Adult Survivors Of Sexual Abuse Research Articles

Longitudinal Effects of Sexual Assault Victims' Drinking and Self-Blame on Posttraumatic Stress Disorder.

Alcohol plays a major role in sexual assaults, but few studies have examined its impact on recovery outcomes, particularly in longitudinal studies. In a longitudinal study of 1,013 adult sexual assault survivors, we investigated the effects of victim drinking on posttraumatic stress disorder (PTSD), as well as the mediating role of characterological and behavioral self-blame attributions. In line with some prior research, victims who were drinking before their assault experienced less PTSD, but more self-blame than those who were not. Characterological, but not behavioral self-blame was related to increased PTSD symptoms. Thus, although drinking was overall related to less PTSD, it was also associated with increased PTSD via self-blame attributions, highlighting the danger of blaming victims of alcohol-related rapes for their assaults. Implications for future research and clinical work with survivors of alcohol-related sexual assaults are drawn.

“NOBODY DESERVES THIS”: ADOLESCENT SEXUAL ASSAULT VICTIMS’ PERCEPTIONS OF DISBELIEF AND VICTIM BLAME FROM POLICE

Prior research reveals that many police engage in victim blaming, skeptical reactions to adult sexual assault survivors. However, little is known about adolescent survivors’ experiences with police. To address this gap, qualitative interviews were conducted with 20 adolescent rape survivors to understand adolescents’ perceptions of their interactions with the police (specifically the messages the officers conveyed about the assault and the victims themselves). Positive perceptions occurred when the adolescents perceived police behavior as indications of believing their story, validating their decision to report, and refraining from judgment of their behavior. On the other hand, negative perceptions were associated with behaviors that were viewed as indications of skepticism, blame, or judgment. Specific behaviors that were associated with each of these themes are discussed. Interactions with the police influenced survivors’ emotional well-being and their hope for their case's success. Implications for improving interactions between police and adolescent sexual assault victims are discussed.

Sexual revictimization, PTSD, and problem drinking in sexual assault survivors

Posttraumatic stress disorder (PTSD) and problem drinking are common and often co-occurring sequelae experienced by women survivors of adult sexual assault, yet revictimization may mediate risk of symptoms over time. Structural equation modeling was used to examine data from a 3-wave panel design with a large (N=1012), ethnically diverse sample of women assault survivors to examine whether repeated sexual victimization related to greater PTSD and problem drinking. Structural equation modeling revealed that child sexual abuse was associated with greater symptoms of PTSD and problem drinking and intervening sexual victimization was associated with greater symptoms of PTSD and problem drinking at both 1 and 2year follow-ups. We found no evidence, however, that PTSD directly influenced problem drinking over the long term or vice versa, although they were correlated at each timepoint. Revictimization during the study predicted survivors' prospective PTSD and problem drinking symptoms inconsistently. Implications and recommendations for future research are discussed.

Improving mental wellbeing for survivors of childhood abuse and neglect: psychological healing and education course in prisons

