Reports of childhood sexual abuse by adolescents and young adults: Stability over time

The consistency of childhood sexual abuse (CSA) reporting was explored in this study. Two‐hundred seventeen adolescents and young adults (ages 14–24) enrolled in urban health care clinics completed self‐report questionnaires assessing CSA and other problem behaviors at enrollment and at 7 months. Results indicated that the stability of CSA self‐report at two time points was poor (58% consistent nonreporters of CSA, 20% consistent reporters, 22% inconsistent reporters). Consistent and inconsistent reporters were differentiated on risk measures. Adolescents who endorsed more items from the CSA scale were five times more likely to be consistent reporters. In sum, adolescent CSA reporting was quite inconsistent over time. Using multi‐item scales and assessing CSA at two time points enhances accuracy of reporting.     

Remembering and forgetting childhood sexual abuse

Twelve white middle-class women who had been severely sexually abused as children by a family member were asked to provide a narrative of their abuse and discuss their subsequent remembering and forgetting of these experiences. Most claimed they had undergone periods during which they had not recalled their abuse, but also claimed that they had never forgotten their experiences at another point during the interview. Nine of the women had actively tried to forget the abusive experiences, although 8 still experienced recurrent and often relentless intrusive memories. Our findings suggest that women with continuous memories may have longer and more coherent narratives than women without continuous memories. Implications of these findings for understanding the phenomenology of memory experiences and the concept of "recovered" memories of childhood sexual abuse are discussed.     

Preventing childhood sexual abuse: an ecological approach

Childhood sexual abuse is a significant public health problem that negatively affects victims, families, organizations, and society. This special issue presents innovative approaches designed to prevent the sexual exploitation of youth. Using both an ecological approach and the Spectrum of Prevention ( Parks, Davis & Cohen, 2010 ), the articles collected for this special issue highlight cutting-edge prevention approaches educating children, parents, professionals, organizations, and the general public.     

Reasons why adolescents and young adults have sex: associations with psychological characteristics and sexual behavior

This study examined associations of psychological characteristics and sexual behavior with types of reasons for episodes of sexual intercourse among youth. After completing a baseline assessment, 62 adolescents (47 female) used a handheld computer to report when they had sex as soon as possible after the event as well as in response to random signals. Youth indicated for each sex event the main reason, categorized as intimacy/desire, external, affect management, and other; analyses were restricted to sex with a main partner (234 events). Baseline sexual behavior was not related to reasons for sex. Higher anxiety was associated with external reasons for sex; younger age and lower self-esteem were associated with affect management reasons. Female youth with higher impulsiveness reported more external reasons and fewer intimacy/desire reasons. Among male youth, lower self-esteem was associated with intimacy/desire reasons, but lower depression was associated with affect management reasons. These findings may aid health care providers and researchers in understanding the differences in young people's motivations for sex.     

The sexual abuse questionnaire: a preliminary examination of a time and cost efficient method in evaluating the presence of childhood sexual abuse in adult patients

This paper provides the results of two studies designed to evaluate a newly constructed self-report instrument, the Sexual Abuse Questionnaire (SAQ). The SAQ was designed as a brief screening device to aid in the identification of a childhood sexual abuse history. A "unique" feature of the SAQ is the inclusion of a number of non-face valid questions derived from clinical experience. Both studies used an undergraduate population of self-reported abused and non-abused participants. Based upon the combined results of the two studies, the final version of the SAQ was developed, which is comprised of 45 items that manifest good test-retest reliability, internal consistency, and convergent and discriminative validity. The SAQ can discriminate between abused and non-abused male and female participants.     

Healing from childhood sexual abuse: a theoretical model

Childhood sexual abuse is a prevalent social and health care problem. The processes by which individuals heal from childhood sexual abuse are not clearly understood. The purpose of this study was to develop a theoretical model to describe how adults heal from childhood sexual abuse. Community recruitment for an ongoing broader project on sexual violence throughout the lifespan, referred to as the Sexual Violence Study, yielded a subsample of 48 women and 47 men who had experienced childhood sexual abuse. During semistructured, open-ended interviews, they were asked to describe their experiences with healing from childhood sexual abuse and other victimization throughout their lives. Constructivist grounded theory methods were used with these data to develop constructs and hypotheses about healing. For the Sexual Violence Study, frameworks were developed to describe the participants' life patterns, parenting experiences, disclosures about sexual violence, spirituality, and altruism. Several analytic techniques were used to synthesize the findings of these frameworks to develop an overarching theoretical model that describes healing from childhood sexual abuse. The model includes four stages of healing, five domains of functioning, and six enabling factors that facilitate movement from one stage to the next. The findings indicate that healing is a complex and dynamic trajectory. The model can be used to alert clinicians to a variety of processes and enabling factors that facilitate healing in several domains and to guide discussions on important issues related to healing from childhood sexual abuse.     

