Positive Reaction to Disclosure and Recovery from Child Sexual Abuse

ABSTRACT

Factors associated with improvement in the behavioral-emotional functioning of sexually abused children, from 6 to 18 years of age, were investigated. Children were classified by their therapist according to current level of disclosure regarding past abuse. Ratings of degree of support offered by significant people in the children's lives were also made. Findings showed children who were in an actively disclosing stage to be exhibiting significantly less externalizing behavior problems than non-disclosing children. Children who were fully disclosing without recantation showed significantly lower dissociation than did all other subjects. Children who recanted with or without re-disclosure showed significantly more post-traumatic stress symptomatology. As all the subjects were in foster care, the reactions to disclosure of foster parents proved to be most salient with respect to current functioning. Children who received full support from foster parents showed significantly lower depression scores than did children who received only partial support.

Other significant findings pertain to the effects of time since initial disclosure, age of subjects, and type of sexual abuse on behavioral-emotional functioning. Implications for developing structured training programs for foster parents and their caseworkers are discussed. Recommendations are made for future study using the present design with a non-foster care population and investigating the effect that the timing of supportive reactions to disclosure has.     

Responding to children's disclosure of familial abuse: what survivors tell us.

This study is based on the reports of 384 adults who were abused physically, sexually, and/or emotionally in childhood by family members. It describes the survivors' attempts, as children, to get help by disclosing the abuse to someone who might intervene; those who did not disclose explain their reasons. The results indicate that disclosure usually did not bring an end to the abuse, and that little action was taken to control the perpetrator, even after disclosure took place. The responses received by the children to their disclosure are linked to their levels of self-esteem and family functioning as adults.     

Partner Abuse Among Women Whose Children Have Been Sexually Abused: An Exploratory Study

ABSTRACT

To explore partner abuse among women in families in which a child has disclosed sexual abuse, 102 mothers completed a measure of partner abuse and the Coping Responses Inventory. Results suggest that, like women in the general population, mothers of children who have been sexually abused have often experienced partner abuse. As expected, physical abuse in a current relationship was found to be related to the use of avoidance strategies in dealing with the sexual abuse disclosure. The implications for practitioners and for future research are discussed.     

Psychological Differences Between HIV-Positive Mothers Who Disclose to All, Some, or None of Their Biological Children

This study explored the psychological differences between HIV-positive women who disclosed their serostatus to all, some, or none of their biological children. Data from this project come from a larger, longitudinal investigation of the disclosure process of HIV-infected women. Data were obtained regarding the disclosure processes and the psychological adjustment of women with children ( n  = 90) based on measures of depression, anxiety, and stress. Results suggest that women who disclose to all, some, or none of their children are not significantly different with regard to emotional well-being. Implications for marriage and family therapists are provided.     

A Psychosocial Understanding of Child Sexual Abuse Disclosure Among Female Children in South Africa

Child sexual abuse is endemic in South Africa, driven by high levels of gender-based violence and underscored by structural and social factors. This article aims to develop an understanding of the process of disclosure in a sample of female children and their caregivers. In-depth semistructured interviews were conducted with 31 female children aged 8–17 years and their caregivers at 3 intervals after presentation to a sexual assault treatment center. Nearly half of the children failed to disclose the sexual abuse immediately, fearing caregivers’ reaction. Most children purposefully disclosed to a confidant through a process of identifying an intermediary to tell caregivers on their behalf. The process of disclosure was influenced by multiple factors, such as a fear of the caregiver’s reaction and disbelief, which is related to parental style. Disclosure was found to be a dynamic process that unfolds and not a single or static event and influenced by multiple factors which all impact on recovery. Our findings highlight the need to address social norms on sexual abuse in order to improve responses to disclosure to facilitate post-sexual-abuse adjustment for the child and the family.     

The Continuum of Disclosure: Exploring Factors Predicting Tentative Disclosure of Child Sexual Abuse Allegations During Forensic Interviews and the Implications for Practice,Policy, and Future Research

When a child sexual abuse investigation ensues, many children do not disclose readily to professionals. Defining disclosure beyond the disclosure versus nondisclosure dichotomy is essential, yet little research exists on factors associated with a continuum of disclosure, including active and tentative disclosure. Through the coding of 196 forensic interviews using content analysis and subsequent regression analysis, findings suggest that children of color, children abused by adults, unintentional initial disclosure, and those lacking family support were more likely to tentatively disclose in this study. Implications include a need to understand tentative disclosure as part of a normal continuum of disclosure within court proceedings and investigations of abuse allegations.     

