Ethnic differences in symptom presentation of sexually abused girls

Although researchers have begun to examine the issue of ethnic and cultural factors in childhood sexual abuse (CSA), relatively little has been done to look at possible ethnic and cultural differences in psychological symptoms related to CSA. This study investigated the relationship between ethnicity and symptom presentation among Hispanic, African American, and Caucasian sexually abused girls. The study examined the relationship between ethnicity and depression, ethnicity and post-trauma intrusive symptoms, and ethnicity and post-trauma avoidance symptoms. Results indicated that African American girls had significantly higher levels of post-trauma avoidance symptoms than Hispanic girls, but not Caucasian girls. No significant differences were found between ethnic groups for depression or intrusive symptoms.     

Ethnic Differences in Symptom Presentation of Sexually Abused Girls

ABSTRACT

Although researchers have begun to examine the issue of ethnic and cultural factors in childhood sexual abuse (CSA), relatively little has been done to look at possible ethnic and cultural differences in psychological symptoms related to CSA. This study investigated the relationship between ethnicity and symptom presentation among Hispanic, African American, and Caucasian sexually abused girls. The study examined the relationship between ethnicity and depression, ethnicity and post-trauma intrusive symptoms, and ethnicity and post-trauma avoidance symptoms. Results indicated that African American girls had significantly higher levels of post-trauma avoidance symptoms than Hispanic girls, but not Caucasian girls. No significant differences were found between ethnic groups for depression or intrusive symptoms.     

Exploring Gender and Racial/Ethnic Differences in the Effects of Child Sexual Abuse

Child sexual abuse (CSA) has been linked to a number of adverse effects including hypersexuality (HYP), substance use (SUB), suicidality (SUI), and depression (DEP). Despite a plethora of research on CSA, little is known about how it affects adolescents and the cultural factors that influence their coping styles. This study was founded on social-cultural coping theory and the model of traumagenic dynamics of sexual abuse, suggesting that CSA consequences lead to maladaptive coping mechanisms influenced by sociocultural factors. Using archival data, loglinear analysis was conducted to examine gender differences within racial/ethnic groups in HYP, SUI, DEP, and SUB among adolescent survivors of CSA in a National sample of 13,583 male and female high school students. The purpose of the study was to identify differences in the effects of CSA as manifested by variations of maladaptive coping across racial/ethnic groups and gender. Boys were significantly more likely to use substances, while girls were more likely to experience depressive symptoms and suicidality. Notably, this study did not reveal any significant racial/ethnic differences in adolescent coping. These findings can inform treatment planning and interventions for adolescents who may present with DEP, SUI, SUB, or risky sexual behaviors, but may have underlying trauma from CSA. This study contributes to the knowledge base about the processes that take place within adolescent CSA survivors, shedding light on cultural nuances among adolescent coping and informing culturally competent practice.     

Disclosure and Psychological Well-Being of Sexually Abused Adolescents in Hong Kong

The role of disclosure on psychological well-being of adolescents with child sexual abuse experience was investigated in a subsample of 74 disclosers among 800 adolescents recruited in the community in Hong Kong. The results supported that CSA experiences have differential impact on adolescents’ psychological well-being. Family characteristics of the disclosers accounted for only a small amount of the variance in an array of psychological well-being measures. CSA characteristics were robust predictors of disclosers’ sexual eroticism and externalizing behavioral symptoms. Disclosers’ cognitive appraisal of CSA experience and quality of parental attachment were strong predictors of their self-esteem and internalizing behavioral problems. After controlling for the aforementioned factors, negative disclosure experience still significantly predicted lower self-esteem, higher sexual anxiety, more internalizing behavior, and more severe post-traumatic stress disorder responses. Research to understand the factors that generate negative disclosure experiences is needed for developing effective intervention strategies to mitigate the negative consequences of disclosure.     

Relationship to perpetrator, disclosure, social reactions, and PTSD symptoms in child sexual abuse survivors

This research examined victim relationship to the perpetrator, disclosure characteristics, social reactions, and PTSD in adult survivors' of child sexual abuse (CSA) identified in a convenience sample of 733 college students. Results indicated that relationship to the perpetrator was related to CSA characteristics and outcomes. More negative reactions such as disbelief were observed for those victimized by relatives compared with acquaintance and stranger victims, especially for those disclosing in childhood. Victims of relatives had more PTSD symptoms if they delayed disclosure, received more negative reactions in childhood, and engaged in self-blame at the time of the abuse. Results are discussed in the context of Freyd's (1996) betrayal trauma theory, in order to better understand the traumatic impact of CSA.     

