Introduction to the special section on adult survivors of childhood sexual abuse.

Sexual abuse researchers need to use more complex models of abuse and more sophisticated research designs for studying long-term effects and for evaluating treatment programs. The articles that comprise this special section integrate the study of sexual abuse with perspectives on adult victimization, developmental psychopathology, and attachment theory and also offer specific methodological suggestions for improving research on long-term effects and therapy with the abuse survivor. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessment of sexual abuse allegations in child custody cases.

Family courts frequently rely on the expertise of mental health professionals to assess allegations of sexual abuse within the context of child custody evaluations. Such evaluations are complex and require knowledge of techniques used in sexual abuse and sexual offender evaluations, as well as knowledge of child custody practices. Preliminary findings from a national survey of 84 psychologists indicated that respondents tend to adhere to the child custody guidelines of the American Psychological Association. However, few practitioners followed formal models, protocols, or guidelines when evaluating alleged victims or alleged perpetrators of sexual abuse in conjunction with child custody disputes. Implications for professional practice are discussed, along with a proposed comprehensive model for assessing sexual abuse allegations in child custody cases. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attachment theory, childhood mistreatment, and religiosity.

Guided by attachment theory, the authors explore the relationship of verbal, physical, and sexual mistreatment to attachment to God, as well as to concepts of God. Each form of mistreatment was related adversely to the religiosity measures. Attachment to parents mediated the relationship between two maltreatment variables (verbal and physical mistreatment) and attachment to God, as well as the concept of God as loving and as distant. However, attachment to parents did not mediate the relationship between attachment to God and the sexual abuse variable. Sexual abuse was strongly related to difficulties with attachment to God and one's concept of God. The findings add support to the notion, even when childhood mistreatment is taken into account, that a secure attachment to parents provides the necessary context for socialization into religion. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

La perception de la relation père-enfant et l'adaptation des enfants suite au dévoilement d'une agression sexuelle.

The present study explores the link between the father–child relationship and outcomes following child sexual abuse disclosure cases. Seventy-nine children completed measures evaluating perceived attachment security to mother and father (Kerns Security Scale; Kerns, Klepac, & Cole, 1996), as well as the child's internalised and externalised behaviour problems (Dominic Interactif; Valla, Bergeron, St-Georges, & Berthiaume, 2000), and self-esteem (Self-Perception Profile for Children; Harter, 1985) after the disclosure of the sexual abuse. Results indicated that perceived attachment security to the father figure is not correlated with perceived attachment security to the mother. A series of hierarchical multiple regression revealed that perception of paternal attachment security added to the prediction of internalised and externalised (marginal) behaviours over and above perceived attachment security to the mother. Results are discussed in terms of implications for intervention with sexually abused children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clarifying the effects of parental substance abuse, child sexual abuse, and parental caregiving on adult adjustment.

Parental alcoholism, childhood sexual abuse, and other forms of child maltreatment are generally viewed as contributing to adult adjustment problems. The long-term effects of these various factors, however, are actually not well understood. The present study found that the largest amount of variance in 255 college students' psychological distress was explained by parental emotional abuse and neglect, with child sexual abuse, parental substance abuse, and other factors explaining additional but smaller amounts of variance in distress. This suggests that comprehensive conceptualizations of family influences on development will result in a more complete understanding of long-term adjustment outcomes than merely focusing on particular childhood risk factors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Disclosure of Child Sexual Abuse: What Does the Research Tell Us About the Ways That Children Tell?

The empirical basis for the child sexual abuse accommodation syndrome (CSAAS), a theoretical model that posits that sexually abused children frequently display secrecy, tentative disclosures, and retractions of abuse statements was reviewed. Two data sources were evaluated: retrospective studies of adults' reports of having been abused as children and concurrent or chart-review studies of children undergoing evaluation or treatment for sexual abuse. The evidence indicates that the majority of abused children do not reveal abuse during childhood. However, the evidence fails to support the notion that denials, tentative disclosures, and recantations characterize the disclosure patterns of children with validated histories of sexual abuse. These results are discussed in terms of their implications governing the admissibility of expert testimony on CSAAS. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Contingency management is especially efficacious in engendering long durations of abstinence in patients with sexual abuse histories.