Differences in Parental Monitoring Components and Their Associated Health Indicators Between Sexual-Minority and Heterosexual Girls

ABSTRACT

Our study sought to assess whether parental monitoring and their associations with health behaviors differed for heterosexual girls compared to sexual-minority girls (girls who identified as lesbian or bisexual, endorsed same-sex attraction, or had same-sex romantic or sexual partners). We analyzed three components of parental monitoring—adolescent disclosure, parental solicitation, and parental knowledge—between heterosexual and sexual-minority girls. We also tested if the associations between these three constructs and adolescent relationship abuse, suicidality, heavy drinking, binge drinking, anxiety symptoms, and depressive symptoms were different for heterosexual girls compared to sexual-minority girls. Sexual-minority girls were less likely to disclose accurately to their parents their location and activities and perceived their parents asked less and knew less about their location and activities than did heterosexual girls. Heterosexual girls who reported higher levels of adolescent disclosure were less likely than were sexual-minority girls to report suicidality and anxiety symptoms. Additionally, heterosexual girls who reported higher levels of parental knowledge were also less likely than were sexual-minority girls to report anxiety and depressive symptoms. These findings suggest that parental monitoring may not be as protective for sexual-minority girls as it is for heterosexual girls.     

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.     

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.     

Undergraduate Students' Reactions to Analogue Male Disclosure of Sexual Abuse

ABSTRACT

Anecdotal evidence indicates that male sexual abuse survivors fail to disclose for fear of others' reactions. This study investigated undergraduates' reactions toward a hypothetical male survivor's disclosure whose abuse occurred at age 5, 15 or 25, with a male or female offender. When age at incident was higher, the survivor was seen as less masculine, more responsible for his abuse, and the male sex role and rape myths were more strongly applied to him. Generally, women's reactions were more positive than men's. Less positive reactions were associated with disclosing to other men, abuse occurring at an older age, and a female offender.     

Coming Out in a School Setting

Abstract

The present study was conducted to learn more about the experiences of gay men and lesbians in educational settings, particularly about experiences relevant to disclosure of their sexual orientation. One hundred six gay men and 156 lesbian women responded to an anonymous questionnaire dealing with how their sexual orientation had affected their experiences in school.

As students, very few respondents had chosen to disclose their sexual orientation to principals, teachers, counselors, or friends. Reasons cited for nondisclosure included fear of the consequences and not wanting others to know. The majority of those who did disclose their sexual orientation received positive feedback for doing so, but respondents reported both positive and negative consequences of coming out. Gay men were aware of their sexual orientation at an earlier age than lesbians and were somewhat more likely to recommend disclosure to principals and teachers. Females were more likely to disclose only to females, whereas males were likely to come out to both males and females. Generally, the similarities between males and females were greater than the differences, with both groups being cautious about coming out in the school setting.     

Disclosure of Child Sexual Abuse Among Adult Male Survivors

Men who were sexually abused during childhood are a stigmatized, under-studied, and marginalized population that is at risk for long-term mental health problems. However, many mental health practitioners feel under-prepared and ill-equipped to effectively treat male survivors of child sexual abuse. Furthermore, little is known about factors that may impact the mental health of male survivors such as disclosure of the sexual abuse. The purpose of this study was to (a) describe the disclosure process of male survivors using a lifespan approach, (b) identify disclosure differences based on age and type of abuser, and (c) explore relationships between disclosure attributes and current mental health. Using a large, purposive sample of male survivors (N = 487), the study found that, on average, men delayed telling (M = 21.38 years) and discussing the abuse (M = 28.23 years) for many years. Older age and being abused by a family member (i.e., incest) were both related to delays in disclosure. Most participants who told someone during childhood did not receive emotionally supportive or protective responses and the helpfulness of responses across the lifespan was mixed. Several variables (e.g., timing of disclosure, discussing with a spouse, response to disclosure) were related to current mental health problems. These findings are helpful for clinical social workers who practice with clients from this population. Specific suggestions for improving clinical practice (e.g., assessment, treatment, professional training) are discussed.     

