Adult Survivors Of Sexual Abuse Research Articles

Empowering adult sexual assault survivors in higher education through emancipatory learning and feminist pedagogy

AbstractThis article presents emancipatory feminist teaching methods to empower adult women who are survivors of sexual assault in higher education settings. It delves into the work of leading scholars such as Paulo Freire, Henry Giroux, and Ira Shor, as well as feminist pedagogy and relevant literature on sexual assault survivorship in higher education. Through analysis and synthesis of this literature, the article provides implications, recommendations, and a critique of applying emancipatory feminist pedagogy to promote emancipatory learning to empower survivors.

Open science and data sharing in trauma research: Developing a trauma-informed protocol for archiving sensitive qualitative data.

The open science movement seeks to make research more transparent, and to that end, researchers are increasingly expected or required to archive their data in national repositories. In qualitative trauma research, data sharing could compromise participants' safety, privacy, and confidentiality because narrative data can be more difficult to de-identify fully. There is little guidance in the traumatology literature regarding how to discuss data-sharing requirements with participants during the informed consent process. Within a larger research project in which we interviewed assault survivors, we developed and evaluated a protocol for informed consent for qualitative data sharing and engaging participants in data de-identification. We conducted qualitative interviews with N = 32 adult sexual assault survivors regarding (a) how to conduct informed consent for data sharing, (b) whether participants should have input on sharing their data, and (c) whether they wanted to redact information from their transcripts prior to archiving. No potential participants declined participation after learning about the archiving mandate. Survivors indicated that they wanted input on archiving because the interview is their story of trauma and abuse and it would be disempowering not to have control over how this information was shared and disseminated. Survivors also wanted input on this process to help guard their privacy, confidentiality, and safety. None of the participants elected to redact substantive data prior to archiving. Engaging participants in the archiving process is a feasible practice that is important and empowering for trauma survivors. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Survivor, family and professional experiences of psychosocial interventions for sexual abuse and violence: a qualitative evidence synthesis.

Survivor, family and professional experiences of psychosocial interventions for sexual abuse and violence: a qualitative evidence synthesis.

Multi-disciplinary Evaluation of Sexual Assault Referral Centres (SARCs) for better Health (MESARCH): protocol for a 1-year cohort study examining health, well-being and cost outcomes in adult survivors of sexual assault attending SARCs in England

IntroductionSexual violence is commonplace and has serious adverse consequences for physical and mental health. Sexual Assault Referral Centres (SARCs) are viewed as a best practice response. Little is known about...

Validation of ICD-11 PTSD and DSO using the International Trauma Questionnaire in five clinical samples recruited in Denmark

ABSTRACT Background: The 11th version of the International Classification of Diseases (ICD-11) revised the diagnosis of Posttraumatic Stress Disorder (PTSD) and introduced Complex PTSD as a sibling disorder to PTSD. As the Danish Health Authorities will implement the ICD-11 in 2022, it is more relevant than ever to introduce a measure that enables the identification of ICD-11 PTSD and CPTSD. Objective: The primary aim of the present study was to test the construct validity of the ICD-11 conceptualization of PTSD and DSO in five clinical samples using translated versions of the International Trauma Questionnaire (ITQ). Method: Data from existing studies of adult survivors of sexual abuse (n = 385), women in shelters (n = 147), psychiatric outpatients endorsing an ICD-10 diagnosis of PTSD (n = 111), a heterogenous sample of psychiatric outpatients (n = 178) and refugees and torture survivors (n = 385) was used for the current study. Confirmatory factor analyses were conducted to test the internal structure of the ITQ, and regression models were conducted to test the convergent and discriminant validity of the factor solutions for each sample. Results: Findings supported the ICD-11 formulation of PTSD and disorders in self-organization (DSO) as a representation of the latent structure of the ITQ across five Danish clinical samples. Uniquely for women in shelters, however, the model displayed an unacceptable fit. A revised operationalization of re-experiencing proved a better fit when ‘recurrent nightmares’ was exchanged with symptoms of intense emotional reactions to reminders of the trauma for women in shelter as well as ICD-10 PTSD psychiatric outpatients. Conclusion: This study supports the use of a Danish translated version of the ITQ to assess symptoms of ICD-11 PTSD and DSO for the introduction of ICD-11 in 2022. Future research is needed to further explore the operationalization of re-experiencing across different trauma exposed populations.

