The Nature of Posttraumatic Growth in Adult Survivors of Child Sexual Abuse

Potential negative sequelae for survivors of child sexual abuse is well documented. However, growing evidence suggests that some individuals who actively cope with traumatic events can progress from a negative trajectory toward positive psychological change, often termed posttraumatic growth. Current posttraumatic growth theories may be of limited applicability to developmental considerations involved in child sexual abuse. This explorative study examines posttraumatic growth among adult female survivors of child sexual abuse. In-depth interviews were conducted with six participants who believed they had grown through coping with their abuse. Data was analyzed using interpretative phenomenological analysis. Three superordinate and nine subordinate themes were identified and explored. Some participants reported experiencing growth and distress simultaneously. Theoretical and clinical implications are examined in relation to the study’s findings.     

Training Mental Health Professionals in Child Sexual Abuse: Curricular Guidelines

This study explored whether counseling practices with women survivors of child sexual abuse reflect the belief that women do not sexually abuse children. Canadian therapists (n?=?164) who work with women survivors of child sexual abuse were surveyed about their beliefs about what constitutes child sexual abuse, who commits child sexual abuse, and their practices regarding inquiries about abusive behavior. A majority self-reported that they ask women and think it is important to ask but most believe that clients will not spontaneously self-disclose inappropriate sexual thoughts or behaviors. How broadly or narrowly therapists defined child sexual abuse was not related to self-reported therapeutic discussion. Therapists demonstrated differential gender beliefs about child sexual abuse perpetration, but this did not relate to self-reported counseling practices. Implications for therapist education are discussed.     

Propensity to perpetrate abusive behaviors: Internet survey of the role of gender,childhood maltreatment,and perception of maltreatment in Nigeria

This article reports on propensity to perpetrate abusive behaviors and examines the role of gender, childhood maltreatment, and perception of abusive behaviors on the propensity. Findings suggest that propensity to perpetrate abusive behaviors cuts across all types of maltreatment (i.e., physical, sexual, and emotional abuse, child neglect, and child labor). Although abusive behavior with high propensity for perpetration includes corporal punishment, propensity to perpetrate abusive behaviors differed by gender. Men were more likely than women to indicate propensity to perpetrate abusive behaviors. Those who perceived behaviors as not abusive, as well as those who reported childhood experience of abusive behaviors, were more likely to intend to perpetrate abusive behaviors. Although childhood experience of sexual abuse was related to perpetration of sexual abuse, history of perpetrating sexual abuse comprised the largest effect size of the propensities to perpetrate abusive behaviors. Implications of findings for policy, practice, and services are discussed.     

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.     

Countertransference issues in the in-home treatment of child sexual abuse

Strong emotions are aroused in people in the presence of child abuse. For the therapist trying to help abusive families, these feelings can destroy any prospect of achieving a therapeutic process. This problem is particularly acute in the in-home situation.     

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.     

Sex Role Identity and Jealousy as Correlates of Abusive Behavior in Lesbian Relationships

Abstract

This article presents the findings of a study from a cross-sectional sample of 105 lesbians taken from a non-clinical setting to investigate to what extent they exhibited abusive behavior toward an intimate female partner and whether the abuse was physical, psychological, or both. This study examined whether an association exists between a lesbian's sex role identity, particularly the dimension of femininity, and her abusive behavior. The hypothesis that jealousy in the relationship would be positively associated with reported incidences of abusive behavior was also examined. The results show that when abuse is broadly defined a sizable minority report high incidences of overall abuse and psychological abuse at some time during their current relationship. The most salient finding of this study was the strong evidence of a relationship between jealousy and abusive behavior. The implications of these findings underscore the need for continued and enhanced delivery of services. Other implications of this study point toward consciousness-raising to the larger community about institutionalized and individual homophobia and heterosexism.     

