Survivors Of Childhood Sexual Abuse Research Articles

Posttraumatic growth, spiritual damage, and psychosocial and mental health problems in survivors of clergy-perpetrated child sexual abuse: A mixed methods approach

IntroductionAlthough clergy-perpetrated child sexual abuse (CSA) implies severe traumatic repercussions for the victims, they may also experience posttraumatic growth (PTG) deriving from the need to deal with the trauma suffered. This PTG is associated with the processes of recovery, healing, and empowerment. ObjectiveApplying a mixed methods approach to analyse PTG outcomes and to explore experiences of PTG in survivors of Spanish clergy-perpetrated CSA and its relation with psychosocial, mental and spiritual suffering. ParticipantsThirty-one survivors (M = 51.6 years; SD = 12.4) in the quantitative stage of the research, and seven (M = 49.3; SD = 8.9) in the qualitative stage. MethodsA sequential explanatory mixed methods study design was applied using standardized questionnaires and semi-structured interviews. Descriptive, correlation and thematic analyses were conducted. The quantitative and qualitative data were integrated. ResultsPositive associations were found between PTG and psychosocial and mental health problems (r = 0.53; p < .01), damage to faith in God (r = 0.43; p < .05) and damage to faith in the Church (r = 0.48; p < .01). Three themes emerged from the qualitative data that explained, expanded, and complemented the quantitative results, highlighting the relationship between damage and growth and the specific meanings of PTG from the perspectives of the survivors. ConclusionsThis study shows that survivors may develop PTG in the course of the processes of psychological suffering, spiritual transformation, and meaning-making of traumatic experiences.

Dissociation and Sexual Concerns in Male Survivors of Childhood Sexual Abuse: The Role of Identity Cohesion

ABSTRACT Research on male survivors of childhood sexual abuse is notably deficient when it comes to addressing their sexual concerns, such as experiences of sexual distress, negative thoughts, and feelings related to their sexuality. Dissociation, a known consequence of childhood sexual abuse, could be associated with higher sexual concerns through identity cohesion. Precisely, dissociation can potentially be related to lower identity cohesion (e.g., not knowing what you want or need). In return, lower identity cohesion may be related to higher sexual concerns by impeding the capacity to know and accept oneself, which tends to promote a positive and healthy sexuality. This study aimed to examine the role of identity cohesion in the link between dissociation and sexual concerns in 105 men consulting for their history of childhood sexual abuse. Men completed questionnaires assessing dissociation, sexual concerns, and identity cohesion at admission in a community setting. Results of a path analysis revealed an indirect association between dissociation and higher sexual concerns through lower identity cohesion. The model explained 27.6% of the variance in sexual concerns. This study highlights the relevance of interventions targeting dissociative symptoms to improve identity cohesion and sexual health in male survivors of childhood sexual abuse.

“Pay Attention! Pay Attention! Pay Attention!!!”: The Pivotal Role of Educators and the Educational System as Experienced by Survivors of Child Sexual Abuse

Educational institutions and educators are significant in children’s lives, and they have a crucial role in implementing policies, practices, and sexual education to enhance children’s safety. Such policies and practices should be based on the voices of CSA survivors. This study explored child sexual abuse (CSA) survivors’ viewpoints on their past experiences with educators and the educational system. A qualitative thematic approach was used to analyze 61 written testimonies collected in 2020–2021 by the Israeli Independent Public Inquiry on CSA. Two interrelated themes arose: (1) CSA survivors’ retrospective perspectives of educators and the educational system’s responses to signs of their CSA, described as ranging from abusive to life-saving. Specifically, they shared three types of responses: (a) harmful and hurtful; (b) dismissive and ignoring; and (c) accepting and attending. (2) The second theme described the survivors’ messages to educators to promote constructive change. The survivors conveyed expectations that educators should play a central role in CSA prevention, detection, and intervention and, specifically, the need for educators to receive professional training, provide beneficial sexual education, and identify and respond to CSA. The findings promoted moving beyond individual-level interventions to focus on improving educational institutional and organizational cultures related to CSA in both national and international contexts.

Is trust an essential therapeutic goal in working with childhood sexual abuse (CSA)? – a body of empirical research

ABSTRACT Impaired ability to develop trusting relationships, self-dysregulation, poor emotional regulation, poor self valuation, and relational sensitivity are key challenges for survivors of Childhood Sexual Abuse. These increase the risk of ruptures in the therapeutic relationship and dropouts. Nevertheless, there is little evidence of the role of therapeutic trust in CSA. We collectively present the findings of a 15-year research journey into CSA recovering. Central to recovering was the establishment and maintenance of trust. Trust was also key for client satisfaction and facilitating the recovering process. Trust mediated regulation of threat responses, facilitated empathy, and enabled accurate symbolisation and re-contextualisation of traumatic narratives. In an increasingly traumatogenic world, more clinicians will be called to respond to disclosures of abuse and maintain engagement. Given the lack of effective interventions for CSA/complex trauma, trust-based person-centred psychotherapies are a promising alternative for managing dropouts, supporting the therapeutic relationship, and facilitating change.

