Childhood Sexual Abuse and Psychobiology

No abstract available for this article.     

Indicators of Sexual Abuse in Children's Rorschach Responses

Rorschach protocols of 18 preadolescent, sexually abused children were compared to protocols of 18 clinical controls. Dependent variables included responses with overt sexual contents, sexual symbols and near-sexual contents. Results suggested that the dependent variables in combination, could differentiate sexually abused children from other clinical groups. Other Rorschach indices, according to the Exner scoring system, were generally not discriminatory. Behavior ratings completed by the parent, indicated that, for males, higher levels of behavior problems were associated wlh sexual abuse. Findings are interpreted in tern of a model of victim response to abuse events. Clinical utility is discussed.     

Spiritual Mechanisms Underlying Substance Abuse Behavior Change in Faith-Based Substance Abuse Treatment

ABSTRACT

Despite increasing interest in “faith-based” substance abuse treatment and HIV risk reduction interventions, there is little systematic evidence of the efficacy of explicitly spiritual interventions. However, fundamental to effective interventions is an explicit conceptualization of mechanisms underlying behavior change. This paper discusses the definition of faith-based organizations, specifically as they relate to substance abuse treatment programs, briefly reviews relevant behavior change theories to identify key variables underlying change, presents an integrative conceptual framework articulating linkages between spiritual intervention components, behavior change processes and substance abuse outcomes, and discusses how the mechanisms identified in our model can be seen in commonly used substance abuse interventions. Overall, the paper suggests that what happens in “faith-based” programs may not be so different from processes taking place in good social work practice in the addictions field.     

Gender Differences in Silencing Following Childhood Sexual Abuse

ABSTRACT

The clinical literature commonly asserts that males are less likely than females to disclose child sexual abuse at the time it occurs and take longer to discuss their experiences. These hypotheses were tested in this study. This study included 145 men and 151 women. Participants were asked about disclosure at the time of the abuse and the length of time it took for them to discuss the experience. Comparison across these two studies found that boys were significantly less likely than girls to disclose the abuse at the time it occurred and also took significantly longer to discuss their childhood experiences later in life.     

Post-Modern Ideas in Substance Abuse Treatment

ABSTRACT

This article describes the use of post-modern ideas in the treatment of substance abusers at a long term residential and day treatment center. It describes some of the changes that ensued as a result of a transformation from a “therapeutic community” (TC) model to a “solution-focused” model. The TC is a deficit model that focuses on a person's flaws and weaknesses. Solution-focused therapy, on the other hand, focuses on what a person has done and is doing right and his or her strengths, assets, and resources. This approach not only improves the quality and effectiveness of substance abuse treatment for clients, but also creates a better working environment for staff.     

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.     

Social and Health Service Use and Treatment Outcomes for Sexual Minorities in a National Sample of Substance Abuse Treatment Programs

This study examines substance use severity, levels of social and health service utilization, and the impact of service utilization on treatment outcomes for sexual minorities versus non-minorities. The sample included 3,094 clients from the National Treatment Improvement Evaluation Study (NTIES). Substance use severity among sexual minorities and non-sexual minorities was similar at treatment entry and at 12 months post-discharge. Differences in social and health service utilization were significant for substance abuse counseling and health services. Significant interactions between sexuality and access services and sexuality and mental health services were also found. Practice and research implications are discussed.     

Prevalence of Childhood Sexual Abuse in China: A Meta-Analysis

The objective of the current study was to explore the estimated prevalence of childhood sexual abuse in China. We conducted a meta-analysis that used the data from 36 articles. A total of 125 independent samples and 131,734 participants were included. The results revealed no significant difference in the prevalence of childhood sexual abuse between Chinese men (9.1%) and women (8.9%). The prevalence of childhood sexual abuse in studies from mainland areas was significantly higher than that from Hong Kong/Taiwan. The estimated prevalence of childhood sexual abuse in China also differed according to the definition of child sexual abuse, data collection method, year of data collection, and the mean age of participants at the time of assessment.     

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.     

Voices of Healing and Recovery from Childhood Sexual Abuse

Child sexual abuse continues to occur for a significant number of children, often having deleterious consequences for survivors’ physical and mental health. Research has thoroughly explored various consequences as a result of child sexual abuse, but scholars and practitioners know less about the healing processes from survivors’ viewpoints. Using a constructivist grounded theory design, this study examined perceptions of healing in 10 female survivors of child sexual abuse. Results conclude with a theoretical model of healing, capturing the significance of supportive relationships, internal characteristics, turning points, and sources of active healing. Important sources of active healing include therapy, informal and formal education, compassion and empathy, blame attribution to abusers, and confronting abusers. Limitations and implications for research and practice are discussed.     