Exposure to sexual victimization is prevalent among persons with substance use disorders (SUDs). Contingency management (CM) treatments utilize concrete and relatively immediate positive reinforcers to retain patients in treatment and reduce substance use, and CM may have particular benefits for patients with histories of sexual victimization. Using data from three randomized trials of CM (N = 393), this study evaluated main and interactive effects of sexual abuse history and treatment condition (standard care versus CM) with respect to during treatment outcomes (retention, proportion of negative urine samples submitted, and longest duration of abstinence) and abstinence at a nine-month follow-up. Compared to patients without sexual abuse histories (N = 316), those with sexual abuse histories (N = 77) submitted a significantly higher proportion of negative samples in treatment. In CM, but not in standard care, patients with sexual abuse histories achieved significantly longer durations of abstinence during treatment than those without sexual abuse histories. Although sexual abuse history was not associated with abstinence at nine-month follow-up evaluations, longest duration of abstinence during treatment was significantly associated with this long-term outcome. Results suggest that SUD patients with sexual abuse histories may accrue particular benefits during CM treatment that are associated with long-term abstinence. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

What is so special about male adolescent sexual offending? A review and test of explanations through meta-analysis.

We tested special and general explanations of male adolescent sexual offending by conducting a meta-analysis of 59 independent studies comparing male adolescent sex offenders (n = 3,855) with male adolescent non-sex offenders (n = 13,393) on theoretically derived variables reflecting general delinquency risk factors (antisocial tendencies), childhood abuse, exposure to violence, family problems, interpersonal problems, sexuality, psychopathology, and cognitive abilities. The results did not support the notion that adolescent sexual offending can be parsimoniously explained as a simple manifestation of general antisocial tendencies. Adolescent sex offenders had much less extensive criminal histories, fewer antisocial peers, and fewer substance use problems compared with non-sex offenders. Special explanations suggesting a role for sexual abuse history, exposure to sexual violence, other abuse or neglect, social isolation, early exposure to sex or pornography, atypical sexual interests, anxiety, and low self-esteem received support. Explanations focusing on attitudes and beliefs about women or sexual offending, family communication problems or poor parent–child attachment, exposure to nonsexual violence, social incompetence, conventional sexual experience, and low intelligence were not supported. Ranked by effect size, the largest group difference was obtained for atypical sexual interests, followed by sexual abuse history, and, in turn, criminal history, antisocial associations, and substance abuse. We discuss the implications of the findings for theory development, as well as for the assessment, treatment, and prevention of adolescent sexual offending. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parenting difficulties in sexual-abuse survivors: A theoretical framework with dual psychodynamic and cognitive-behavioral strategies for intervention.

Systematic investigations of the consequences of sexual abuse and clinical literature on interventions with survivors have frequently neglected the impact of sexual abuse on parenting. Grounded in both object-relations and trauma theory, this article presents a case illustration to depict the unconscious repetition of one 30-yr-old mother's childhood abusive relationship with her own child. We explore how this survivor's parenting conflicts became increasingly salient during specific developmental stages of the child, as themes of sexuality and aggression triggered unresolved conflicts, distorted cognitions, and trauma reactions. The reenactment impairs parenting in critical ways, hence increasing the risk for sexual abuse in the next generation. Strategies for interventions to modify the mother's poor parenting responses are described using a therapeutic approach that integrates concepts from psychodynamic and cognitive-behavioral theories. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

La relation entre l'abus sexuel subi durant l'enfance et la satisfaction conjugale chez l'homme.