Closure for Survivors of Abusive Relationships

This article presents a five-step clinical approach that describes a process for child sexual abuse survivors, who are now adults, to initiate a statement with their abuser, whereby the survivor can explain the abuse and its impact on their lives. This method may also have applicability for survivors of general child maltreatment. The timing of this intervention needs to be carefully assessed in a partnership between the survivor and clinician. Clinicians might consider this approach if they are conducting long-term psychotherapy with adult survivors of child maltreatment and child sexual abuse, in particular. In addition to delineating steps to be taken, the authors suggest a measurement path. This closure process provides a unique and unduplicated opportunity for personal and professional growth.

Mental Health and Sociodemographic Correlates of Child Sexual Abuse

Abstract Background: Child sexual abuse (CSA) has long-term deleterious effects on mental health. The prevalence of CSA is more in females than males. A lifetime diagnosis of anxiety, depression, eating disorders, posttraumatic stress disorder (PTSD), sleep disorders, and suicide attempts has been associated with a history of sexual abuse. Few studies have focused on the role of temperament and the relationship between psychiatric morbidity and sociodemographic variables. Aim: This study aimed to assess the relationship between psychiatric morbidity and sociodemographic variables in cases of CSA. Methodology: After ethical approval, 168 consecutive survivors of an alleged history of child sexual assault brought by the police were enrolled after informed consent from legal guardians and assent from survivors. A specially designed semi-structured pro forma was used to collect data. Psychiatric morbidity was diagnosed using the Diagnostic and Statistical Manual of Mental Disorders-5. Scales assessing temperament, perceived social support and global functioning, were used. Results: Seventy-seven percent of survivors in this study had psychiatric morbidity. Adjustment problems were more in children with slow-to-warm temperament. A positive family history of mental illness was significant in major depressive disorder (MDD) but not in PTSD. Those with a history of being assaulted multiple times (36 out of 42) had a higher chance of developing MDD. Conclusion: This study highlights that the adjustment problems were more in children with slow-to-warm temperament, highlighting the need for targeted and timely intervention in this subgroup of CSA survivors. This study shows an association between childhood environmental adverse event and development of psychiatric morbidity.

Detecting child sexual abuse in child and adolescent psychiatry: a survey study of healthcare professionals' assessment practice.

Research shows that only around half of all survivors of child sexual abuse (CSA) disclose the abuse during childhood and adolescence. This is worrying, as CSA is related to substantial suffering later in life. The proportion of children and adolescents who have been exposed to CSA is significantly higher in Child and Adolescent Psychiatry (CAP) than in the general population. Healthcare professionals report that uncovering CSA is a complex and challenging task. However, we know little about how they proceed when uncovering CSA. More knowledge of healthcare personnel's experience is therefore necessary to facilitate and increase CSA disclosure. The study aims to explore how CAP healthcare professionals in Norway proceed when assessing and detecting CSA, how they experience this work, and what hinders or facilitates their efforts. The study employed a mixed method approach. Data was collected through an anonymous online survey, generating both quantitative and qualitative data. The sample consisted of 111 healthcare professionals in CAP, of whom 84% were women, with a mean age of 40.7 years (range 24-72; sd = 10.8). Mean years of CAP clinical experience were 8.3 years (range 0-41; sd = 7.5). The quantitative data was analysed using descriptive statistics, correlations, and independent sample t-tests, while the qualitative data was analysed using a team-based qualitative content analysis. The results showed that detection of CSA was viewed as an important, but complex task in CAP, and the existing procedures were deemed to be insufficient. The therapists mostly felt confident about how to proceed when they suspected or detected CSA, yet they seldom detected CSA. In their initial assessment they applied standardised procedures, but if their suspicion of possible CSA persisted, they seemed to rely more on clinical judgement. Specific challenges and facilitators for CSA detection were identified, both in the individual and in the organisation. The study highlights the challenges and complexities healthcare professionals and the CAP system face when assessing CSA, which may account for the low detection rate. The results show that healthcare professionals believe room for clinical autonomy and targeted competence development may improve CSA detection. Additionally, the findings suggest a need for CAP to define roles and responsibilities within and between agencies.

Breaking the cycle: Mentalizing moderates and mediates the link between childhood sexual abuse and satisfaction with adult romantic relationships.

