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.     

The Indirect Effect of Child Maltreatment Severity on Adult PTSD Symptoms through Anxiety Sensitivity

Although the rate of posttraumatic stress disorder (PTSD) among survivors of child maltreatment is high, individuals differ in symptom severity and many do not experience clinically significant levels of psychopathology. The present study tested the indirect effects of child maltreatment severity on adult PTSD, suicidal ideations, and alcohol dependence via anxiety sensitivity. A sample of 336 participants (mean age of 22.81 years, SD = 8.93; 70.2% female) completed an online survey of child abuse and neglect, anxiety sensitivity, PTSD symptom severity, suicidal ideation severity, and alcohol dependence severity. The results revealed significant indirect effects of child maltreatment on PTSD symptom severity through cognitive and social concerns, but not physical concerns. No direct or indirect effects were demonstrated for suicidal ideations or alcohol dependence severity. These findings elucidate mechanisms in the robust relationship between child maltreatment and adult PTSD symptoms and can potentially inform future research on mechanisms of change in psychotherapy.     

Ethnicity and child sexual abuse experiences of female college students

This research examines the understudied issue of race/ethnicity in relation to child sexual abuse experiences (CSA) in a cross-sectional convenience sample of 461 female college students completing a survey. Comparisons of students' abuse experiences revealed ethnic differences in sexual abuse prevalence, severity of abuse, the victim- offender relationship and post-abuse coping. Black students reported more sexual abuse than other ethnic groups, followed by Hispanics, Whites, and Asians. Although timing and extent of disclosure of sexual abuse did not vary by ethnicity, negative social reactions to disclosure were more common for certain ethnic groups than others. No ethnic differences emerged for depressive or PTSD symptoms. Implications are drawn for future research on the issue of ethnic differences in the aftermath of CSA experiences.     

Perpetration,Revictimization, and Self-Injury: Traumatic Reenactments of Child Sexual Abuse in a Nonclinical Sample of South African Adolescents

Risk factors for traumatic reenactments of child sexual abuse experiences (perpetration, revictimization, and self-injury) were examined in a sample of 718 South African secondary school adolescents. Logistic regression analyses indicated that the most consistent predictors of reenactments were a history of child sexual abuse (rape and/or indecent assault) and respondents’ gender, with males being significantly more likely than females to report perpetration (OR = 13.5) and females being more likely to report revictimization (OR = 3.2) and self-injury (OR = 2.5). An analysis restricted to respondents with a history of child sexual abuse indicated that negative abuse-related cognitions were the most consistent predictor of all forms of traumatic reenactment.     

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.     

The relative effects of intimate partner physical and sexual violence on post-traumatic stress disorder symptomatology

This study examined the relative effects of intimate partner physical and sexual violence on Post-Traumatic Stress Disorder (PTSD) symptomatology. Severity of physical and sexual violence as well as PTSD severity were assessed in a sample of 62 help-seeking battered women. The results of this study were consistent with prior research, finding significant and positive relationships between physical and sexual violence as well as sexual violence and PTSD symptoms. In order to further clarify these relationships, the unique effects of sexual violence on PTSD were examined after controlling for physical violence severity. Results indicated that sexual violence severity explained a significant proportion of the variance in PTSD severity beyond that which was already accounted for by physical violence severity. These findings have important implications for mental health and social service professionals who work with battered women.     

What Lies Beneath: Trauma Events,PTSD, and Alcohol Misuse in Driving Under the Influence Program Clients

The prevention and reduction of alcohol misuse is one of the Grand Challenges of Social Work. Addressing client needs beyond alcohol misuse can improve client outcomes. Driving under the influence program clients (N = 1,248) were screened for trauma events and posttraumatic stress disorder (PTSD). Results found that males more often reported having been assaulted with a weapon or that they caused injury to someone else. Females more often reported sexual assault and other unwanted sexual experience. About 26% overall screened positive for PTSD. Social workers need to be alert to various types of trauma and help clients identify the connection between trauma and alcohol misuse.     

Traumatic Responding in Children Exposed to Domestic Violence

Abstract

The present cross-cultural study summarizes the traumatic responses of Mexican, Mexican American, and non-Mexican American children who were residents of three shelters for battered women in Monterrey Mexico, McAllen Texas, and Ft. Worth Texas. Sixty-eight mothers reported on their children's (n = 90) individual and total traumatic symptoms. Findings revealed very slight differences in individual responses with no overall trauma symptom differences. Multiple regression analyses revealed that mothers' experiences of physical, and sexual abuse predicted greater trauma responses in children. Implications for practice with children and mothers in shelters for battered women are highlighted.     