Since 1989, the National Association for People Abused in Childhood (NAPAC) has been working to help adult survivors of childhood abuse and neglect achieve recovery from the consequences of their trauma. NAPAC was set up to address this specific need In the absence of any existing national organisation and has developed ways of working which draw on a range of existing therapeutic and educational methods. Through experience gained by running a national free support phone line and listening to thousands of survivor accounts, NAPAC has Identified some common problems and practical ways to overcome them.COMMON PROBLEMSKey texts informing the development of NAPAC's approach were self-help books for survivors first published in the USA: The Courage to Heal1 for females and Victims No Longer2 for males. Both texts encouraged adult survivors to work through their problems at their own pace and explained many of the issues survivors face in adulthood. Some of the problems described include:*Not talking about the problems having been made to fear the consequences by the abuser(s) during childhood;*Self-blaming having been told by the abuser(s) that they were at fault in childhood;*Believing no one else shares the experience or could understand it; and*A belief in being damaged beyond any hope of recovery.Dr Judith Lewis Herman3 of Harvard Medical School brought rigorous academic analysis to the topic In Trauma and Recovery: The Aftermath of Violence by comparing the consequences of trauma on three social groups: domestic violence victims, military personnel injured in combat and adult survivors of sexual abuse during childhood. Herman Identified significant differences In the long term sequelae between these groups due to such factors as early age of onset, number of traumatic events and number of perpetrators and public recognition of the reality of the trauma. The consequences of sexual abuse during childhood were shown to be far more complex and difficult to address than combat trauma, for example, partly because the general public is less likely to believe a child's account than that of an adult member of the armed services engaged in action widely reported in the news media. For these and other reasons, Herman identified the concept of complexity In post-traumatic stress disorder (PTSD), which means that simple interventions such as cognitive behavioural therapy are less likely to be effective with survivors of childhood abuse than with personnel wounded in combat. Recovery from childhood trauma takes more time and harder work with more support than simple PTSD. Coping mechanisms learned In childhood may become deeply embedded through adulthood and therefore hard to replace; memories may have been repressed by the child and stored subconsciously causing a range of mental and physical problems.Such understanding has now become widely accepted by practitioners:The traumatic stress field has adopted the term complex trauma to describe the experience of multiple, chronic and prolonged, developmentally adverse traumatic events, most often of an interpersonal nature (e.g., sexual or physical abuse, war, community violence) and early-life onset.4More recently, the UK Government commissioned the Victims of Violence and Abuse Prevention Programme overseen by the late Dr Catherine Itzen, a very large scale assessment of the problem. Their report summarises the situation as follows in their Introduction:Domestic and sexual violence and abuse affects a very substantial minority of the population. It is largely women, and children of both sexes, who are affected, but men are also raped and experience domestic violence. Child physical, emotional or sexual abuse and neglect and domestic violence are causal factors in the mental and physical ill-health of children, adolescents and adults and affect a significant proportion throughout their lives. The high costs in prevalence and economic burden on health and social care services and the criminal justice system have pushed these issues up the policy agenda. …

Social Reactions, Self-Blame and Problem Drinking in Adult Sexual Assault Survivors.

The purpose of this study was to test a model of the relations of social reactions to sexual assault disclosure, self-blame and problem drinking. This is the first study to investigate whether type of self-blame has different relationships with social reactions and problem drinking in a large, diverse sample of sexually assaulted women. These relationships are important to investigate in order to identify specific targets for treatment and intervention with sexual assault victims and their social networks. Community-residing female sexual assault survivors (N = 1863) in a large metropolitan area completed a mail survey about sexual assault, social reactions to disclosure, self-blame attributions, and problem drinking symptoms. Structural equation modeling showed that characterological self-blame mediated the effect of negative social reactions on drinking, but behavioral self-blame did not function as a mediator. A second model showed unique relationships of specific positive and negative social reactions to drinking through characterological and behavioral self-blame. Characterological self-blame needs to be targeted in treatment and intervention with survivors, as it appears to be a key mechanism through which social reactions may influence recovery. Secondary prevention with informal social networks should educate people about social reactions to avoid negative reactions and promote those that are helpful, so people can better respond to survivors' sexual assault disclosures and improve recovery.

Identifying and treating adult survivors of sexual assault.

About 18% of women and 3% of men report being a victim of sexual assault, but fewer than one-third of victims seek immediate medical attention or psychological counseling. Over time, victims may experience physical and emotional reactions and turn to primary care providers, who should be prepared to identify survivors of sexual assault and provide thoughtful referrals for long-term follow-up.

An Exploratory Study of Trauma and Religious Factors in Predicting Drinking Outcomes in African American Sexual Assault Survivors.

