Women's history of sexual abuse, their sexuality, and sexual self-schemas.

In this study, the authors assessed 48 female survivors of child sexual abuse (CSA) and 71 female control participants using measures of adult sexual function, psychological function (i.e., depression and anxiety), and sexual self-schemas. The primary purpose of this study was to examine whether differences existed between women with and without a history of CSA in the way that they viewed themselves as a sexual person and, if so, whether such differences mediated the link between early unwanted sexual experiences and later adult sexuality. CSA survivors were found to view themselves as less romantic and passionate than women who were not abused. In particular, CSA survivors showed an inverse relationship between romantic/passionate sexual self-schemas and negative sexual affect during sexual arousal. The relationship between CSA and negative sexual affect was independent from symptoms of depression and anxiety, suggesting that the impact of CSA on sexual self-schemas may be independent from the impact that the abuse may have in other areas of the survivor's life. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-definition as a survivor of childhood sexual abuse among Navy recruits.

This study explored how specific childhood sexual experiences (CSEs) might be related to self-identification as a victim of sexual abuse and to gender differences in self-defined victimization. Hierarchical logistic regression was used to estimate the relationship of demographic and CSE characteristics with self-definitions. The characteristics most strongly associated were threats--force, incest, and younger age at the time of the experience. Men were less likely than were women to acknowledge abuse and to report CSE characteristics indicative of abuse. Women were more likely to identify themselves as victims the more CSEs they reported involving sexual penetration. Finally, in an analysis of familial abuse, men were more likely to define themselves as victims if the perpetrator was also male. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Leader training and practices in groups for survivors of childhood sexual abuse.

Little is known about the actual practices of group leaders of childhood sexual abuse groups. A survey of 60 group leaders of CSA groups for children, adolescents, and adults found that most are adhering to ethical and training guidelines. The groups range from psychoeducational and support to counseling and therapy groups. Many of the groups are co-led, especially children and adolescent groups. The article discusses the screening, group structure, and interventions that leaders are using and suggests multiple areas for further research, as well as tips for practitioners. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Autobiographical memory specificity after manipulating retrieval cues in adults reporting childhood sexual abuse.

Traumatized samples have relative difficulty in generating specific autobiographical memories on a cue word task, compared to nonexposed controls. Simultaneously, trauma is associated with highly specific intrusive trauma memories in day-to-day life. Possibly, day-to-day intrusions and memories generated to cue words rely on different retrieval processes, with the former dependent on close associations between retrieval cues and specific memory representations (direct retrieval), and the latter on iterative retrieval cycles through a hierarchical memory system (generative retrieval). This study investigated this distinction using two versions of the cue word task, designed to promote generative and direct retrieval, respectively, in participants with or without a history of child sexual abuse (CSA). The data demonstrated that CSA participants were less specific than nonabused controls to generative retrieval cues, but this difference disappeared with direct retrieval cues. This interaction was stronger in CSA participants with relatively greater posttraumatic stress and remained significant when participants with past or current major depressive disorder were excluded and also when only those participants with corroborated CSA were included. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The co-occurrence of childhood sexual abuse, adult sexual assault, intimate partner violence, and sexual harassment: A mediational model of posttraumatic stress disorder and physical health outcomes.

This study examined the co-occurrence of childhood sexual abuse, adult sexual assault, intimate partner violence, and sexual harassment in a predominantly African American sample of 268 female veterans, randomly sampled from an urban Veterans Affairs hospital women's clinic. A combination of hierarchical and iterative cluster analysis was used to identify 4 patterns of women's lifetime experiences of violence co-occurrence. The 1st cluster experienced relatively low levels of all 4 forms of violence; the 2nd group, high levels of all 4 forms; the 3rd, sexual revictimization across the lifespan with adult sexual harassment; and the 4th, high intimate partner violence with sexual harassment. This cluster solution was validated in a theoretically driven model that examined the role of posttraumatic stress disorder (PTSD) as a mediator of physical health symptomatology. Structural equation modeling analyses revealed that PTSD fully mediated the relationship between violence and physical health symptomatology. Consistent with a bio-psycho-immunologic theoretical model, PTSD levels more strongly predicted pain-related physical health symptoms compared to nonpain health problems. Implications for clinical interventions to prevent PTSD and to screen women for histories of violence in health care settings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical characteristics of adults reporting repressed, recovered, or continuous memories of childhood sexual abuse.

