Partner Abuse Among Women Whose Children Have Been Sexually Abused: An Exploratory Study

ABSTRACT

To explore partner abuse among women in families in which a child has disclosed sexual abuse, 102 mothers completed a measure of partner abuse and the Coping Responses Inventory. Results suggest that, like women in the general population, mothers of children who have been sexually abused have often experienced partner abuse. As expected, physical abuse in a current relationship was found to be related to the use of avoidance strategies in dealing with the sexual abuse disclosure. The implications for practitioners and for future research are discussed.     

Perceived Loss of Social Contact and Trauma Symptoms among Adolescents Who Have Experienced Sexual Abuse

ABSTRACT

Child sexual abuse (CSA) is a robust predictor of trauma symptoms. Past research has identified many correlates of trauma symptoms following disclosure of CSA. Theory suggests that loss of social contact may be another important contributor to adolescents’ trauma symptoms following CSA. A clinical sample of 166 adolescents (95% female) between 11 and 19 years (M = 13.80, SD = 1.87) reported on perceived loss of social contact, the extent to which the CSA was coercive, appraisals of self-blame for the abuse, supportiveness of a primary non-abusing caregiver, and trauma symptoms. The adolescent’s relationship to the abuser, abuse severity and duration were coded from forensic interviews. Results indicated that greater perceived loss of social contact was associated with higher levels of trauma symptoms, even after controlling for other correlates of trauma symptoms and demographic variables. These findings suggest that perceived loss of social contact may be an important variable to consider in assessing and intervening with adolescents who have been sexually abused.     

The Dialectic of Chaos and Control in the Experience of Therapists Who Work With Sexually Abused Children

The aim of this study is to contribute to the understanding the interaction between the emotionally destructive intensity of the trauma and forces that foster growth in therapists who treat sexually abused children. Data were collected through in-depth semistructured interviews with 14 experienced social workers. Content analysis reveals two emotional poles. At one pole, the dominant experiences are anxiety, turmoil, and intrusion that disrupted the order in the interviewee’s secure world. At the opposing pole, the dominant experiences are positive, such as hope and faith. These formed the basis of empowering meaning construction that engendered a sense of control, enabling the therapists to trust the value of intervention with sexually abused children. The discussion uses a dialectical perspective to examine how interaction between these two poles enhances our understanding of the emotional and existential threats inherent in working with children who have experienced sexual abuse and on the potential for positive change.     

Factors Influencing the Degree and Pattern of Parental Involvement in Play Therapy for Sexually Abused Children

Although much has been written about the role of therapists in children's recovery from child sexual abuse, relatively little attention has been paid to the role of nonoffending parents. This study investigated the work of a team of therapists who sometimes included such parents in therapy sessions with children. The study sought to understand what factors were influencing the degree and pattern of parental involvement and to understand what effect these patterns of parental involvement were having on the process and outcomes of therapy. The study successfully identified a range of factors influencing the patterns of parental involvement, but more research will be needed to understand the effect on outcomes.     

A Psychosocial Understanding of Child Sexual Abuse Disclosure Among Female Children in South Africa

Child sexual abuse is endemic in South Africa, driven by high levels of gender-based violence and underscored by structural and social factors. This article aims to develop an understanding of the process of disclosure in a sample of female children and their caregivers. In-depth semistructured interviews were conducted with 31 female children aged 8–17 years and their caregivers at 3 intervals after presentation to a sexual assault treatment center. Nearly half of the children failed to disclose the sexual abuse immediately, fearing caregivers’ reaction. Most children purposefully disclosed to a confidant through a process of identifying an intermediary to tell caregivers on their behalf. The process of disclosure was influenced by multiple factors, such as a fear of the caregiver’s reaction and disbelief, which is related to parental style. Disclosure was found to be a dynamic process that unfolds and not a single or static event and influenced by multiple factors which all impact on recovery. Our findings highlight the need to address social norms on sexual abuse in order to improve responses to disclosure to facilitate post-sexual-abuse adjustment for the child and the family.     

