Coping and Adjustment in Male and Female Survivors of Childhood Sexual Abuse

ABSTRACT

This study investigates the effects of childhood sexual abuse for male and female survivors, characteristics of the abuse experience, current coping strategies, and current psychological adjustment. Nineteen male and 59 female adult survivors of childhood sexual abuse, recruited from both local and national support groups, completed a background questionnaire, dispositional coping inventories measuring current and retrospective abuse-specific coping styles, and measures of current psychological adjustment. In response to sexual abuse experienced during childhood, avoidance coping emerged as the most frequently used strategy by both sexes. Although there were no gender differences in current use of problem-focused and avoidance strategies, males related more use of acceptance whereas females utilized more emotion-focused coping. In general* females reported significantly greater trauma-related distress than males, including higher levels of anxiety, depression, and post-trauma symptoms.     

Victim to Victimizer: The Psychology of Isomorphism in a Case of a Recidivist Pedophile in Finland

ABSTRACT

An extreme case of a six victim, 38-year-old recidivist sex offender was selected for examining the isomorphic relationships between child sexual abuse trauma and adult sex offenses. This sex offender had victimized children of both sexes and an adult woman. Life history, letter, file, and the Adult Attachment Interview information were analyzed to seek the relations between childhood abuse experiences and adult offending. Both subjective reports and file data revealed that the man had experienced severe physical, psychological, and sexual abuse in childhood. His pattern of sexual offending against children was similar to his own experiences of sexual abuse by his father. The age of the child victims fell in the range of his age at the time of the childhood sexual abuse. Moreover, the use of coercion to gain victim compliance resembled the way his father had acted towards him. The pedophile's offending behavior was interpreted using the isomorphic and attachment perspectives.     

Cocaine Abusing Women Who Report Sexual Abuse: Implications for Treatment

ABSTRACT

Four hundred seventy-three substance-abusing women were assessed for histories of sexual abuse. The results of bivariate analysis indicated that Sexual Abuse Survivors (SAS) had higher levels of depression, anxiety, and psychological distress. A greater number of SAS reported histories of emotional and physical abuse. They also had greater severity on ASI scales of alcohol, drug, medical, and family/social difficulty. Logistic regression analysis indicated that women who were survivors of sexual abuse were more likely to have histories of emotional and physical abuse, higher levels of addiction severity, and more family members who used drugs. Implications for research and treatment are discussed.     

Sexual Abuse and Sexual Functioning in a Chronic Pelvic Pain Sample

ABSTRACT

Sexual abuse, particularly childhood sexual abuse, has been linked to chronic pelvic pain and to sexual dysfunction, though the sexual functioning of survivors of sexual abuse has not been studied in a chronic pain population. Sixty-three women with chronic pelvic pain completed measures of sexual function, sexual abuse, and pain. Using an index of the extent of sexual abuse experiences in childhood and adolescence/adulthood, higher scores were related to lower rates of sexual activity, less satisfaction with orgasm and feelings of closeness with sexual partners, and greater severity of and interference from pain. Findings point to the importance of controlling for relationship status in analyses of long-term effects of sexual abuse and of assessing chronic pelvic pain patients for histories of sexual abuse using measures that address the extent or severity of abuse.     

Contributions of Child Sexual Abuse,Self-Blame,Posttraumatic Stress Symptoms,and Alcohol Use to Women’s Risk for Forcible and Substance-Facilitated Sexual Assault

