Partner abuse among women whose children have been sexually abused: an exploratory study

To explore partner abuse among women in families in which a child has disclosed child 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.     

Aggressive behavior among women sexually abused as children

Although research shows that sexually abused children appear to be at risk of subsequent aggressive behavior, few investigations address whether such behavior persists beyond childhood. This research describes the self-reported adolescent and adult fighting behavior of 136 women sexually abused as children and examines the role of intervening variables in the risk of such behavior. The women are part of a longitudinal study of 206 primarily low-income, urban women whose abuse was documented at the time it occurred. Fighting was common, particularly during adolescence. Adult aggression was strongly associated with being a victim of violence by an intimate partner. A history of exposure to other forms of violence significantly increased the risk of fighting while strong maternal attachments mitigated the risk, primarily by reducing the likelihood of involvement in an abusive intimate relationship.     

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.     

An individual treatment programme for sexually abused adult males: description and preliminary findings

Growing recognition of male sexual abuse and its potentially debilitating effects has underscored the need to develop effective treatment interventions for this population. The present study describes an individual treatment programme that was developed for adult males who have experienced childhood sexual abuse. The treatment programme focused on three areas related to sexual abuse, specifically feelings of self‐blame, anger and anxiety. The study also presents preliminary findings on treatment effects, using self‐report measures that five participants completed prior to treatment and at various assessments following treatment termination. Overall findings indicated improvements in behavioural self‐blame, anger, state anxiety and trait anxiety. Treatment did not appear to have an effect on characterological self‐blame over the long term. The study's findings are limited by the reliance on self‐report data and the absence of a comparison group. As such, our findings should be viewed as an initial contribution to the currently limited empirical data on treatment effects for sexually abused adult males. Copyright © 2005 John Wiley & Sons, Ltd.     

Pivotal partings: Forced termination with a sexually abused boy

The termination phase of therapy is an integral part of the treatment process engendering its own unique set of dynamics. However, the potential eruption of new material dislodged by the trauma of the impending loss may in some cases require a reassessment of discharge goals and consequent alteration of treatment modality. The likelihood of new material surfacing at this critical juncture is perhaps highest among the caseloads of therapist trainees, wherein the termination date is forced by the time-limited nature of the learning contract. In the following article, supervisor and trainee detail the process of therapeutic shift from a dynamic to a crisis-oriented modality in the case of a young boy whose central trauma emerged during termination.     

The impact of childhood abuse and neglect on adult mental health: a prospective study

This paper examines the impact of three types of victimization in childhood--sexual abuse, physical abuse, and neglect--on lifetime measures of mental health among adults. In contrast to research that relies on retrospective recall of childhood victimization, this work uses a prospective sample gathered from records of documented court cases of childhood abuse and neglect in a midwestern city around 1970. These subjects were interviewed about twenty years later. In addition, this research compares outcomes of the 641 members of the abuse and neglect group with a matched control group of 510 persons who did not have documented cases of abuse or neglect. The results indicate that men who were abused and neglected as children have more dysthymia and antisocial personality disorder as adults than matched controls, but they did not have more alcohol problems. Abused and neglected women report more symptoms of dysthymia, antisocial personality disorder, and alcohol problems than controls. After controlling for stressful life events, however, childhood victimization had little direct impact on any lifetime mental health outcome. This research indicates the importance of adopting an approach that places childhood victimization in the context of other life stressors and of prospective changes over the life course.     

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.     

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.     

Disordered eating in college freshman women: a prospective study

The authors assessed eating behaviors and attitudes of 225 college freshman women on the bulimia and restraint scales at the beginning of the year. Seven months later, they reassessed 104 of the original students. Concurrent data regression analyses found that symptoms of eating pathology were associated with figure dissatisfaction, ineffectiveness, public self-consciousness, and vigor on the Profile of Mood States, and for bulimia, self-efficacy to control eating when experiencing negative feelings, and reward conditions. Both bulimia and restraint were highly stable across the 7 months. Prospective analyses, controlling for the initial level of eating pathology in hierarchical regressions, found that figure dissatisfaction, ineffectiveness, and alcohol use/abuse over the past year were significant predictors of worsening symptoms. Beginning levels of bulimia and restraint were the best predictors of eating pathology at the end of the study. The roles that self-image and alcohol use may play as vulnerabilities for eating pathology are also considered.     

