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.     

Comment on Cross,Fine, Jones,and Walsh (2012): Good Therapeutic Services— Therapeutic Advocacy and Forensic Neutrality

Cross, Fine, Jones, and Walsh (2012 Cross, T. P., Fine, J. E., Jones, L. M. and Walsh, W. A. 2012. Mental health professionals in children's advocacy centers: Is there role conflict?. Journal of Child Sexual Abuse, 21(1): 91–108. [Taylor & Francis Online] , [Google Scholar]) provided a thoughtful review and critique of a book chapter describing the interview process at Child Advocacy Centers. They observed some of the ways that concerns raised in that chapter are being addressed and described revised guidelines that further clarify issues. Ongoing research and examination of the important processes carried on by child advocacy centers and the role fulfilled by mental health professionals in the investigation of child sexual abuse contributes positively to service delivery.     

Comment on Cross,Fine, Jones,and Walsh (2012): We Are Now on the Same Page

Role conflict has been an issue in the intervention of child abuse cases since the beginning of the alliance drawn between the legal and mental health professions. In child abuse cases, clearly defined roles will prevent an attack on the process, thereby providing successful interventions to protect children. The child advocacy center concept is one of the best ways to meld the two professional functions into a cohesive approach to those interventions.     

Sister–Sister Incest: Data from an Anonymous Computerized Survey

Retrospective data were entered anonymously by 1,521 adult women using a computer-assisted self-interview. Thirty-one participants were victims of sister–sister incest, 40 were victims of brother–sister incest, 19 were victims of father–daughter incest, 8 were victims of sexual abuse by an adult female (including one mother), and 232 were victims of sexual abuse by an adult male other than their father before reaching 18 years of age. The rest (1,203) served as controls. The victims of sister–sister incest had significantly more problematic outcomes than controls on many measures as adults. Victims of sister–sister incest were more depressed and more likely than controls to be distant from the perpetrator-sister and to have traded sex for money, experienced an unplanned pregnancy, engaged in four different types of masturbation, and engaged in 13 different same-sex behaviors. Our findings were consistent with other reports of early eroticization and persistent hypereroticization of incest victims.     

Expert Testimony Influences Juror Decisions in Criminal Trials Involving Recovered Memories of Childhood Sexual Abuse

We examined the impact of expert witness orientation (researcher or clinical practitioner) and type of testimony (testimony for the prosecution, defense, both prosecution and defense, or no testimony) on mock jurors’ decisions in a sexual abuse trial. Participants acted as mock jurors on a sexual abuse criminal trial based on recovered memory that included expert witness testimony. Results showed that expert witness testimony provided by a researcher did not impact mock jurors’ guilt ratings any differently than the expert witness testimony provided by a clinical practitioner. However, type of testimony had a significant effect on jurors’ guilt ratings such that jurors who read only defense or only prosecution testimony made decisions favoring the relevant side.     

Depression and Parenting by Nonoffending Mothers of Children Who Experienced Sexual Abuse

Parenting may be one mechanism by which depression in nonoffending mothers impacts child emotional and behavioral adjustment after sexual abuse. This study examined the relationship between self-reported maternal depression and parenting behaviors by nonoffending mothers of children who experienced sexual abuse. The participants were 204 nonoffending biological mother–child pairs recruited from a clinic providing services for children who experienced sexual abuse. The mothers completed pretreatment self-report measures of demographic information, depression, and parenting behaviors. Children (7 to 17 years) completed a measure of mothers’ parenting behaviors. Mothers with clinically high levels of self-reported depression employed more inconsistent parenting behavior and provided poorer monitoring/supervision of their children than mothers without clinically high levels of self-reported depression. Implications for clinical practice and future research are discussed.     

“Who Can You Tell?” Features of Arab Culture That Influence Conceptualization and Treatment of Childhood Sexual Abuse

The literature on child sexual abuse reflects growing recognition of the manner in which culture impacts the conceptualization, experience, and treatment of such cases. Despite heightened visibility of Arab Americans within the United States, population due to recent media attention, little empirical research exists on the occurrence of child sexual abuse within this population. Arab culture is often characterized by an emphasis on collectivism and familial obligations, and such features may prove to either facilitate or impede assessment and treatment of child sexual abuse, depending on how they are manifested. In terms of reporting child sexual abuse, cultural values pertaining to shame and honor as well as the stigma attached to mental health problems may influence the response to abuse. As such, enhancing the cultural competence of the therapist is key to facilitating effective cultural practice. Empirical research is required to investigate and substantiate these concepts as they relate to child sexual abuse in Arab-American populations.     

The Relationship between Knowledge and Child and Caregiver Distress during the Medical Examination for Child Sexual Abuse

When child sexual abuse is suspected, a child sexual abuse–related medical examination is recommended to ensure the child's well-being. While the extant research has sought to identify factors influencing child distress during this examination, only recently have studies began examining variables that may be directly associated with the child or with the medical setting. Knowledge of the child sexual abuse–related medical examination is one medical-related variable that has been implicated in child and caregiver distress during the examination. The current study contributes to the existing literature by investigating associations among examination knowledge in relation to caregiver and child anxiety at the time of a child sexual abuse–related medical examination, taking into account ethnicity, past child abuse, injury to child as result of abuse, and caregiver response to disclosure. Sixty-eight children and their nonoffending caregiver were assessed. Results indicated that understanding of the examination and caregiver response to disclosure were significantly associated with caregiver and child anxiety.     

A National Survey of Child Advocacy Center Directors Regarding Knowledge of Assessment,Treatment Referral,and Training Needs in Physical and Sexual Abuse

Mental health services are a core component of child advocacy centers in the United States. Child advocacy center directors were surveyed about (a) trauma and posttraumatic stress disorder; (b) referral criteria for treatment of abuse victims; (c) evidence-based treatments for abused children; (d) reliable, valid, and normed measures helpful in assessment; and (e) training needs. Directors accurately identified posttraumatic stress disorder symptoms, but additional symptoms were misidentified. Directors identified best practices for assessment and treatment, but they misidentified non-evidence-based practices. Primary reasons for referral for services included severity of abuse and emotional response of the child. However, referrals based on assessment findings were not a high priority. Directors expressed some training needs for staff consistent with issues identified in the study.     

Pilot Study on Childhood Sexual Abuse,Diurnal Cortisol Secretion,and Weight Loss in Bariatric Surgery Patients

Childhood sexual abuse increases risk for adult obesity. A potential contributing factor is altered cortisol secretion. In this pilot study, relationships among childhood sexual abuse, diurnal salivary cortisol secretion, and weight loss were explored in 17 bariatric surgery patients. Measurement points were before surgery (baseline) and 3 and 6 months after surgery. Childhood sexual abuse was measured by the Childhood Trauma Questionnaire. The results showed moderate but nonsignificant positive correlations between the childhood sexual abuse subscale score and baseline morning cortisol, evening cortisol, and daily mean cortisol. An unexpected positive correlation was noted between the Childhood Trauma Questionnaire total score and weight loss at six months. Diurnal cortisol secretion did not change over time after surgery nor correlate significantly with weight loss at six months.