Post-Traumatic Stress Disorder,Dissociation, and Neuropsychological Performance in Latina Victims of Childhood Sexual Abuse

This study compared the memory, attention/concentration, and executive functioning of 12 women with histories of child sexual abuse with a control group of 12 women without childhood abuse. Participants completed a neuropsychological test battery and various instruments assessing post-traumatic stress disorder and dissociation. The child sexual abuse group had lower performance than the control group on long- and short-term visual and verbal memory and presented more limited performance on executive functioning tasks. Functioning in these areas showed a negative correlation with post-traumatic stress disorder and dissociative symptoms. These findings suggest that child sexual abuse is associated with memory and executive functioning deficits and supports the idea that people with trauma histories and increased post-traumatic stress disorder and dissociation symptoms may have alterations in neuropsychological functioning.     

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.     

Peritraumatic Tonic Immobility and Trauma-Related Symptoms in Adult Survivors of Childhood Sexual Abuse: The Role of Posttrauma Cognitions

Tonic immobility is a set of involuntary motor responses elicited under conditions of extreme fear and perceived inescapability, and it is one type of peritraumatic distress reported by survivors of child sexual abuse. Experiencing tonic immobility during child sexual abuse is associated with increased risk for developing symptoms of post-traumatic stress disorder, although less is known about relations between tonic immobility and other established risk factors for post-traumatic stress disorder. We investigated posttraumatic cognitions as a potential mediator of the relations between peritraumatic fear, perceptions of inescapability, tonic immobility, and post-traumatic stress disorder symptoms. Specifically, we tested posttraumatic negative beliefs about the self, the world, and self-blame as pathways that might increase risk for post-traumatic stress disorder symptoms in child sexual abuse survivors who had experienced tonic immobility. Forty-six women with a history of unwanted childhood sexual contact completed questionnaires measuring peritraumatic tonic immobility, posttraumatic cognitions, and current posttraumatic stress symptoms. Negative beliefs about the self independently mediated the relation between peritraumatic perceptions of inescapability and post-traumatic stress disorder symptoms, but the data did not support similar path model for the physical symptoms of tonic immobility and post-traumatic stress disorder. We discuss ways in which treatment of survivors and future research on CSA can benefit from attention to the impact of peritraumatic distress on posttraumatic beliefs.     

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.     

Impact Evaluation of a Cognitive Behavioral Group Therapy Model in Brazilian Sexually Abused Girls

This study evaluated the impact of a cognitive behavioral group therapy model in Brazilian girls who had experienced sexual abuse. The effect of the waiting period before treatment and the enduring effectiveness of the treatment after six and 12 months were also evaluated. Forty-nine female sexual abuse victims between the ages of 9 and 16 completed instruments measuring depression, anxiety, stress, and post-traumatic stress disorder before, during, and after the group therapy. The group therapy had a positive impact on their psychological functioning, significantly reducing symptoms of anxiety, stress, and post-traumatic stress disorder. The therapeutic effects lasted six to 12 months after the treatment ended. The model proved effective for treating young female victims of sexual abuse.     

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.     

Body-Related Emotions in Posttraumatic Stress Disorder Following Childhood Sexual Abuse

Traumatic experiences are associated with emotions such as anxiety, shame, guilt, disgust, and anger. For patients who have experienced child sexual abuse, these emotions might be triggered by perceptions of their own body. The aim of this study was to investigate the extent of the association of the body to traumatic experiences and to discern the emotions linked to trauma-associated body areas. Ninety-seven female participants were assigned to four groups: post-traumatic stress disorder following child sexual abuse with co-occurring borderline personality disorder, post-traumatic stress disorder following child sexual abuse without co-occurring borderline personality disorder, borderline personality disorder without post-traumatic stress disorder, and healthy controls. Participants rated 26 body areas regarding their association with trauma and 7 emotions. Emotions were assessed by questionnaires. Results suggest that specific areas of the body are associated with trauma and linked to highly aversive emotions. In post-traumatic stress disorder patients, the areas associated with highly negative emotions were the pubic region and inner thighs. Thus, the patient’s body may act as a trigger for traumatic memories.     

Correlates of Sexual Abuse in a Sample of Adolescent Girls Admitted to Psychiatric Inpatient Care

We examined correlations of child sexual abuse among 300 adolescent girls in psychiatric inpatient treatment. Diagnostic and Statistical Manual of Mental Disorders (4th ed.)-based psychiatric diagnoses were obtained from the Schedule for Affective Disorder and Schizophrenia for School-Age Children—Present and Lifetime and from data on family and behavioral characteristics from the European Addiction Severity Index (EuropASI). A total of 79 girls (26.3%) had experienced child sexual abuse during their lifetime. Child sexual abuse was associated with an adolescent’s home environment, sibling status, smoking, posttraumatic stress disorder diagnosis, self-mutilating behavior, and suicidal behavior. At least 62% of the perpetrators were acquaintances of the victims. Correlates of child sexual abuse can be used to identify child sexual abuse victims and persons at heightened risk for child sexual abuse.     

