Healing from Childhood Sexual Abuse: A Theoretical Model

Childhood sexual abuse is a prevalent social and health care problem. The processes by which individuals heal from childhood sexual abuse are not clearly understood. The purpose of this study was to develop a theoretical model to describe how adults heal from childhood sexual abuse. Community recruitment for an ongoing broader project on sexual violence throughout the lifespan, referred to as the Sexual Violence Study, yielded a subsample of 48 women and 47 men who had experienced childhood sexual abuse. During semistructured, open-ended interviews, they were asked to describe their experiences with healing from childhood sexual abuse and other victimization throughout their lives. Constructivist grounded theory methods were used with these data to develop constructs and hypotheses about healing. For the Sexual Violence Study, frameworks were developed to describe the participants' life patterns, parenting experiences, disclosures about sexual violence, spirituality, and altruism. Several analytic techniques were used to synthesize the findings of these frameworks to develop an overarching theoretical model that describes healing from childhood sexual abuse. The model includes four stages of healing, five domains of functioning, and six enabling factors that facilitate movement from one stage to the next. The findings indicate that healing is a complex and dynamic trajectory. The model can be used to alert clinicians to a variety of processes and enabling factors that facilitate healing in several domains and to guide discussions on important issues related to healing from childhood sexual abuse.     

Childhood Sexual Abuse and Psychobiology

No abstract available for this article.     

Childhood Sexual Abuse Severity Reconsidered: A Factor Structure of CSA Characteristics

To address the lack of empirically grounded measures of childhood sexual abuse severity, a survey of self-report items was developed following a thorough review of the childhood sexual abuse literature. An exploratory factor analysis was conducted using data collected from a convenience sample of college students that included 275 females and males with a history of childhood sexual abuse. The solution produced seven factors interpreted as the following: (a) less intrusive forms of childhood sexual abuse (e.g., sexual invitations, kissing), (b) more intrusive forms of childhood sexual abuse (e.g., oral sex, intercourse), (c) humiliation/fear, (d) childhood sexual abuse involving photography, (e) familiarity with the perpetrator, (f) physical force/rape, and (g) active digital penetration. Correlations among these factors further suggested the existence of two relatively independent second-order factors, one based on the levels of physical intrusiveness and the other composed of the psychological/emotional factors. While arguably the most common measurement of severity, physical intrusiveness had little association with critical factors such as humiliation, fear, and association with the perpetrator. Consequently, physical intrusiveness appears to be an inadequate stand-alone measure of childhood sexual abuse severity. These results are proposed to lay the groundwork for an improved, more comprehensive measure of childhood sexual abuse severity.     

Healing from Childhood Sexual Abuse: A Meta-Synthesis of Qualitative Studies

ABSTRACT

Although the global prevalence of childhood sexual abuse (CSA) is very high, the experience of healing after such abuse has not been well documented. The goal of this study was to characterize the healing experience among CSA survivors presented in the literature. Metaethnography was used to synthesize an integrative literature review. The CINAHL, PubMed, PsycINFO, and Web of Science databases were used as data sources. Eight articles that explored healing experiences from CSA, published between 2007 and 2017, were included in the analysis. After performing a quality assessment, line-of-argument synthesis was used to construct the integrating scheme of healing experiences from CSA. CSA healing experiences included dissociating oneself from the memories of CSA, finding peace by creating a comfort zone, disclosure as the start of healing, attempting to establish identity through ongoing self-reflective activities, feeling comfort by sharing experiences and connecting with CSA survivors, and accepting CSA as part of the life history and stepping forward. Healing experiences from CSA synthesized from the analysis focused on personal growth, supporting previous theory on CSA health in the broader literature. A tailored care plan could be developed for CSA survivors who are at varying stages of healing.     

Childhood Sexual Abuse and Brain Development: A Discussion of Associated Structural Changes and Negative Psychological Outcomes

The effects of traumatic exposure have been researched for many years and studies have shown that the parts of the brain affected by sexually traumatic experiences in childhood are also linked to many physical and psychological problems, such as depression, posttraumatic stress disorder, somatic complaints and suicide. Neuroimaging studies have provided a breadth of evidence that childhood sexual abuse is related to structural changes in the brain. Taken together, childhood sexual abuse affects brain development, leading to differences in brain anatomy and functioning that have lifelong consequences for mental health. Several limitations of neuroimaging research on childhood sexual abuse are discussed, including a lack of refined and sensitive neuroimaging measures and problems interpreting results of structural imaged subjects with associated psychiatric conditions. Future, large‐scale studies are warranted to examine the type and severity of the sexual abuse and how each of the levels of childhood sexual abuse contributes to structural and functional changes. Furthermore, future studies are needed to control for comorbid psychiatric conditions in order to disentangle the effects of childhood sexual abuse from psychiatric conditions that damage brain development. © 2018 John Wiley & Sons, Ltd.

