The impact of childhood sexual abuse and intimate partner violence on sexually transmitted infections

Childhood sexual abuse (CSA) and adult intimate partner violence (IPV) have both been found to be associated with sexually transmitted infections (STIs) independently, but studies of STIs have rarely looked at victimization during both childhood and adulthood. This paper examines the relationship between CSA, IPV and STIs using data from a nested case-control study of 309 women recruited from multiple health care settings. Overall, 37.3% of women experienced no violence, 10.3% experienced CSA only, 27.3% experienced IPV only, and 25.0% experienced both CSA and IPV. Having ever been diagnosed with an STI was associated with violence (CSA only, odds ratios [OR] = 2.8, 95% confidence intervals [CI] = 1.0-7.5; IPV only, OR = 2.2, 95% CI = 1.0-4.9; CSA and IPV: OR = 4.0, 95% CI = 1.7-9.4), controlling for demographic characteristics. Women who experienced CSA were younger when they were first diagnosed. Understanding how both childhood and adult victimization are associated with diagnosis of STIs is important to reducing the incidence and prevalence of STIs, as well as the associated consequences of STIs.     

Factors related to childhood sexual abuse among gay/bisexual male Internet escorts

This exploratory investigation examined the relationship between childhood sexual abuse (CSA) and related psychosocial characteristics and sexual behaviors among 46 gay/bisexual male escorts who advertise via the Internet. More than a quarter of men (28.3%) reported some history of CSA. Men reporting CSA were more likely to be from an ethnic minority group, identify as bisexual, have a primary male partner, and were less likely to identify an anal receptive ("bottom") sexual role preference. Men with a history of CSA were more likely to report unprotected sex with work-related partners, increased internalized homophobia, and decreased adolescent isolation. Interventions designed for male escorts with a history of CSA should emphasize safer sex strategies with work partners and reducing internalized homophobia.     

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.     

Correlates of partner abuse in male same-sex relationships

We investigated correlates of partner abuse in male same-sex relationships in a randomly selected community sample (N = 186). We included factors associated with abuse in heterosexual relationships, as well as factors of relevance to gay relationships. We assessed perpetration and receipt of partner abuse to examine whether variables were associated independently with abuse perpetration and/or receipt. Correlates of same-sex partner abuse were largely parallel to established correlates of heterosexual abuse. Income, education, and attachment orientation were associated with bidirectional partner abuse, and family violence and substance use were uniquely associated with victimization. Further, there were factors unique to same-sex partner abuse; HIV status and public outness were associated with bidirectional partner abuse, and internalized homophobia was uniquely associated with abuse perpetration.     

Partnering with parents to prevent childhood sexual abuse

Although research demonstrates that child‐focused sexual abuse prevention programmes can teach children personal safety knowledge and skills, childhood sexual abuse (CSA) prevention programmes that involve parents have a number of distinct advantages. The more knowledge parents have about CSA, the greater likelihood they can create safer environments for their children and thus prevent the occurrence of sexual exploitation. Research has demonstrated that parents lack crucial information about CSA and can benefit from even brief educational efforts. This paper will identify potential barriers to participation and offer practical suggestions for enhancing both recruitment and retention rates. Recommendations for parent education programmes are offered, including improving parents' confidence and skills in educating their children about CSA, providing them with parent‐friendly materials to use and developing Internet applications. Copyright © 2010 John Wiley & Sons, Ltd.     

Pathways from physical childhood abuse to partner violence in young adulthood

Analyses investigated several competing hypotheses about developmental pathways from childhood physical abuse and early aggression to intimate partner violence (IPV) for young adult males and females at age 24. Potential intervening variables included: adolescent violence (age 15 to 18), negative emotionality at age 21, and quality of one's relationship with an intimate partner at age 24. At the bivariate level, nearly all variables were associated in the expected directions. However, tests of possible intervening variables revealed only a few significant results. For males, a strong direct effect of abuse on later partner violence was maintained in each model. For females, the quality of one's relationship with an intimate partner did appear to mediate the effect of childhood abuse on later violence to a partner, raising the possibility of gender differences in developmental pathways linking abuse to IPV. Implications with regard to prevention are discussed.     

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.     

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.     

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.     

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.     

The ultimate deception: childhood sexual abuse in the church

Childhood sexual abuse is a serious problem. Significant evidence exists that victims experience both short-term and long-term emotional and psychological problems related to the abuse. Childhood sexual abuse committed by clergy or other adults affiliated with the church may have additional ramifications because of deep violations of trust, honesty, and love. In addition, it can create spiritual distress in victims. Child and adolescent mental health nurses need to actively promote risk-reduction strategies to help prevent the abuse from occurring in their communities.     

Resilience and risk factors associated with experiencing childhood sexual abuse

The effects of child sexual abuse are wide‐ranging and impact on children, families and health/social care systems. The authors review this literature, examining the shortcomings of the ‘victim–offender’ model, and consider the complex, multifactorial nature of this question. Factors associated with a progression from victim to perpetrator are explored and the prevalence of abuse in the general population is also discussed. Protective as well as risk factors are considered and the pivotal role of ‘personal reliance’ is considered as it relates to empowering damaged young people to become healthy adults. The authors also discuss implications for the treatment of young people who become abusers. Two case examples are brie?y reported upon and the article concludes with a consideration of ways to helpfully address the needs of children who become sexual perpetrators. Copyright © 2004 John Wiley & Sons, Ltd.     

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.     

A comparative study of therapy duration for survivors of childhood sexual abuse

The goal of this study was to determine whether duration of group therapy affected outcomes for women with a history of childhood sexual abuse (CSA). The sample included women from 6-month therapy groups (n = 42) and the comparison group who completed 12 months of therapy (n = 114). When outcomes attained by the 6-month group were compared with those of the 12-month group, those in the 6-month group showed significantly greater gains in self-esteem, symptom change, and posttraumatic stress disorder symptoms. In addition, although participants in the 6-month group improved more in depression scores than those in the 12-month group, the difference was not statistically significant. The results of this study indicate that intensive 6-month group therapy for female survivors of CSA may be even more beneficial than less intensive 12-month groups.     

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.     

Storytelling,organizations, and the coherent self: The chronotope of childhood in professional life histories

Professional life histories and organizational stories rarely follow the model of beginnings, middles, and ends. Most interviews end up being subjected to what Boje (2008. Storytelling organizations. Thousand Oaks, CA: Sage) refers to as the spiral of story disorder. However, some storytelling strategies are often used by interviewees to produce a coherent projection of the self and convey a unified professional ethos. This is the role the time and space of childhood – the childhood chronotope – plays in professional life histories. Childhood is often used by storytellers to bring coherence to their organizational stories – and this is no truer than in the context of interviews. Based on interviews from museum directors, this article illustrates how the childhood chronotope might be a meaningful notion for narrative analysis in organizational studies: childhood is mobilized and reinvested by the individual's self-construction in order to produce a sense of coherence and control over his or her organizational experience and professional self.     

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.     

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.     

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.