Social support as a mediator of revictimization of low-income African American women

Mediating effects of social support on the link between childhood maltreatment and adult intimate partner violence (IPV) were explored in a sample of 362 low-income, African American women. We examined relations between childhood maltreatment experiences (total maltreatment, sexual abuse, physical abuse, emotional abuse, emotional neglect, and physical neglect) and adult maltreatment (physical IPV and nonphysical IPV). Results of hierarchical multiple regression analyses revealed small, but significant, effects. Further, social support mediated revictimization. Social support fully mediated relations in which the form of childhood maltreatment was different than the form of adult IPV (e.g., the relation between childhood sexual abuse and adult nonphysical IPV), but only partially mediated the relations in which the form of childhood maltreatment was similar to adult IPV (e.g., the relation between childhood emotional abuse and adult nonphysical IPV). Implications for clinical interventions for women with intimate partner violence experiences are discussed.     

Social reactions to child sexual abuse disclosures: a critical review

Recent studies have examined disclosure of child sexual abuse to determine the correlates and consequences of telling others about this form of victimization. The present article reviews the current empirical literature on disclosure and reactions to adult survivors to assess what is known about the process of disclosure and whether telling others is therapeutic and leads to positive outcomes. Most studies assessing social reactions in detail have concerned adult survivors retrospectively reporting on their disclosures of child sexual abuse. Few empirical studies have been conducted in this area but research suggests that few victims tell anyone about child sexual abuse as children, and that the type of reactions to disclosure vary according to when disclosure occurs (childhood or adulthood), the extent and nature of the disclosure, and the person to whom one discloses. Clear evidence shows that negative social reactions are harmful to survivors' well-being, but better assessment of specific reactions and their effects are needed in theoretically-based studies to evaluate how these responses affect survivors' recovery in the context of other variables. Suggestions for future research on social reactions of others to adult survivors disclosing child sexual abuse are presented.     

Differences in Perceptions of Child Sexual Abuse Based on Perpetrator Age and Respondent Gender

Child sexual abuse changes the lives of countless children. Child sexual abuse victims experience short and long term negative outcomes that affect their daily functioning. In this study, undergraduate students' perceptions of CSA were obtained using vignettes with an adult or child perpetrator and a general questionnaire. Results indicated participants receiving the child-on-child vignette were less likely to rate the vignette as abuse, saw the abuse as less severe, and assigned less blame to the perpetrator than participants reading the adult-on-child vignette. On a general questionnaire, male participants saw child-on-child abuse as less severe and more encouraged by society than did female participants. The information can be utilized by professionals in treatment planning and preventing revictimization at disclosure.     

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.     

Interviewing children versus tossing coins: accurately assessing the diagnosticity of children's disclosures of abuse

We describe a Bayesian approach to evaluating children's abuse disclosures and review research demonstrating that children's disclosure of genital touch can be highly probative of sexual abuse, with the probative value depending on disclosure spontaneity and children's age. We discuss how some commentators understate the probative value of children's disclosures by: confusing the probability of abuse given disclosure with the probability of disclosure given abuse, assuming that children formally questioned about sexual abuse have a low prior probability of sexual abuse, misstating the probative value of abuse disclosure, and confusing the distinction between disclosure and nondisclosure with the distinction between true and false disclosures. We review interviewing methods that increase the probative value of disclosures, including interview instructions, narrative practice, noncontingent reinforcement, and questions about perpetrator/caregiver statements and children's reactions to the alleged abuse.     

Sexual Revictimization: Double Betrayal and the Risk Associated with Dissociative Amnesia

This study aimed to identify new treatment targets in order to develop more empirically informed initiatives to prevent sexual revictimization. A retrospective Web-based survey employing a mixed-methods design attracted a self-selecting sample of 481 community respondents, 183 of whom indicated a history of childhood sexual abuse. Seventy-four percent were females whose ages ranged from 16 to 69 years (mean = 31.2 years). Betrayal trauma referred to CSA committed by a trusted perpetrator (often caregivers). Disclosure experiences in childhood were reported though open-dialogue boxes. Double betrayal referred to high-betrayal trauma being combined with a negative response to a disclosure. This was associated with both higher incidences of prior psychogenic amnesia for CSA and sexual revictimization in later life. The findings have implications for educating the guardians of children about the prevalence and implications of CSA as well as the importance of early recognition and appropriate responding.     

