Childhood abuse history,secondary traumatic stress,and child welfare workers

Social workers are exposed to trauma vicariously through the trauma of their clients. This phenomenon, called secondary traumatic stress, vicarious traumatization, or compassion fatigue, presents a risk of negative personal psychological consequences. Based on a sample of 166 child welfare workers and using standardized measures, the study findings document the link between a personal history of primary trauma, childhood abuse or neglect, and the heightened risk for secondary traumatic stress in child welfare workers.     

Psychological assessment through performance-based techniques and self-reports: a case study of a sexually abused girl at preschool age

We investigated the implicit psychological and behavioral consequences of sexual abuse in an adolescent girl who suffered child sexual abuse at preschool age in this case report. We report the manifestations of this abuse on her personality and psychological functioning using a structured clinical interview and a comprehensive psychological battery including the Beck Anxiety Inventory, the Beck Depression Inventory, the Standard Progressive Matrices, Rorschach Ink Blots, and the Schema Mode Inventory. These investigations were useful in formulating both a diagnosis and a management plan. The girl fulfilled diagnostic criteria for a major depressive episode and borderline personality disorder. This combination of psychological testing may be useful in establishing an accurate multiaxial diagnosis and for understanding the behavioral and psychological sequelae of child sexual abuse in similar cases. The study further suggests that schema-focused therapy is a useful therapeutic tool for individuals who have suffered child sexual abuse at an early age and who have borderline personality disorder.     

Psychological Assessment through Performance-Based Techniques and Self-Reports: A Case Study of a Sexually Abused Girl at Preschool Age

We investigated the implicit psychological and behavioral consequences of sexual abuse in an adolescent girl who suffered child sexual abuse at preschool age in this case report. We report the manifestations of this abuse on her personality and psychological functioning using a structured clinical interview and a comprehensive psychological battery including the Beck Anxiety Inventory, the Beck Depression Inventory, the Standard Progressive Matrices, Rorschach Ink Blots, and the Schema Mode Inventory. These investigations were useful in formulating both a diagnosis and a management plan. The girl fulfilled diagnostic criteria for a major depressive episode and borderline personality disorder. This combination of psychological testing may be useful in establishing an accurate multiaxial diagnosis and for understanding the behavioral and psychological sequelae of child sexual abuse in similar cases. The study further suggests that schema-focused therapy is a useful therapeutic tool for individuals who have suffered child sexual abuse at an early age and who have borderline personality disorder.     

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.     

Exploring the Relations Among the Nature of the Abuse,Perceived Parental Support,and Child's Self-Concept and Trauma Symptoms Among Sexually Abused Children

ABSTRACT

This study examined two resiliency factors: self-concept and perceived parental support, in conjunction with abuse factors that impact psychological functioning. Data were collected on 61 sexually abused children prior to treatment. Findings indicate that a child's self-concept was associated with all the trauma symptoms except sexual concerns and did account for a significant amount of variance in relation to trauma symptomatology. Parental support was only associated with the Dissociation and was not found to account for variance in relation to trauma symptoms. Factors specific to the sexual abuse found that when a child endured a lengthy abuse period, their self-concept was more negative.     

The pattern of child sexual abuse in northern ireland

A team from the Departments of Child Psychiatry, Royal Belfast Hospital for Sick Children, and of Epidemiology and Public Health, Queens University Belfast, conducted a study in 1987 of the reported incidence of child sexual abuse in Northern Ireland. The incidence rate of established cases of child sexual abuse was 0.9 per 1000 children under the age of 17 years. Further analysis of all the cases of sexual abuse (suspected, alleged and established) and an estimation of the potential under-ascertainment indicated that the actual rate was between 0.9 per 1000 and 1.85 per 1000 children. Data obtained from a detailed structured questionnaire on each sexually abused child was analysed. The results are presented in relation to the child, age and sex; the abuse, type and duration; the abuser, sex, age and relationship to the child; and outcome factors, initial psychological sequelae, physical signs and symptoms, and social sequelae.     

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.     