Perspectives on disclosure among children living with HIV in India

BackgroundFollowing the widespread uptake of anti-retroviral therapy (ART), young children living with HIV are entering adolescence and beyond, necessitating disclosure of HIV status. However, few studies have described children's experiences following disclosure.MethodsWe assessed disclosure status among children attending HIV clinics at two tertiary-care centers in southern India. Children who had disclosure were administered a pre-tested questionnaire assessing their knowledge about HIV, ART, experiences following disclosure, perceived stigma and ideas about their future. The association of the children's responses with social desirability bias was examined using a modified social desirability scale.ResultsTwenty-four caregiver-child dyads participated in this study. They constituted a subset of children who had been told of their HIV diagnosis from a larger study of 247 dyads. Mean age at disclosure was 10.9 ± 2.5 years. Medical personnel were responsible for disclosure to 14 children, parents/caregivers to 3 children, both medical and care personnel together to 4 children and other relatives to remaining 3 children. Disclosure was met with acceptance by one-third of the children. Despite disclosure, five children did not know how HIV spreads, and three were unaware about how infection could be prevented. Notwithstanding their positive status, 20 children felt that they were treated well at school and by their immediate relatives, although 11 children mentioned that they needed to hide while taking ART. Social desirability bias did not play a role in the responses given by these children.ConclusionsThe rate of disclosure of HIV status among children living with HIV in India was low, even among older children. Most children accepted their status, but knowledge about HIV and ART was inadequate. Disclosure was predominantly performed by medical personnel, rather than the primary caregiver. Incorporating disclosure into the care process for older children is likely to be beneficial, and should be recognized as an iterative process with a need for incorporating cultural sensitivities and a comprehensive approach to health education.     

Factors Associated with Adolescents’ Disclosure of Sexual Abuse Experiences in Hong Kong

This research project is the first study conducted in Hong Kong using adolescent subjects to explore predictors of child sexual abuse disclosure. Eight-hundred male and female adolescents aged 13 to 16 years were recruited from the community while another 30 adolescents joined the study from a clinical setting. One hundred and seventy-seven adolescents acknowledged having a child sexual abuse experience. Results showed that the severity of sexual abuse activities and parent attachment were associated with disclosure in the clinical setting, while abuser’s gender and the adolescents’ disclosure tendency were associated with disclosure among participants in the community setting. Among the 104 participants who had disclosed their childhood sexual abuse, 70% of them had disclosed it within one month and 63% of them had disclosed to 2 to 5 people. The majority of the disclosers (81%) shared their child sexual abuse experience(s) with their friends. Participants from the clinical setting tended to reveal the experience more to adults than those from the community. The study suggested that when choosing a potential confidant, adolescents paid more attention to confidant characteristics than to anticipated confidant responses to their disclosure. Limitations and practical implications for increasing child sexual abuse disclosure rates are discussed.     

The Use of the NICHD Protocol to Enhance the Quantity of Details Obtained from Children with Low Verbal Abilities in Investigative Interviews: A Pilot Study

ABSTRACT

This study explored the impact of the NICHD protocol to enhance the quantity and content of details reported by children with low verbal abilities. Thirty-four children aged from 6 to 14 were interviewed following their experience of sexual abuse. Half the interviews were conducted using the NICHD protocol. Results indicate that NICHD interviews contained more open-ended prompts and more details overall. Open-ended invitations yielded significantly more detailed responses than did closed-ended questions for both children with low and average verbal abilities. Although children with low verbal abilities provided fewer details than children with average verbal abilities, the NICHD protocol helped them provide detailed responses containing the core elements of the sexual abuse.     

Recantation of Sexual Abuse Disclosure Among Child Victims: Accommodation Syndrome

Background: Disclosing the sexual abuse may be related on many individual and/or environmental factors in all age groups. The sociocultural context is the most influential factor of the disclosing process especially for those living in patriarchal cultural values. This study compares the impacts of sexual abuse and other sociodemographic variables between recanting and non-recanting victimized groups in Adana city from Turkey.

Methods: The samples attending our department were divided into two groups: group 1 comprised victims who recanted their first abuse disclosure, and group 2 comprised victims who insisted on the veracity of their first report at further evaluations. The characteristics of the child, family, and abuser were compared between recanting victims and non-recanting victims by retrospective data.

Results: Each group included 27 children, for a total of 54 subjects. All adverse social reactions after the sexual abuse, including keeping secrets and a repressive family attitude, were higher among group 1 victims than group 2 victims (p < 0.0001).