Relationship Variables in Group Psychotherapy for Women Sexual Trauma Survivors

ABSTRACT This study examined relational group psychotherapy processes, including group cohesion, bond with group leaders, perceptions of shame, and posttraumatic stress disorder (PTSD) symptomatology for sexual trauma survivors. Six separate treatment groups of women who were either adult sexual assault survivors (N = 24) or adult survivors of childhood sexual abuse (N = 9) participated in the study. Participants completed the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) pre- and posttreatment, the Group Climate Questionnaire, Bond scale of the Working Alliance Inventory Short Form (WAI-S), and Compass of Shame Scale at four intervals. Growth curve models analyzed Engagement, Bond, and Shame Reactions over time. PCL-5 scores were compared pre- and posttreatment and examined in relationship to the process variables of Engagement and Bond. Results showed increases in group cohesion and perceptions of Bond with group leaders and decreases in PTSD symptoms and attacking self-shame reactions. Clinical implications and recommendations for this population are presented.

Anti-Sexual Assault Activism and Positive Psychological Functioning among Survivors

In the present study, we examined the links between involvement in anti-sexual assault activism with post-traumatic growth and positive affect among 282 U.S. adult sexual assault survivors. We also explored potential mediators (i.e., self-blame, shame, community connection, meaning in life, trauma coping self-efficacy, and personal control) in these linkages. Results indicated that involvement in anti-sexual assault activism was positively correlated with both post-traumatic growth and positive affect. In addition, our findings revealed that involvement in anti-sexual assault activism was indirectly related to post-traumatic growth via community connection and coping self-efficacy/control (a composite variable) whereas involvement in anti-sexual assault activism was indirectly related to positive affect through meaning in life and coping self-efficacy/control. That is, more involvement in anti-sexual assault activism was related to greater community connection, more meaning in life, and greater coping/control which in turn was associated with more positive psychological functioning. Results of the present study may inform advocacy and support services and clinical interventions with survivors of sexual assault, with an emphasis on how collective action may foster positive mental health outcomes.

From pain to power: An exploration of activism, the #Metoo movement, and healing from sexual assault trauma.

In this qualitative study, we explored the role that social activism and #MeToo and other large scale antiviolence activist movements may play in sexual assault survivors' healing process and how they navigate and make sense of their sexual assault experience. We interviewed 16 adult sexual assault survivors (13 women, 2 genderqueer/nonconforming individuals, and 1 identifying as a man and genderqueer) who were engaged in anti-sexual assault activism and analyzed their data using thematic analysis. Participants were predominately White and highly educated. We found that activism helped participants find their voice and regain their power. They described a process of moving from silence and shame around their sexual assault to freedom and empowerment. Their involvement in activism and/or connection to larger scale antiviolence activist movements (a) helped increase their understanding of themselves and their sexual assault experience, (b) served as a useful coping mechanism, (c) improved their self-confidence and relationships, (d) allowed them to stand up and speak out against attitudes and behaviors that foster rape culture, (e) provided support, validation, and connection to others, and (f) provided a source of meaning and fulfillment in their lives. Helping other survivors through their activist work also contributed to participants' healing process. Participants also described challenges associated with anti-sexual assault activism and #MeToo and related movements. These included being triggered, being inundated with media coverage and public narratives about sexual assault, burning out, and feeling disillusioned and frustrated. Finally, participants noted the importance of mainstream movements in increasing awareness. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Multiple perpetrator sexual assault: correlates of PTSD and depressive symptoms in a sample of adult women

