Disabled Women Sexually Abused in Childhood: Treatment Considerations

There is a dearth of literature addressing the issues presented in the treatment of adult disabled women who were victims of childhood sexual abuse. This article focuses on the pertinent issues involved in clinically treating this population, such as the meaning of the traumatic event of sexual abuse for the individual, the disability and how it may have impacted her in terms of dependence, body integrity, and sexuality. Coping strategies and case examples are presented and possible countertransferential reactions are examined.     

Maternal victimization and child trauma: The mediating role of mothers' affect

This study examined the effects of maternal childhood and adult victimization on child trauma symptomatology both directly and indirectly via three types of maternal affective problems as mediators (depression, anxiety, and hostility). A high proportion of mothers in the sample reported a history of childhood or adulthood physical and sexual abuse and findings showed that these experiences impacted how victimized women may function as parents. Mothers' adult victimization had a stronger effect on children compared to maternal childhood victimization. The relationship between maternal adult victimization and child trauma symptoms was mediated by maternal depression. Maternal anxiety mediated the relationship between both maternal childhood and adulthood victimization and child trauma symptoms, but anxiety played a buffering role. Maternal hostility was associated with both childhood and adulthood victimization, but did not serve as a mediator. Implications for practice with victimized mothers and their children are discussed.     

Exploring Posttraumatic Outcomes as a Function of Childhood Sexual Abuse

There is sparse systematic examination of the potential for growth as well as distress that may occur for some adult survivors of childhood sexual abuse. The presented study explored posttraumatic growth and its relationship with negative posttrauma outcomes within the specific population of survivors of childhood sexual abuse (N = 40). Results showed that 95% of the participants experienced clinically significant post-traumatic stress disorder symptomatology related to their childhood sexual abuse. In conjunction with these high levels of negative symptoms, the population evidenced posttraumatic growth levels that were comparable to other trauma samples. This research has clinical relevance in terms of adding to the knowledge base on sexual abuse and the usefulness of this knowledge in therapeutic interventions and relationships.     

Psychiatric Symptoms and Same-Sex Sexual Attraction and Behavior in Light of Childhood Gender Atypical Behavior and Parental Relationships

This study explores the relation between the level of current symptoms of depression and anxiety and recalled childhood gender atypical behavior (GAB), and quality of relationships with parents among men and women who reported same-sex sexual attraction or engaged in same-sex sexual behavior and men and women who did not. Matched pairs, 79 men (n = 158) and 148 women (n = 296), with equal levels of GAB were created of Finnish participants with either same-sex sexual attraction or behavior and participants without. The measures used were retrospective questionnaires. Ratings of maternal and paternal over-control and coldness differed as a function of same-sex sexual attraction or behavior. Childhood GAB was correlated with negative ratings of parental relationships. Both same-sex sexual attraction or behavior and a history of childhood GAB affected the reported levels of current depression and anxiety. Only gender typical participants with no same-sex sexual attraction or behavior reported significantly lower levels of symptoms. The findings suggest that childhood GAB is related to later distress both among hetero- and homosexual individuals. The elevated level of psychological distress among homosexual individuals, reported in several studies, might—to some extent—be caused by their generally higher levels of childhood GAB as opposed to a homosexual orientation per se.     

Acute stress reactions to everyday stressful life events among sexual abuse survivors with PTSD

This study examined symptoms of Acute Stress Disorder (ASD), which is often thought of as a precursor to PTSD, among 54 women who already had PTSD for childhood sexual abuse for which they were seeking treatment. We examined the prevalence of ASD symptoms as well as their relationships to trauma symptoms measured by the Trauma Symptom Checklist-40. The ASD diagnosis requires the occurrence of a traumatic life event as well as meeting specific symptoms criteria. We found that fourty-four percent of participants met all symptom criteria for ASD, but only three of these 24 participants described a traumatic life event. Moreover, ASD symptoms were significantly related to trauma symptom scores. These findings suggest that a significant proportion of women with PTSD for childhood sexual abuse may be highly symptomatic for everyday stressful events that would not be experienced as traumatizing to others. Thus, these individuals need assistance in coping with everyday life stressors that do not involve a serious threat or injury in addition to needing help to alleviate their trauma symptoms.     