Child sexual abuse and adult sexual assault have been linked to increased self-blame, posttraumatic stress symptoms, and alcohol use. The current study aims to examine (a) whether these constructs explain women’s risk for later adult sexual assault and revictimization, (b) whether such factors differentially confer risk for specific types of adult sexual assault (i.e., substance-facilitated and forcible), and (c) if self-blame confers risk indirectly through other risk factors. Multiple types of self-blame, posttraumatic stress, and alcohol use were examined among 929 female college students as serial mediators of the relationship between child sexual abuse and adult sexual assault and as risk factors for sexual revictimization among child sexual abuse survivors. In the model predicting risk for substance-facilitated adult sexual assault, child sexual abuse indirectly predicted greater risk for substance-facilitated adult sexual assault mediated through two separate paths: global blame-to-posttraumatic-stress and global blame-to-alcohol use. In the model predicting risk for forcible adult sexual assault, child sexual abuse directly predicted greater risk for forcible adult sexual assault, and this relation was mediated by the global blame-to-posttraumatic-stress path. Among child sexual abuse survivors, child sexual abuse specific characterological and behavioral self-blame directly predicted greater risk for forcible and substance-facilitated revictimization, but the pathways were not mediated by posttraumatic stress or alcohol use. Results emphasize the importance of assessing different types of self-blame in predicting posttraumatic stress symptoms as well as examining risk for sexual victimization and revictimization. Findings did not support hypotheses that increased posttraumatic stress would predict increased alcohol use but did indicate that heightened self-blame is consistently associated with heightened posttraumatic stress and that heightened global self-blame predicts increased alcohol use. Implications for future research and intervention are discussed.     

Compensatory Weight Control Behaviors of Women in Emerging Adulthood: Associations Between Childhood Abuse Experiences and Adult Relationship Avoidance

Abstract

Objective: To examine correlates of compensatory weight control behaviors among women in transition between adolescence and adulthood. Participants: The authors recruited a sample of undergraduate women (N = 759) at a large northwestern university during the 2009–2010 academic year. Methods: Logistic regression was used to assess relations among childhood abuse, psychosocial functioning, adult dating relationship factors, and women's endorsement of compensatory weight control behaviors. Results: The final model reliably distinguished between participants who endorsed versus denied use of compensatory behaviors (χ²[5, N = 747] = 36.37, p < .001), with global psychosocial functioning and relationship avoidance accounting for the most variance. Conclusions: These findings illustrate the importance of considering childhood abuse histories and adult relationships while assessing young women's compensatory weight control behaviors.     

The Connections of Mental Health Problems,Violent Life Experiences,and the Social Milieu of the “Stroll” with the HIV Risk Behaviors of Female Street Sex Workers

Abstract

This paper examines the connections of mental health, victimization, and sexual risk behaviors among a sample of 278 street-based female sex workers in Miami. Using targeted sampling strategies, drug-using sex workers were recruited into an HIV prevention research program. Data were collected by trained interviewers, and focused on drug use and sexual risk for HIV, childhood abuse, recent victimization, and mental health. More than half of the participants reported histories of physical (51.1%) or sexual (53.1%) abuse as children, 37.4% were classified with moderate or severe anxiety symptoms, and 52.9% had symptoms of moderate or severe depression. Logistic regression analyses demonstrated significant associations between mental health issues and engagement in recent unprotected vaginal and oral sex. The program development and policy implications of these findings are discussed.     

Types of female orgasm

This study was designed to evaluate the relationship between child sexual abuse (CSA), family violence, and other negative childhood experiences within the home and adult adjustment (TSC‐40 and Rosenberg's Self‐Esteem Scale) in a sample of first‐year female psychology students (n = 199). An experience of CSA was reported by 23.6% of women. Results of a discriminant function analysis revealed that level of family violence, father's traditional family values and mother's and father's sexual punitiveness were the variables that best discriminated between sexually abused and nonabused women. After other differences in family background were accounted for by using hierarchical multiple regression, level of family violence significantly improved the prediction of adult psychological adjustment. Standard multiple regression revealed that characteristics and severity of CSA were not significant predictors of adult adjustment. These results were interpreted as support for the use of an integrated risk‐sequelae model of CSA in evaluating the relationship between CSA and adult adjustment. Within this model, the interrelationships among CSA, violence, and dysfunctional familial environments should be simultaneously assessed.     

The Role of Shame in Women's Recovery from Alcoholism

Abstract

This study compares the recovery experience of female members of Alcoholics Anonymous (AA) who reported a history of childhood sexual abuse (68%) with those who did not report experiencing childhood sexual abuse. A sample of 53 women was obtained from AA. A significant relationship was found between shame and two measures of difficulties in recovery-problems in social adjustment and relapse. Though the hypothesis that experiences of child sexual abuse predicted difficulty in recovery was not supported, these data suggest that shame may be an important variable in both the etiology and treatment of alcoholism in women.     