Abuse of children in day care centres: Characteristics and consequences

While day care sexual abuse cases share features in common with sexual abuse in other settings, many characteristics of abuse in day care settings merit special attention. These factors include the young age of the child victims, the involvement of multiple victims and multiple perpetrators, females as perpetrators, use of extreme threats, severity of the abuse, and in some instances ritualistic activities. Research findings support clinical impressions that children are negatively impacted by sexual abuse in day care. Consequences of abuse in day care include anxiety, excessive fearfulness, behavioural disturbances, sexual acting out and sleep disorders. Parents whose children are abused in day care centres also experience psychological distress with symptom profiles consistent with post-traumatic stress disorder. Abuse of children in day care settings warrants a specialized treatment approach. A major goal of treatment is to decrease symptomatology among all family members.     

Maternal Child Sexual Abuse Is Associated With Lower Maternal Warmth Toward Daughters but Not Sons

Mothers with a history of child sexual abuse report less warmth toward their children, but whether this association differs by child gender is unknown. We examined the association of maternal child sexual abuse and warmth across child gender, accounting for depression, post-traumatic stress disorder, and child physical abuse. We verbally administered self-report measures to a cross-sectional sample of 154 mothers with a child between 8 and 12 years old. Eighty-five mothers based warmth responses on a son, and 69 on a daughter. We conducted a hierarchical multiple regression, including child gender, maternal child sexual abuse, child physical abuse, depression, post-traumatic stress disorder, and 4 two-way interaction terms with child gender. Maternal depression predicted decreased warmth, regardless of child gender, and maternal child sexual abuse predicted decreased warmth, but only toward daughters. Given previous research suggesting that maternal warmth predicts child well-being, the current finding may represent an important avenue of intergenerational transmission of risk in girls.     

The Clinical Correlates of Reported Childhood Sexual Abuse: An Association Between Age at Trauma Onset and Severity of Depression and PTSD in Adults

This study investigated the relationship between the age of -self‐reported sexual abuse occurrence and the development of post-traumatic stress disorder and/or depressive symptoms in adulthood. Subjects were evaluated for the presence of post-traumatic stress disorder and/or depressive symptoms as well as for a self-reported history of sexual abuse before the age of 18. Results found that relative risk of having severe post-traumatic stress disorder symptoms was 10 times higher in patients reporting sexual abuse after age 12 than in those reporting sexual abuse before age 12. Relative risk of having severe depressive symptoms was higher for those abused before the age of 12 than for those abused after the age of 12. Findings suggest that the impact of reported sexual abuse at different stages of development may lead to distinct psychiatric symptoms in adulthood.     

Psychophysiological Reactivity in Child Sexual Abuse

Sexual abuse has physiological and emotional implications. The purpose of this study is to evaluate the neurobiological sequels of childhood sexual trauma by monitoring physiological variables among sexually abused girls and women compared to controls. We assessed posttrauma and traumatic life events of 35 females sexually abused in their childhood (age range 7–51 years) and 25 control females (age range 7–54 years). Electroencephalography, frontalis electromyography, electrodermal activity, and heart rate parameters were recorded while watching sets of pictures representing neutral and trauma-suggestive stimuli. A minority of participants met the Diagnostic and Statistical Manual of Mental Disorders criteria for post-traumatic stress disorder. Abused females displayed significant elevations in heart rate, electromyography, and electroencephalography while viewing allusive stimuli and elevated heart rate while viewing neutral stimuli. The dysfunctional regulation of the physiological stress system associated with child sexual abuse may endanger the victims with various stress and anxiety disorders.     

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.     

The relationship of child maltreatment and self-capacities with distress when telling one's story of childhood sexual abuse

This study examined the impact of telling one's story of childhood sexual abuse and its relationship with the survivor's self-capacities and history of other child maltreatment. The baseline data were collected from 134 female CSA survivors who were participating in a large intervention study. Participants were given 10 minutes to describe their childhood sexual abuse and completed a post-interview questionnaire assessing post-traumatic stress symptoms and their emotional response. The distress in response to their narrative was both predicted and mediated by the survivors' self-capacities and other forms of child maltreatment beyond child sexual abuse.     

Child-Parent Relationship Therapy with Extra-Familial Abused Children

Sexual abuse by a perpetrator outside of the family is the most prevalent form of child sexual abuse. It is associated with serious consequences for both the child and his family. Surprisingly, however, the issue of extra-familial sexual abuse has received very little research and clinical attention. The purpose of the current study was to explore the effectiveness of Child-Parent Relationship Therapy (CPRT), which uses nondirective play therapy tools, among parents of extra-familial abused children and their parents. In order to do so, data was collected from 51 parents who participated in CPRT, at three points in time: pretreatment stage, at the beginning of the first meeting; and in the post treatment stage. The data included the parents’ reports via three questionnaires: Parenting Stress Inventory (PSI), Compassion Fatigue Self-Test (CFST), Child Behavior Checklist (CBCL). Overall, the results indicated a decrease in internalizing and externalizing symptoms among the children, as well as in parenting stress and in parental secondary trauma symptoms. This study contributes to the literature on interventions with victims of extra-familial child abuse and their parents. Specifically, the results highlight the benefits and importance of involving both parents and children in therapeutic interventions for victims of extra-familial child sexual abuse, with particular emphasis on the benefits of Child-Parent Relationship Therapy.     