Coming to terms with sexual abuse: a day care perspective

SUMMARY. Pre-five establishments are increasingly identifying or having to admit children who have suffered from sexual abuse. The feelings that sexual abuse arouse in staff., their need for support and praise in managing the children's needs, the angry and abusive parents and families, and the conflict between the various agencies in child protection requires some consideration. This article offers an insight into a group of nursery workers' efforts to come to terms with identifying abuse, understanding their right to express feelings and acknowledge anger and disgust and their attempt to integrate a preventive approach in the nursery curriculum     

Challenging the Child/Adult Distinction in Theory and Practice on Prostitution

This article argues that contemporary concern about ending child prostitution is misdirected in its strategy. Some theorists and activists, even the ILO, are seeking to create a distinction between adult and child prostitution as if child prostitution could be ended whilst adult prostitution remains intact. The motivation for the distinction relies upon trends in the 1990s to characterize men's prostitution abuse of adult women as constituting legitimate work, choice and agency for the women themselves, and to construct a profitable prostitution industry which can create profits for governments and sex industrialists. I will argue that child and adult prostitution are inextricably interlinked, both in personnel (the women and children work together), in terms of the abusers (who make no distinctions), in the harm they cause and in that both constitute harmful traditional practices which must be ended. The acceptance of men's prostitution abuse as the basis for the industrialization of adult prostitution increases the scale and harm of child prostitution. Thus only policies to eradicate all of men's abusive prostitution behaviour will serve to mitigate child prostitution.     

Russian perspectives on elder abuse: an exploratory study

The purpose of this exploratory study was to analyze Russian perceptions of elder abuse as reflected in their examples of abusive behavior from an adult child to an aging parent. Also of interest was the possibility of gender differences in the Russian perspectives on elder abuse. The convenience sample consisted of 21 Russian participants (10 males, 10 females, and one without gender identified), who provided examples of extreme, moderate, and mild abuse from an adult child towards an aging parent. Most examples of extreme abuse were forms of physical violence. Typical examples of moderate abuse were instances of psychological aggression-particularly verbal aggression-and neglect. The most common examples of mild abuse were verbal aggression and neglect. One-way analyses of variance revealed statistically significant gender differences in the number of references to psychological aggression in general and to verbal aggression in particular in the examples of moderate abuse, with females giving more examples than males.     

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.     

Assessing the Traumatic Impact of Child Sexual Abuse

A sample of 531 self-identitied adult and adolescent survivors of sexual abuse were sent or given a 686 item Post-Traumatic Stress Questionnaire. Each respondent described between 1-3 different sexually abusive experiences with different perpetrators, in detail, for a total of 1140 experiences. A series of statistical analyses examined the correlations and relationships between aspects of the abuse (including perceived severe impact, duration, frequency, type of abuse, use of force, age of onset) and scores on a variety of standardized instruments. Results of these analyses of the Impact of Events Scale, the Trauma Symptom Checklist-33, and the MMPI-PTSD scale revealed that the cognitive variable of perceived severity of impact accounted for the most variance in scores on the instruments. Other variables which influenced higher scores were greater number of abusers, greater intrusiveness of abuse with force, and greater intrusiveness of abuse without force.     

Turkey: a pilot study of elder mistreatment in a convenience sample

Attitudes towards elder abuse were explored through a survey on International Perspectives on Family Violence and Abuse in a Turkish convenience sample of 25 females and 14 males, ranging in age from 22 to 58. Participants gave examples of behaviors considered in their culture to be extremely abusive, moderately abusive, and mildly abusive from an adult child toward his or her older parent. Responses were coded into four major categories of abuse, each of which had several subcategories: psychological aggression (including the subcategories of verbal aggression, emotional abuse, disrespect, disobedience, power assertion, blame, and imprisonment), neglect (including physical neglect, psychological neglect, abandonment, and putting the older individual into a nursing home), physical aggression (including beating and hitting), and mistreatment related to goods and services (including economic demands, economic withholding, and labor). The most common examples of extreme abuse were neglect, particulary physical neglect, followed by physical abuse. At the moderate and mild levels, various forms of psychological aggression were most commonly mentioned. The only significant gender difference was that men listed more instances of verbal aggression as examples of extreme abuse than women. A positive correlation was found between age and the number of abandonment examples at the extreme level. Results were interpreted from a cultural perspective.     

