Parental support and outcome in sexually abused children

The purpose of this study was to compare how parental support, attachment of the parent, and the child's report regarding the quality of the parent/child relationship differentially relate to child and parent reports of the child's symptomatology. After controlling for those variables that covary with it, parental support was only significantly related to 2 of 17 scales of parent- and child-reported symptomatology. Parent attachment and the child's report regarding the quality of the parent/child relationship were better predictors than parental support of the child's outcome but varied in the manner in which they contributed to outcome.     

Psychoeducational groups with foster parents of sexually abused children

Psychoeducational groups for foster parents of sexually abused children were successfully delivered. Groups with nonrelative foster parents required less basic behavior management training than groups for foster parents related to the children in their care. Relative groups also required considerable attention to issues of visitation with birth parents. The groups helped foster parents improve their ability to care for sexually abused children. Participants were highly satisfied with the groups. Additional program development and research is clearly warranted.Ms. Winterfelt is in private practiceThe Project was supported by the Children's Bureau, ACF. DHHS.Copies of the training curriculum and videotape are available from Ms. Yeaton, Dept. of Psychiatry, Children's Hospital, 747 52nd Street.     

Needed services for foster parents of sexually abused children

Foster parents with little preparation and short notices must often deal with severe emotional and behavioral difficulties of sexually abused children. This article reports on a survey of the services provided to foster parents who care for sexually abused children in a large city in the Northeast United States. Agency directors, social workers and foster parents were asked to respond to mailed questionnaires. The results indicated that foster parents consistently reported that they received less extensive educational and support services than were reported by social workers and directors of foster care agencies. All groups recommend further expansion of training programs for foster parents of sexually abused children.This paper was presented at the Temple University Chapter, Phi Delta Kappa, Philadelphia, PA, April 5, 1990.Ms. Egan is a Research Assistant; Ms. Cossett and Ms. Auletta were studients from Smith College School for Social Work.     

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.     

The role of the medical provider in the evaluation of sexually abused children and adolescents

It was only 30 years ago that the medical community began to develop an increased awareness of child sexual abuse, and the role of the medical provider in the evaluation of sexually abused children has evolved significantly. As clinicians worldwide develop a greater understanding of the impact of the sexual abuse evaluation on the child, the roles of the physician and nurse have changed. In the United States, current practice often uses a multidisciplinary assessment involving skilled forensic interviewing of the child and a medical examination done by a medical provider with specialized training in sexual abuse. In order to minimize child interviews, these assessments are frequently held in settings such as child advocacy centers, where forensic interviewers and medical clinicians, child protective service workers, and police and district attorneys can work jointly to address the legal and protective issues in a coordinated fashion.     

Comparison of open versus closed group interventions for sexually abused adolescent girls

A first aim of this study is to evaluate the efficacy of an open group therapy for sexually abused teenagers using a quasi-experimental pretest/posttest treatment design. A second aim was to explore whether differential gains were linked to an open versus a closed group format. Results indicate that sexually abused girls involved in an open group therapy showed significant gains relative to teenagers of the control group girls for the majority of the variables considered. Analyses contrasting the two formats of group therapy fail to identify statistical differences suggesting that both open and closed group formats are likely to be associated with the same significant gains for sexually abused teenagers.     

The fate of the sexually abused child

This article emphasizes the importance of understanding the specific meaning of sexual abuse to the particular child in his/her particular developmental stage. A critique of the research is presented, along with discussion of the psychodynamic impact of sexual abuse on the developing ego of the child. The primary means of adaptation following the trauma are (1) identification with the aggressor and (2) the repetition compulsion. It is also suggested that Freud's seduction theory can coexist with his later fantasy theory. Two case vignettes are presented to highlight the theoretical discussion.     

Non-abusive mothers of sexually abused children. The role of rumination in maternal outcomes

This study of 125 mothers examined the role of rumination in maternal emotional and behavioral outcomes subsequent to discovery of the sexual abuse of their children. Abuse severity, a maternal history of child abuse experiences, and life hassles were examined as predictors of negative outcomes. The central finding was that these factors, many of which are not controllable, were less likely to predict poor maternal outcomes than was rumination, a cognitive process that may be alterable. Rumination was the strongest correlate with each outcome. Further, the effects of most predictors on outcomes in this study were mediated by a ruminative cognitive style. Abuse severity, income, ethnicity, and education lacked significant relationships with maternal outcomes. This study asserts that rumination is a central component for understanding maternal outcomes in the post-discovery phase of sexual abuse cases. It recommends that rumination be routinely assessed both for research and treatment purposes.     