Sexual Self-Concept and Sexually Abused Males: Early Data on the Development of a Scale

ABSTRACT

This article describes the early development and psychometric piloting of the Sexual Self-Concept Scale for Sexually Abused Males, a one-dimensional measure assessing the gender-based self-perceptions of males with histories of childhood sexual abuse (CSA). A sample of 459 males with histories of CSA completed a demographic survey and responded to a pool of items using a Likert-type scale. Strong and promising evidence was rendered for face validity, content validity, convergent validity, criterion validity, discriminant validity, test-retest reliability, split-half reliability, internal consistency and item-total correlations. The scale may be used by helping professionals and clients to identify beliefs, emotions and behavior emanating from CSA with respect to gender-based sexual self-concept, design interventions to modify or ameliorate such effects, and to mark progress across phases of treatment.     

Winning a Race: Narratives of Healing and Psychotherapy in Children and Adolescents Who Have Been Sexually Abused

This article explores the process of recovering from sexual abuse according to children and adolescents who have been sexually abused and have successfully completed psychotherapy. In this qualitative study, interviews were conducted with 20 participants from 8 to 18 years of age and then subject to narrative analysis. Results show that participants’ narratives of recovery involve an improvement of psychological well-being. Moreover, they feel better equipped to overcome future challenges, feeling empowered and able to retake control of their lives. Factors that support and inhibit recovery are examined, as are developmental differences. Discussion underlines the valuable role of psychotherapy in helping children and adolescents in their healing process, changing the meaning of the abusive experience, and developing new capacities.     

Gender Differences in the Characteristics and Outcomes of Sexually Abused Preschoolers

ABSTRACT

This study examined whether sexually abused preschool boys and girls (ages 2–5) differed in terms of abuse characteristics or psychological outcomes. A retrospective chart review of 74 cases of sexually abused children (29 boys and 45 girls) treated at an urban mental health clinic in Maryland was conducted. Information was collected on: (1) demographics; (2) abuse characteristics (victim's age, type of sexual abuse, relationship to perpetrator); (3) abuse discovery pattern (accidental vs. purposeful); (4) children's symptomatology; and (5) child and familial factors. No differences were found between boys and girls in terms of the victim's age at the time of abuse, perpetrator's age, or the identity of the perpetrator. However, boys and girls experienced different forms of abuse; boys were more likely to experience fondling, oral and anal intercourse. The majority of boys and girls were abused by males, typically someone they knew (biological parent/parent figure or relative). No differences were evident in the type of disclosure; however, older children were more likely to self-disclose than younger children. Results indicated that boys exhibited more developmental delays and aggressive symptoms than girls. Clinical implications of these findings are discussed as well as recommendations for future research.     

Post-Traumatic Stress Disorder and Quality of Life in Sexually Abused Australian Children

The study used publicly available data on post-traumatic stress disorder in a sample of the Australian population with a history of sexual abuse to demonstrate how this evidence can inform economic analyses. The 2007 Australian Mental Health Survey revealed that 8.3% of 993 adolescents experienced childhood sexual abuse, of which 40.2% were diagnosed with post-traumatic stress disorder. Post-traumatic stress disorder diagnosis corresponded to a significant loss of quality of life. Survival analysis was used to estimate the lifetime persistence of post-traumatic stress disorder symptoms. The average time between post-traumatic stress disorder onset and remission was 11.4 years. Results suggest that successful treatment of post-traumatic stress disorder will save 2.05 quality adjusted life years per child or adolescent with post-traumatic stress disorder.     

Support and Profiles of Nonoffending Mothers of Sexually Abused Children

Maternal support offered to sexually abused children following disclosure may be a crucial factor in children's recovery. A person-centered approach was used to examine how profiles of nonoffending mothers could better describe their ability to support their children after disclosure. Cluster analyses based on a total of 226 nonoffending mothers recruited from child protective services yielded four distinctive groups of mothers: resilient, avoidant-coping, traumatized, and anger-oriented reaction. These profiles differed on measures of support, parenting, and variables related to attitude following disclosure. The discussion underscores the relevance of adopting a tailored approach to intervention with mothers of sexually abused children.     