Experiences of disclosure of childhood sexual abuse and psychopathology

Reported child sexual abuse is associated with the development of anorexia and bulimia nervosa overall, but the mediating factors that determine whether such abuse is relevant in individual cases are not adequately understood. This study considers the importance of the experience of initial disclosure as a mediator in a case series of eating-disordered women. The extent of psychopathology (particularly the frequency of vomiting and the presence of the symptoms of borderline personality disorder) was associated with the nature of the perceived response to an attempted disclosure. A perceived lack of response or a negative, hostile response was associated with specific patterns of symptomatology. Further research is suggested to extend these conclusions, and the clinical implications of these findings are discussed.     

The ultimate deception: childhood sexual abuse in the church

Childhood sexual abuse is a serious problem. Significant evidence exists that victims experience both short-term and long-term emotional and psychological problems related to the abuse. Childhood sexual abuse committed by clergy or other adults affiliated with the church may have additional ramifications because of deep violations of trust, honesty, and love. In addition, it can create spiritual distress in victims. Child and adolescent mental health nurses need to actively promote risk-reduction strategies to help prevent the abuse from occurring in their communities.     

Resilience and risk factors associated with experiencing childhood sexual abuse

The effects of child sexual abuse are wide‐ranging and impact on children, families and health/social care systems. The authors review this literature, examining the shortcomings of the ‘victim–offender’ model, and consider the complex, multifactorial nature of this question. Factors associated with a progression from victim to perpetrator are explored and the prevalence of abuse in the general population is also discussed. Protective as well as risk factors are considered and the pivotal role of ‘personal reliance’ is considered as it relates to empowering damaged young people to become healthy adults. The authors also discuss implications for the treatment of young people who become abusers. Two case examples are brie?y reported upon and the article concludes with a consideration of ways to helpfully address the needs of children who become sexual perpetrators. Copyright © 2004 John Wiley & Sons, Ltd.     

Emotionally Focused Therapy for couples and childhood sexual abuse survivors

This study explored Emotionally Focused Therapy (EFT) for couples with childhood sexual abuse survivors (CSA) and their partners. Half of the couples in this study reported clinically significant increases in mean relationship satisfaction and clinically significant decreases in trauma symptoms, and thematic analyses identified numerous areas where trauma survivors were challenged in fully engaging in the therapy process. In particular, trauma symptoms such as affect dysregulation and hypervigilance were identified to play a role in the challenges that survivors experienced in fully engaging in the EFT process. Results of these thematic analyses yielded clinical recommendations for working with CSA survivors and their partners in EFT for traumatized couples. Recommendations for future study were articulated.     

Childhood sexual experiences and adult health sequelae among gay and bisexual men: defining childhood sexual abuse

Gay and bisexual men carry the burden of HIV infections in the United States and have high rates of childhood sexual abuse that predict HIV and other health outcomes. This study examined differential effects of forced, consensual, and no childhood sexual experiences (CSE) on health outcomes among a probability sample of adult men who have sex with men (MSM). The forced sex group had the highest levels of psychological distress, substance use, and HIV risk. There were no differences in rates of depression and suicidal ideation between the consensual- and no-sex groups. The consensual- and forced-sex groups had higher rates of substance use and transmission risk than the no-sex group. The forced-sex group, however, had significantly higher rates of frequent drug use and high-risk sex than the consensual group. Findings suggest that forced CSEs result in a higher-risk profile than consensual or no childhood sexual experiences, the kind of risk pattern differs between forced and consensual childhood sexual experiences, and the underlying mechanisms that maintain risk patterns may vary. It is important to clarify risk patterns and mechanisms that maintain them differentially for forced and consensual sex groups so that interventions may be tailored to the specific trajectories related to each experience.     

Problem behaviors,substance abuse and sexual abuse in psychiatrically hospitalized adolescents with bulimia nervosa

Twenty-eight adolescent bulimics were compared to 201 psychiatrically hospitalized non-eating disordered patients. Non-eating disordered patients were found to be reliably more aggressive, delinquent, and under-controlled than patients with bulimia nervosa. Sexual abuse was found to be less prevalent among bulimic adolescents than comparison adolescents. No significant between group differences were achieved on any measure of alcohol/drug abuse. The behavioral profiles of substance abusing bulimics were highly similar to those of non-eating disordered patients. Three months follow-up of bulimic patients found that they were less depressed, had less somatization, and were less overcontrolled; however, they showed no reliable improvements in eating attitudes/behaviours or drug/alcohol use.     