Childhood sexual abuse (CSA) is a significant risk factor with consistently demonstrated negative implications for satisfaction with adult romantic relationships. Yet, research on risk and protective factors in this context is scarce, particularly among well-functioning adults. Addressing this gap, the present study focused on the potential mediating and moderating roles of mentalizing or reflective functioning, i.e., the capacity to understand oneself and others in terms of intentional mental states. We investigated whether impairments in mentalizing underlie the association between CSA and relationship satisfaction and whether robust mentalizing can buffer the CSA-relationship satisfaction link. A sample of 667 individuals engaged in a meaningful romantic relationship was drawn from a larger sample obtained in an online convenience survey. A mediation and moderation model was examined using PROCESS. The results confirmed our integrative model-the association between CSA and satisfaction with romantic relationships was mediated by impairments in mentalizing (uncertainty about mental states) and was simultaneously moderated by robust mentalizing (certainty about mental states). These effects were shown even when controlling for age, gender, education, and psychopathological symptoms. These findings highlight the importance of mentalizing, a key transdiagnostic factor. Reduced mentalizing is a risk factor for harmful impact of CSA on romantic relationships, while greater mentalizing abilities can be a significant resilience factor protecting CSA survivors. This study supports the potential contribution of mentalization-based interventions with survivors of CSA at risk for dissatisfaction with romantic relationships. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The externalization of suffering among male survivors of child sexual abuse: “A deeply buried rage that must come out”.

The externalization of suffering among male survivors of child sexual abuse: “A deeply buried rage that must come out”.

Emotional Betrayal From Child Sexual Abuse Measure (EBSCAM): A psychometric analysis.

This study examined the psychometric properties of a new scale, the Emotional Betrayal from Child Sexual Abuse Measure (EBCSAM), which assesses feelings of betrayal in adult survivors of child sexual abuse (CSA). Emotional betrayal is examined with respect to the perpetrator as well as others in the survivor's immediate environment (i.e., family, friends, etc.) during the time of the abuse. A sample of 342 CSA survivors were anonymously surveyed online in order to examine the psychometric properties of the EBCSAM. The original 16-item measure did not produce a good-fitting model, nor was it considered reliable or valid. Instead, a shortened six-item measure produced a successful model, was reliable (overall Cronbach's α = .85), and exploratory/confirmatory factor analyses suggested two valid latent subscales (Perpetrator Betrayal and Environmental Betrayal). This measure could be useful to clinicians treating survivors of child sexual abuse, as well as researchers, to reveal and evaluate aspects of emotional betrayal that impacted survivors.CSA). Emotional betrayal is examined with respect to the perpetrator as well as others in the survivor's immediate environment (i.e., family, friends, etc.) during the time of the abuse. A sample of 342 CSA survivors were anonymously surveyed online in order to examine the psychometric properties of the (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Understanding Black and Latino sexual minority men's perspectives on assessment of sexual history in diverse health care settings.

This exploratory analysis aims to understand conditions under which cisgender Black and Latino sexual minority men (SMM) would be willing to share potentially abusive childhood sexual experiences with health care providers. Black and Latino SMM may be overrepresented among childhood sexual abuse (CSA) survivors, but some abusive experiences are appraised as consensual due to cultural pressures, leading to underreporting and a delay in identification and treatment. Prior research highlights the importance of screening for sexual abuse histories in primary care and substance use treatment settings, though studies indicate that such assessments rarely occur. In-depth qualitative interviews were conducted with 61 cisgender Black and Latino SMM who reported sexual experiences in childhood that met criteria for CSA. Interviews explored men's experiences with and attitudes toward sexual history taking in diverse health care settings. Most respondents felt that providers should assess sexual history and be aware of prior abuse. Barriers to disclosure included perceived provider bias and insincerity and concerns that provider characteristics (e.g., gender) might limit their ability to understand a client's experiences. Findings suggest that a trauma-informed approach to the assessment of sexual histories should consider that patients' current physical and mental states may be (in)directly linked to earlier, traumatic events and that intersecting identities (e.g., gender and race) could influence men's willingness to share their histories. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

What are the Experiences of and Interventions for Adult Survivors of Childhood Sexual Abuse in South Asia? A Systematic Review and Narrative Synthesis.