This exploratory study examined the relationships between religious factors, trauma histories and life satisfaction to alcohol-related outcomes in adult sexual assault survivors. A mail survey was administered to a community sample of African American survivors (N = 836) in the Chicago metropolitan area. Hierarchical regression analyses showed that for non-religious women, interpersonal trauma was related to greater frequency of heavy drinking. For moderately religious women, interpersonal and contextual traumas were related to more frequent heavy drinking. For highly religious women, religious coping was related to less frequent heavy drinking. Implications are drawn for research and treatment of female survivors.

An integrative model in trauma treatment: Utilizing eye movement desensitization and reprocessing and a relational approach with adult survivors of sexual abuse.

An integrative model in trauma treatment: Utilizing eye movement desensitization and reprocessing and a relational approach with adult survivors of sexual abuse.

Correlates of Perceived Helpfulness of Mental Health Professionals Following Disclosure of Sexual Assault

A diverse sample of more than 365 adult sexual assault survivors, recruited from college and community sources, was surveyed about sexual assault experiences, post-assault factors, and perceived helpfulness of and satisfaction with mental health professionals. Regression analyses were conducted to identify factors associated with perceived helpfulness of and satisfaction with mental health professionals. Older age, higher posttraumatic stress disorder (PTSD), greater control over recovery, and more emotional support reactions were associated with positive perceptions of mental health professionals. Stranger offenders, greater resistance during assault, high victim post-assault upset, and blaming social reactions from others were associated with negative perceptions of mental health professionals.

Therapy for Childhood Sexual Abuse Survivors Using Attachment and Family Systems Theory Orientations

The aim of this article is to understand the effects of childhood sexual abuse on a survivor's later life. For understanding and treating the emotional distress and interpersonal problems resulting from childhood sexual abuse, attachment theory provides a valuable framework. When this framework is combined with family systems theory, it can help therapists understand the family context where sexual abuse occurs and how this affects health and functioning throughout the lifespan. Case examples of female adult sexual abuse survivors are also explored, with insight from the intersection of systems and attachment theories.

Childhood Sexual Abuse and Intimate Relationships: A Support Group for Male Partners

Individual and group therapy modalities are common approaches to treating survivors of child sexual abuse (CSA). Survivors have identified a number of interpersonal problems that they experience with romantic partners but little is known about the partner’s perspective. Additionally, partners of abuse survivors are generally excluded from the treatment process. A short-term support group for the partners of adult survivors of sexual abuse was conducted concurrently with an Incest Resolution Group. The goal of the Partner’s Support Group was to gain greater understanding of the interpersonal relational problems as experienced by the partners, and to provide support, insight, and education regarding the impact of CSA. Clinical implications are discussed.

Group work for adult survivors of sexual abuse in childhood

Lorna Coulson and Heather Morfett describe how women overcame feelings of isolation and shame by sharing their experiences in a safe, all-female space

Acceptance and Commitment Therapy With Survivors of Adult Sexual Assault

A number of studies have found experiential avoidance to mediate the relationship between sexual assault and adverse long-term effects. One treatment approach that has been developed for the treatment of experiential avoidance is Acceptance and Commitment Therapy (ACT). A small body of research has demonstrated preliminary efficacy for the use of ACT with trauma survivors suffering from posttraumatic stress disorder (PTSD). However, no treatment studies to date have evaluated ACT as a treatment model with survivors of adult sexual assault. In this case study, ACT was applied to an 18-year-old survivor of adult sexual assault suffering from PTSD symptoms. The results indicated that ACT was effective in reducing experiential avoidance, thought suppression, trauma symptomatology, and increasing valued action and quality of life. The findings of this study suggest that the use of grounding techniques, visual metaphors, and experiential mindfulness exercises in ACT may be particularly helpful for survivors of adult sexual assault.

