Child Sexual Abuse Disclosure: Maternal Response and Other Variables Impacting the Victim

Disclosure of childhood sexual abuse is a process unique to each victim and may be influenced by factors of race, ethnicity, culture, religion, and gender, as well as by abuse specific factors. The response by caregivers and professionals effects disclosure and can be responsible for recantation. Maternal responses that convey protection and support have been found to be associated with victims' improved mental health and social functioning. Non-abusive caregivers are often marginalized by the child welfare system in its attempt to secure physical safety for the child. This article summarizes the literature regarding sexual abuse disclosure and maternal response. Areas for future research are discussed.     

Experiences of Mothers Who Are Child Sexual Abuse Survivors: A Qualitative Exploration

Child sexual abuse has been associated with a number of problems affecting women over their lifespan, including difficulties with parenting. However, there is a modest number of qualitative studies examining the impact of child sexual abuse on survivors who are mothers. There is a particular need for qualitative investigations that ask survivors who are mothers general questions about the impact of child sexual abuse on their lives rather than those that specifically ask about the impact of child sexual abuse on parenting. The former approach would allow survivors to describe effects that may impact parenting but that survivors do not consciously link to affecting their parenting. Such information may inform interventions to assist this population of survivors. This secondary data analysis examined themes revealed in interviews with 44 survivors of child sexual abuse who were mothers. Participants were seeking treatment for their child sexual abuse and completed an in-person interview in which they were asked open-ended questions about the sexual abuse they experienced as a child and how their abuse affects them now as adults. The interviews were recorded, transcribed, and coded using thematic analysis. The following six themes emerged from the narratives: (a) being a parent, (b) family of origin dysfunction, (c) the impact of abuse, (d) the abuse history and response to abuse, (e) coping, and (f) hopes and desires for the future. This study highlights several ways in which child sexual abuse impacts survivors who are mothers, areas for further study, and the need for interventions to assist this population in meeting the challenges they face as mothers.     

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.     

Differentiating Children with and without a History of Repeated Problematic Sexual Behavior

Although the issue of dissociative amnesia in adult survivors of child sexual abuse has been contentious, many research studies have shown that there is a subset of child sexual abuse survivors who have forgotten their abuse and later remembered it. Child sexual abuse survivors with dissociative amnesia histories have different formative and therapeutic issues than survivors of child sexual abuse who have had continuous memory of their abuse. This article first discusses those differences in terms of the moderating risk factors for developing dissociative amnesia (e.g., age, ethnicity, gender, etc.) and then mediating risk factors (e.g., social support, trait dissociativity, etc.). The differences between the two types of survivors are then explored in terms of treatment issues.     

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.     

“I Felt Like I Was Being Abused All Over Again”: How Survivors of Child Sexual Abuse Make Sense of the Perinatal Period Through Their Narratives

ABSTRACT

Sequelae following child sexual abuse pervade the lives of adult survivors, significantly impacting on pregnancy and childbirth. Symptoms of this distress are recognized, but meanings for women are less understood. This research aimed to examine the meaning for women themselves of the impact of child sexual abuse on experiences of pregnancy, childbirth, and the postnatal period. Taking a critical feminist perspective, three open-ended interviews with three survivors enabled women’s narratives of pregnancy and childbirth to be heard, explored the structure of these narratives, including how experiences were connected, and identified key themes and how selves and others were positioned. Women themselves contributed to the analysis of their own narratives. The different struggles of each woman occurred within three domains of experience: identity, embodiment, and parenting. They were underpinned by a fluctuation between empowerment and disempowerment. These findings, although based on detailed analysis of the experiences of only three women, dovetail with, integrate, and extend the existent literature, offering a framework for understanding the complexity of meaning making for women. Further research might develop this. The framework may facilitate clinicians’ understandings of what it is like for some women having children who have experienced child sexual abuse.     

The process of coping following child sexual abuse:a qualitative study

This research employed both quantitative and qualitative approaches to studying the immediate and long-term coping strategies adopted by survivors of child sexual abuse, focusing on how strategies evolve over time. Qualitative findings showed that coping with child sexual abuse is not static, but changes over time. The narratives of these nonclinical survivors suggest that an adaptive outcome may be associated with a particular evolution of strategies across time, i.e., survivors reported coping predominantly by engaging in psychological escape methods initially, and then adopting cognitive appraisal and positive reframing strategies in the longer term. It appears that coping processes can affect psychological outcome following child sexual abuse. This study offers insight into the evolution of coping methods associated with an adaptive outcome.     