The Use of Peer Support for Parents and Youth Living with the Trauma of Child Sexual Abuse: An Innovative Approach

ABSTRACT

This article describes and reports on an innovative intervention program for parents of sexually abused children and youth. Peer support provided by non-professional staff and volunteers, who have been personally affected by the trauma of child sexual abuse, is an approach with unique advantages. Many of these consumers have not been able to benefit from traditional service delivery approaches. Goals and objectives of the Peer Support Program (PSP) have been developed through inter-agency collaboration initiatives comprised of a coalition of existing social service agencies. This report examines characteristics of service delivery and level of consumer satisfaction of parents and youth who have participated in the peer support program. Implications for interventions with sexually abused youth and parents of sexually abused children are discussed.     

Nonoffending Parent Expectations of Sexually Abused Children: Predictive Factors and Influence on Children's Recovery

This study examined the influence of parental expectations on the functioning of sexually abused children. Participants included 67 sexually abused youth and 63 of their nonoffending primary caregivers. Parental expectations about how sexual abuse will impact children were predictive of parents' ratings of children's behavior at pretreatment, while parental expectations of children's overall future functioning were not predictive of parents' ratings of children's behavior. Parental expectations about how sexual abuse will impact their children and about their children's overall future functioning were not predictive of parents' ratings of children's behavior at posttreatment. Results highlight the influential role the sexual abuse label has in shaping parental expectations about children's functioning. Recommendations for research and intervention are discussed.     

Heterogeneous Symptom Patterns of Sexually Abused Children in Treatment: Understanding the Complexity of the Problem

A major challenge for clinicians and researchers is the heterogeneity of the severity and type of symptoms presented by sexually abused youth, including those who are subclinical on traditional clinical measures but still present to treatment. Most research continues to treat sexually abused youth as a single population and has not assessed the outcomes or symptom trajectories of various groups of sexually abused youth. Participants included 107 sexually abused children and their nonoffending parents presenting to a cognitive-behavioral group treatment. A cluster analysis using child- and parent-report measures revealed four profiles, including Subclinical, Highly Distressed, Problem Behaviors, and Self-Reported Distress clusters. Hierarchical linear modeling was used to create separate child- and parent-report models of weekly symptomatology to examine differential change over the course of treatment. Contrary to expectation, there was little variation in the weekly rates of change for the different symptom groups; however, all groups evidenced a decrease in symptoms over the course of treatment, including the Subclinical cluster.     

Clinicians' Attributions of Responsibility for Sexual and Physical Child Abuse

Although responsibility attribution is known to influence decisions in clinical practice, factors which influence responsibility attribution for child abuse are not well understood. In the present study, licensed practicing psychologists from two states (n = 328) responded to clinical case vignettes which experimentally manipulated five two-level independent variables. As dependent measures, subjects assigned relative percentages of responsibility for abuse to the father, mother, child/victim, and an older sister. Results indicated that fathers suspected of sexual abuse were held significantly more responsible than those suspected of physical abuse. In addition, adolescent age victims were held significantly more responsible than seven year old victims. All of the sources of responsibility were affected by the child providing a verbal disclosure of abuse to a psychotherapist. Regression analyses also showed that certainty in the occurrence of abuse and responsibility attributed to the child/victim and older sister accounted for 31% of the variance in decisions to report the case as suspected abuse.     

Characteristics of Sexually Abused Children and Their Nonoffending Mothers Followed by Child Welfare Services: The Role of a Maternal History of Child Sexual Abuse

