Family environment in Hispanic college females with a history of childhood sexual abuse

This study sought to examine the family environments of a sample of Hispanic women who reported childhood sexual abuse. Eighteen women, taken from a larger college sample, were individually interviewed and administered the Family Environment Scale (FES; Moos & Moos, 1994). Cultural values and the relationship of family characteristics to the individual's experience of sexual abuse were explored. The abused women obtained significantly higher scores on the Achievement-Orientation subscale of the FES than the normative group. Qualitative data revealed some patterns in these families regarding sexual discussions and poor conflict resolution skills. Implications for treatment of Hispanic victims are discussed.     

Resiliency factors in the relation between childhood sexual abuse and adulthood sexual assault in college-age women

Research has suggested that childhood sexual abuse (CSA) may be a risk factor for adulthood sexual assault. This study examined associations between CSA experiences, cognitive resiliency variables, and revictimization. Participants were 73 college-age females who completed self-report questionnaires assessing CSA, adult assault, self-efficacy, locus of control (LOC), and coping styles. Sexual assault was categorized as forced or coerced assault based on the tactics used by the perpetrator. Results indicated that CSA alone was the strongest independent predictor of forced adult assault; however, LOC and positive coping were associated with resiliency to coercive sexual assault. The current findings have clinical implications in that LOC and coping styles are characteristics that can be enhanced through therapy.     

Psychiatric comorbidity in women with a history of childhood sexual abuse

Childhood sexual abuse (CSA) is associated with the development of numerous adult mental disorders. Women with a history of CSA were surveyed concerning their abuse experience and prevalence of DSM-IV mental disorders. The 63 women in the low morbidity cluster had a mean of 1.02 disorders. The 11 women in the moderate morbidity cluster had a mean of 2.36 disorders. The 16 women in the severe morbidity cluster had a mean of 4.75 disorders. Childhood family environment and CSA during preschool years were important predictors of morbidity cluster membership.     

Partner awareness regarding the adult sequelae of childhood sexual abuse for primary and secondary survivors

This qualitative study investigates factors that may facilitate or impede awareness within couples regarding the sequelae of childhood sexual abuse for adult females and their partner. Six couples were interviewed about perceived effects of the abuse for self and partner and their perceptions regarding their awareness of these effects. Transcribed data were analyzed using grounded-theory methodology. Emergent themes regarding potential barriers to and facilitators of agreement are outlined in the context of the expressive and receptive abilities and motivations of each partner in communicating about the abuse. Preliminary implications for marriage and family therapy and further research are provided.     

Exploring the link between sexualized behaviour and sexual abuse in a clinical setting

This study examined the issue of sexualized behaviour in children as an indicator of sexual abuse. The purpose was to develop alternative explanations for sexualized behaviour if sexual abuse was not confirmed or suspected. Other possible explanations explored were the presence of frequent disruptions to family life, previous unresolved exposure to sexual abuse or contact with a sexualized child. Data were collected on 81 cases of sexualized behaviour referred to a specialist child protection assessment unit over a 7‐year period. It was found that in very few cases was sexual abuse considered an explanation for the sexualized behaviour. Of the remaining cases, a substantial number showed evidence of family disruption, which could lead to sexualized behaviour developing as a comforting response for the child. Furthermore, a number of children also had experienced sexual abuse in the past, which might have been unresolved for the child, or had contact with another sexualized child, and this might have accounted for their behaviour. It would appear that many of the children were facing difficulties in their lives and might require therapeutic intervention, even if concerns about recent sexual abuse had been allayed. Copyright © 1999 John Wiley & Sons, Ltd.     

Efficacy of a group intervention for adult women survivors of sexual abuse

This study evaluates the effects of a group intervention for women sexually abused in childhood or adulthood. The sample consisted of 41 women involved in a group intervention based on a feminist approach offered by help centers for sexual assault victims in Quebec and 11 women in a wait-list comparison group. Results reveal that the group intervention reduced psychological distress and consequences associated with sexual abuse and that gains were maintained at three-month follow- up. Analyses of potential factors related to differential gains indicated that abuse-related variables and concurrent individual interventions were not linked to outcomes. Exploratory analyses suggested that women experiencing severe physical partner violence showed greater gains with respect to self-blame/stigmatization, sexual anxiety, and anxiety related to assertiveness.     

The sexual abuse questionnaire: a preliminary examination of a time and cost efficient method in evaluating the presence of childhood sexual abuse in adult patients

This paper provides the results of two studies designed to evaluate a newly constructed self-report instrument, the Sexual Abuse Questionnaire (SAQ). The SAQ was designed as a brief screening device to aid in the identification of a childhood sexual abuse history. A "unique" feature of the SAQ is the inclusion of a number of non-face valid questions derived from clinical experience. Both studies used an undergraduate population of self-reported abused and non-abused participants. Based upon the combined results of the two studies, the final version of the SAQ was developed, which is comprised of 45 items that manifest good test-retest reliability, internal consistency, and convergent and discriminative validity. The SAQ can discriminate between abused and non-abused male and female participants.     