Mediators of Sexual Revictimization Risk in Adult Sexual Assault Victims

This study examined sexual risk behaviors and sexual refusal assertiveness in relationship to child sexual abuse, emotion dysregulation, and adult sexual revictimization. Path analyses of 1,094 survivors who had sex in the past year were done to examine sexual risk behavior and sexual refusal assertiveness mediational pathways by which child sexual abuse severity and emotion dysregulation may affect revictimization over one year in adult female sexual assault survivors. Exchanging sex for money and sexual refusal assertiveness were significantly associated with emotion dysregulation, whereas exchanging sex for money, and not sexual refusal assertiveness, was only significantly related to child sexual abuse severity. Both exchanging sex for money and sex refusal assertiveness mediated the relationship between emotion dysregulation and adult sexual revictimization. Exchanging sex for money mediated the child sexual abuse severity-revictimization relationship. These findings demonstrate the importance of considering both risky and protective sexual behaviors in research and prevention programming that address sexual revictimization in women.     

Religiosity and Child Sexual Abuse: A Risk Factor Assessment

ABSTRACT

This study was conducted to examine the relationship between religion and child sexual abuse. A self-report survey questionnaire was administered to 397 freshmen students at a southern university. The students were asked about several social background factors, including involvement with church and religious activities. They were also asked to disclose whether they had been sexually abused as a child. The present study found significant relationships between religiosity and victims of child sexual abuse by both relatives and non-relatives. Persons sexually abused by a relative were much more likely to be affiliated with fundamental Protestant religions. Persons sexually abused by a non-relative were much more likely to rarely or never be involved in church and religious activities and were affiliated with liberal religious denominations or indicated they were atheists or agnostics.     

The Relationship Between Perceptions of Response to Disclosure of Childhood Sexual Abuse and Later Outcomes

This study assessed whether perceptions of others’ reactions to disclosure are related to psychological and physical outcomes among individuals with a history of child sexual abuse. Eighty-six female undergraduates completed a series of questionnaires assessing child sexual abuse, nonsexual trauma, depression, anxiety, posttraumatic stress disorder, somatic symptoms, disclosure, and social reactions to disclosure. Those who reported child sexual abuse endorsed higher levels of psychological and physical symptoms than those who reported a nonsexual traumatic event. Child sexual abuse survivors who reported more hurtful responses to disclosure had higher levels of posttraumatic stress disorder, anxiety, and physical symptoms than nonsexual trauma survivors. These findings suggest that many survivors of CSA may need psychological services, and an important focus of treatment may be assessing and strengthening social support.     

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.     

Child Sexual Abuse and the Superfluous Association with Negative Parenting Outcomes: The Role of Symptoms as Predictors

The purpose of this study was to investigate the relationship between child sexual abuse and high‐risk maternal parenting indicators and the extent to which maternal depression and self‐perceived parenting competence influence that relationship. Using path analysis, results indicate maternal depression and parenting sense of competence mediate the relationship between child sexual abuse and outcome variables. Post hoc analyses indicated that child sexual abuse was significantly associated with decreased parenting sense of competence, controlling for depression. These results highlight that the pathways for increased risk in parenting outcomes for child sexual abuse survivors may be indirect and associated with beliefs of their own sense of competence and depression as opposed to a direct association with sexual abuse itself. Implications are discussed.     

The Impact of Religiosity on Lesbian and Bisexual Women's Psychosexual Development

SUMMARY

We examined the relation between religiosity (importance of religion) and child maltreatment, psychosexual development, self-disclosure of homosexuality and reactions to same with two samples of sexual minority women (Internet n = 84, Coffee House n = 92) obtained with block sampling designs. Extremely important religiosity currently was associated with precocious psychosexual development and self-disclosure in the Internet sample only. Very important religiosity currently was associated with psychosexual development and self-disclosure of minority sexual orientation at significantly older ages. We discuss these results in the context of arguments that religiosity may be a risk factor for sexual minorities. Although not a risk factor in our samples, religiosity appeared to have lost the protective influence observed in studies of the general population.     

