therefore, a promising tool to meet this need. The Transgenerational Trauma and Resilience Genogram (TTRG) was created as a dynamic tool that can assist practitioners in conducting compressive trauma assessment and intervention from a transgenerational trauma and resilience framework. The TTRG emphasizes an ecosystemic view of trauma, culturally relevant and strength-based interventions, and attention to sociopolitical concerns that may impact trauma and recovery. The author explicates the use of the TTRG in trauma counseling, including the theoretical foundations and implications for trauma and recovery. A case example of the use of the TTRG and implications for counseling practice using the TTRG and its guiding principles are provided.     

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.     

Transgenerational patterns of abusive parenting: Analog and clinical tests

Two studies were conducted to determine whether there was an association between punitive childhood histories and abusive parenting. In the first experiment, undergraduate students who reported more punitive childhood histories and undergraduates who reported mild or nonpunishing childhoods were tested with an Analog Parenting Task. The task used photographic stimuli to depict child behaviors and to elicit disciplinary choices in response to children's transgressions. Persons from the more punitive backgrounds were significantly more likely to endorse potentially injurious disciplinary responses. Additionally, in a post-hoc analysis, women with mild punishment backgrounds were more likely to indicate they were annoyed by the depicted child behaviors than women with the severe punishment backgrounds and men with both punishment histories. In the second experiment, childhood histories of parents of children seen at a psychiatric clinic were assessed. The data indicated an association between severely punitive backgrounds of parents and the probability that the referred child had been physically abused. Also, the punishment histories of the parents were associated with the presence of antisocial and aggressive presenting problems displayed by the referred child. The two experiments together were considered to provide support for a modified version of the trans-generational hypothesis of abuse.     

The importance of distinguishing between harassment-only and assault military sexual trauma during screening

Extant research demonstrates that a history of military sexual trauma (MST) is associated with PTSD and depression diagnoses as well as heightened risk for suicidal ideation and death by suicide. Past studies of MST and its sequelae typically collapse harassment-only and assault MST screening items into a single response, recorded as positive or negative for a history of MST. It is presently unclear whether assault is associated with poorer mental health outcomes relative to harassment-only MST. Female service members/Veterans (n = 656) completed an online survey assessing history (present, absent) and type (harassment-only, assault) of MST, PTSD, depression, sexual satisfaction and function symptoms, as well as suicidal ideation. Findings revealed that those who reported a history of MST, and assault more specifically, were more likely to report higher PTSD symptoms and probable PTSD diagnosis, higher depression symptoms and probable depression diagnosis, worse sexual function and probable sexual function diagnosis, lower sexual satisfaction, and presence of suicidal ideation. Those who reported harassment-only MST also reported higher PTSD severity and probable PTSD diagnosis, but the magnitude of the association of harassment-only MST and PTSD severity relative to assault MST and PTSD severity was substantially lower. Findings suggest it is critical to distinguish between history and type of MST during screening as a combined screening item loses sensitivity to identify those at heightened risk for distress and dysfunction.     

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.     

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.     

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.