CHILDHOOD SEXUAL ABUSE AND COUPLES' RELATIONSHIPS: FEMALE SURVIVORS' REPORTS IN THERAPY GROUPS

Therapy videotapes from five therapy groups for female child sexual abuse (CSA) survivors were analyzed for emerging themes of couples' difficulties reported by clients. Subsequently, the thematic categories were applied to sessions selected from an additional four groups and then correlated with CSA-specific variables. The two most frequent relationship themes were difficulties with emotional communication or intimacy, and polarized positions on control. Whereas these two themes were correlated with survivors' CSA characteristics, sexual difficulties were correlated with survivors' level of current traumatic symptomatology. Results are discussed in terms of implications for the treatment of CSA survivors and their partners.     

Posttraumatic stress disorder among foster care alumni: the role of race, gender, and foster care context

Little is known about the prevalence of posttraumatic stress disorder (PTSD) in adult alumni of foster care and its demographic and contextual correlates. This is one of the first studies to report on racial/ethnic and gender differences and the influence of foster care experiences (i.e., revictimization during foster care, placement change rate, and placement in kinship care) on past year PTSD. Findings revealed significant gender disparities and a moderating influence of kinship care on the relationship between gender and PTSD, as well as increased risk associated with a history of emotional and sexual abuse. Recommendations are made for clinical and systemic intervention.     

Relationship to perpetrator, disclosure, social reactions, and PTSD symptoms in child sexual abuse survivors

This research examined victim relationship to the perpetrator, disclosure characteristics, social reactions, and PTSD in adult survivors' of child sexual abuse (CSA) identified in a convenience sample of 733 college students. Results indicated that relationship to the perpetrator was related to CSA characteristics and outcomes. More negative reactions such as disbelief were observed for those victimized by relatives compared with acquaintance and stranger victims, especially for those disclosing in childhood. Victims of relatives had more PTSD symptoms if they delayed disclosure, received more negative reactions in childhood, and engaged in self-blame at the time of the abuse. Results are discussed in the context of Freyd's (1996) betrayal trauma theory, in order to better understand the traumatic impact of CSA.     

Training Mental Health Professionals in Child Sexual Abuse: Curricular Guidelines

This study explored whether counseling practices with women survivors of child sexual abuse reflect the belief that women do not sexually abuse children. Canadian therapists (n?=?164) who work with women survivors of child sexual abuse were surveyed about their beliefs about what constitutes child sexual abuse, who commits child sexual abuse, and their practices regarding inquiries about abusive behavior. A majority self-reported that they ask women and think it is important to ask but most believe that clients will not spontaneously self-disclose inappropriate sexual thoughts or behaviors. How broadly or narrowly therapists defined child sexual abuse was not related to self-reported therapeutic discussion. Therapists demonstrated differential gender beliefs about child sexual abuse perpetration, but this did not relate to self-reported counseling practices. Implications for therapist education are discussed.     

Impact of Traumatic Events on Posttraumatic Stress Disorder among Danish Survivors of Sexual Abuse in Childhood

Childhood sexual abuse can be extremely traumatic and lead to lifelong symptomatology. The present study examined the impact of several demographic, abuse, and psychosocial variables on posttraumatic stress disorder severity among a consecutive sample of treatment-seeking, adult child sexual abuse survivors (N = 480). The child sexual abuse sample was characterized by severe trauma exposure, insecure attachment, and significant traumatization, with an estimated 77% suffering from posttraumatic stress disorder, more than twice the level of the comparison group. Regression analyses revealed risk factors associated with the development of posttraumatic stress disorder in which the strongest predictors being additional traumas, negative affectivity, and somatization. The findings add to existing research confirming the stressful nature of child sexual abuse and the variables that contribute to the development and severity of posttraumatic stress disorder.     

Post-traumatic Stress Disorder in Childhood Sexual Abuse: A Synthesis and Analysis of Theoretical Models

The notion that post-traumatic stress disorder (PTSD) may be found in children who have experienced sexual abuse has become an important issue in research and clinical practice. To date however, there is a lack of consensus on what theoretical model(s), if any, best account for PTSD within this population. As a way of contributing to the existing body of literature pertaining to PTSD and its relationship to childhood sexual abuse, this paper synthesizes and presents a critical analysis of contemporary theoretical models.     