Factors that predict how women label their own childhood sexual abuse

Despite the psychological impact of child sexual abuse, many victims do not acknowledge that their experiences were "abuse". This study sought to identify factors that predict how women label their own experiences of childhood sexual abuse. This cross-sectional study was conducted in a family medicine clinic with adult female patients. Subjects completed structured interviews about their childhood environment and their sexual abuse history. Logistic regression analysis showed that labeling of abuse was dependent upon intercourse (beta = 7.43, p = .006), the frequency of abuse by the first perpetrator (beta = 5.08, p = .024), and paternal overprotection (beta = 6.69, p = .010). Findings suggest that the severity of abusive acts is most important and an over-protective father may enhance the victim's acknowledgment that sexual touching is abusive.     

The relationship between re-incarceration and their own childhood foster care experience of women

Using matched state administrative records of women in the Illinois state prison system, we investigate whether incarcerated women with foster care experience during their early (aged 10 to 14) and late (aged 15 to 18) teens do better or worse in re-incarceration rates compared to female counterparts who went to prison but had no foster care experience. We find that women with the early-teen foster care experience have higher rates of re-incarceration than women without foster care, regardless of whether they were reunited with their parents. The adverse association between the first foster care placement during early-teens and re-incarceration is particularly stronger among former female inmates with low education or history of drug addiction than others. We conclude that incarcerated women with foster care experiences, especially in their early teens, need more attention and extra support from the appropriate institutions upon their release. In addition, it seems that foster care can work as a strong signal of possible re-incarceration among women with low education and history of drug addiction.     

Remembering and forgetting childhood sexual abuse

Twelve white middle-class women who had been severely sexually abused as children by a family member were asked to provide a narrative of their abuse and discuss their subsequent remembering and forgetting of these experiences. Most claimed they had undergone periods during which they had not recalled their abuse, but also claimed that they had never forgotten their experiences at another point during the interview. Nine of the women had actively tried to forget the abusive experiences, although 8 still experienced recurrent and often relentless intrusive memories. Our findings suggest that women with continuous memories may have longer and more coherent narratives than women without continuous memories. Implications of these findings for understanding the phenomenology of memory experiences and the concept of "recovered" memories of childhood sexual abuse are discussed.     

Childhood sexual experiences and adult health sequelae among gay and bisexual men: defining childhood sexual abuse

Gay and bisexual men carry the burden of HIV infections in the United States and have high rates of childhood sexual abuse that predict HIV and other health outcomes. This study examined differential effects of forced, consensual, and no childhood sexual experiences (CSE) on health outcomes among a probability sample of adult men who have sex with men (MSM). The forced sex group had the highest levels of psychological distress, substance use, and HIV risk. There were no differences in rates of depression and suicidal ideation between the consensual- and no-sex groups. The consensual- and forced-sex groups had higher rates of substance use and transmission risk than the no-sex group. The forced-sex group, however, had significantly higher rates of frequent drug use and high-risk sex than the consensual group. Findings suggest that forced CSEs result in a higher-risk profile than consensual or no childhood sexual experiences, the kind of risk pattern differs between forced and consensual childhood sexual experiences, and the underlying mechanisms that maintain risk patterns may vary. It is important to clarify risk patterns and mechanisms that maintain them differentially for forced and consensual sex groups so that interventions may be tailored to the specific trajectories related to each experience.     

The relationship between childhood abuse and suicidality in adult bipolar disorder

This study evaluates the effect of childhood sexual and physical abuse on suicidality in adults with bipolar disorder. We conducted a retrospective chart review of adult outpatients (N= 381) with DSM-IV-TR-defined bipolar disorder seeking evaluation and treatment at an academic specialty research program (i.e., Mood Disorders Pharmacology Unit, University Health Network, University of Toronto) between October 2002 and November 2005. Eighteen percent (n = 68) of adult patients with bipolar disorder had a recorded history of childhood abuse (p = 0.009). Sixty-three percent (n = 43) of bipolar patients with a history of childhood abuse reported lifetime suicidality (chi2 = 6.885, df= 1, p = 0.009). Logistic regression analysis indicated that Childhood abuse was a significant predictor of lifetime suicidality in adult bipolar patients (OR = 2.05, CI = 1.19-3.510). Childhood abuse is associated with suicidal ideation and suicide attempts in adults with bipolar disorder. Anamnestic inquiry regarding childhood maltreatment is salient to risk assessment, illness management planning, preventative strategies, and treatment interventions in bipolar disorder.     