Types of female orgasm

This study was designed to evaluate the relationship between child sexual abuse (CSA), family violence, and other negative childhood experiences within the home and adult adjustment (TSC‐40 and Rosenberg's Self‐Esteem Scale) in a sample of first‐year female psychology students (n = 199). An experience of CSA was reported by 23.6% of women. Results of a discriminant function analysis revealed that level of family violence, father's traditional family values and mother's and father's sexual punitiveness were the variables that best discriminated between sexually abused and nonabused women. After other differences in family background were accounted for by using hierarchical multiple regression, level of family violence significantly improved the prediction of adult psychological adjustment. Standard multiple regression revealed that characteristics and severity of CSA were not significant predictors of adult adjustment. These results were interpreted as support for the use of an integrated risk‐sequelae model of CSA in evaluating the relationship between CSA and adult adjustment. Within this model, the interrelationships among CSA, violence, and dysfunctional familial environments should be simultaneously assessed.     

Child Sexual Abuse,Post-Traumatic Stress Disorder,and Substance Use: Predictors of Revictimization in Adult Sexual Assault Survivors

This study examined the unique effects of child sexual abuse simultaneously with post-traumatic stress disorder symptom clusters, problem drinking, and illicit drug use in relation to sexual revictimization in a community sample of female adult sexual assault victims. Participants (N?=?555) completed two surveys a year apart. Child sexual abuse predicted more post-traumatic stress disorder symptoms in adult sexual assault victims. Post-traumatic stress disorder numbing symptoms directly predicted revictimization, whereas other post-traumatic stress disorder symptoms (reexperiencing, avoidance, and arousal) were related to problem drinking, which in turn predicted revictimization. Thus, numbing symptoms and problem drinking may be independent risk factors for sexual revictimization in adult sexual assault victims, particularly for women with a history of childhood sexual abuse.     

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.     

Differences in perceptions of child sexual abuse based on perpetrator age and respondent gender

Child sexual abuse changes the lives of countless children. Child sexual abuse victims experience short and long term negative outcomes that affect their daily functioning. In this study, undergraduate students' perceptions of CSA were obtained using vignettes with an adult or child perpetrator and a general questionnaire. Results indicated participants receiving the child-on-child vignette were less likely to rate the vignette as abuse, saw the abuse as less severe, and assigned less blame to the perpetrator than participants reading the adult-on-child vignette. On a general questionnaire, male participants saw child-on-child abuse as less severe and more encouraged by society than did female participants. The information can be utilized by professionals in treatment planning and preventing revictimization at disclosure.     

Affective, behavioral, and social-cognitive dysregulation as mechanisms for sexual abuse revictimization

Using a sample of 1117 female college students, this study examined emotional, behavioral, and social-cognitive mechanisms of sexual abuse revictimization. It was hypothesized that numbing, alexithymia, alcohol problems, mistrust, and adult attachment dimensions would mediate the relationship between childhood sexual abuse (CSA) and adult sexual abuse (ASA). Aside from the close adult attachment dimension, the results indicated that all of the hypothesized mediators were associated with CSA. However, only alcohol problems and mistrust met the necessary conditions of mediation. The results with respect to mistrust are especially unique in that it is one of the first empirical demonstrations of a social-cognitive mechanism for sexual abuse revictimization. Thus, these results enhance our understanding of interpersonal mediators of the relationship between CSA and ASA and provide a new direction for future research.     

Association between child sexual abuse and sexual revictimization in adulthood among women sex partners of injection drug users

Community-recruited women (n = 1490) were interviewed about their early and adult sexual victimization histories to determine whether there was an association between child sexual abuse and adult revictimization by sex partners and strangers/nonsex partners. Adolescent sexual abuse, lifetime sex-trading, drug treatment, and mental health treatment were examined as mediating variables. One-fourth of the women had been revictimized (i.e., experienced child sexual abuse and at least one instance of adult sexual victimization). Child sexual abuse was associated with both rape and other sexual victimization by a sex partner in adulthood, as well as adult rape by a stranger/nonsex partner. Drug and mental health treatments reduced abused women's chances of being raped by a sex partner; drug treatment also decreased the likelihood of other sexual victimization by a sex partner. Sex-trading increased abused women's likelihood of rape by a stranger or nonsex partner. Intervention--including drug treatment--can help women with child sexual abuse histories overcome some of the abuse-related sequelae that make them vulnerable to adult revictimization.     

Assessment of the likelihood of primary school teachers believing children's disclosures of sexual abuse

Primary school teachers are reasonably well informed about sexual abuse but many have inaccurate knowledge about the age groups of victims and abusers. Male teachers were less well informed and less likely to believe a child's disclosure of sexual abuse than their female colleagues. Professional experience of an abused child did not affect teachers' level of knowledge or their likelihood of believing a disclosure.     

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.     