Some correlates of women's childhood sexual experiences: A retrospective study

Relatively few empirical studies have addressed long‐range effects of childhood sexual experiences. This study examined the relationships of various childhood sexual experiences to adult functioning in five areas: (a) family relations, (b) depression, (c) marital satisfaction, (d) sexual satisfaction, and (e) self‐esteem. A retrospective survey was conducted with a sample of 501 predominantly middle‐class women. No clinical or offender populations were used. Five standardized scales were used as dependent variables. On none of the five variables were the scores of women with childhood sexual experiences significantly different from those of women with no childhood sexual experiences. However, the interactions of negative experiences, such as the use of force and abusive behavior, with the type of partner, such as a parent or other relative, were significantly associated with adult functioning. Some of the findings challenge commonly held beliefs and have far‐reaching implications for the helping professions and others who study human sexuality.     

Systemic effects of trauma in clinic couples: an exploratory study of secondary trauma resulting from childhood abuse

Clinical literature suggests that those close to a trauma survivor may experience intrapersonal and interpersonal distress because of indirect or secondary effects of the trauma. The focus of this study is on the association between reported childhood physical and sexual abuse and current individual stress symptoms, relationship satisfaction, and family adjustment. The participants included 96 clinic couples who reported a history of childhood physical or sexual abuse in one or both partners and 65 clinic couples in which neither partner reported such abuse. Couples in which one or both partners reported childhood abuse reported significantly lower marital satisfaction, higher individual stress symptoms, and lower family cohesion than couples with no abuse history. No significant differences were found between individuals who reported a history of abuse and their partners who reported no history of childhood abuse, suggesting support for secondary trauma theory. Clinical and future research implications are discussed.     

Re-traumatization among adult women sexually abused in childhood: exploratory analyses in a prospective study

The current exploratory study examined a variety of risk factors related to re-traumatization, defined broadly, in a prospective sample of women who were sexually abused in childhood. Eighty women, who were part of a larger longitudinal study of the effects of child sexual abuse, were interviewed at three points in time: in childhood and at two points in early adulthood. Risk factors were measured at the second interview and used to predict reported trauma exposure between interviews two and three. Given theoretical arguments for differences in risk factors based on ecological context, analyses were conducted separately for married and unmarried women. Situational and intrapersonal risk factors such as homelessness and depression were predictive of re-traumatization risk while reported social support satisfaction was a protective factor. Reports of trauma exposure between interviews two and three were related to mental health symptoms.     

Traumatic symptomatology characteristics of adult children of alcoholics

Traumatic experience symptomatology, resiliency factors, and stress among young adults who had experienced alcoholism within their family of origin were assessed in comparison to adults who as children experienced traumatic life events other than alcoholism and those who indicated neither problem (parental alcoholism or traumatic life event) during their childhood. These three groups were compared on self-report measures of stress, resiliency, depressive symptomatology, and trauma symptoms. Results indicated adult children of alcoholics (ACOA) had more self-reported stress, more difficulty initiating the use of mediating factors in response to life events, and more symptoms of personal dysfunction than the control group. Results suggest ACOAs may develop less effective stress management strategies and present more clinically at-risk patterns of responses than their counterparts.     

Controlling Anxiety Mediates the Influence of Childhood Adversities on Risky Sexual Behaviors Among Emerging Adults

Relatively little research has assessed the exposure-response relationship of childhood adversities on engaging in risky sexual behaviors. Also, no previous research has examined the interrelationship among childhood adversities, adult anxiety and depressive symptoms, and risky sexual behaviors. This study aimed to investigate their interrelationships. We used data from a multisite survey of emerging adults aged 18 to 29 studying at four universities in Hong Kong between September and December 2015. Structural equation modeling (SEM) was used to examine the pathways from childhood adversities to risky sexual behaviors. Participants who had higher childhood adversity scores reported more severe adult anxiety symptoms (β = 0.20, p = 0.002); and adult anxiety symptoms were associated with significantly more risky sexual behaviors (β = 0.46, p < 0.0001). The model with adult anxiety symptoms as the mediator between childhood adversities and risky sexual behaviors showed good fit (root mean square error of approximation [RMSEA] = 0.04, comparative fit index [CFI] = 0.96, Tucker-Lewis index [TLI] = 0.94 and standardized root mean square residual [SRMSR] = 0.04). However, adult depressive symptoms failed to mediate between childhood adversities and risky sexual behaviors. This study demonstrates the link between childhood adversities and risky sexual behaviors via adult anxiety but not adult depressive symptoms. It is essential to reduce anxious symptoms in dealing with emerging adults who have risky sexual behaviors to prevent sexually transmitted infections (STIs) and unintended pregnancy.     