The process of coping with domestic violence in adult survivors of childhood sexual abuse

Research suggests that the use of disengaged or avoidant strategies to cope with interpersonal violence contributes to the development of depressive symptoms and other psychological difficulties. Survivors of childhood sexual abuse (CSA) who are exposed to subsequent episodes of abuse may be more likely to rely on disengaged coping strategies, placing them at elevated risk of psychological symptomatology. In this study, we explored the interrelationships between coping, depression, and self-esteem in an ethnically diverse sample of domestic violence survivors (N = 219) with and without a history of CSA. As predicted, CSA survivors (n = 86) reported significantly greater use of disengaged coping strategies (wishful thinking, self-criticism, and social withdrawal) than non-CSA survivors (n = 133). As hypothesized, both a CSA history and the use of disengaged coping significantly predicted higher levels of depression and lower self- esteem. Clinical implications of the findings are discussed.     

Healing from childhood sexual abuse: a theoretical model

Childhood sexual abuse is a prevalent social and health care problem. The processes by which individuals heal from childhood sexual abuse are not clearly understood. The purpose of this study was to develop a theoretical model to describe how adults heal from childhood sexual abuse. Community recruitment for an ongoing broader project on sexual violence throughout the lifespan, referred to as the Sexual Violence Study, yielded a subsample of 48 women and 47 men who had experienced childhood sexual abuse. During semistructured, open-ended interviews, they were asked to describe their experiences with healing from childhood sexual abuse and other victimization throughout their lives. Constructivist grounded theory methods were used with these data to develop constructs and hypotheses about healing. For the Sexual Violence Study, frameworks were developed to describe the participants' life patterns, parenting experiences, disclosures about sexual violence, spirituality, and altruism. Several analytic techniques were used to synthesize the findings of these frameworks to develop an overarching theoretical model that describes healing from childhood sexual abuse. The model includes four stages of healing, five domains of functioning, and six enabling factors that facilitate movement from one stage to the next. The findings indicate that healing is a complex and dynamic trajectory. The model can be used to alert clinicians to a variety of processes and enabling factors that facilitate healing in several domains and to guide discussions on important issues related to healing from childhood sexual abuse.     

Experiences of disclosure of childhood sexual abuse and psychopathology

Reported child sexual abuse is associated with the development of anorexia and bulimia nervosa overall, but the mediating factors that determine whether such abuse is relevant in individual cases are not adequately understood. This study considers the importance of the experience of initial disclosure as a mediator in a case series of eating-disordered women. The extent of psychopathology (particularly the frequency of vomiting and the presence of the symptoms of borderline personality disorder) was associated with the nature of the perceived response to an attempted disclosure. A perceived lack of response or a negative, hostile response was associated with specific patterns of symptomatology. Further research is suggested to extend these conclusions, and the clinical implications of these findings 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.     

Exploring the multiplicity of childhood sexual abuse with a focus on polyincestuous contexts of abuse

This study explored the prevalence of multiple abusers and polyincest in a clinical sample of 88 adult women, focusing on interviews with a subset of 30. For the sample as a whole, 43% reported three or more abusers and 23% reported polyincest. The narrative data was divided into three categories defined as Single-Abuser (N=8), Multiple Abuser (N=8), and Polyincestuous (N=14). These were compared to determine how survivors perceived family members' and others' reactions to disclosure of CSA. All three groups experienced various forms of silencing. The most negative responses were linked to polyincestuous abuse. Three themes were identified as denial/ minimization/normalization, fear/reprisal, and negative/inadequate. Results suggest the need for further research on the frequency of multiple abusers among victims of sexual abuse, as well as the ways in which family and social contexts serve as collusive environments for the practice of CSA.     

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.     

Shame and guilt in men exposed to childhood sexual abuse: a qualitative investigation

This study examined the experiences of shame and guilt in adult males sexually abused as children. Seven participants attending a service for male sexual abuse completed measures of shame, guilt, dissociation, and childhood trauma history and subsequently participated in a focus group. All participants experienced childhood sexual abuse in the "severe" range and showed elevated scores for shame, guilt, and dissociation. Four superordinate themes with associated subordinate themes emerged: (a) self-as-shame (foundations of self-as-shame, fear of exposure, temporary antidote: connection), (b) pervasiveness and power of doubt and denial (from others, from self, consequences of incredulity), (c) uncontrollability (of problems after disclosure, of rage, of intrusions and emotional pain), and (d) dissociation. Results are discussed with reference to the existing literature and the emerging "self-as-shame" construct, which appeared to encapsulate participants' view of themselves.