Caregiver–Youth Communication about Sex in South Africa: The Role of Maternal Child Sexual Abuse History

Much of the research on child sexual abuse focuses on negative outcomes. This brief report explores a potentially protective parenting behavior among black South African female caregivers with and without a child sexual abuse history. Using cross-sectional baseline data, we hypothesized that caregiver child sexual abuse history would be positively associated with caregiver–youth sex communication and this relationship would be strongest for girls. Youth whose caregiver experienced child sexual abuse were more likely to report communicating with their caregiver about sex than youth whose caregivers did not experience child sexual abuse; however, this relation did not hold for caregiver reported communication. Child sexual abuse survivors’ ability and decision to discuss sex with their youth has the potential to protect youth from sexual risk and demonstrates resilience among a group rarely acknowledged for positive parenting practices.     

“Who Can You Tell?” Features of Arab Culture That Influence Conceptualization and Treatment of Childhood Sexual Abuse

The literature on child sexual abuse reflects growing recognition of the manner in which culture impacts the conceptualization, experience, and treatment of such cases. Despite heightened visibility of Arab Americans within the United States, population due to recent media attention, little empirical research exists on the occurrence of child sexual abuse within this population. Arab culture is often characterized by an emphasis on collectivism and familial obligations, and such features may prove to either facilitate or impede assessment and treatment of child sexual abuse, depending on how they are manifested. In terms of reporting child sexual abuse, cultural values pertaining to shame and honor as well as the stigma attached to mental health problems may influence the response to abuse. As such, enhancing the cultural competence of the therapist is key to facilitating effective cultural practice. Empirical research is required to investigate and substantiate these concepts as they relate to child sexual abuse in Arab-American populations.     

Health Professionals' Responses to Disclosure of Child Sexual Abuse History: Female Child Sexual Abuse Survivors' Experiences

This study reports on a postal questionnaire, conducted in 2004, with female survivors of historic child sexual abuse. The questionnaire explored their experiences of health professionals' responsiveness to disclosure of child sexual abuse history. Of 61 participants, aged between 22 and 65, 69% had disclosed to health professionals. Those who had not disclosed reported that they would have liked to but were not asked about child sexual abuse. Thirty-five percent of participants suggested routine questioning about child sexual abuse. Most participants related a fear of common medical examination procedures to their experience of child sexual abuse, and 64% said this stopped them from attending regular health checks. The current study suggests the development of guidelines for dealing with possible child sexual abuse survivors would be useful for health professionals.     

Parents' knowledge,attitudes and practices about preventing child sexual abuse: a literature review

Increased concern about high rates of child sexual abuse has led to the demand for more prevention programmes, particularly those aimed at parents. Research on how parents manage and reduce the risk of child sexual abuse can help plan programmes. This literature review explores published research on the knowledge, attitudes and practices of parents on the risk and prevention of child sexual abuse and identifies gaps and needs for further research. The majority of studies reviewed originated in North America and Asia, were quantitative, surveyed mainly mothers and were more than ten years old. Recommendations are made for more current and country specific research, further research to gain a deeper understanding of how parents manage the risk of child sexual abuse, more comprehensive research covering a range of knowledge, attitude and practice variables, and greater inclusion of fathers in research. Copyright © 2009 John Wiley & Sons, Ltd.     

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.     

Holocaust child survivors and child sexual abuse

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.     

Health Care and Female Survivors of Childhood Sexual Abuse: Health Professionals' Perspectives

The present study explored health professionals' experiences with adult survivors of child sexual abuse in New Zealand. Face-to-face, semistructured interviews of up to an hour took place with 13 health professionals. The participants were asked about training, screening practices, their response to disclosures, and advice to other health professionals. A model—transition to ethical practice—emerged from the data, where delivering more sensitive health care to child sexual abuse survivors sits on a continuum from lack of awareness of child sexual abuse to delivery of care where all patients are comfortable. We recommend making sensitive care for all as the standard care of practice and providing training for health professionals on how to deal with disclosures.