Differences in childhood sexual abuse experience between adult Hispanic and Anglo women in a primary care setting

The literature on racial and ethnic factors in childhood sexual abuse is limited. The purpose of this exploratory study was to document Hispanic-Anglo differences in childhood sexual abuse experiences and assess whether these differences may be explained by socio-demographic and family environmental differences. Adult Hispanic (n = 69) and Anglo (n = 19) women from a family medicine clinic waiting room reporting a history of childhood sexual abuse completed an in-depth survey concerning the sexual abuse experience and their childhood environment. In this study, Hispanics were more likely to report a family member as the perpetrator and to experience more self-blame as a result of the abuse. Hispanics were also more likely to take action in response to the abuse, especially those who were more acculturated to U.S. culture. However, most of the observed differences in this study could be explained by socio-demographic or family environment variables, not by ethnic background. Qualitative research on the family environments of Hispanic victims of child sexual abuse may further explicate the dynamics and risk factors for abuse by family members.     

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.     

Asking the Question: Childhood Sexual Abuse in Adults with Mental Illness

Enquiry about childhood sexual abuse (CSA) is not routine practice for mental health practitioners undertaking client assessment. This study audited 100 patient charts to determine rates of enquiry and response by mental practitioners around CSA. Fifty-seven mental health staff also completed a subsequent questionnaire exploring factors that influence practice in regard to sexual abuse. Staff lacked confidence in how to ask and effectively respond to sexual abuse disclosure. Mandatory training focusing on trauma informed care could improve staff confidence and capacity to identify and effectively address not only sexual abuse, but childhood trauma and abuse more generally.     

Irish child sexual abuse victims attending a specialist centre

We profiled a cohort of CSA cases referred for assessment to a specialist child sexual abuse (CSA) centre in a national paediatric hospital in Ireland. Historical and clinical data were drawn from records of 171 cases. The majority of cases were referred by social workers following purposeful disclosure of CSA. Three quarters of the cases were female with a mean age of 9 years. They were from a wide spectrum of socioeconomic groups and many had suffered a range of family adversities. In most cases, the abuse involved masturbation of the child by the abuser. Almost all of the perpetrators were male with a mean age of 28 years and in 60% of cases extrafamilial abuse had occurred. In 23% of cases, the perpetrator had a history of previous sexual offending. Anxiety was the most common emotional problem before disclosure and after disclosure the most common emotional problem was guilt. Before disclosure school refusal was the most common behavioural problem and after disclosure fighting was the most prevalent behavioural difficulty. The most common factors supporting the credibility of CSA allegations were labile mood, the child's ability to differentiate fact from fantasy and a detailed disclosure of contextual details. More adolescents showed deterioration in schoolwork after disclosure and for more pre school children clinginess following disclosure was a significant emotional problem. More primary school aged children were abused by perpetrators who had abused a number of children. For children abused by such perpetrators, vaginal intercourse was less common. Vaginal intercourse was more common in 6–11‐year‐old victims and those who were abused on a daily basis. The threat that disclosure posed to the integrity of the family structure was more often a factor hindering disclosure in victims abused by father figures and abused very frequently. Copyright © 2003 John Wiley & Sons, Ltd.     

Evolving Narratives About Childhood Sexual Abuse: Challenging the Dominance of the Victim and Survivor Paradigm

This research project explored the ongoing process of constructing a narrative, following childhood sexual abuse. Twenty‐two men and women aged 25–70 were interviewed about their childhood sexual experiences with adults using narrative inquiry methodology. These experiences occurred in different social and historical contexts, when the theoretical understandings and treatment of the issue of child sexual abuse were significantly different from the present. Many factors made disclosure even more difficult then than it is now including: respect for authority; rigid gender roles; the taboo surrounding sexual issues; lack of supportive adults; and lack of language to describe what was happening. Participants told four differing narratives about their experiences: narratives of silence; narratives of ongoing suffering; narratives of transformation; and narratives of transcendence. These narratives were examined in relation to the changing social and historical context and the current dominance of the victim and survivor paradigm in the child sexual abuse literature.     

Barriers to disclosing child sexual abuse (CSA) in ethnic minority communities: A review of the literature and implications for practice in Australia

Research on child sexual abuse (CSA) among ethnic minority communities in Australia is essentially absent. To begin to address the gap, a systematic literature review was conducted; which necessarily borrowed from overseas to help inform the national context. A wide array of barriers to disclosure were identified, suggesting that this is a fundamental issue for ethnic minorities. The most significant of these barriers appears to be the need to protect family name. This also leads to non-supportive and protective responses from non-offending mothers, however this experience (although more intense) is shared with the Western mainstream. In comparison, fear of stigmatising their whole community is a unique barrier and highlights that racism is a significant and additional burden. The findings suggest that service worker training in Australia is critical for informing professionals of: the importance of family reputation for collectivist groups; the importance of responding supportively and protectively to child victims who have disclosed to them first; the cross-cultural complexities that surround construals of ‘child safety’; educating non-offending mothers about the importance of at least believing their child's disclosure (associated with mediating mental illness among victims, but also culturally appropriate because it acknowledges the protective role of family cohesion in collectivist cultures and the high motivation to avoid social exclusion – the most common reprisal for shaming the family name); exploring acculturation as a possible predictor of disclosure; and the risk of racism being overlooked or minimised. Overall, it is argued that practice informed by a well-developed national research agenda is critical.     