Considering the importance of mother’s support in the adaptation of a sexually abused child, it is relevant to determine if the mothers and children involved in an intergenerational cycle of child sexual victimization differ from dyads in which only the child has been abused. The purpose of this study was to compare mother–child dyads with sexually abused children according to whether the mother had herself been victim of child sexual abuse. The sample included 87 dyads with sexually abused children aged 3–18 years old and their mothers (44 reporting maternal and child abuse), followed by social welfare services of the province of Quebec (Canada). The two groups of mothers were compared on their past family abuse experiences and past family relations, their mental health history, their current psychological distress, their parenting behaviors, and their current levels of family functioning. Children were compared on their adaptation. Multivariate analyses indicated that mothers reporting child sexual abuse were more likely to report more other maltreatments in their childhood and greater prevalence of lifetime history of alcohol abuse disorders, dysthymia, and panic disorder compared with mothers who had not experienced CSA. Compared to children whose mothers had not experienced CSA, those whose mothers had experienced CSA showed higher rates of problems behaviors and were more likely to report having been sexually abused by a trusted person. These results highlight the specific clinical needs for the assessment and treatment for sexually abused children whose mothers experienced child sexual abuse.     

The Convergent Validity of the Trauma Symptom Checklist for Young Children for a Sample of Sexually Abused Outpatients

ABSTRACT

The convergent validity of the Trauma Symptom Checklist for Young Children (TSCYC) was examined with a sample of 172 sexually abused outpatient treatment-seeking children and their caregivers. The TSCYC evidenced good convergent validity with other parent ratings (e.g., the Child Behavior Checklist, Child Sexual Behavior Inventory, and the University of California at Los Angeles Post-Traumatic Stress Disorder Reaction Index [UCLA PTSD Index]). The convergent validity of the TSCYC and the Trauma Symptom Checklist for Children was weak, perhaps illustrating the lack of agreement often found between children and caregivers and illustrating the need for a multi-informant approach to screening and assessment of sexually abused children. The TSCYC seems to hold promise based on the emerging evidence for its convergent validity.     

The Effects of Childhood Sexual Abuse and Other Trauma on Drug Court Participants

Within the context of a larger study of drug court participants, this study examined the impact of traumatic experiences on psychiatric distress and on court outcomes. In the analyses, the participants (n = 229) were separated into 3 groups: childhood sexual abuse (CSA; n = 18), other trauma (n = 134), and no trauma (n = 77). The CSA group had higher mean scores on depression, anxiety, panic disorder, social phobia, somatization, and posttraumatic stress disorder than the other trauma group. Path analyses suggest that a history of trauma is a positive predictor of psychiatric distress and negative court events (positive urine screens, sanctions, etc.), with indirect effects on substance abuse severity, and failure in the drug court. These results suggest a need for the initial assessment procedure in drug courts to include a screening for trauma history, including CSA. They also suggest a need for trauma-informed care within drug courts.     

A Short Form of the Trauma Symptom Checklist for Young Children

A short form of the Trauma Symptom Checklist for Young Children was derived from the original 90 items. An exploratory factor analysis of each factor identified the four items from each of the original factors with the highest eigenvalues. These items were subjected to confirmatory factor analysis. The best fit was obtained for an 8-factor, 32-item model. The short form evidenced good convergent validity with parent ratings obtained from the Child Behavior Checklist, the Child Sexual Behavior Inventory, and the University of California at Los Angeles Post-traumatic Stress Disorder Reaction Index (UCLA PTSD RI). Norms (t-scores and percentiles based on raw scores) were calculated by age and by gender. The short form has promise as a screening measure with parents in settings like a child advocacy center.     

Posttraumatic Stress Disorder and Suicidal Ideation Among Sexually Abused Adolescent Girls: The Mediating Role of Shame

ABSTRACT

Sexual abuse is associated with a host of negative repercussions in adolescence. Yet the possible mechanisms linking sexual abuse and negative outcomes are understudied. The purpose of this study was to investigate the relationships among self-blame, shame, coping strategies, posttraumatic stress disorder, depressive symptoms, and suicidal ideation. The sample included 147 sexually abused adolescent girls between 14 and 18 years of age. A total of 66% of girls reached clinical score for posttraumatic stress disorder, and 53% reached clinical score for depressive symptoms. Close to half (46%) reported suicidal thoughts in the past 3 months. Shame was found to partially mediate the relationship between self-blame and posttraumatic stress disorder. Shame and depressive symptoms were also found to partially mediate the relationship between self-blame and suicidal ideation. Results suggest that shame is a crucial target in interventions designed for sexually abused adolescent girls.