ABSTRACT While most sexual assaults are committed by a sole perpetrator, multiple-perpetrator assaults (MPSAs) still occur. However, less is known about their post-assault impacts. This study examined demographic, assault, and post-assault characteristics as correlates of post-traumatic stress disorder (PTSD) and depressive symptoms in a community sample of adult sexual assault survivors who experienced MPSA (N = 350) in the Chicago area. This study also included demographic and assault characteristics of perpetrators as reported by survivors. Backward regression analysis showed that stressful life events, more violent assaults, post-assault maladaptive coping and characterological self-blame, and receiving acknowledgement without support (e.g. acknowledging the assault happened, but giving inadequate support) reactions were related to greater PTSD symptoms. Older age and greater perceived control over recovery were associated with fewer PTSD symptoms. Greater violence, maladaptive coping, and characterological self-blame were related to greater depressive symptoms, whereas more education and greater perceived control over recovery correlated with fewer depressive symptoms. This study adds to research on MPSA and findings have implications for clinical treatment, intervention, and prevention with survivors.

Psychopathology, perceived social support, and coping in survivors of adult sexual assault: A cross-sectional hospital-based study.

Background:Adult sexual assault (ASA) is often associated with negative mental health consequences. The psychological needs of ASA survivors are overlooked while the legal and social needs focused on.Methodology:It is a cross-sectional study. The ASA survivors who came for medical evaluation were included in the study after obtaining consent. Fifty ASA survivors were interviewed for the study. Psychopathology, perceived social support, and coping mechanisms were assessed during interview using especially designed semi-structured pro forma.Results:The mean age of participants was 25.6 ± 7.2 years. Forty-one of 50 survivors suffered from major depressive disorder or posttraumatic stress disorder or both with 33 expressing suicidal ideas. Maximum social support was perceived from family and least from significant others such as health-care workers, police, and judiciary. Problem solving and expressive action are associated with better perceived social support by family as well as friends.Conclusion:Depression and suicidal ideas among majority the survivors of ASA highlight the mental devastation the sexual assault causes to a woman. Although family is primary social support to them, health-care workers and law enforcement officials are not perceived as supportive toward the survivors. Routine mental health assistance and empathetic approach by all parties involved in the management of survivors are needed in these cases.

Believe #metoo: sexual violence and interpersonal disclosure experiences among women attending a sexual assault service in Australia: a mixed-methods study

ObjectivesSexual abuse is a strong predictor of future psychiatric problems. A more nuanced qualitative understanding of mental health outcomes, in the context of interpersonal responses from family members towards survivors...

"I Love and Hate Him in the Same Breath": Relationships of Adult Survivors of Sexual Abuse With Their Perpetrating Siblings.

The term sibling sexual abuse (SSA) captures a broad continuum of sexual behaviors in childhood and adolescence that exceed the threshold of age-appropriate curiosity. Based on a sample of 15 adult survivors of SSA, this qualitative study examines experiences of relationships with perpetrating siblings during childhood and adulthood. Thematic analysis of semistructured qualitative interviews reveals two continua that characterize SSA survivors' lives: the "reciprocity-coercion" continuum in childhood and the "distance-closeness" continuum in adulthood. Findings reveal that regardless of how the relationships were perceived in childhood, most participants chose to distance themselves from their perpetrating siblings as adults. Thus, even in cases where the relationships were considered mutual during childhood, reconceptualization of the abuse in adulthood led to renewed understanding of its meanings and implications for the survivors' personal lives. Research findings underscore the need to further study the experiences of SSA survivors to better inform policy makers, therapists, and welfare workers, to address the complex and multifaceted nature of SSA, and to provide adequate interventions to survivors and other family members.

Ethical gaps in conducting research among adult survivors of child sexual abuse: a review.

Although there have been numerous studies, especially in the last few decades, on the impact of child sexual abuse (CSA) on adult survivors, there is a dearth of studies focusing on the ethical aspects of research in this area. Against this background, we reviewed the literature published between January 2000 and December 2016 on the reporting of ethical guidelines followed in research on adult survivors of CSA. We conducted a PubMed (MEDLINE) and Google Scholar search to find published research, using the keywords: "child sexual abuse", "adult survivors", "research", "guidelines" and "ethics". Our findings suggest that no particular assessment method is superior in terms of disclosure of information or reduction of distress. The use of developmentally appropriate educative materials, sensitisation, and debriefing sessions have shown some benefit in reducing distress. There is a lack of legal or social consensus on mandatory legal reporting of information provided by adult survivors of sexual abuse, with most researchers working on the premise that adults have the freedom of choice. Often, a constraint among researchers is the lack of structured training or supervision in sensitive research, which may negatively impact both the participant and the researcher. Institute ethics boards and institutions currently lack the framework to consider protocols and facilitate research, and this poses serious obstacles to fostering research. In this situation, ongoing research needs to focus on ethical aspects. Together with this, we recommend certain ethical practices drawn from various studies that may be employed for participants, researchers, and institutional ethics boards.