Child Abuse: A Cognitive Behavioral Intervention Model

The frequency of child abuse, together with its generational pattern of reocurrence, has created a need for additional models for child abuse treatment. Presented herein is a six-step child abuse intervention model based upon cognitive-behavioral change strategies. Allowing immediate alleviation of abuse when only one adult family member is in contact with the assisting agency, the proposed model provides for the restructuring of parenting style to increase the probabilities of permanent change.
This model is currently being utilized by one of the authors to assist self-referred abusive patients in a group setting.     

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.     

Russian Perspectives on Elder Abuse: An Exploratory Study

ABSTRACT

The purpose of this exploratory study was to analyze Russian perceptions of elder abuse as reflected in their examples of abusive behavior from an adult child to an aging parent. Also of interest was the possibility of gender differences in the Russian perspectives on elder abuse. The convenience sample consisted of 21 Russian participants (10 males, 10 females, and one without gender identified), who provided examples of extreme, moderate, and mild abuse from an adult child towards an aging parent. Most examples of extreme abuse were forms of physical violence. Typical examples of moderate abuse were instances of psychological aggression–particularly verbal aggression–and neglect. The most common examples of mild abuse were verbal aggression and neglect. One-way analyses of variance revealed statistically significant gender differences in the number of references to psychological aggression in general and to verbal aggression in particular in the examples of moderate abuse, with females giving more examples than males.     

“A Very Steep Climb”: Therapists’ Perspectives on Barriers to Disclosure of Child Sexual Abuse Experiences for Men

ABSTRACT

Recent studies indicate that men experience unique barriers to disclosure of child sexual abuse. Blind spots held by mental health providers and social service agencies may inadvertently help produce and sustain these barriers. However, therapists who specialize in treating this population may also hold important insights into the barriers clients face. Because delayed and nondisclosure of child sexual abuse have been associated with negative mental health outcomes for adult survivors, understanding these barriers is critical to improve clinical practice and facilitate help-seeking. Using conventional content analysis, this study examined the perceptions of nine therapists who specialize in the treatment of men who were sexually abused in childhood, many of whom are considered pioneers in the field. Analyses identified nine types of barriers, which were organized into three categories: intrapersonal experience (difficult feelings, lack of language, and self-engagement), social milieu (internalized social stigma, negative responses, social loss or judgment, and masculine identity dissonance), and health care environment (structural barriers, relational challenges with therapists, and unhelpful therapeutic strategies). Implications for future research, clinical training, and clinical practice are discussed.     

Turkey: A Pilot Study of Elder Mistreatment in a Convenience Sample

ABSTRACT

Attitudes towards elder abuse were explored through a survey on International Perspectives on Family Violence and Abuse in a Turkish convenience sample of 25 females and 14 males, ranging in age from 22 to 58. Participants gave examples of behaviors considered in their culture to be extremely abusive, moderately abusive, and mildly abusive from an adult child toward his or her older parent. Responses were coded into four major categories of abuse, each of which had several subcategories: psychological aggression (including the subcategories of verbal aggression, emotional abuse, disrespect, disobedience, power assertion, blame, and imprisonment), neglect (including physical neglect, psychological neglect, abandonment, and putting the older individual into a nursing home), physical aggression (including beating and hitting), and mistreatment related to goods and services (including economic demands, economic withholding, and labor). The most common examples of extreme abuse were neglect, particulary physical neglect, followed by physical abuse. At the moderate and mild levels, various forms of psychological aggression were most commonly mentioned. The only significant gender difference was that men listed more instances of verbal aggression as examples of extreme abuse than women. A positive correlation was found between age and the number of abandonment examples at the extreme level. Results were interpreted from a cultural perspective.     

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.