Risky Sexual Behaviors and Pregnancy Outcomes in Young Adulthood Following Substantiated Childhood Maltreatment: Findings From a Prospective Birth Cohort Study

Childhood maltreatment is associated with a range of adverse mental and physical health outcomes, including increased rates of sexually transmitted infections (STIs) later in life. However, the impact on risky sexual behaviors and pregnancy outcomes has not been adequately studied. This is particularly true for physical abuse, emotional abuse, and neglect. We examined associations between prospectively substantiated childhood maltreatment and reports of risky sexual behaviors by men and women, as well as selected pregnancy outcomes in women. We followed up 3,081 (45.7% female) participants from the Mater-University of Queensland Study of Pregnancy, a prospective Australian birth cohort study. Using logistic regression, we examined the association between substantiated childhood maltreatment from birth to 14 years, and self-reported risky sexual behaviors and youth pregnancy outcomes at the 21-year follow-up. In adjusted analyses, children who had experienced multiple childhood maltreatment exhibited more risky sexual behaviors than their nonmaltreated counterparts. In specific models, those exposed to each form of childhood maltreatment, independent of co-occurring forms of childhood maltreatment, had an increased likelihood of risky sexual behaviors, particularly an early sexual debut and, for women, youth pregnancy. Neglect was also associated with multiple sexual partners, and emotional abuse with higher rates of miscarriage. There was no difference between men and women in how different forms of childhood maltreatment predicted risky sexual behaviors in young adulthood. All forms of substantiated childhood maltreatment, including multiple substantiations, were associated with risky sexual behavior in both sexes as well as higher rates of youth pregnancy in women. Moreover, emotional abuse persistently predicted miscarriages in young adult women. Understanding the association between childhood maltreatment and risky sexual behaviors and youth pregnancy outcomes may help suggest preventive strategies.     

Emotionally Focused Therapy for couples and childhood sexual abuse survivors

This study explored Emotionally Focused Therapy (EFT) for couples with childhood sexual abuse survivors (CSA) and their partners. Half of the couples in this study reported clinically significant increases in mean relationship satisfaction and clinically significant decreases in trauma symptoms, and thematic analyses identified numerous areas where trauma survivors were challenged in fully engaging in the therapy process. In particular, trauma symptoms such as affect dysregulation and hypervigilance were identified to play a role in the challenges that survivors experienced in fully engaging in the EFT process. Results of these thematic analyses yielded clinical recommendations for working with CSA survivors and their partners in EFT for traumatized couples. Recommendations for future study were articulated.     

Personality disorders, coping strategies, and posttraumatic stress disorder in women with histories of childhood sexual abuse

Using a treatment-seeking sample of adult female survivors of childhood sexual abuse, the relationships between coping strategies, personality disorders (PD) and Posttraumatic Stress Disorder (PTSD) were explored. A variety of PDs were found to exist in this population, with avoidant, antisocial, dependent PDs having higher frequencies than borderline PD. Avoidant coping and PTSD severity significantly correlated with many of these PDs. PTSD severity and avoidant coping were also significantly correlated. Additionally, women with PTSD displayed higher rates of avoidant and dependent PDs, as well as more avoidant coping, than did women without PTSD. Results support a more complex conceptualization of the trauma-related symptoms that occur in adult survivors of childhood sexual abuse that incorporate the relationships between avoidant coping, personality disorders, and PTSD.     

Long‐Term Physical Health Consequences of Adverse Childhood Experiences

This study examined associations between adverse childhood family experiences and adult physical health using data from 52,250 U.S. adults aged 18 to 64 from the 2009 to 2012 Behavioral Risk Factor Surveillance System. We found that experiencing childhood physical, verbal, or sexual abuse, witnessing parental domestic violence, experiencing parental divorce, and living with someone who was depressed, abused drugs or alcohol, or who had been incarcerated were associated with one or more of the following health outcomes: self‐rated health, functional limitations, diabetes, and heart attack. Adult socioeconomic status and poor mental health and health behaviors significantly mediated several of these associations. The results of this study highlight the importance of family‐based adverse childhood experiences on adult health outcomes and suggest that adult socioeconomic status (SES) and stress‐related coping behaviors may be crucial links between trauma in the childhood home and adult health.     