Assessing the Long-Term Effects of EMDR: Results from an 18-Month Follow-Up Study with Adult Female Survivors of CSA

ABSTRACT

This 18-month follow-up study builds on the findings of a randomized experimental evaluation that found qualified support for the short-term effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) in reducing trauma symptoms among adult female survivors of childhood sexual abuse (CSA). The current study provides preliminary evidence that the therapeutic benefits of EMDR for adult female survivors of CSA can be maintained over an 18-month period. Furthermore, there is some support for the suggestion that EMDR did so more efficiently and provided a greater sense of trauma resolution than did routine individual therapy.     

Sociodemographic and Health-Related Risk Factors Among African-American,Caucasian and Hispanic Homeless Men: A Comparative Study

Data from a 1989-1990 cross-sectional survey of homeless adults in California were stratified by ethnicity to examine whether adverse childhood events and adult medical disorders preceding homelessness differed between 269 African-American, 599 Caucasian, 201 foreign-born Hispanic, and 136 native-born Hispanic men. Although African-Americans were overrepresented (21%) compared with their presence in local (3%) and state (7%) populations, within the homeless they were better educated and more likely to have held white collar jobs than Caucasians or Hispanics. In addition, despite being more likely to grow up in poverty, African-Americans reporled lower prevalences of alcohol and drug abuse, overnight psychiatric hospitalizations, placement in foster care, and physical or sexual abuse than Caucasians. Foreign-born Hispanics were the most likely to have low levels of education and job skills, but were least impaired by adult medical disorders. Native-born Hispanics reported lower rates of adverse childhood events, illegal drug use, and psychiatric hospitalizations than Caucasians, but were most likely among the three ethnic groups to suffer from alcohol abuse. The lower prevalences of adverse childhood events, addictive disorders, and psychiatric hospitalizations among homeless African-Americans, despite their higher representation in absolute numbers, suggests that factors such as childhood poverty may play a disproportionate role in homelessness among this ethnic minority group.     

Perception vs. Circumstances of the Child Sexual Abuse Event in Relation to Depression and Post-traumatic Stress Symptomatology

The study examined the impact of the circumstances of childhood sexual abuse on post-traumatic stress symptoms and depression among female adult survivors of childhood sexual abuse. The sample consisted of 225 Israeli women divided into two groups according to the identity of the perpetrator (nonfamily perpetrator versus a family member perpetrator). A self-report questionnaire was used consisting of the following scales: demographic variables, the Traumatic Events Questionnaire, Childhood Sexual Experiences Scale, Post-Traumatic Stress Disorder Symptom Scale, and Depression Scale. The findings indicated that the identity of the offender significantly differed between groups only if intercourse had occurred. Women who experienced coerced intercourse scored significantly higher on depression and post-traumatic stress compared to those who experienced other forms of childhood sexual abuse.     

Sexual Risk-Taking among High-Risk Urban Women with and without Histories of Childhood Sexual Abuse: Mediating Effects of Contextual Factors

This study investigated the mechanisms of risk for urban women at high risk for HIV with and without childhood sexual abuse histories. Childhood sexual abuse survivors reported more unprotected intercourse and sexually transmitted infections (STIs). The association of STI locus of control with frequency of unprotected sex was fully mediated by being intoxicated during sex and engaging in sex work, whereas the association between relational control and unprotected sex was not mediated by contextual factors for the childhood sexual abuse group. The mechanisms of risk are different for those with divergent childhood sexual abuse histories and thus interventions should be developed to educate women with a history of childhood sexual abuse about ways to avoid revictimization, particularly within a context of poverty, prostitution, and drug use.     

Chronic Avoidance Helps Explain the Relationship Between Severity of Childhood Sexual Abuse and Psychological Distress in Adulthood

ABSTRACT

Recent studies have found that chronic avoidance of unpleasant internal experiences (e.g., thoughts, emotions, memories) is a maladaptive means of affect regulation often adopted by women with a history of sexual victimization in childhood. The primary aim of this study was to replicate and extend previous findings suggesting that higher levels of experiential avoidance may account for the relationship between childhood sexual abuse (CSA) and psychological distress in adulthood. It was hypothesized that, in a sample of undergraduate females (n = 151), the relationship between severity of CSA (e.g., frequency, nature of victimization) and trauma-related psychological distress would be mediated by avoidance. Results supported this hypothesis. Findings are consistent with previous studies, and further suggest that the general tendency to avoid or escape from unpleasant internal experiences may be a specific factor that exacerbates psychological distress among women with a history of sexual victimization in childhood.     

