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.     

Sexual Revictimization in Adult Women: Examining Factors Associated with Their Childhood and Adulthood Experiences

Using data collected from a sample of adult women (n = 234), this study examined the relationship between the experience and disclosure of childhood sexual abuse and subsequent adult sexual violence. Multivariate analyses revealed that physical force during the childhood sexual abuse experience was significant in both children's decisions to disclose as well as in adult revictimization experiences. Furthermore, childhood disclosures were significantly associated with adulthood disclosures about revictimization, but only when there was no action following the childhood disclosure. The implications for enhancing training and education about understanding and responding to children and women's disclosures about sexual violence are discussed.     

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.     

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.     

Coping,Emotion Regulation,and Self-Blame as Mediators of Sexual Abuse and Psychological Symptoms in Adult Sexual Assault

This study examined whether coping, emotion regulation, and self-blame mediate relationships of trauma histories with post-traumatic stress disorder and depression in adult sexual assault victims (N = 1863). A path analysis showed that theorized mediators partially mediated associations between trauma history variables and psychological symptoms. Specifically, child sexual abuse severity was related to greater post-traumatic stress disorder and depression indirectly through maladaptive coping and decreased emotion regulation but not self-blame. Other traumas had direct relationships with symptoms and partially mediated effects through maladaptive coping and emotion regulation. Child sexual abuse was unrelated to self-blame, but other traumas were related to greater self-blame. Results differed according to whether women had counseling post-assault. Implications are drawn for future research and clinical treatment of adult sexual assault victims.     

A Comparison of Sexual Assault Cases with Child and Adult Victims

Researchers have suggested that sexual assault cases involving children are treated differently than cases involving adults; they have suggested that cases with child victims are more likely to be dismissed and are less likely to result in conviction or incarceration of the offender. The present study used data from Detroit Recorder's Court to compare the outcome of sexual assault cases involving children and adults. The results indicated that cases with child victims differed in important ways from cases with adult victims, and that these differences affected case outcomes. Cases with child victims were less likely than cases with adult victims to be aggravated sexual assaults. When these differences were taken into account, offenders convicted of assaulting children faced a higher risk of incarceration than did offenders convicted of assaulting adults.     

Perpetration,Revictimization, and Self-Injury: Traumatic Reenactments of Child Sexual Abuse in a Nonclinical Sample of South African Adolescents

Risk factors for traumatic reenactments of child sexual abuse experiences (perpetration, revictimization, and self-injury) were examined in a sample of 718 South African secondary school adolescents. Logistic regression analyses indicated that the most consistent predictors of reenactments were a history of child sexual abuse (rape and/or indecent assault) and respondents’ gender, with males being significantly more likely than females to report perpetration (OR = 13.5) and females being more likely to report revictimization (OR = 3.2) and self-injury (OR = 2.5). An analysis restricted to respondents with a history of child sexual abuse indicated that negative abuse-related cognitions were the most consistent predictor of all forms of traumatic reenactment.     

The Seven Pillars of Quality Care in a Statewide Pediatric Sexual Assault Nurse Examiner Program

This article describes a systematic approach used by a statewide pediatric sexual assault nurse examiner program to ensure the quality of forensic medical examinations it provides in child sexual abuse investigations. Seven strategies for enhancing quality are described: (a) hiring experienced professionals, (b) effective training, (c) comprehensive protocols, (d) ample support for pediatric sexual assault nurses, (e) management oversight, (f) a clinical coordinator to provide ongoing training and technical assistance, and (g) a quality assurance process in which expert child abuse pediatricians review each statewide pediatric sexual assault nurse examination. To show the evolution of quality care over time, the program's experience from 2004 to 2010 is reviewed, and quality assurance data are analyzed.     

Attributions of Blame in Child Sexual Abuse Victims

Attributions of self-blame, molester-blame, and blame for consequences to the victim's family were assessed in male and female child sexual abuse victims across three age groups: children (8-12), adolescents (13-17); and adult who were molested as children (18 and older). The majority of child victims rated themselves as not at all to blame for their victimizations, and totally blaming of their perpetrator. Contrasts in lower levels of blame in the child than older victim's groups are discussed with regard to developmental, clinical, and sampling issues. Gender differences were found in correlations between the three attributional variables and between attributional variables and victimization characteristics. Males, unlike females, showed evidence of blurring victim-perpetrator boundaries and a sensitivity to issues related to control. Theoretical implications of the findings and directions for future research are discussed.     