The Relationship Between Childhood Sexual Abuse and Sexual Dysfunction in Jamaican Adults

This study examined the associations between early traumatic sexualization and later sexual dysfunction in a sample of 100 Jamaican adults while identifying the linkages between age, frequency of abuse, and gender on sexual functioning. Participants were selected via purposive and convenience sampling and divided equally into comparison and experimental groups based on sociodemographic characteristics. Results indicated that childhood sexual abuse is a likely factor in the development of sexual dysfunction in Jamaican adults, especially in the domains of Orgasm and Sexual Drive and Relationship. Gender, frequency, and age of abuse are also seen to impact specific areas of an individual's sexual functioning. Results are discussed in light of previous research for their implications in order to better understand sexuality in the Jamaican context.     

Re-Collections of Childhood Sexual Abuse: A Biopsychosocial Perspective

A number of theories—biological, psychological, and sociological—inform clinical practice with adults who report memories of childhood sexual abuse. However, each of these theories is inadequate in and of itself. This has several, potentially damaging clinical implications. Therapists might doubt the validity of their clients' reports of traumatic incidents, they may place too heavy an emphasis on the recollection of traumatic events, or they may shy away from discussing these events. Any of these responses can jeopardize the helping relationship, leaving clients without professional assistance in managing a most difficult emotional situation. This paper provides a review of the biological, psychological, and sociological perspectives that lie at the foundation of current practice. These perspectives are then integrated via social work's biopsychosocial perspective. This holistic view provides an empirical base for effective, ethical social work. Specific practice implications are discussed.     

Providing sexual education to victims of child sexual abuse:what is a clinician to do?

Despite the large body of research on childhood sexual abuse, virtually no one has examined the coverage of sexual education in treatment. Agencies from across the United States that specialize in treating child and adolescent victims of sexual abuse were surveyed. The results indicate that sexual education is covered in treatment with children of all ages, with male and female clients, and in both individual and group therapy. There was a statistically significant difference in the coverage of sexual education based on clients' age, but not based on gender or treatment modality. Parents are often included in treatment; however, the amount of parental involvement varies. Published materials, such as children's books and videos, are frequently used. Participants (i.e., clinicians) are satisfied with their coverage of sexual education in treatment even though clients often experience negative reactions. Results suggest that covering sexual education in treatment helps decrease some of the negative effects of sexual abuse. This study also serves as a test of Dillman's Total Design Method of conducting mail surveys.     

Cognitive behavioural psychotherapy intervention in childhood sexual abuse: identifying new directions from the literature

The short‐ and long‐term consequences of childhood sexual abuse have been extensively reported. However, for many years there has been an absence of psychological conceptual frameworks for understanding and treating abuse trauma symptoms. This paper reviews a number of outcome studies for the treatment of child sexual abuse where a post‐traumatic stress disorder (PTSD) conceptualization was used to plan treatment interventions. The paper concludes that, contrary to some concerns expressed by clinicians, sexually abused children and their non‐abusing carers can signi?cantly bene?t from cognitive behavioural interventions which use reliving and confrontation of the abusive experience. Notwithstanding this, there is a need for further controlled outcome research of cognitive behavioural interventions using reliving techniques to explore how and why these interventions help in reducing abuse‐related PTSD symptoms. Copyright © 2004 John Wiley & Sons, Ltd.     

The Effect of Severe Child Sexual Abuse and Disclosure on Mental Health during Adulthood

This study examined the relationship among severe child sexual abuse, disclosure, and mental health symptoms during adulthood. The sample consisted of 172 adults who were sexually abused in childhood. The multivariate model showed that respondents in their 30s and 40s who were abused by more than one abuser, who were injured by their abusers, who were abused by a biological relative, who told someone about the abuse when it occurred, and who did not discuss their abuse in depth within one year of the abuse had a greater number of mental health symptoms. Abuse severity and disclosure history should be assessed by professionals to identify clients who are at higher risk of mental health symptoms and to focus therapy.     

From behind the shadows: a profile of the sexual abuse of older men residing in nursing homes

Previous research on the sexual abuse of older adults has revealed few cases of the sexual abuse of older men. The first national study of the sexual abuse of vulnerable adults in facilities, reported in this article, collected data on alleged, investigated, and substantiated cases of sexual abuse. This study revealed 26 cases reported and screened in for investigation concerning the alleged sexual abuse of older men (aged 50 and older) residing in nursing homes. Cases occurred in five states within a six month time period. Of these cases, six were confirmed upon investigation by Adult Protective Services or other regulatory agencies. Victims tended to be predominantly white males with cognitive and physical deficits that limited their ability for self care. The most typical sexual abuse alleged and substantiated was fondling. Residents were more often substantiated as the abuser than other perpetrators. Sexual abuse of older men in nursing homes crosses traditional gender, cultural, and role boundaries for both victims and perpetrators.