Association between physical partner violence, posttraumatic stress, childhood trauma, and suicide attempts in a community sample of women

Our objective was to estimate the prevalence of intimate partner violence (IPV) and to explore its association with childhood maltreatment, substance misuse, posttraumatic stress, and suicidal behavior in a representative community sample of women. IPV was operationalized as a "physical attack or beating by a spouse, boyfriend, or live-in partner." We surveyed 637 women in Memphis, Tennessee, by telephone survey. Sixteen percent reported ever experiencing IPV by a male partner, and 75% endorsed multiple assaultive acts. Of abused women, 5.9% met current PTSD diagnostic criteria, and an additional 11.8% were assessed with subthreshold symptoms. Abused women were more likely than other women to be divorced, to have less than 13 years education, to endorse high levels of childhood victimization, to have abused drugs and alcohol, and to have attempted suicide. Twenty-three percent of IPV+ (abused) women reported a suicide attempt at some time in their lives compared with 3% of IPV- (nonabused) women (p < .0001). Further, multiple logistic regression analysis showed that childhood sexual and emotional abuse and low educational attainment were the only significant predictors of IPV. These results suggest that in women who endorse IPV, careful inquiry of past abuse, trauma-related symptoms, suicidal behavior, and drug use may be important, so that interventions can be both timely and appropriate.     

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.     

Prevalence of Sexual Trauma History Using Behaviorally Specific Methods of Assessment in First Year College Students

There are several challenges associated with evaluating the prevalence of sexual trauma, including child sexual abuse and adult sexual assault. The aim of this study was to assess sexual trauma prevalence rates among first year college students (N = 954) using behaviorally specific questions and a more representative recruitment sample that did not rely on self-selection. Participants completed a list of sexual trauma questions, including general questions containing labels such as “rape” or “abuse” as well as behaviorally specific questions that describe specific behaviors that qualify as sexual trauma without labels. Results indicated that 6.7% of the sample reported at least one incident of child sexual abuse, with similar rates for men and women. Women were more likely to report a history of adult sexual assault, which was reported by 12.4% of the total sample. Participants were also more likely to endorse a history of sexual trauma when answering behaviorally specific rather than general “label” questions. Women survivors in particular were more likely than men to identify their experiences as abuse/assault (66.7% versus 21.1% for child sexual abuse), which may help explain prevalence differences between men and women in prior research. Men may be less likely than women to label their experiences as abuse and may be underidentified in sexual trauma research without the use of behaviorally specific questions. Overall, the results of this study suggest that the prevalence of sexual trauma is better assessed using behaviorally specific questions and that this is an important topic of study among both men and women.     

Intimate sexual victimization among women with protective orders: types and associations of physical and mental health problems

Intimate sexual violence was examined among a sample of women who had recently obtained protective orders against male partners using three groups: no sexual victimization (n = 368), sexual insistence (n = 114), and threatened and/or forced sex (n = 117). Differences in childhood sexual abuse as well as types of partner psychological abuse, stalking, and severe physical violence experiences were found across the groups. Multivariate analysis showed that women with no sexual victimization had significantly fewer mental health problems than women who had experienced sexual insistence and women who had been threatened or forced to have sex. Findings from this study underscore the importance of health, mental health, and criminal justice professionals assessing for a range of sexually abusive acts when working with victims of partner violence.     

Women Reentering the Community: Understanding Addiction and Trauma-Related Characteristics of Recidivism

Women represent 26% of those arrested for serious crimes; many have posttraumatic stress and co-occurring substance use disorders, which may influence recidivism. This study examined 57 women residing in a community re-entry program after exiting prison. Participants completed the Trauma Symptom Inventory and Substance Abuse Subtle Screening Inventory. A discriminant function analysis accounted for 34% of between-group variability and provided a profile of women who recidivated. Women who recidivated had greater alcohol dependence and lower rates of sexual dysfunction and sexual concerns. Practitioners should consider potential links between substance abuse, trauma, and sexual behavior in treatment settings.     

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.