‘Childhood sexual abuse affects brain development, leading to differences in brain anatomy and functioning that have lifelong consequences for mental health’

Key Practitioner Messages

• Childhood sexual abuse is linked to observable structural changes in the brain.
• These structural changes in the brain are associated with a myriad number of negative psychological effects.
• Research is limited in elucidating the role of childhood sexual abuse on brain development, as the bulk of the research has focused only broadly on child maltreatment.

     

The Relationship Between Childhood Sexual Abuse and Sexual Dysfunction in Jamaican Adults

This study examined the associations between early traumatic sexualization and later sexual dysfunction in a sample of 100 Jamaican adults while identifying the linkages between age, frequency of abuse, and gender on sexual functioning. Participants were selected via purposive and convenience sampling and divided equally into comparison and experimental groups based on sociodemographic characteristics. Results indicated that childhood sexual abuse is a likely factor in the development of sexual dysfunction in Jamaican adults, especially in the domains of Orgasm and Sexual Drive and Relationship. Gender, frequency, and age of abuse are also seen to impact specific areas of an individual's sexual functioning. Results are discussed in light of previous research for their implications in order to better understand sexuality in the Jamaican context.     

Male Survivors of Childhood Sexual Abuse: A Qualitative Study and Issues for Clinical Consideration

ABSTRACT

This qualitative study explored the effects of childhood sexual abuse with 10 adult male survivors. The men who participated in the research were largely motivated by their perception that North American society does not acknowledge the sexual abuse of boys. They described the abuse as having significantly affected their sexual identity, as well as their emotional and sexual relationships as adults. The implications of these issues for clinical intervention are described.     

Shame and Guilt in Men Exposed to Childhood Sexual Abuse: A Qualitative Investigation

This study examined the experiences of shame and guilt in adult males sexually abused as children. Seven participants attending a service for male sexual abuse completed measures of shame, guilt, dissociation, and childhood trauma history and subsequently participated in a focus group. All participants experienced childhood sexual abuse in the “severe” range and showed elevated scores for shame, guilt, and dissociation. Four superordinate themes with associated subordinate themes emerged: (a) self-as-shame (foundations of self-as-shame, fear of exposure, temporary antidote: connection), (b) pervasiveness and power of doubt and denial (from others, from self, consequences of incredulity), (c) uncontrollability (of problems after disclosure, of rage, of intrusions and emotional pain), and (d) dissociation. Results are discussed with reference to the existing literature and the emerging “self-as-shame” construct, which appeared to encapsulate participants’ view of themselves.     

Gender Differences in Silencing Following Childhood Sexual Abuse

ABSTRACT

The clinical literature commonly asserts that males are less likely than females to disclose child sexual abuse at the time it occurs and take longer to discuss their experiences. These hypotheses were tested in this study. This study included 145 men and 151 women. Participants were asked about disclosure at the time of the abuse and the length of time it took for them to discuss the experience. Comparison across these two studies found that boys were significantly less likely than girls to disclose the abuse at the time it occurred and also took significantly longer to discuss their childhood experiences later in life.     

Perceptions of Childhood Sexual Abuse Survivors: Development and Initial Validation of a New Scale to Measure Stereotypes of Adult Survivors of Childhood Sexual Abuse

The Childhood Sexual Abuse Stereotypes Scale was developed to assess stereotypes of adult survivors of childhood sexual abuse. Scale items were derived from two studies that elicited cultural and personal beliefs about, and emotions experienced towards adult childhood sexual abuse survivors among university undergraduates. Two scales, Emotions and Characteristics, were developed and administered online to 182 participants. Exploratory factor analysis produced 7 factors, 4 for the Emotions Scale and 3 for the Characteristics Scale. Study 2 replicated this factor structure using confirmatory factor analysis (N?=?457). Reliability and validity analyses suggest that the Childhood Sexual Abuse Stereotypes Scale has satisfactory psychometric properties. The Childhood Sexual Abuse Stereotypes Scale can be used to examine stereotypes of legal and health care professionals likely to work with survivors as well as in stereotyping research.     

Service Patterns of Adult Survivors of Childhood Versus Adult Sexual Assault/Abuse

This analysis compared the characteristics and service patterns of adult survivors of childhood sexual assault/abuse and adult survivors of adult sexual assault/abuse. Utilizing data from sexual assault crisis centers serving survivors in a Midwestern state over a six year period and controlling for revictimization, we describe and compare the demographic characteristics, referral sources, and service patterns of the two groups. Results indicate that paths into service differ for the two groups. Furthermore, adult survivors of childhood sexual assault/abuse obtain significantly more hours of service and service contacts on average than adult survivors of adult sexual assault/abuse. Implications for policy and practice are discussed.     