The goal of the present study was to evaluate the relationship between child sexual abuse and men's dyadic adjustment, using a theoretical model integrating attachment, that is anxiety about abandonment and avoidance of proximity, and psychological distress. Participants were 316 men forming a probabilistic sample of French-Quebecer living in couple. Structural equation analyses showed that sexual abuse predicted dyadic adjustment through anxiety about abandonment and psychological distress. Moreover, there was no relationship between sexual abuse and avoidance of proximity, while this variable was associated to dyadic adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Research on the prevalence of child sexual abuse: New directions.

Explores reasons for the inconsistent figures for the rate of sexual abuse in the general population by comparing the sampling techniques and methodology used by 4 major studies (R. Badgley, 1984; D. Finkelhor, 1979 and 1984; and D. E. Russell, 1984). In all 4 studies, information was gathered from adults about past experiences of sexual abuse during their childhood years. One study included information about experiences of current children. The need is emphasized for gathering information about the rate at which new cases are detected; characteristics of cases that influence how they are handled by authorities; the rate of sexual abuse in particular populations, especially troubled or deviant adult or adolescent groups; the ways in which long-term effects of sexual abuse are detected; and the use of statistical information for policy justification. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Co-occurrence of eating disorders and incest: The role of attachment, family environment, and social competencies.

Childhood attachment, family environment, and adult social competencies were examined to explain the association between sexual abuse and eating disorders (EDs). Female college students (n?=?102) and female clients sexually abused in childhood (n?=?52) completed surveys retrospectively that assessed parental bonds, family environment, and sexual abuse, as well as current self-efficacy, social support, intimacy, adult attachment style, and ED symptoms. Client incest survivors had a higher ED rate (47%) than did sexually abused clients (22%), student incest survivors (24%), or nonabused students (17%). Significant associations were found between family environment, incest, social competencies, and eating disorders. Incest survivors had more dysfunctional families and lower social competencies than did nonabused women. Among incest survivors, those with the lowest levels of social competencies and poorest bonds with their mothers had more ED symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Child sexual abuse: Critical perspectives on prevention, intervention, and treatment.

Reviews the book, Child sexual abuse: Critical perspectives on prevention, intervention, and treatment edited by Christopher R. Bagley and Ray J. Thomlison (1991). This book is a compilation of a series of literature reviews originally commissioned by Health and Welfare Canada in 1987 and completed in 1988. The individual papers included in this edited version represent a cross section of Canadian academicians, clinicians, and case workers who are integrally involved in the policies and practices regarding child sexual abuse in Canada. The work provides a comprehensive perspective on prevention at the primary, secondary, and tertiary levels. The list of authors is impressive in terms of their expertise and experience. At a time when numerous books on child sexual abuse are appearing on the market, it is nice to see a book that has some unusual aspects. Aside from its distinctly Canadian perspective, the book addresses several important, yet frequently ignored, topics. The book provides an up-to-date review of several core issues: conceptualization of the problem, prevention strategies, impact of sexual abuse, investigative interviewing, treatment outcome studies, and treatment issues for child molesters. The more unique topics include a review of the strategies used to evaluate prevention programs, prevalence rates among a number of special populations, the role of medical practitioners in preventing and intervening in child sexual abuse, and sexual abuse and exploitation among disabled individuals. Overall, I can recommend this book for clinicians and researchers in Canada and elsewhere who are interested in child sexual abuse. This compilation of literature reviews highlights the leading role that Canadian social service agencies have taken in developing programs for sexually abused children and their families. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Graduate-level education and training in child sexual abuse.

The purpose of this article is to further graduate-level education and training in child sexual abuse. Two graduate-level courses that focus on child sexual abuse are considered as well. The following points are made: (a) Training in child sexual abuse should be incorporated into professional training programs; (b) research and theory courses on child sexual abuse are indicated; (c) the topic of child sexual abuse should be mainstreamed into existing practica; (d) the multidisciplinary nature of the field necessitates consideration of resources and references beyond those specific to psychology as well as professional engagement with individuals from many disciplines; and (e) training in child sexual abuse elicits strong emotional responses in trainees and others. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Childhood Sexual Abuse Narratives in Clinically and Nonclinically Distressed Adult Survivors.