Constructing Victims: The Erasure of Women's Resistance to Sexual Assault

How do the news media portray women's resistance to sexual assault? We analyze articles from a systematic sample of 16 U.S. newspapers across 1 full calendar year to assess whether and how newspapers describe women's resistance. We find that in most cases, newspaper reports reinforce the belief that women are incapable of effectively defending themselves. Most articles fail to mention women's resistance or do so only to note its failure; the longer the article, the more likely it is to follow these patterns. Headlines exaggerate these patterns, presenting virtually no evidence that the articles that follow, or that assaults themselves, contain any female resistance or agency. In only a very small minority of cases are women described as strong, competent actors with the ability to defend themselves against violence. We conclude with a discussion of the potential individual and societal consequences of these patterns.     

Child Sexual Abuse Allegations Amidst Divorce and Custody Proceedings

This study describes 18 cases of child sexual abuse allegations investigaled by the Boulder County (Colorado) Sexual Abuse Team which revolved around divorce and custody disputes. Determining whether such allegations are reliable or fictitious presents a challenge to caseworkers who are apt to find themselves caught up in the highly charged atmosphere of divorce and custody proceedings. Initially, only 5.6% of the cases investigated were believed to be founded by the sexual abuse evaluation team. After applying the clinical process of validation used at the Kernpe Center in Denver. Colorado, the cases were subject to further review and categorized as follows: reliable accounts; recantations; unsubstantiated suspicions; insufficienl information; fictitious reports by adults; and fictitious reports by children. Subsequent to applying this clinical Drocess of validation. the number of cases categorized as founded hcreased to 44.4%. Application of a systematic process of validation by clinicians is suggested in the determination of whether reports are likely to be vacd or fictitious. Tentative conclusions are drawn which acknowledge that the atmosphere surrounding divorce/ custody proceedings can affect objectivity by clinicians and which suggest adherence to a systematic clinical process of validation.     

Maladaptive Schemas as Mediators in the Relationship Between Child Sexual Abuse and Displaced Aggression

Child sexual abuse is one of the most serious forms of abuse due to the psychological consequences that persist even into adulthood. Expressions of anger among child sexual abuse survivors remain common even years after the event. While child sexual abuse has been extensively studied, the expression of displaced aggression has been studied less. Some factors, such as the maladaptive early schemas, might account for this deficiency. The objective of this study was to analyze the relationships between child sexual abuse, displaced aggression, and these schemas according to gender and determine if these early schemas mediate the relationship between child sexual abuse and displaced aggression. A total of 168 Spanish subjects who were victims of child sexual abuse completed measures of childhood trauma, displaced aggression, and early maladaptive schemas. The results depict the relationship between child sexual abuse, displaced aggression, and early maladaptive schemas. Women scored higher than men in child sexual abuse, emotional abuse, disconnection or rejection and impaired autonomy. Mediational analysis found a significant mediation effect of disconnection or rejection on the relationship between child sexual abuse and displaced aggression; however, impaired autonomy did not mediate significantly.     

Latinas and Sexual Assault

SUMMARY

This paper will discuss the problem of sexual assault among Latinas, an under-researched population whose social and cultural characteristics contextualize the trauma of sexual assault in ways that need to be considered by service providers striving to provide culturally syntonic interventions. The authors will present the sparse empirical data on sexual assault among Latinas, Including prevalence, assault characteristics, and post-assault sequelae. Given the bicultural reality of most Latinas in the U.S., a working model of sexual assault in Latinas is presented that frames the problem as occurring within both traditional Latino and modern American gender role systems. The result is a dual dilemma for Latina victims of sexual assault with both negative and positive implications that need to be better understood by victims and service providers.     