Healing from Childhood Sexual Abuse: A Meta-Synthesis of Qualitative Studies

ABSTRACT

Although the global prevalence of childhood sexual abuse (CSA) is very high, the experience of healing after such abuse has not been well documented. The goal of this study was to characterize the healing experience among CSA survivors presented in the literature. Metaethnography was used to synthesize an integrative literature review. The CINAHL, PubMed, PsycINFO, and Web of Science databases were used as data sources. Eight articles that explored healing experiences from CSA, published between 2007 and 2017, were included in the analysis. After performing a quality assessment, line-of-argument synthesis was used to construct the integrating scheme of healing experiences from CSA. CSA healing experiences included dissociating oneself from the memories of CSA, finding peace by creating a comfort zone, disclosure as the start of healing, attempting to establish identity through ongoing self-reflective activities, feeling comfort by sharing experiences and connecting with CSA survivors, and accepting CSA as part of the life history and stepping forward. Healing experiences from CSA synthesized from the analysis focused on personal growth, supporting previous theory on CSA health in the broader literature. A tailored care plan could be developed for CSA survivors who are at varying stages of healing.     

Sexual Revictimization: Double Betrayal and the Risk Associated with Dissociative Amnesia

This study aimed to identify new treatment targets in order to develop more empirically informed initiatives to prevent sexual revictimization. A retrospective Web-based survey employing a mixed-methods design attracted a self-selecting sample of 481 community respondents, 183 of whom indicated a history of childhood sexual abuse. Seventy-four percent were females whose ages ranged from 16 to 69 years (mean = 31.2 years). Betrayal trauma referred to CSA committed by a trusted perpetrator (often caregivers). Disclosure experiences in childhood were reported though open-dialogue boxes. Double betrayal referred to high-betrayal trauma being combined with a negative response to a disclosure. This was associated with both higher incidences of prior psychogenic amnesia for CSA and sexual revictimization in later life. The findings have implications for educating the guardians of children about the prevalence and implications of CSA as well as the importance of early recognition and appropriate responding.     

The Role of Sex-Related Alcohol Expectancies in Alcohol-Involved Consensual and Nonconsensual Sex Among Women of Asian/Pacific Islander and Women of European Race/Ethnicity

Alcohol-involved sexual experiences, including incapacitated sexual assault and alcohol-involved sex, are major public health concerns among college women. Further, racial/ethnic diversity among college students is increasing, particularly with regard to increases in college students of Asian/Pacific Islander (API) race/ethnicity. Of relevance, evidence suggests differences in sexual assault rates across ethnicities and cultures; however, no known study to date has examined differences by ethnicity and first language in expectancies and experiences specifically surrounding alcohol and sex. The current study sought to examine differences in incapacitated sexual assault, alcohol-involved sex, and heavy episodic drinking, as well as differences in sex-related alcohol expectancies among native English-speaking college women of European (EU) race/ethnicity, native English-speaking women of API race/ethnicity, and non–native English-speaking women of API race/ethnicity (NNES-API). EU reported higher frequency of heavy episodic drinking, alcohol-involved sex, and incapacitated sexual assault compared to API and NNES-API. In addition, API reported more frequent alcohol-involved sex and incapacitated sexual assault compared to NNES-API, in part due to API’s stronger endorsement of sexual disinhibition–related alcohol expectancies (indirect effects: β = ?.04, p = .04, and β = ?.07, p = .04, respectively). Findings highlight the important role of expectancies in acculturation and influence on actual alcohol-involved sex and sexual assault.     

Impact of child sexual abuse disclosure on the health of nonoffending parents: A longitudinal perspective

The impact of child sexual abuse (CSA) disclosure on parents’ psychological health has been documented among samples of nonoffending parents. Much less is known about the parents’ physical health. This study assesses the longitudinal impact of CSA disclosure on both the mental and physical health of parents and explores potential gender differences. Interviews with 92 mothers and 32 fathers were completed approximately 12 months and 18 months following disclosure. Generalized as well as mixed model analyses revealed that mothers reported more psychological distress, Posttraumatic Stress Disorder (PTSD) symptoms and activity limitation than fathers. With the exception of PTSD symptoms which showed a significant reduction over time, all other psychological and physical symptoms persisted. The findings highlight the importance of ensuring services for an extended period for the small proportion of parents who display especially high vulnerability.     

The role of disclosing child sexual abuse on adolescent adjustment and revictimization

The role of disclosing child sexual abuse on adolescent survivors' symptomatology and the presence of additional unwanted sexual experiences was investigated in a subsample of 111 adolescents from the National Survey of Adolescents who reported child sexual abuse. Results indicated that prompt disclosure of sexual abuse to an adult moderated the influence of penetration during the abuse on the number of symptoms at assessment. Thus, prompt disclosure buffered the influence of more severe abuse. Disclosure also had a main effect on the likelihood of further victimization. Participants who told an adult promptly after the abuse were less likely to report additional unwanted sexual experiences.