The Effects of Childhood Abuse on Relationship Quality: Gender Differences and Clinical Implications

This study examined the relationship between self-reported childhood physical and sexual abuse, romantic relationship quality, possible gender differences, and clinical implications. Three hundred thirty-eight women and 296 men who sought services at a university mental health clinic in the northeast region of the United States completed a 30-minute self-report assessment questionnaire before their first therapy session. Among the items in the questionnaire were measures of childhood physical and sexual abuse, relationship stability, problem areas in the relationship, and other demographic information. Results from structural equation modeling indicated that childhood physical abuse influenced relationship quality for both men and women whereas childhood sexual abuse did not have a significant impact on relationship quality for either gender. The results of the study indicated that there may be more gender similarities than differences in experiences of childhood abuse and relationship quality than previous research has shown. Key Words: child abuse, marital quality, physical abuse, sexual abuse. The National Incidence Study IV (Sedlak et al., 2010) reported that an estimated 323,000 children were physically abused and 135,300 children were sexually abused between 2005 and 2006. Over the past few decades, numerous studies have been conducted on both the short-term and long-term negative effects that child abuse can have on the victim (Alpher & France, 1993; Braver, Bumberry, Green, & Rawson, 1992; Futa, Nash, Hansen, & Garbin, 2003; Springer, Sheridan, Kuo, & Cames, 2007). Most studies, however, have focused on the potential that the victim has for becoming a perpetrator as an adult (Wilcox, Richards, & O'Keeffe, 2004), for entering abusive romantic relationships (Griffing et al., 2005; Van Benschoten, 1995), or for abusing their own children (Hall, Sachs, & Rayens, 1998; Lawson, 2001). Within the existing research, multiple studies examined the relationship between childhood abuse and sexual satisfaction in marriage (Finkelhor, Hotaling, Lewis, & Smith, 1989; Leonard, Iverson, & Follette, 2008; Loeb et al., 2002), but few have examined the relationship between childhood abuse and the overall quality of the adult's committed romantic relationships (Alpert, Brown, & Courtois, 1998; Finkelhor et al., 1989). Additionally, few studies have focused on how gender impacts those long-term effects. The purpose of this study was to examine the relationship between the frequency of childhood physical and sexual abuse and relationship quality, with a focus on possible gender differences and the clinical implications of any gender differences. Age and length of relationship were controlled to take into account the developmental stage of the relationship and recognize that a young married couple may be different from an old married couple. LITERATURE REVIEW Childhood Physical Abuse and the Psychosocial Consequences in Adulthood Childhood physical abuse has been found to have negative effects on adult mental and psychological functioning (Arata, Langhinrichsen-Rohling, Bowers, & O'Farrill-Swails, 2005; Springer et al., 2007; Styron & Janoff-Bulman, 1997; Swenson & Kolko, 2000). Individuals who experienced physical abuse in childhood were more likely to report physical illness, depression, anger, and anxiety than nonabused individuals (Springer et al., 2007). Childhood Sexual Abuse and the Psychosocial Consequences in Adulthood Childhood sexual abuse has also been associated with psychological and relational impairment in adult life (Alpert et al., 1998; Jesness, 2009; Sypeck, 2005; Wilcox et al., 2004). Research suggested that many adult survivors of sexual abuse had gone on to experience difficulty forming healthy relationships. These victims often blamed themselves for the abuse, which made it difficult to come to terms with the psychological, emotional, and social consequences ofthat type of violation. …

Researching Sexual Abuse: Methodological Issues

Researching Sexual Abuse: Methodological Issues

Transformative justice: survivor perspectives on clergy sexual abuse litigation

This paper examines the motivations of men and women who entered into mass tort litigation against the Catholic Church, primarily the Archdiocese of Boston, which alleged clergy sexual abuse by Roman Catholic priests. The study is based on in‐depth interviews with adult survivors of sexual abuse (perpetrated against boys and girls), and with their attorneys and other legal advocates. We explore the challenges faced by survivor‐litigants, as well as their accounts of the subjective experience and meaning of litigation. Our focus is on clarifying petitioners’ multiple objectives and illuminating some of the unanticipated ways in which participation in the case offered possibilities for positive, even transformative, outcomes. The study contributes to our understanding of the course and effects of litigation from the perspective of the litigants, and has important implications for the theoretical literature on the transformation of disputes.