Understanding the complex dynamics involved in sexual abuse trauma is of central importance to clinicians working with adult survivors of childhood sexual abuse. In this study 20 volunteer participants formed 2 gender-balanced groups differentiated by clinical (vs. nonclinical) levels of distress. A negative case analysis revealed group differences in participants' perceptions of the impact of the abuse, meaning attributions for the abuse, and social support experiences. Resolving traumatic attachment to the perpetrator may be the core therapeutic task complicating the process of reclaiming trust, expressing grief and anger, and developing empowered meaning attributions. Successful negotiation of the complex pathways to recovery requires a therapeutic environment free from countertransferential errors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impact of child sexual abuse: A review of the research.

Reviews studies that have tried to empirically confirm the effects of child sexual abuse cited in the clinical literature. In regard to initial effects, empirical studies have indicated reactions—in at least some portion of the victim population—of fear, anxiety, depression, anger and hostility, aggression, and sexually inappropriate behavior. Frequently reported long-term effects include depression and self-destructive behavior, anxiety, feelings of isolation and stigma, poor self-esteem, difficulty in trusting others, a tendency toward revictimization, substance abuse, and sexual maladjustment. The kinds of abuse that appear to be most damaging are experiences involving father figures, genital contact, and force. The effects of duration and frequency of abuse, age at onset, the child's reporting of the offense, parental reaction, and institutional response are also considered. The controversy over the impact of child sexual abuse is discussed. (49 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Co-occurrence of avoidant personality disorder and child sexual abuse predicts poor outcome in long-standing eating disorder.

Few consistent predictive factors for eating disorder have been identified across studies. In the current 5-year prospective study, the objective was to examine whether (a) personality disorder and child sexual abuse predict the course of severity of eating disorder symptoms after inpatient treatment and (b) how the predictors interact. A total of 74 patients with long-standing eating disorder and mean age of 30 years were assessed at the beginning and end of inpatient therapy and at 1-, 2-, and 5-year follow-up. A mixed model was used to examine the predictors. Avoidant personality disorder and child sexual abuse interacted in predicting high levels of eating disorder over a long-term course. These results suggest that eating disorder, avoidant personality disorder, and sequelae after child sexual abuse are potential targets for treatment that need further investigation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Presenting problems of sexually abused girls receiving psychiatric services.

Twenty-three behaviors among those suggested in the literature to be associated with sexual abuse were studied in 195 girls, ages 2–18 years, who were consecutive admissions to three Midwestern mental health agencies. Results indicated that sexually inappropriate behaviors, sleep disturbance, depressed mood, and delinquent behavior occurred more frequently in young abuse victims than in clinic comparisons. Sexually inappropriate behaviors and running away appeared more often in older sexually abused girls, than they appeared in older clinic comparisons. These comparisons of the presenting problems of sexually abused and nonabused girls suggest there are few behavioral "markers' of sexual abuse in clinical samples and that sexual abuse may not be a unique contributing factor in the ontogeny of childhood psychopathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Healing the incest wound: Adult survivors in therapy, 2nd edition.

Reviews the book, Healing the incest wound: Adult survivors in therapy, 2nd edition by Christine A. Courtois (see record 2010-06160-000). Similar to the first edition, the second edition is divided into three main sections: Section I gives a broad but in-depth overview of the characteristics and dynamics of incest; Section II provides a breadth of information on the long-term effects, assessment, and diagnosis; and Section III details current evidence-informed best practice in working with survivors of prolonged child sexual abuse. The book presents a wide range of treatment modalities that represent a bevy of both empirically supported and supplemental techniques, from cognitive–behavioral to expressive therapies, such as art or poetry. The second edition of Healing the incest wound is an important read for any practitioner, novice or experienced, working with child sexual abuse survivors. Courtois both provides a solid basis for those beginning work with child sexual abuse survivors and adds to the knowledge of seasoned practitioners by bringing together the most current empirical evidence and clinical wisdom regarding child sexual abuse treatment. (PsycINFO Database Record (c) 2011 APA, all rights reserved)