Compassion-Focused Therapy as an Intervention for Adult Survivors of Sexual Abuse

ABSTRACTChild sexual abuse can have long-term negative impacts across psychological, physical, and interpersonal domains. Some of the common issues for survivors of sexual abuse include shame and self-blame, attachment-based difficulties, avoidant coping strategies, and reduced capacity for self-compassion. Compassion-focused therapy is a transdiagnostic intervention that specifically responds to these concerns. Compassion-focused therapy was originally developed for clients who experience high levels of shame and self-criticism and aims to strengthen the soothing and affiliative system through the cultivation of compassion. This article will highlight the theoretical alignment between some of the common issues and impacts associated with experiences of sexual abuse, with the core underlying principles of compassion-focused therapy. This includes (a) the capacity of the therapy’s evolutionary framework to reduce perceptions of self-blame, (b) the cultivation of compassion to respond to feelings of shame, (c) acknowledgment of the role of early attachment experiences and facilitation of corrective affiliative experiences, (d) regulation of the threat-based system following trauma, and (e) provision of an alternative to avoidant-based coping by responding to distress with compassion. It is proposed that the theoretical framework and core focus and aims of compassion-focused therapy are highly applicable for survivors of sexual abuse and therefore holds significant promise as a treatment option for this client group.

Development of the Healthcare Triggering Questionnaire in adult sexual abuse survivors.

One in 4 women and 1 in 10 men in the United States are survivors of sexual abuse (SA). For these survivors, healthcare experiences may trigger memories, thoughts, feelings or sensations related to this past abuse. Such triggering can be associated with negative responses to healthcare (e.g., anxiety, avoidance). However, to date, no healthcare triggering assessment tool exists. Therefore, the study goal was to describe the prevalence of healthcare triggering, to develop a brief Healthcare Triggering Questionnaire (HTQ), and to examine its initial validity. An initial pool of 117 items was developed based on previous research. Two-parameter logistic item response theory models were used to develop the scales. SA survivors [male (n = 233), female (n = 222)] and a comparison group of non-SA individuals [male (n = 114), female (n = 106)] were recruited through Amazon Mechanical Turk and completed the study anonymously online. Three 10-item scales were developed: (a) the HTQ-M for males; (b) the HTQ-F for females; and (c) the HTQ-U (unisex) for all respondents. The results supported the utility and initial validity of the gender-specific and unisex scales. The HTQ scales are a psychometrically sound approach to evaluating healthcare triggering experienced by adult sexual abuse survivors. The HTQ may be considered for use by researchers interested in studying healthcare triggering, healthcare retraumatization, and healthcare adherence. The HTQ may also be of use to clinicians interested in identifying trauma survivors who are more likely to experience triggering in healthcare settings. (PsycINFO Database Record

Recovering Process from Child Sexual Abuse During Adulthood from an Integrative Approach to Solution-Focused Therapy: A Case Study

ABSTRACTIn recent times, strengths-based recovery approaches that focus on the present and build strategies that look toward the future have become popular. However, some cases require the consideration of experiences from previous stages of the clients’ development. This single-case study explores the psychotherapeutic process of a middle-aged woman who presented with a history of child sexual abuse (incest) and a long-term adult diagnosis of depression that was treated in public health services. This psychotherapy involved an integrative approach to solution-focused therapy; specifically, the approach proposed by Yvonne Dolan to work with adult survivors of sexual abuse, in conjunction with techniques and strategies from the transtheoretical model. Measures incorporating therapeutic working alliance and outcomes were administered over sessions. Results showed positive outcomes from this therapeutic intervention, which remained at 3-month and 12-month follow-ups. Implications for practitioners’ specialist practice in health services are discussed, given the complexity of comorbid mental health conditions with a history of child sexual abuse.