The authors assessed women and men who either reported continuous memories of their childhood sexual abuse (CSA, n = 92), reported recovering memories of CSA (n = 38), reported believing they harbored repressed memories of CSA (n = 42), or reported never having been sexually abused (n = 36). Men and women were indistinguishable on all clinical and psychometric measures. The 3 groups that reported abuse scored similarly on measures of anxiety, depression, dissociation, and absorption. These groups also scored higher than the control group. Inconsistent with betrayal trauma theory, recovered memory participants were not more likely to report abuse by a parent or stepparent than were continuous memory participants. Rates of depression and posttraumatic stress disorder did not differ between the continuous and recovered memory groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The benefits and risks of patient self-disclosure in the psychotherapy of women with a history of childhood sexual abuse.

This article explores the potential benefits and risks of patient self-disclosure in the psychotherapy of adult women survivors of childhood sexual abuse (CSA). Two primary questions frame this discussion: How are the primary benefits of patient disclosure influenced by CSA status, and what are the specific risks associated with each of these benefits in the case of CSA patients? The authors examine these questions by evaluating, from the perspective of clinical work with CSA patients, each of 6 putative benefits of self-disclosure in psychotherapy: self-awareness and identity formation, intimacy, validation and affirmation, differentiation, authenticity, and catharsis. The authors suggest that although clinical work with CSA survivors often necessitates encouraging these patients to discuss traumatic material, such disclosure may include substantial costs as well as benefits. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anger expression and adaptation to childhood sexual abuse: The role of disclosure.

Previous research on anger and childhood sexual abuse (CSA) is largely cross-sectional and retrospective. In this study, we prospectively examined the consequences of expressing anger among sexually abused women in contexts of either voluntarily disclosing or not disclosing a previous abuse episode (n = 94). All CSA survivors in the study had documented histories of CSA. These participants and a matched, nonabused sample were asked to describe their most distressing experience while being videotaped to allow coding of anger expression. Approximately two thirds of the CSA survivors voluntarily disclosed a previous abuse experience. Participants completed measures of internalizing symptoms and externalizing symptoms at the time of disclosure and again two years later. The expression of anger was associated with better long-term adjustment (decreased internalizing and externalizing symptoms), but only among CSA survivors who had expressed anger while not disclosing an abuse experience. For CSA survivors who disclosed an abuse experience and for nonabused women, anger expression was unrelated to long-term outcome. These findings suggest that the benefits of anger expression for CSA survivors may be context specific. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Childhood sexual abuse, stigmatization, internalizing symptoms, and the development of sexual difficulties and dating aggression.

Potential pathways from childhood sexual abuse (CSA) to subsequent romantic intimacy problems were examined in a prospective longitudinal study of 160 ethnically diverse youth with confirmed CSA histories. Participants were interviewed at the time of abuse discovery, when they were 8-15 years of age, and again 1-6 years later. Stigmatization (abuse-specific shame and self-blame) and internalizing symptoms (posttraumatic stress and depressive symptoms), more than abuse severity, explained which youth with CSA histories experienced more sexual difficulties and dating aggression. Stigmatization was found to operate as a predictive mechanism for subsequent sexual difficulties. Internalizing symptoms were not predictive of romantic intimacy problems, although they did show correlational relations with sexual difficulties and dating aggression. Early interventions such as trauma-focused cognitive-behavioral therapy that target stigmatization may be important for preventing the development of sexual difficulties in CSA youth. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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)     

A meta-analytic review of gender differences in perceptions of sexual harassment.