The Levels of Cortisol,Oxidative Stress,and DNA Damage in the Victims of Childhood Sexual Abuse: A Preliminary Study

In this study we aimed to investigate serum cortisol, oxidative stress, and DNA damage in children who are sexual abuse victims. The study included 38 children who sustained child sexual abuse and 38 age- and gender-matched children who did not have a history of trauma. Cortisol levels reflecting the status of the hypothalamic-pituitary-adrenal axis, anti-oxidant enzymes glutathione peroxidase, superoxide dismutase, natural anti-oxidant coenzyme Q, and 8-hydroxy-2-deoxyguanosine as the indicator of DNA damage were analyzed in serum samples using the enzyme linked immunosorbent assay method. Cortisol levels were significantly higher in the child sexual abuse group compared to the control group. There were no significant differences between the groups in terms of oxidative stress and DNA damage. Cortisol and 8-hydroxy-2-deoxyguanosine levels decreased as the time elapsed since the sexual abuse increased. Coenzyme Q level was lower in victims who sustained multiple assaults than in the victims of a single assault. Cortisol and superoxide dismutase levels were lower in the victims of familial sexual abuse. Decreases in cortisol and 8-hydroxy-2-deoxyguanosine levels as time elapsed may be an adaptation to the toxic effects of high cortisol levels over a prolonged period of time. Child sexual abuse did not result in oxidative stress and DNA damage; however, some features of sexual abuse raised the level of oxidative stress.     

Neurodevelopmental biology associated with childhood sexual abuse

Child maltreatment appears to be the single most preventable cause of mental illness and behavioral dysfunction in the United States. Few published studies examine the developmental and the psychobiological consequences of sexual abuse. There are multiple mechanisms through which sexual abuse can cause post-traumatic stress disorder, activate biological stress response systems, and contribute to adverse brain development. This article will critically review the psychiatric problems associated with maltreatment and the emerging biologic stress system research with a special emphasis on what is known about victimization by sexual abuse.     

Exploring Mental Health Adjustment of Children Post Sexual Assault in South Africa

Large numbers of children are affected by child sexual abuse in South Africa. This study aimed to assess psychological adjustment of children post sexual assault. In-depth, semistructured interviews were conducted with caretakers, and structured interviews using mental health assessment screening tools were given to children at three intervals over a five-month period after presentation at a sexual assault center. Almost half of the children met clinical criteria for anxiety, and two-thirds met criteria for full symptom post-traumatic stress disorder two to four weeks post disclosure. With standard care, we observed some recovery; 43.3% of children still met full symptom post-traumatic stress disorder nearly six months postdisclosure. Our findings indicate that current practice in South Africa does not promote adequate recovery for children.     

Mental Health and Behavioral Outcomes of Sexual and Nonsexual Child Maltreatment Among Child Welfare-Involved Youth

Our research team used the nationally representative National Survey of Child and Adolescent Well-Being II to explore the differences in mental health and behavioral outcomes between children who enter the child welfare system with substantiated sexual abuse and those who enter with exclusively nonsexual maltreatment. The sample included 380 children between the ages of 8 to 17.5 who were substantiated for maltreatment (sexual and nonsexual) and had the same caregivers at both wave 1 and 2 (n = 380). Results show that the average age of children in the sample was 11 years old, and the results corroborate literature that has indicated children and youth with histories of childhood sexual abuse experience significantly more post-traumatic stress disorder symptoms than children with histories of nonsexual maltreatment. This finding held after controlling for baseline trauma symptoms and all covariates, including race, age, placement type, and caregiver characteristics. Childhood sexual abuse was not significantly related to an increase in behavioral symptoms after controlling for covariates. Implications for research and practice are offered.     

Impact of Traumatic Events on Posttraumatic Stress Disorder among Danish Survivors of Sexual Abuse in Childhood

Childhood sexual abuse can be extremely traumatic and lead to lifelong symptomatology. The present study examined the impact of several demographic, abuse, and psychosocial variables on posttraumatic stress disorder severity among a consecutive sample of treatment-seeking, adult child sexual abuse survivors (N = 480). The child sexual abuse sample was characterized by severe trauma exposure, insecure attachment, and significant traumatization, with an estimated 77% suffering from posttraumatic stress disorder, more than twice the level of the comparison group. Regression analyses revealed risk factors associated with the development of posttraumatic stress disorder in which the strongest predictors being additional traumas, negative affectivity, and somatization. The findings add to existing research confirming the stressful nature of child sexual abuse and the variables that contribute to the development and severity of posttraumatic stress disorder.