Attitudinal and normative predictors of alcohol use by older adolescents and young adults

A model of alcohol use based on the theory of planned behavior, expectancy theory, and the developmental literature on the influence of parents and peers was examined with 87 eleventh grade students, 105 college freshmen, and 107 college juniors. Specifically, the influence of attitudes about the positive and negative consequences of drinking, perceived parental and peer norms about alcohol consumption, and perceived control over drinking predicted self-reported alcohol use. The results suggest that, during adolescence, decisions to consume alcohol are rational, based on the consideration of the positive consequences of alcohol use and perceptions of control over drinking; however, the negative consequences of alcohol use are discounted. While perceived peer norms predicted alcohol consumption in all three age groups, the influence of perceived parental norms varied such that they predicted alcohol use only among the college juniors. Implications and avenues for future research are discussed.     

Trauma symptoms, sexual behaviors, and substance abuse: correlates of childhood sexual abuse and HIV risks among men who have sex with men

Childhood sexual abuse is associated with high-risk sexual behavior in men who have sex with men. This study examined psychological and behavioral correlates of HIV risk behavior associated with childhood sexual abuse in a sample of men who have sex with men. Men attending a large gay pride event (N = 647) completed anonymous surveys that assessed demographic characteristics, childhood sexual abuse history, symptoms of dissociation and trauma-related anxiety, borderline personality characteristics, substance use, and sexual risk behavior. Results indicated that men who have a history of childhood sexual abuse were more likely to: engage in high-risk sexual behavior (i.e., unprotected receptive anal intercourse), trade sex for money or drugs, report being HIV positive, and experience non-sexual relationship violence. Results of this study extend previous research to show that men who have sex with men and who have a history of child sexual abuse are more likely to be at high risk for HIV infection.     

Shame and guilt in men exposed to childhood sexual abuse: a qualitative investigation

This study examined the experiences of shame and guilt in adult males sexually abused as children. Seven participants attending a service for male sexual abuse completed measures of shame, guilt, dissociation, and childhood trauma history and subsequently participated in a focus group. All participants experienced childhood sexual abuse in the "severe" range and showed elevated scores for shame, guilt, and dissociation. Four superordinate themes with associated subordinate themes emerged: (a) self-as-shame (foundations of self-as-shame, fear of exposure, temporary antidote: connection), (b) pervasiveness and power of doubt and denial (from others, from self, consequences of incredulity), (c) uncontrollability (of problems after disclosure, of rage, of intrusions and emotional pain), and (d) dissociation. Results are discussed with reference to the existing literature and the emerging "self-as-shame" construct, which appeared to encapsulate participants' view of themselves.     

Exploring the multiplicity of childhood sexual abuse with a focus on polyincestuous contexts of abuse

This study explored the prevalence of multiple abusers and polyincest in a clinical sample of 88 adult women, focusing on interviews with a subset of 30. For the sample as a whole, 43% reported three or more abusers and 23% reported polyincest. The narrative data was divided into three categories defined as Single-Abuser (N=8), Multiple Abuser (N=8), and Polyincestuous (N=14). These were compared to determine how survivors perceived family members' and others' reactions to disclosure of CSA. All three groups experienced various forms of silencing. The most negative responses were linked to polyincestuous abuse. Three themes were identified as denial/ minimization/normalization, fear/reprisal, and negative/inadequate. Results suggest the need for further research on the frequency of multiple abusers among victims of sexual abuse, as well as the ways in which family and social contexts serve as collusive environments for the practice of CSA.     

Social conservatism: Determinants and structural stability over time

The decade of the 1970s is generally regarded as one of increasing conservatism in attitudes and lifestyle. Using general social survey data from the period 1972–1980 the paper describes and explains some of the fundamental shifts in socially conservative attitudes (i.e. attitudes concerning civil liberty, abortion, racial segregation) which occurred during the 1970s. Findings suggest the following: (1) attitude structures changed little over time; (2) levels of conservatism showed a statistically significant increase over the decade; (3) the overall explanatory structure (both slopes and intercepts) changed over the time period investigated. However, levels of education and levels of church attendance had consistent (but inverse) impacts on degree of conservatism; (4) size of place of current residence was conspicuously absent as an important predictor. Since this is the most often used proxy for rural vs urban milieu, we encourage caution in interpreting much of the literature on rural-urban differences.     

Psychiatric comorbidity in women with a history of childhood sexual abuse

Childhood sexual abuse (CSA) is associated with the development of numerous adult mental disorders. Women with a history of CSA were surveyed concerning their abuse experience and prevalence of DSM-IV mental disorders. The 63 women in the low morbidity cluster had a mean of 1.02 disorders. The 11 women in the moderate morbidity cluster had a mean of 2.36 disorders. The 16 women in the severe morbidity cluster had a mean of 4.75 disorders. Childhood family environment and CSA during preschool years were important predictors of morbidity cluster membership.