Research on gender differences in perceptions of sexual harassment informs an ongoing legal debate regarding the use of a reasonable person standard instead of a reasonable woman standard to evaluate sexual harassment claims. The authors report a meta-analysis of 62 studies of gender differences in harassment perceptions. An earlier quantitative review combined all types of social–sexual behaviors for a single meta-analysis; the purpose of this study was to investigate whether the magnitude of the female–male difference varies by type of behavior. An overall standardized mean difference of 0.30 was found, suggesting that women perceive a broader range of social–sexual behaviors as harassing. However, the meta-analysis also found that the female–male difference was larger for behaviors that involve hostile work environment harassment, derogatory attitudes toward women, dating pressure, or physical sexual contact than sexual propositions or sexual coercion. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Introduction to special section on clinical intervention in child sexual abuse.

The purpose of this special section is to further research, clinical practice, and teaching in the area of child sexual abuse. Although most of the articles are written by psychologists and are relevant to research, practice, and teaching by psychologists, the articles have relevance to other professionals as well. The special section is composed of seven articles. The first focuses on the effects of child sexual abuse. The next five articles have relevance for assessment and treatment. The last article focuses on teaching clinical intervention in child sexual abuse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pathways from childhood abuse and neglect to HIV-risk sexual behavior in middle adulthood.

Objective: This study examines the relationship between childhood abuse and neglect and sexual risk behavior in middle adulthood and whether psychosocial factors (risky romantic relationships, affective symptoms, drug and alcohol use, and delinquent and criminal behavior) mediate this relationship. Method: Children with documented cases of physical abuse, sexual abuse, and neglect (ages 0–11) processed during 1967–1971 were matched with nonmaltreated children and followed into middle adulthood (approximate age 41). Mediators were assessed in young adulthood (approximate age 29) through in-person interviews between 1989 and 1995 and official arrest records through 1994 (N = 1,196). Past year HIV-risk sexual behavior was assessed via self-reports during 2003–2004 (N = 800). Logistic regression was used to examine differences in sexual risk behavior between the abuse and neglect and control groups, and latent variable structural equation modeling was used to test mediator models. Results: Child abuse and neglect was associated with increased likelihood of risky sexual behavior in middle adulthood, odds ratio = 2.84, 95% CI [1.74, 4.64], p ≤ .001, and this relationship was mediated by risky romantic relationships in young adulthood. Conclusions: Results of this study draw attention to the potential long-term consequences of child abuse and neglect for physical health, in particular sexual risk, and point to romantic relationships as an important focus of intervention and prevention efforts. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Effects of childhood abuse on relapse in a recently homeless substance-dependent veteran population.

The impact of childhood abuse, both childhood sexual abuse (CSA) and childhood physical abuse (CPA), is well documented. Both CSA and CPA have been associated with a number of mental health difficulties, including substance dependence. Though the association between abuse and mental health problems is well documented, what has received little attention is the impact that abuse histories may have on the ability to complete treatment for these problems. This study evaluates the association between abuse and failure to complete treatment due to substance relapse in 70 substance-dependent homeless men served by a Veterans Affairs Domiciliary Residential Rehabilitation and Treatment Program. Demographic and mental health variables were compared with incident rates of sexual and physical abuse as well as with rates of relapse prior to program completion. Contrary to predictions, results found that physical abuse, not sexual abuse, was associated with higher relapse rates. Limitations, implications, and future directions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"I keep that hush-hush": Male survivors of sexual abuse and the challenges of disclosure.