Child Sexual Abuse, Post-Traumatic Stress Disorder, and Substance Use: Predictors of Revictimization in Adult Sexual Assault Survivors

This study examined the unique effects of child sexual abuse simultaneously with post-traumatic stress disorder symptom clusters, problem drinking, and illicit drug use in relation to sexual revictimization in a community sample of female adult sexual assault victims. Participants (N = 555) completed two surveys a year apart. Child sexual abuse predicted more post-traumatic stress disorder symptoms in adult sexual assault victims. Post-traumatic stress disorder numbing symptoms directly predicted revictimization, whereas other post-traumatic stress disorder symptoms (reexperiencing, avoidance, and arousal) were related to problem drinking, which in turn predicted revictimization. Thus, numbing symptoms and problem drinking may be independent risk factors for sexual revictimization in adult sexual assault victims, particularly for women with a history of childhood sexual abuse.

Prospective effects of sexual victimization on PTSD and problem drinking

Posttraumatic stress disorder (PTSD) and problem drinking are common and often co-occurring sequelae experienced by women survivors of adult sexual assault, yet it remains unclear whether survivors drink to cope with PTSD symptoms or whether PTSD symptoms are exacerbated by drinking. Thus, we used a cross-lagged panel design with a large ( N = 555), ethnically diverse sample of women assault survivors to determine whether PTSD prospectively led to problem drinking or vice versa. We also examined whether cumulative sexual victimization experiences related to greater PTSD and problem drinking. Structural equation modeling revealed that child sexual abuse was associated with greater symptoms of PTSD and problem drinking and intervening sexual victimization was associated with greater symptoms of PTSD and problem drinking 1 year later. We found no evidence, however, that PTSD directly influenced problem drinking over the long term, or vice versa. Rather, experiencing revictimization during the study predicted survivors' prospective PTSD and problem drinking symptoms. Implications and recommendations for future research are discussed.

Moving Within the Spiral

To uncover implicit and explicit meanings that are embedded in the experiences of adult survivors of sexual assault, the authors conducted interviews with 12 women survivors. Using Heideggerian hermeneutic phenomenology, they uncovered three relational themes and one overarching pattern from the data. “Breaking down” describes the violence that survivors experience, “making meaning” expresses the ways in which survivors incorporate the assault into the narratives of their lives, and “going beyond themselves” explicates what survivors do with their story, who they tell, and what they want to happen. Moving within the spiral: the process of surviving, the constitutive pattern, contains emerging themes, lived experiences, and the practices of participants.

PTSD Symptoms and Self-Rated Recovery Among Adult Sexual Assault Survivors: The Effects of Traumatic Life Events and Psychosocial Variables

Prior research has demonstrated that self-blame is predictive of more posttraumatic stress disorder (PTSD) symptoms and poorer recovery ( Frazier, 2003 ; Koss, Figueredo, & Prince, 2002 ), and perceived control over recovery is associated with less distress ( Frazier, 2003 ) in adult sexual assault (ASA) survivors. A structural equation model was tested to examine the role of traumatic events, self-blame, perceived control over recovery, and coping strategies on PTSD symptoms and self-rated recovery in women ASA survivors. Adaptive coping partially mediated the effects of other traumas, self-blame, and perceived control over recovery on PTSD symptoms and showed a small positive association with increased PTSD symptoms. As hypothesized, maladaptive coping partially mediated the effects of other traumas, self-blame, and perceived control over recovery on both PTSD symptoms and self-rated recovery; greater maladaptive coping was associated with increased PTSD symptoms and lower self-rated recovery. Implications and directions for future research are discussed.