Maladaptive Schemas as Mediators in the Relationship Between Child Sexual Abuse and Displaced Aggression

Child sexual abuse is one of the most serious forms of abuse due to the psychological consequences that persist even into adulthood. Expressions of anger among child sexual abuse survivors remain common even years after the event. While child sexual abuse has been extensively studied, the expression of displaced aggression has been studied less. Some factors, such as the maladaptive early schemas, might account for this deficiency. The objective of this study was to analyze the relationships between child sexual abuse, displaced aggression, and these schemas according to gender and determine if these early schemas mediate the relationship between child sexual abuse and displaced aggression. A total of 168 Spanish subjects who were victims of child sexual abuse completed measures of childhood trauma, displaced aggression, and early maladaptive schemas. The results depict the relationship between child sexual abuse, displaced aggression, and early maladaptive schemas. Women scored higher than men in child sexual abuse, emotional abuse, disconnection or rejection and impaired autonomy. Mediational analysis found a significant mediation effect of disconnection or rejection on the relationship between child sexual abuse and displaced aggression; however, impaired autonomy did not mediate significantly.     

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.     

A Review of Child Sexual Abuse: Impact,Risk, and Resilience in the Context of Culture

Child sexual abuse is a problem with both a national and worldwide prevalence. In this review, the authors note that while empirical research has clearly shown the negative impact of child sexual abuse on social, psychological, and sexual functioning later in life, it has also been reported that some individuals remain asymptomatic despite a history of experiencing child sexual abuse. This implies that negative outcomes later in life are not inevitable and illustrates the critical need to elucidate how resilience may moderate the negative impacts of child sexual abuse. In addition to emphasising the role of resilience, this review also underscores the important role that cultural context plays in understanding child sexual abuse, as there are known risk factors and protective factors specific to different cultures. Similarly, one’s culture may also influence whether abuse is reported and addressed, and the topic is given special attention in this paper because it is not widely discussed within the existing literature. The impact of child sexual abuse on mental health, sexual health, and social functioning is also discussed.     

Research Based Recommendations for Child Custody Evaluation Practices and Policies in Cases of Intimate Partner Violence

This article reviews recent research on child custody evaluations in intimate partner violence (IPV) cases. Specifically, it covers assessment methods, evaluator selection, evaluator education, guidelines, differential assessment, and state policies. Special attention is given to new methods of bias reduction, the need to focus on coercive and controlling abuse, and the need to interpret psychological tests within a trauma framework. Recommendations are made in each area reviewed.     

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 myths: attitudes, beliefs, and individual differences

Child sexual abuse myths comprise incorrect beliefs regarding sexual abuse, victims, and perpetrators. Relations among myth acceptance, responses to disclosure, legal decisions, and victims' subsequent psychological and health outcomes underscore the importance of understanding child sexual abuse myths. Despite accurate knowledge regarding child sexual abuse among many professional and other individuals, child sexual abuse myths persist. A Google search produced 119 child sexual abuse myths, some with overlapping themes. Coders grouped myths into four categories: (a) minimizations or exaggerations of the extent of harm child sexual abuse poses, (b) denials of the extent of child sexual abuse, (c) diffusions of perpetrator blame, and (d) perpetrator stereotypes. This review provides available data regarding the prevalence for these myths, empirical research that refutes or confirms myth categories, and considerations of cultural contexts and implications.     

Editorial

Undergoing a traumatic experience can be a life-changing event, having a significant impact on individuals, families, communities, workplaces and societies. Traumatology is therefore a complex field of study demanding a sophisticated level of understanding to serve as a theory base. This article explores the potential for existentialist philosophy to make an important contribution to our understanding of trauma and its effects. It presents trauma as an existential injury and explores the psychosocial basis of traumatic experience — that is, conceptualising trauma as having both psychological and sociological dimensions, the combination of which has profound existential resonances. While the theoretical ideas discussed can be applied to trauma at any stage in the life course, this paper focuses in particular on childhood trauma. Consequently, child abuse is used as an example of how trauma can have a significant (and detrimental) effect on identity development, invoking a need for a commitment to trauma recovery.     

Persistent Complications of Child Sexual Abuse: Sexually Compulsive Behaviors,Attachment, and Emotions

ABSTRACT

Child sexual abuse has the potential to cause distress for the victim across the lifespan. Romantic relationships may be particularly difficult for victims of child sexual abuse. This retrospective study examined differences in adult romantic attachment, sexually compulsive behaviors, and emotion regulation by history of child sexual abuse in a large, nonclinical sample. Those with a history of child sexual abuse reported more attachment anxiety in romantic relationships and engaged in more sexually compulsive behaviors. Overall, males displayed more sexually compulsive behaviors than females regardless of history of sexual abuse. Males with a history of sexual abuse displayed the greatest number of sexually compulsive behaviors. Surprisingly, no differences were observed in emotion regulation or attachment avoidant behaviors by history of child sexual abuse. Future research should seek to replicate current findings and examine emotion regulation difficulties experienced as a result of trauma.     