Conclusions: Although they are victimized by protecting family integrity, victims may show a tendency to keep secrets and to not immediately disclose an abuse event.     

Irish child sexual abuse victims attending a specialist centre

We profiled a cohort of CSA cases referred for assessment to a specialist child sexual abuse (CSA) centre in a national paediatric hospital in Ireland. Historical and clinical data were drawn from records of 171 cases. The majority of cases were referred by social workers following purposeful disclosure of CSA. Three quarters of the cases were female with a mean age of 9 years. They were from a wide spectrum of socioeconomic groups and many had suffered a range of family adversities. In most cases, the abuse involved masturbation of the child by the abuser. Almost all of the perpetrators were male with a mean age of 28 years and in 60% of cases extrafamilial abuse had occurred. In 23% of cases, the perpetrator had a history of previous sexual offending. Anxiety was the most common emotional problem before disclosure and after disclosure the most common emotional problem was guilt. Before disclosure school refusal was the most common behavioural problem and after disclosure fighting was the most prevalent behavioural difficulty. The most common factors supporting the credibility of CSA allegations were labile mood, the child's ability to differentiate fact from fantasy and a detailed disclosure of contextual details. More adolescents showed deterioration in schoolwork after disclosure and for more pre school children clinginess following disclosure was a significant emotional problem. More primary school aged children were abused by perpetrators who had abused a number of children. For children abused by such perpetrators, vaginal intercourse was less common. Vaginal intercourse was more common in 6–11‐year‐old victims and those who were abused on a daily basis. The threat that disclosure posed to the integrity of the family structure was more often a factor hindering disclosure in victims abused by father figures and abused very frequently. Copyright © 2003 John Wiley & Sons, Ltd.     

Predicting disclosure of MSM status to providers in a primarily socially conservative state

ABSTRACT

Purpose: This study aimed to determine what predicts a man who identifies as MSM living in a conservative state to inform his provider of his sexual behaviors and/or his sexual orientation. Methods: We administered an anonymous online survey to 148 men who reported seeing a general medical provider in the last 12 months. All participants resided in Oklahoma. Results: When controlling for HIV status, previous STI diagnosis, and age, logistic regression modeling yielded significant results (x²(9) = 31.22, p <.001) predicting 70.3% of cases. Age and overall disclosure of sexual orientation and/or sexual behaviors were significant predictors. Conclusion: Individuals who did not disclose their sexual orientation or same-sex behaviors to friends and family members were less likely to inform their providers of their sexual orientation. Disclosure of MSM status provides additional opportunities to enhance primary and secondary prevention strategies in rural and conservative areas that are necessary to optimize health, including but not limited to HIV screening and discussion of pre-exposure prophylaxis that their counterparts in urban settings more readily receive.     

Assessing Sexual Abuse/Attack Histories with Bariatric Surgery Patients

This study assessed sexual abuse/attack histories in 537 bariatric surgery patients using the PsyBari. The prevalence rates found were lower (15.5%, 19.3% of women, 5.2% of men) than other studies that used bariatric surgery patients but consistent with studies that used nonbariatric obese subjects. Furthermore, bariatric surgery patients who disclosed sexual abuse/attack were more likely to disclose physical abuse, psychological problems, psychological treatment, psychiatric medication, and psychiatric hospitalization. Among bariatric surgery patients who disclosed sexual abuse/attack, females were more likely to disclose suicidal ideation. A logistic regression found that for females, physical abuse and suicidal ideation reliably predicted abuse/attack status. For males, psychological problems, psychiatric medications, hospitalization, and suicidal ideation, reliably predicted abuse/attack status.     

Prevalence of Sexually Abusive Experiences in Childhood and Adolescence Among a Community Sample of Latinas: A Descriptive Study

This study examined the prevalence, severity, and circumstances of self-reported sexually coercive and abusive experiences in childhood and adolescence in a community sample of Latina women (N?=?204) ages 18 to 34 years. Results from structured phone interviews indicated that 35%?of the women reported experiencing some form of sexual abuse, 31%?of the reported perpetrators were family members, and 52%?were boyfriends, friends, or acquaintances. Of those who reported an abusive experience, 44%?had not disclosed the abuse to anyone; for those who did disclose, 74%?reported feeling supported. Findings highlight the importance of including peer and dating-partner abuse in the assessment of CSA and the necessity for outreach to Latina women who may have never disclosed their experiences of abuse.