Efficacy of a group therapy for sexually abused adolescent girls

The effects of a group therapy program for teenage girls reporting child sexual abuse were evaluated by means of a pretest/ post-test design with a control group. The psycho-educational intervention consisted of an average of 20 weekly two-hour meetings. Results of the repeated analyses of variance (ANOVA) revealed a significant improvement in youth participating in the therapy when compared with the control group on measures of post-traumatic stress, internalizing and externalizing behavior problems, coping strategies, relationship with the mother, and sense of empowerment. The findings suggest that the group therapy offered by the Centre d'Intervention en Abus Sexuels pour la Famille (CIASF) was effective in reducing symptoms for sexually abused teenagers.     

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.     

Group therapy with sexually abused boys: Notes toward managing behavior

This article examines the gender-specific defense mechanisms of sexually abused boys as they emerge in group therapy, using Finkelhor's model of traumagenic dynamics. Concrete interventions address the acting out behavious that are typical for this population, connecting the acting out behaviors to the boys' common background of sexual abuse. Without these concrete interventions to address the unsafe, aggressive behaviours of sexually abused boys, their problems and experiences cannot be shared, nor can the group therapist address the issues outlined in a curriculum for group therapy for sexually abused children.     

Internet use among college students: an exploratory study

The author and associates surveyed 1,300 college students in classrooms at eight academic institutions to identify how the students' use of the Internet has affected their social or academic lives. Although the typical Internet-using student uses the Internet for 100 minutes per day, a small group of students use the Internet to a degree that interferes with other aspects of their lives. Most of them are men and are found among the hard science academic majors. Some ideas for dealing with this problem are suggested.     

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.     

The relationship between psychic reality and trauma with special reference to an adult patient who was sexually abused as a child

Theory is an important tool in our efforts to gain access to a deeper understanding of what truth and reality are for a particular client. However, because any theoretical perspective cannot fully account for the data, it also limits our capacity to both understand and treat the problems our clients present to us. The thesis of this paper is that current social work practice theories overemphasize the role of external factors and down-play the importance of psychic reality when explaining the causes of human malaise. Such a bias is tantamount to a countertransference enactment which elevates a common client fantasy to the status of a scientifically derived truth. Both parties in the treatment relationship tend to see the client as a helpless victim of powerful external forces while defensively disclaiming personal involvement in creating problems. This paper explores the implications of this bias for the diagnosis and treatment of adult survivors of childhood sexual abuse. The paper also presents clinical material illustrating the subtle interaction of fantasy and trauma in the treatment of an adult female who was sexually abused by her father.     

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.     

A prospective study of sexual assault and alcohol use among first-year college women

This study prospectively examined the relation between alcohol use and sexual assault in a sample (N = 319) of first-year college women. Both frequency of drinking and frequency of binge drinking were measured. Over the course of their freshman year, 19.3% reported experiencing at least one sexual assault. Frequent binge drinking and frequent drinking predicted a subsequent sexual assault; however, experiencing a sexual assault did not predict changes in alcohol use. Frequent binge drinking demonstrated a stronger association with sexual assault than did frequent drinking. Findings help clarify the relation between alcohol use and sexual assault in college women and call for continued differentiation in assessment of alcohol use.     

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.     

Signs of resilience in sexually abused adolescent girls in the foster care system

In a sample of 99 sexually abused adolescent girls in the foster care system (64% in congregate living situations and 36% in family/foster care homes), nearly half were psychologically functioning well despite having experienced moderate-to-severe emotional, physical, and sexual abuse. It was hypothesized that these girls with resilient trajectories would differ from the currently symptomatic girls on several protective factors: education, future orientation, family support, peer influence, and religion. The results revealed that the girls with resilient trajectories were significantly more certain of their educational plans and optimistic about their future and had more positive peer influences.