Why should child welfare pay more attention to emotional maltreatment?

A significant body of research indicates that emotional maltreatment (EMT) is harmful to children, resulting in long-term negative impacts on emotional and behavioral development. The child welfare system's focus on physical abuse, physical neglect, and sexual abuse has led a relative lack of attention to EMT. Reported rates of EMT vary widely across states – ranging from 0.2% to 44.9% in a recent national report on child maltreatment – indicating that it is not being measured consistently. This paper uses data collected by the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) to (1) describe the nature and characteristics of emotional maltreatment experienced by 846 LONGSCAN youth across time, and (2) describe the relation between four subtypes of emotional maltreatment (psychological safety and security, acceptance and self-esteem, autonomy, and restriction) and child trauma symptoms and risk behaviors at age 18. Exposure to EMT was related to increased trauma symptoms and risky behaviors. EMT is common, identifiable, harmful, and potentially preventable; and a better understanding of it will help to inform the provision of effective child welfare and mental health services to children and their families. Findings suggest a need for greater understanding of parental behaviors, and the motivations behind them, that result in emotionally harmful outcomes for children, as well as a better understanding of appropriate interventions for children who experience various types of EMT.     

Staying safe: strategies for qualitative child abuse researchers

Undertaking interview‐based research with victim/survivors of child abuse can be difficult and challenging for researchers. Much has been written about the impact of research on participants, but researcher effects are less explored. This paper reviews the literature on sensitive interview‐based research and child abuse research. The theoretical underpinnings of researcher trauma are outlined and challenges identified and related to child abuse research using researcher reflections from the authors' interview‐based research with children who have been abused and young mothers who were sexually abused in childhood. Strategies and recommendations are developed to minimise child abuse researcher trauma. Copyright © 2009 John Wiley & Sons, Ltd.     

An Exploratory Study of Group Therapy for Sexually Abused Adolescents and Nonoffending Guardians

ABSTRACT

Adolescent survivors of sexual abuse frequently report severe trauma, depression, anxiety, and low self-esteem. While cognitive-behavioral group interventions show promise, interpreting efficacy is problematic due to commonly high attrition. This article reports promising exploratory study findings relating to a 12-week multimodal abuse-specific group intervention with a nonoffending parent/caregiver component. Participants (aged 11–16 years) consisted of six adolescents with severe abuse histories, and their caregivers. Participants completed pre-, post-, and 1-month follow-up measures. The results were consistent with the possibility that the program produced clinically meaningful reductions in abuse-related psychological sequelae, the program had excellent face validity with participants, and there were no dropouts.     

Emotional death: the charity advert and photographs of childhood trauma

This essay will use current and historical advertisements by the British charity Barnardo’s to analyse the representation of abused children. In particular, it will focus on the 1999–2003 campaigns to explore the connection between the experience of trauma, death and the photographic image in the context of a first world, Western preoccupation with the spectre of the missing, lost or abused child. It will consider the complex attempt to photographically capture the missing image, to invoke a subjective loss and to conjure up the accompanying wound of trauma. The Barnardo’s adverts, like many charity adverts of abuse, attempt to show a traumatic past, that by its very nature as trauma, defeats easy representation. Trauma as an experience produces a crisis of representation. The traumatic event, with its radical disruption of psychic defences, results in an absence or gap in memory, knowledge and recall. The devastating event so overwhelms the senses that it produces a perpetual sense of “belated uncertainty” about “a truth to which there is no simple access” (Caruth , p. 6). These photographs attempt to capture the dislocation of time and distortion of identity for the traumatised child. Whilst structurally they can be read for invoking a sense of aura or credibility as testimony, they do so in a digital age when the status of the “truth” of the photograph as evidence is called into doubt (Robins ). This dislocation of image from referent can be read for its parallels with the dislocating structures of trauma. As such they raise questions of the ethics of “spectral evidence” in a commercialised charity sector.