Body-Related Emotions in Posttraumatic Stress Disorder Following Childhood Sexual Abuse

Traumatic experiences are associated with emotions such as anxiety, shame, guilt, disgust, and anger. For patients who have experienced child sexual abuse, these emotions might be triggered by perceptions of their own body. The aim of this study was to investigate the extent of the association of the body to traumatic experiences and to discern the emotions linked to trauma-associated body areas. Ninety-seven female participants were assigned to four groups: post-traumatic stress disorder following child sexual abuse with co-occurring borderline personality disorder, post-traumatic stress disorder following child sexual abuse without co-occurring borderline personality disorder, borderline personality disorder without post-traumatic stress disorder, and healthy controls. Participants rated 26 body areas regarding their association with trauma and 7 emotions. Emotions were assessed by questionnaires. Results suggest that specific areas of the body are associated with trauma and linked to highly aversive emotions. In post-traumatic stress disorder patients, the areas associated with highly negative emotions were the pubic region and inner thighs. Thus, the patient’s body may act as a trigger for traumatic memories.     

Childhood Sexual Abuse Profiles and Psychological Functioning in Adult Males

ABSTRACT

This study used a person-centered approach to generate profiles of males’ sexual abuse characteristics and then link profiles to other types of childhood maltreatment and adversity, and adult outcomes. Data were drawn from 215 North American males (86% Caucasian) aged 17–61 years recruited from websites offering support for sexual abuse. Latent profile analysis identified three profiles, ranging from 1–2 instances of fondling by an unfamiliar extrafamilial perpetrator to chronic, penetrative abuse by individuals within and outside the family. Profiles were labeled Severe (26%), More Severe (33%), and Most Severe (41%). Chi-squares and analysis of variance showed that men in the Most Severe profile were more likely to experience childhood emotional and physical abuse, and a greater number of non-victimization adversities, than men in the other two profiles. After controlling for multiple victimization and adversity, men in the More Severe and Most Severe profiles reported significantly greater internalizing problems than men in the Severe profile, and men in the Most Severe profile reported significantly more trauma symptoms than men in the Severe profile. While these results require replication, they suggest that treatment should be tailored to the individual needs of male survivors.     

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.     

Establishing a Parenting Program for Fathers in Substance Abuse Treatment

This paper describes a systemic, trauma and attachment model for a parenting program for fathers in residential substance abuse treatment. It emphasises the complex nature of delivering parenting programs in this context and the importance of going beyond simple linear principles of reward and punishment, upon which many other parenting programs are predicated.     

The Impact of Childhood Sexual Abuse on Later Sexual Victimization among Runaway Youth

Path analysis was used to investigate the impact of childhood sexual abuse on later sexual victimization among 372 homeless and runaway youth in Seattle. Young people were interviewed directly on the streets and in shelters by outreach workers in youth service agencies. High rates of both childhood sexual abuse and street sexual victimization were reported, with females experiencing much greater rates compared with their male counterparts. Early sexual abuse in the home increased the likelihood of later sexual victimization on the streets indirectly by increasing the amount of time at risk, deviant peer affiliations, participating in deviant subsistence strategies, and engaging in survival sex. These findings suggest that exposure to dysfunctional and disorganized homes place youth on trajectories for early independence. Subsequently, street life and participation in high‐risk behaviors increases their probability of sexual victimization.     

Prevalence of Sexual Abuse in Childhood: Some Critical Methodological Reflections

This article attempts to analyze the prevalence rates of sexual abuse in childhood reported in comparative empirical studies, giving an overview of a selection of representative studies reporting high rates of abuse and comparing it to an overview of studies reporting lower rates. Extremely discrepant rates of childhood sexual abuse are reported in a number of empirical studies conducted in this field over the past 26 years, particularly those looking beyond prevalence to study the links between this type of trauma and future motherhood. To shed light on the disparities in the reported prevalence rates, the article reviews the principal methodological biases that have contaminated the findings. The authors then offer several suggestions for improvement that might be implemented in future studies.     

Interpersonal Dependency Among Adult Survivors of Childhood Sexual Abuse in Therapy

ABSTRACT

This study investigated dependency in survivors of childhood sexual abuse (CSA). The Interpersonal Dependency Inventory (IDI) was administered at intake to 24 men and 85 women seen in therapy at a university-based community mental health clinic. In contrast to findings from earlier studies, no significant gender differences were obtained for IDI whole-scale or subscale scores. Analyses comparing CSA IDI scores with the IDI scores of previously studied groups indicated that among women, CSA survivors obtained higher dependency scores than non-CSA psychiatric patients, community adults, and college students. Findings for men were less consistent. Follow-up analyses revealed that commonly investigated CSA characteristics were unrelated to survivors' dependency scores. Implications of these findings for future research and clinical practice are explored.     

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.