Prevalence of Sexual Trauma History Using Behaviorally Specific Methods of Assessment in First Year College Students

There are several challenges associated with evaluating the prevalence of sexual trauma, including child sexual abuse and adult sexual assault. The aim of this study was to assess sexual trauma prevalence rates among first year college students (N = 954) using behaviorally specific questions and a more representative recruitment sample that did not rely on self-selection. Participants completed a list of sexual trauma questions, including general questions containing labels such as “rape” or “abuse” as well as behaviorally specific questions that describe specific behaviors that qualify as sexual trauma without labels. Results indicated that 6.7% of the sample reported at least one incident of child sexual abuse, with similar rates for men and women. Women were more likely to report a history of adult sexual assault, which was reported by 12.4% of the total sample. Participants were also more likely to endorse a history of sexual trauma when answering behaviorally specific rather than general “label” questions. Women survivors in particular were more likely than men to identify their experiences as abuse/assault (66.7% versus 21.1% for child sexual abuse), which may help explain prevalence differences between men and women in prior research. Men may be less likely than women to label their experiences as abuse and may be underidentified in sexual trauma research without the use of behaviorally specific questions. Overall, the results of this study suggest that the prevalence of sexual trauma is better assessed using behaviorally specific questions and that this is an important topic of study among both men and women.     

Combining Primary Prevention and Risk Reduction Approaches in Sexual Assault Protection Programming

Abstract

Objective: The object of this study is to extend prior evaluations of Elemental, a sexual assault protection program that combines primary prevention and risk reduction strategies within a single program. Participants and Methods: During 2012 and 2013, program group and control group students completed pretest, posttest, and 6-week and 6-month follow-up surveys assessing sexual attitudes and knowledge as well as experiences with assault. Results: The results reinforce previous findings that Elemental is effective in reducing sexual assault risk. Program effects were both direct, in that participation was associated with lower risk of assault, and mediated, in that participation impacted attitudes and beliefs that are empirically linked to risk of later assault. Conclusions: By combining both primary prevention and risk reduction approaches, Elemental is not only effective at reducing incidences of assault, it is also consistent with a number of recent recommendations for directions in sexual assault prevention programming.     

Recantation of Sexual Abuse Disclosure Among Child Victims: Accommodation Syndrome

Background: Disclosing the sexual abuse may be related on many individual and/or environmental factors in all age groups. The sociocultural context is the most influential factor of the disclosing process especially for those living in patriarchal cultural values. This study compares the impacts of sexual abuse and other sociodemographic variables between recanting and non-recanting victimized groups in Adana city from Turkey.

Methods: The samples attending our department were divided into two groups: group 1 comprised victims who recanted their first abuse disclosure, and group 2 comprised victims who insisted on the veracity of their first report at further evaluations. The characteristics of the child, family, and abuser were compared between recanting victims and non-recanting victims by retrospective data.

Results: Each group included 27 children, for a total of 54 subjects. All adverse social reactions after the sexual abuse, including keeping secrets and a repressive family attitude, were higher among group 1 victims than group 2 victims (p < 0.0001).

Conclusions: Although they are victimized by protecting family integrity, victims may show a tendency to keep secrets and to not immediately disclose an abuse event.     

Group Treatment of Latency-Age Male Victims of Sexual Abuse

Researchers and clinicians across the country have documented increases in reports of sexual victimization of males. Awareness of the immediate and long-term needs of young male victims has highlighted the need for specialized, multi-modal treatment programs for these youngsters. Group therapy can be an important adjunct to individual and family unit therapy with this population. This article provides concrete suggestions for developing, implementing and evaluating a group therapy program for young male victims of sexual abuse. Specific areas addressed include: selection and preparation of group members; structure, phases, and salient tasks of the group; therapeutic group activities; co-leadership issues; managing transference and countertransference in the context of group; and, methods for evaluating the group's effectiveness.     

Difficulties in Emotion Regulation as a Mediator of the Relationship Between Child Sexual Abuse Victimization and Sexual Aggression Perpetration in Male College Students

Although numerous studies document a link between child sexual abuse and later sexual assault perpetration in men, little research has examined why this relationship exists. One potential mechanism may be emotional regulation difficulties. The current study utilizes a college sample of 132 men to examine the mediating role of emotion regulation difficulties on the relationship between experiencing child sexual abuse and later sexual aggression. Although emotion regulation difficulties in general was not significantly related to sexual aggression, one facet, impulse control difficulties, emerged as a significant mediator of the relationship between child sexual abuse and sexual aggression. Intervention programs should focus on the care that children receive following sexual abuse, with particular emphasis on how emotion regulation abilities may be impacted.