A relational understanding of the needs of siblings of children who have been sexually abused

This participatory research project highlighted the views and experiences of young people who are the brothers and sisters of children and young people who have experienced child sexual abuse. By working with young people who had experienced sexual abuse and their siblings, this practitioner research sought to give these young people a voice. The research involved a group process with young people who have experienced sexual abuse and have siblings, and one-to-one online consultations with the brothers and sisters of young people who have experienced abuse. All the young people spoke of their sibling and family relationships as unique and requiring unique responses to these relationships by services and health-care professionals. Siblings’ needs in the aftermath of a child sexual abuse discovery are often overlooked. This research describes how just as children who have experienced sexual abuse may feel anger, fear, guilt, shame, anxiety, and confusion, so do their siblings. Brothers and sisters of young people who have experienced sexual abuse describe significant relational trauma with intense emotional experiences of isolation, confusion, sadness, and anger. There is a real need to support young people and families to find words and develop capacities to talk about child sexual abuse -- a need to find supportive ways to speak about what has occurred and understand its impact on all. The study clearly demonstrated the significant level of need and impact on brothers and sisters of young people who have experienced sexual abuse.     

Treatment outcome research with the non-offending parents of sexually abused children: a critical review

Potentially deleterious effects arise from the experience of childhood sexual abuse, but maternal supportiveness has been identified as a crucial mediator. Consequently, a body of knowledge has begun to develop on interventions designed to improve the supportiveness and adjustment of the non-offending parent. The present paper attempts to provide a critical review of the treatment outcomes reported for these new interventions. Studies have been organized according to the sexually abused child's stage of development: preschool, school-aged, and adolescence. Recommendations for service delivery and research follow.     

Suicidal behavior and associated factors in sexually abused adolescents

Objectives

The aim of the present study is to determine the rate of suicidal ideation and suicide attempts in sexually abused adolescents and to determine the factors associated with suicidal behavior.

Method

106 adolescents between the ages of 12–18 (94 girls, 12 boys) who were exposed to sexual abuse and referred for the preparation of forensic reports were included in the study. The investigators retrospectively examined the case files, forensic reports and social worker reports.

Results

It has been found that in cases exposed to sexual abuse, suicidal ideation developed in 63.2% (n = 67) of the individuals and 24.5% (n = 26) of them attempted suicide. The rate of suicidal ideation and suicide attempts was higher in cases who live separately from one or both parents, those who have ASD or PTSD after sexual abuse, cases in which abuse involved penetration, cases who were abused by someone known or someone from the family, cases where sexual abuse was accompanied by coercion and physical violence, and those who were exposed to abuse continuously. Among girls, in cases who have suicide history before sexual abuse and those who were abused by more than one abuser, the rate of suicidal ideation was higher.

Conclusion

It has been shown in many studies that sexual abuse in childhood increases the risk of suicidal behavior. Consideration of the factors associated with suicidal behavior in victims of sexual abuse will be helpful to clinicians in preventing suicide attempts.     

Anatomical dolls: their use in assessment of children who may have been sexually abused

This article examines anatomical dolls in interviews of children who may have been sexually abused from three perspectives. The article summarizes research findings on anatomical dolls, discusses advantages and disadvantages of using them, and describes endorsed doll uses. Although additional, ecologically-valid research is needed on anatomical dolls, the selective use of anatomical dolls, as communication aids, when interviewing children who may be reluctant or unable to describe sexual abuse is warranted.     

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.     

Betrayal and repetition: Understanding aggression in sexually abused girls

Betrayal by a significant object is seen as primary in causing behavioral and emotional disturbances in incest victims, leading to a pervasive identification with the aggressor and disturbances in object relations development. Identification with the aggressor is understood not as a uniform defense mobilized against a specific affect but as a complex compromise formation which defends against anxiety, while also providing libidinal, aggressive and superego gratifications. Far from simply attempting to overcome the past, identifications thus preserve affects that have become pleasurable and self-defining. Two case studies of adolescent girls illustrate how treatment can help victims recognize and begin to forego the sadomasochistic pleasure derived from these identifications, a relinquishment necessary for true mastery.     

Attributions and coping in sexually abused adolescents referred for group treatment

This study aims to assess the predictive value of two sets of variables, self-attributions, and coping behaviors, on sexually abused (SA) teenagers' functioning, while controlling for abuse-related and family variables. A total of 103 female adolescents completed self-report measures to assess their psychological functioning in terms of anxiety, depression, PTSD, sexual concerns, dissociation, anger, their self-injurious behaviors, antisocial behaviors, and drug use. After controlling for SA and family characteristics, final regression models indicate that attributions and coping behaviors explained between 22% and 39% of additional unique variance for seven out of the nine measures of adolescent functioning. Attributions and coping behaviors did not significantly explain additional variance for scores of antisocial behaviors and drug use. Personal attributions of blame for negative events were the strongest predictors of adolescents' functioning. Implications for future research and interventions are highlighted.