Expert Testimony Influences Juror Decisions in Criminal Trials Involving Recovered Memories of Childhood Sexual Abuse

We examined the impact of expert witness orientation (researcher or clinical practitioner) and type of testimony (testimony for the prosecution, defense, both prosecution and defense, or no testimony) on mock jurors’ decisions in a sexual abuse trial. Participants acted as mock jurors on a sexual abuse criminal trial based on recovered memory that included expert witness testimony. Results showed that expert witness testimony provided by a researcher did not impact mock jurors’ guilt ratings any differently than the expert witness testimony provided by a clinical practitioner. However, type of testimony had a significant effect on jurors’ guilt ratings such that jurors who read only defense or only prosecution testimony made decisions favoring the relevant side.     

Voices of Healing and Recovery from Childhood Sexual Abuse

Child sexual abuse continues to occur for a significant number of children, often having deleterious consequences for survivors’ physical and mental health. Research has thoroughly explored various consequences as a result of child sexual abuse, but scholars and practitioners know less about the healing processes from survivors’ viewpoints. Using a constructivist grounded theory design, this study examined perceptions of healing in 10 female survivors of child sexual abuse. Results conclude with a theoretical model of healing, capturing the significance of supportive relationships, internal characteristics, turning points, and sources of active healing. Important sources of active healing include therapy, informal and formal education, compassion and empathy, blame attribution to abusers, and confronting abusers. Limitations and implications for research and practice are discussed.     

A Scoping Review of Challenges in Adult Intimate Relationships After Childhood Sexual Abuse

Childhood sexual abuse is a severe problem worldwide. Childhood sexual abuse can be detrimental to children and their abilities to cope with and communicate in their subsequent adult intimate relationships. The aim of this review was to generate and summarize knowledge about how childhood sexual abuse manifests in adult intimate relationships so healthcare professionals can incorporate this knowledge into treatment and care. A scoping review methodology was selected because it supports examination of the extent, range, and nature of research activity. A content analysis of the studies included in this review led to three thematic categories of challenges in adult intimate relationships after childhood sexual abuse: (a) relationship satisfaction, (b) sexual satisfaction, and (c) communication and trust.     

The Impact of Childhood Sexual Abuse and Other Forms of Childhood Adversity on Adulthood Parenting

This study investigated the independent impact of child sexual abuse on five dimensions of adulthood parenting after controlling for other forms of childhood adversity in a predominantly African-American sample of mothers receiving public assistance (N = 483). An analysis of data previously collected as part of the Illinois Families Study Child Well-Being Supplement was conducted to address these questions. Data were analyzed using hierarchal multiple regression. Childhood sexual abuse survivors reported significantly lower rates of parental warmth, higher rates of psychological aggression, and more frequent use of corporal punishment than mothers who had not experienced childhood sexual abuse. These effects, however, were nonsignificant when sociodemographic factors and other forms of childhood adversity were considered. Implications for future research are provided.     

Child Sexual Abuse and Women's Sexual Health: The Contribution of CSA Severity and Exposure to Multiple Forms of Childhood Victimization

Research studies have provided increasing evidence for the potential adverse impact of child sexual abuse on women's sexual health. The present study examined the association between child sexual abuse and sexual health while controlling for various forms of childhood victimization. Self-report questionnaires were administered to 889 young women from the province of Quebec. Results suggest that child sexual abuse survivors were more likely to report having experienced other forms of childhood victimization than were women without child sexual abuse. Women with a history of both child sexual abuse and multiple forms of victimization were at greater risk of experiencing more adverse outcomes, including risky sexual behaviors, sexual problems, and negative sexual self-concept. Regression analyses revealed that child sexual abuse was significantly related to indicators of sexual health outcomes even when controlling for the effect of single forms of victimization. Clinically, interventions optimizing sexual health may be particularly helpful for a subgroup of child sexual abuse survivors.     

Exploring Posttraumatic Outcomes as a Function of Childhood Sexual Abuse

There is sparse systematic examination of the potential for growth as well as distress that may occur for some adult survivors of childhood sexual abuse. The presented study explored posttraumatic growth and its relationship with negative posttrauma outcomes within the specific population of survivors of childhood sexual abuse (N = 40). Results showed that 95% of the participants experienced clinically significant post-traumatic stress disorder symptomatology related to their childhood sexual abuse. In conjunction with these high levels of negative symptoms, the population evidenced posttraumatic growth levels that were comparable to other trauma samples. This research has clinical relevance in terms of adding to the knowledge base on sexual abuse and the usefulness of this knowledge in therapeutic interventions and relationships.