Cumulative childhood maltreatment and its dose-response relation with adult symptomatology: Findings in a sample of adult survivors of sexual abuse

In the present study, we examined the role of cumulative childhood maltreatment experiences for several health related outcomes in adulthood, including symptoms of psychological distress as well as perceived social support and hardiness. The sample comprised adult survivors of sexual abuse (N=278, 95.3% women, mean age at first abusive incident=6.4 years). One-way ANOVAs revealed a statistically significant dose-response relation between cumulative childhood maltreatment scores and self-reported symptoms of posttraumatic stress (PTSS), anxiety, depression, eating disorders, dissociation, insomnia, nightmare related distress, physical pain, emotional pain, relational problems, self-harm behaviors as well as on a measure of symptom complexity. Cumulative childhood maltreatment was also associated with lower levels of work functioning. An inverse dose-response relation was found for perceived social support and hardiness. Using a Bonferroni corrected alpha level, cumulative childhood maltreatment remained significantly associated with all outcome measures with the exception of eating disorder symptoms after controlling for abuse-related independent variables in hierarchical regression analyses. Results add to previous literature by showing that dose-response relation between cumulative childhood adversities and adult symptom outcomes could also be identified in a sample characterized by high exposure to adversities, and lends support to the notion put forth by previous authors that cumulative childhood adversities seem to be related to the severity of adult health outcomes in a rule-governed way.

Supplemental Material for Development of the Healthcare Triggering Questionnaire in Adult Sexual Abuse Survivors

Supplemental Material for Development of the Healthcare Triggering Questionnaire in Adult Sexual Abuse Survivors

Self-Blame and Avoidance Coping as Predictors of Post-Traumatic Stress Symptoms Among Sexually Abused Children

Abstract BACKGROUND: Child sexual abuse is clearly associated with posttrau-matic stress symptoms (PTSS). Prior studies have identified self-blame and coping as important predictors of PTSS among adult survivors of sexual assault. However, few studies have explored the potential impact of self-blame and avoidance coping in influencing PTSS in children who have disclosed sexual abuse. OBJECTIVES: This study attempted to test the contribution of self-blame and avoidance coping to the prediction of PTSS among sexually abused children. The severity of the abuse and child’s gender were also examined. DESIGN/METHODS: The sample consisted of 477 sexually abused children (319 girls and 128 boys), aged 6 to 12. Self-blame and PTSS were evaluated by the Children’s Impact of Traumatic Events Scale II. A brief version of the Self-Report Coping Scale was used to assess children’s coping avoidance. These questionnaires were child self-report measures. The severity of the abuse was categorized as (1) less severe (physical contact over clothing), (2) severe (physical contact under clothing without penetration or force) and (3) more severe (physical contact with penetration or attempted penetration). Linear regression analysis was used to test the contribution of self-blame and avoidance coping to the prediction of PTSS. First, the child’s gender and the severity of the abuse were entered, and secondly, self-blame and avoidance coping. RESULTS: A total of 10.7% of the sample reported less severe sexual abuse, 27.7% reported severe sexual abuse and 61.6% reported more severe abuse. The model which only included child’s gender and severity of the abuse explained 3.8% of the variance (F=9.04, p<0.001) in PTSS. Adding self-blame and avoidance coping, the proportion of explained variance increased to 35.1% (F=56.62%, p<0.001). Being a girl (beta=0.15, p<0.001), reporting high levels of self-blame (beta=0.26, p<0.001) and using avoidance coping (beta=0.43, p<0.001) were predictors of PTSS. The severity of the abuse was significant into the first model (beta=0.14, p=0.004), but not into the final one (beta=0.08, p=0.057). CONCLUSION: Results suggest that sense of self-blame and using avoidance coping are important targets for clinical intervention with sexually abused children, because these factors contribute to the prediction of PTSS among this vulnerable population.

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.