Contributions of Child Sexual Abuse,Self-Blame,Posttraumatic Stress Symptoms,and Alcohol Use to Women’s Risk for Forcible and Substance-Facilitated Sexual Assault

Child sexual abuse and adult sexual assault have been linked to increased self-blame, posttraumatic stress symptoms, and alcohol use. The current study aims to examine (a) whether these constructs explain women’s risk for later adult sexual assault and revictimization, (b) whether such factors differentially confer risk for specific types of adult sexual assault (i.e., substance-facilitated and forcible), and (c) if self-blame confers risk indirectly through other risk factors. Multiple types of self-blame, posttraumatic stress, and alcohol use were examined among 929 female college students as serial mediators of the relationship between child sexual abuse and adult sexual assault and as risk factors for sexual revictimization among child sexual abuse survivors. In the model predicting risk for substance-facilitated adult sexual assault, child sexual abuse indirectly predicted greater risk for substance-facilitated adult sexual assault mediated through two separate paths: global blame-to-posttraumatic-stress and global blame-to-alcohol use. In the model predicting risk for forcible adult sexual assault, child sexual abuse directly predicted greater risk for forcible adult sexual assault, and this relation was mediated by the global blame-to-posttraumatic-stress path. Among child sexual abuse survivors, child sexual abuse specific characterological and behavioral self-blame directly predicted greater risk for forcible and substance-facilitated revictimization, but the pathways were not mediated by posttraumatic stress or alcohol use. Results emphasize the importance of assessing different types of self-blame in predicting posttraumatic stress symptoms as well as examining risk for sexual victimization and revictimization. Findings did not support hypotheses that increased posttraumatic stress would predict increased alcohol use but did indicate that heightened self-blame is consistently associated with heightened posttraumatic stress and that heightened global self-blame predicts increased alcohol use. Implications for future research and intervention are discussed.     

Reclaiming the Mother-daughter Relationship after Sexual Abuse

This paper seeks to provide direction to therapists working with mothers and daughters after a disclosure of father-daughter sexual abuse. The importance of the mother's belief in and support for the child's recovery is highlighted, as are some of the cultural assumptions about mothers and daughters which negatively impact on the relationship. Despite paying lip service to offender responsibility, there continues to be a culture of mother blaming in the child sexual abuse and family therapy literature on incest. Current research findings challenge some of the prevalent myths about mothers’ responses to their children's disclosures. Few clinical sources have addressed this issue, and therapists who reject the mother blaming literature are therefore left with little guidance as to how to work more effectively with mothers and daughters. Consequently they may unwittingly further undermine the relationship. Work with mothers and daughters as they recover from intrafamilial sexual abuse is discussed, and key therapeutic themes and guidelines for practice presented. We explore the significant theme of the rebuilding of trust between mothers and daughters and facilitate a process whereby the woman is able to bear witness to and acknowledge the trauma experienced by her daughter.     

Physical symptoms in sexually abused women: somatization or undetected injury?

Medically unexplained physical symptoms and disorders in women sexually abused in childhood are widely interpreted as somatization—the expression of emotional pain and stress through bodily symptoms. However, the somatization theory is not based on detailed knowledge of the abusive incidents, and may underestimate the direct effects of violence and injury, repeated over years, to children's developing bodies. When adult survivors fully describe their childhood abuse, the extent of violence involved becomes clear. For example, their accounts of oral abuse invite us to reconsider how ‘psychogenic’ conditions like paradoxical vocal cord dysfunction or temporomandibular disorders may have come about. This also raises the important issue of whether paradoxical vocal chord dysfunction should be reclassed as an abnormal and suspicious sign in children. The paper outlines several forms of research which may elucidate further the role of physical damage and injury in adult survivors' physical disorders, including prospective studies; retrospective studies in collaboration with sexual abuse survivors; and comparative studies of international literature on the long‐term physical health effects of torture and child marriage. Copyright © 2002 John Wiley & Sons, Ltd.     

Self Psychology and Male Child Sexual Abuse: Healing Relational Betrayal

The prevalence of male child sexual abuse (MCSA) is higher than initially thought with up to 26 % of men in community samples reporting sexual abuse in childhood, and up to 36 % of men in clinical samples reporting childhood sexual abuse. Disclosure of MCSA is complex because of men’s difficulties in viewing themselves as victims, especially of sexual violence. This difficulty is exacerbated by societal attitudes that sexual abuse rarely occurs with boys, and is further complicated with the taboo of victimization by same sex perpetrators. Too often, the response to disclosure is disbelief and minimization. For these reasons disclosure is often delayed or withheld thus prolonging the abuse. The negative effects of child sexual abuse are well documented and far reaching with depression, anxiety, post-traumatic stress disorder, addictions, sexual dysfunction and impaired interpersonal relations as common presenting issues in therapy. Treatment is indicated for significant numbers of male survivors. This paper identifies aspects of interpersonal relational difficulties commonly experienced by male sexual abuse survivors, and describes self psychology as guiding a clinical approach to address these interpersonal difficulties. The application of self psychology with male sexual abuse survivors is traced and discussed through the use of a clinical case study with Adam.