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.     

Pediatric HIV and Sexual Abuse

No abstract available for this article.     

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.     

Childhood Sexual Abuse and Psychobiology

No abstract available for this article.     

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.     

Holocaust Child Survivors and Child Sexual Abuse

ABSTRACT

This study utilized a qualitative analysis of child survivors of the Holocaust who were sexually abused during World War II. The research study aimed to give this specific group of survivors a voice and to explore the impact of multiple extreme traumas, the Holocaust and childhood sexual abuse, on the survivors. Twenty-two child survivors of the Holocaust who were sexually abused during the war completed open-ended interviews. The data was qualitatively analyzed according to Tutty, Rothery, and Grinnell's (1996) guidelines. Three major themes were found: issues relating to the sexual abuse trauma, survivors' perceptions of the abuse, and survivors' general perspectives towards life. The identity of the offenders, Jewish or non-Jewish, determined the survivors' feelings towards themselves, the perpetrators, and about the worth of life.     

Coping Strategies Used by Survivors of Childhood Sexual Abuse on the Journey to Recovery

This interpretative phenomenological analysis study explored seven adult survivors' experiences of coping with childhood sexual abuse and identified their coping strategies on the road to recovery. Data for the analysis was collected using semistructured interviews. The analytical process yielded two key theme clusters: avoidant coping strategies and problem-focused coping strategies. The participants journeyed through similar gradual and dynamic coping processes by initially adopting avoidant strategies before turning to problem-focused ones. A healthy process of coping with sexual abuse involved seeking support, cognitive engagement, optimistic thinking, self-acceptance, and seeking meaning strategies. This study suggests that problem-focused coping strategies should be promoted as part of therapeutic intervention.     

Balancing Acts: Reconceptualizing Support in Maternal Response to Intra-familial Child Sexual Abuse

This article reports the findings of a grounded theory study aimed at identifying factors contributing to maternal response, and aspects of more and less supportive responses, to children who were sexually abused by the mother's intimate partner. The discovery-oriented nature of the research revealed dimensions of maternal support that have not been clearly articulated in previous investigation. Maternal reaction, response, and support are terms that have frequently been used interchangeably. A general lack of clarity in defining support specifically in relation to maternal response has resulted in inconsistent conceptual application in research and has implications for assessment and treatment. Based on qualitative analysis of ten mothers' interview data a more comprehensive picture of support emerged. Dimensions of belief, and affective and behavioral support are expanded upon, and the notion of initial and enduring response are introduced as considerations for practice with mothers of sexually abused children. An expanded framework is offered as a tool for assessing the complexities of maternal support and changes over time therefore assisting social work clinicians in identifying specific targets for intervention.     

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.     

Obfuscating Child Sexual Abuse II: Listening to Survivors

The reality of the extent and experience of child sexual abuse cannot be revealed while children are unable to ‘stand up and be counted’. Limited alternatives, lack of information and dependence on adults prevent the true scale of the problem being appreciated. Similarly, media and legal treatment of abused children also operate to suppress the truth. The expertise and knowledge of those who have suffered abuse need to be acknowledged and utilized in order that child sexual abuse can no longer be obfuscated. © 1997 John Wiley & Sons, Ltd.     

An Exploratory Study of Domains of Parenting Concern among Mothers Who Are Childhood Sexual Abuse Survivors

This study conducted an exploratory factor analysis and initial validation of Ruscio’s (2001) parenting attitudes questionnaire, which assessed parenting concerns among child sexual abuse survivors. Child sexual abuse survivor mothers (N = 60) reported on their abuse experiences and completed the parenting attitudes questionnaire, the Center for Epidemiologic Studies Depression Scale, and subscales of the Parenting Stress Index and the Parent–Child Relationship Inventory. Three primary factors emerged: (a) concerns regarding the child’s sexuality and safety, (b) boundary disturbances within the child–survivor relationship, and (c) lack of energy for parenting due to recovery issues. Concerns about safety and sexuality and lack of energy for parenting were robust predictors of parenting outcomes. Assessment of such concerns may facilitate discussion of the balance between recovery work and parenting challenges.     

Practical Ways Psychotherapy Can Support Physical Healthcare Experiences for Male Survivors of Childhood Sexual Abuse

This pilot study was conducted to examine older child molestation victims' self-report of their long-term psychological adjustment at least 12 months after the date of their initial clinic evaluation. Female participants were assesed using the Piers-Harris Children's Self-Concept Scale, Children's Depression Inventory, and the Hopelessness Scale which were also administered during their first evaluation. T-ratios revealed that scores on all measures, including five of the six Piers-Harris subscales showed significant improvement. The high rate of noncompliance associated with this population is also discussed in terms of removal from the home, type of abuse, and age of the perpetrator.     

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.

     

Training Mental Health Professionals in Child Sexual Abuse: Curricular Guidelines

This study explored whether counseling practices with women survivors of child sexual abuse reflect the belief that women do not sexually abuse children. Canadian therapists (n?=?164) who work with women survivors of child sexual abuse were surveyed about their beliefs about what constitutes child sexual abuse, who commits child sexual abuse, and their practices regarding inquiries about abusive behavior. A majority self-reported that they ask women and think it is important to ask but most believe that clients will not spontaneously self-disclose inappropriate sexual thoughts or behaviors. How broadly or narrowly therapists defined child sexual abuse was not related to self-reported therapeutic discussion. Therapists demonstrated differential gender beliefs about child sexual abuse perpetration, but this did not relate to self-reported counseling practices. Implications for therapist education are discussed.     

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.     

Pilot Study on Childhood Sexual Abuse,Diurnal Cortisol Secretion,and Weight Loss in Bariatric Surgery Patients

Childhood sexual abuse increases risk for adult obesity. A potential contributing factor is altered cortisol secretion. In this pilot study, relationships among childhood sexual abuse, diurnal salivary cortisol secretion, and weight loss were explored in 17 bariatric surgery patients. Measurement points were before surgery (baseline) and 3 and 6 months after surgery. Childhood sexual abuse was measured by the Childhood Trauma Questionnaire. The results showed moderate but nonsignificant positive correlations between the childhood sexual abuse subscale score and baseline morning cortisol, evening cortisol, and daily mean cortisol. An unexpected positive correlation was noted between the Childhood Trauma Questionnaire total score and weight loss at six months. Diurnal cortisol secretion did not change over time after surgery nor correlate significantly with weight loss at six months.     

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.     

Childhood Sexual Abuse Profiles and Psychological Functioning in Adult Males

ABSTRACT

This study used a person-centered approach to generate profiles of males’ sexual abuse characteristics and then link profiles to other types of childhood maltreatment and adversity, and adult outcomes. Data were drawn from 215 North American males (86% Caucasian) aged 17–61 years recruited from websites offering support for sexual abuse. Latent profile analysis identified three profiles, ranging from 1–2 instances of fondling by an unfamiliar extrafamilial perpetrator to chronic, penetrative abuse by individuals within and outside the family. Profiles were labeled Severe (26%), More Severe (33%), and Most Severe (41%). Chi-squares and analysis of variance showed that men in the Most Severe profile were more likely to experience childhood emotional and physical abuse, and a greater number of non-victimization adversities, than men in the other two profiles. After controlling for multiple victimization and adversity, men in the More Severe and Most Severe profiles reported significantly greater internalizing problems than men in the Severe profile, and men in the Most Severe profile reported significantly more trauma symptoms than men in the Severe profile. While these results require replication, they suggest that treatment should be tailored to the individual needs of male survivors.