Disclosure is a prominent variable in child sexual abuse research, but little research has examined male disclosure experiences. Sixteen male survivors of childhood sexual abuse were interviewed regarding experiences of disclosure. Analytic techniques included a grounded theory approach to coding and the use of conceptually clustered matrices. Participants described distinct personal (e.g., lack of cognitive awareness, intentional avoidance, emotional readiness, and shame), relational (e.g., fears about negative repercussions, isolation), and sociocultural (e.g., lack of acceptance for men to experience or acknowledge victimization) reasons for their struggles with disclosure. These results highlight that barriers to disclosure exist in multiple domains of experience and are encountered across the lifespan. Implications for future research and clinical interventions are discussed. (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)     

Final report of APA working group on investigation of memories of childhood abuse: A critical commentary.

This commentary evaluates the evidence presented by Alpert, Brown, and Courtois in the Final Report of the APA Working Group on Investigation of Memories of Childhood Abuse (1996). The weaknesses in their assessment of evidence and their theoretical arguments go beyond those identified by Ornstein, Ceci, and Loftus. Historical and clinical data are uncritically overvalued, and empirical concepts (like state-dependent memory) are borrowed for explanatory purposes without appreciating the limits and inconsistencies in the underlying empirical research. An argument is advanced that clinical evidence can never be free of the influence of cherished beliefs and that some therapeutically recovered memories may reflect the cherished beliefs of clinicians who recover them. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Directed forgetting of trauma cues in adults reporting repressed or recovered memories of childhood sexual abuse.

An item-cuing directed forgetting task was used to investigate whether women reporting repressed (n?=?13) or recovered (n?=?13) memories of childhood sexual abuse (CSA) exhibit an avoidant encoding style (and resultant impaired memory) for trauma cues relative to women reporting no CSA experience (n?=?15). All participants viewed intermixed trauma (e.g., molested), positive (e.g., confident), and categorized neutral (e.g., mailbox) words on a computer screen and were instructed either to remember or to forget each word. The results provided no support for the hypothesis that people reporting either repressed or recovered memories of CSA are especially adept at forgetting words related to trauma. These groups recalled words they were instructed to remember more often than words they were instructed to forget regardless of whether they were trauma related. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Posttraumatic stress symptoms mediate the relation between childhood sexual abuse and nonsuicidal self-injury.

Prior research consistently has shown a strong relation between childhood abuse and nonsuicidal self-injury (NSSI), yet it is unclear why this relation exists. The authors examined 2 specific posttraumatic stress disorder (PTSD) symptom clusters as potential mechanisms through which childhood abuse may be related to NSSI. Participants were 86 adolescents (78% female, 22% male; 73% Caucasian, 27% other races/ethnicities; mean age = 17.03 years, range = 12-19 years) who completed measures of childhood abuse, Diagnostic and Statistical Manual of Mental Disorders (4th ed.) PTSD symptoms, and NSSI. Analyses revealed a significant relation between childhood sexual abuse in particular and the presence and frequency of NSSI. Moreover, data supported a theoretical model in which PTSD reexperiencing and avoidance/numbing symptoms independently mediate this relation. Future research must test the temporal relation between childhood sexual abuse, PTSD symptoms, and NSSI and identify additional pathways to engagement in NSSI. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Context matters: The benefits and costs of expressing positive emotion among survivors of childhood sexual abuse.

Positive emotions promote adjustment to aversive life events. However, evolutionary theory and empirical research on trauma disclosure suggest that in the context of stigmatized events, expressing positive emotions might incur social costs. To test this thesis, the authors coded genuine (Duchenne) smiling and laughter and also non-Duchenne smiling from videotapes of late-adolescent and young adult women, approximately half with documented histories of childhood sexual abuse (CSA), as they described the most distressing event of their lives. Consistent with previous studies, genuine positive emotional expression was generally associated with better social adjustment two years later. However, as anticipated, CSA survivors who expressed positive emotion in the context of describing a past CSA experience had poorer long-term social adjustment, whereas CSA survivors who expressed positive emotion while describing a nonabuse experience had improved social adjustment. These findings suggest that the benefits of positive emotional expression may often be context specific. (PsycINFO Database Record (c) 2010 APA, all rights reserved)