Male Survivors of Childhood Sexual Abuse: A Qualitative Study and Issues for Clinical Consideration

ABSTRACT

This qualitative study explored the effects of childhood sexual abuse with 10 adult male survivors. The men who participated in the research were largely motivated by their perception that North American society does not acknowledge the sexual abuse of boys. They described the abuse as having significantly affected their sexual identity, as well as their emotional and sexual relationships as adults. The implications of these issues for clinical intervention are described.     

Sexual Dysfunction,Paraphilias and their Relationship to Childhood Abuse in Men who have Sex with Men

ABSTRACT

This study aimed to examine 1) the occurrence of sexual dysfunctions and paraphilias and 2) the relationship between childhood abuse and current sexual disorders in a MSM sample. Participants were MSM in the Midwest who completed baseline surveys prior to attending a sexual health seminar. Most men reported a sexual dysfunction or paraphilia. Thirty-nine percent of the sample reported childhood abuse. Results indicated childhood abuse was associated with a significant increased risk of male erectile disorder (OR = 1.83) and secondary sexual dysfunction (OR = 2.01). The intent of the study was to generate hypotheses to guide future research efforts.     

Childhood Sexual Abuse Profiles and Psychological Functioning in Adult Males

ABSTRACT

This study used a person-centered approach to generate profiles of males’ sexual abuse characteristics and then link profiles to other types of childhood maltreatment and adversity, and adult outcomes. Data were drawn from 215 North American males (86% Caucasian) aged 17–61 years recruited from websites offering support for sexual abuse. Latent profile analysis identified three profiles, ranging from 1–2 instances of fondling by an unfamiliar extrafamilial perpetrator to chronic, penetrative abuse by individuals within and outside the family. Profiles were labeled Severe (26%), More Severe (33%), and Most Severe (41%). Chi-squares and analysis of variance showed that men in the Most Severe profile were more likely to experience childhood emotional and physical abuse, and a greater number of non-victimization adversities, than men in the other two profiles. After controlling for multiple victimization and adversity, men in the More Severe and Most Severe profiles reported significantly greater internalizing problems than men in the Severe profile, and men in the Most Severe profile reported significantly more trauma symptoms than men in the Severe profile. While these results require replication, they suggest that treatment should be tailored to the individual needs of male survivors.     

Partner Abuse Among Women Whose Children Have Been Sexually Abused: An Exploratory Study

ABSTRACT

To explore partner abuse among women in families in which a child has disclosed sexual abuse, 102 mothers completed a measure of partner abuse and the Coping Responses Inventory. Results suggest that, like women in the general population, mothers of children who have been sexually abused have often experienced partner abuse. As expected, physical abuse in a current relationship was found to be related to the use of avoidance strategies in dealing with the sexual abuse disclosure. The implications for practitioners and for future research are discussed.     

Association between child sexual abuse and sexual revictimization in adulthood among women sex partners of injection drug users

Community-recruited women (n = 1490) were interviewed about their early and adult sexual victimization histories to determine whether there was an association between child sexual abuse and adult revictimization by sex partners and strangers/nonsex partners. Adolescent sexual abuse, lifetime sex-trading, drug treatment, and mental health treatment were examined as mediating variables. One-fourth of the women had been revictimized (i.e., experienced child sexual abuse and at least one instance of adult sexual victimization). Child sexual abuse was associated with both rape and other sexual victimization by a sex partner in adulthood, as well as adult rape by a stranger/nonsex partner. Drug and mental health treatments reduced abused women's chances of being raped by a sex partner; drug treatment also decreased the likelihood of other sexual victimization by a sex partner. Sex-trading increased abused women's likelihood of rape by a stranger or nonsex partner. Intervention--including drug treatment--can help women with child sexual abuse histories overcome some of the abuse-related sequelae that make them vulnerable to adult revictimization.     

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.