Adult survivors of childhood sexual abuse (CSA) may experience emotional, social, and psychological difficulties, heightened due to the interpersonal nature of harm. Despite the demonstrated effectiveness of trauma-focused treatments in the West, a culturally specific understanding of the needs of and treatments for survivors in South Asia is still in its infancy. The study aimed to systematically review research findings on the mental health impacts of CSA on adult survivors and current treatment approaches and their efficacy and acceptability in South Asia. Seven databases (Scopus, Ovid, CINAHL, ProQuest, EThOS, Google Scholar, and Dogpile) and five peer-reviewed South Asian journals were searched from inception until March 30, 2023. Searches included participants who were adult survivors of CSA of South Asian origin residing in South Asia. Studies on their mental health, different treatments, and the efficacy and acceptability of these treatments were included. Quality assessment tools were used to appraise the quality of included studies. The results were synthesized narratively. A total of 3,362 records were retrieved, and 24 articles were included in the final review. Twenty studies reported mental health impacts of CSA on adult survivors, four studies reported current treatments offered, and two studies were on recovery. However, no study focused on the efficacy or acceptability of the treatments being delivered. Even though the needs of adult CSA survivors in South Asia have been partly identified, there is very little research into the treatments for them.

"We Need to Raise Awareness and Never Give Up": Israeli Druze and Muslim Arab Kindergarten Teachers' Proactivity When Facing the Sexual Abuse of Their Students.

Kindergarten teachers are expected to lead the intervention process in cases of child sexual abuse (CSA) in their kindergarten. This study examines the proactive role of Druze and Muslim Arab kindergarten teachers in addressing and coping with the CSA of their kindergarten students in Israel. A qualitative thematic analysis was used to investigate the semi-structured interviews conducted with eight Druze Arab and six Muslim Arab kindergarten teachers. Three distinct themes were revealed. The first theme described the participants' fear and concern for their personal children and themselves when dealing with CSA incidents involving their students. The second and third themes described their proactive coping on two fronts: (1) inside their homes to protect their own children and (2) as educators within religious communities, using professional and religious principles to support CSA survivors and raise awareness among parents. The results emphasized the personal burden on kindergarten teachers coping with CSA in their kindergarten and, as mainly expressed by Druze kindergarten teachers, the contribution of religious values to CSA intervention and prevention processes among their students and communities. Thus, there is a need for comprehensive support that considers ethnic and religious characteristics and will be available to kindergarten teachers facing CSA in their kindergarten.

Mindfulness and posttraumatic growth in childhood sexual abuse and psychological maltreatment survivors

Many studies focusing on childhood sexual abuse (CSA) may have neglected the consequences related to experiencing other types of childhood maltreatment, such as psychological maltreatment. Moreover, the literature has focused more on negative consequences related to CSA, hence potentially leaving out more adaptive and resilient trajectories. This qualitative study aimed to explore childhood psychological maltreatment and CSA, mindfulness, sexuality, and intimate relationships in adult survivors. The interview data from 19 individuals who experienced CSA and psychological maltreatment were analyzed using conventional content analysis. Four conceptual categories developed: (a) an unsafe family environment that hindered the development of positive experiences and relationships; (b) impaired mindfulness dispositions: the reliving of trauma, the avoidance of suffering, and feeling engulfed; (c) impaired intimacy: instability, codependence, emotional distance, and self-silencing; and (d) mindfulness dispositions and posttraumatic growth (PTG) in participants’ intimate lives. These findings highlight that mindfulness, sexuality, and intimate relationships are often poor among survivors of psychological maltreatment and CSA. Yet opportunities to develop mindfulness dispositions appear to enhance PTG in survivors’ intimate relationships, significantly contributing to survivors’ healing processes.

Understanding the Narratives of Child Sexual Abuse.

This qualitative study consisted of in-depth, retrospective interviews with participants over the age of 18 who experienced child sexual abuse. Through narrative analysis, study findings shed light on three overall findings: the perception of memories, the perception of grooming, and the perception of the lived lives of child sexual abuse survivors. Findings suggest that the narratives elicited from the participants included current views but also past experiences and anticipation about the future, including individual and societal levels of meaning. These narratives are furthermore entangled and inexorably linked - temporally, culturally, generationally, materially, and emotionally - and the results are thus presented from a holistic perspective. Study findings help explain the complex dimensions concerning the lived experiences of child sexual abuse. As such, this research speaks to the field of social and health care practitioners working with children and families facing the complex phenomenon of child sexual abuse.

Suicide attempts and depression associated factors among the male child sexual abuse survivors in Bangladesh

In Bangladesh, male child sexual assault is seldom ever reported. Due to cultural standards, sexual assault survivors often refrain from talking about their experiences. Depression therefore overtakes them. Their mental health declines and their chance of committing suicide rises. The goal of this study was to explore depression and suicide attempts among Bangladeshi male child sexual assault survivors. An online survey was conducted, and data was collected using the Patient Health Questionnaire (PHQ-9) and one suicide attempt item. Descriptive analysis, Pearson chi-square test, and a binary logistic regression model were fit to analyze the data. A total of 61 participants participated. All the participants were depressed, with 67.21 % having severe depression. 21.31 % of the survivors attempted suicide at least once. Disclosure rates were relatively low, with only 14.75 % of participants reporting affirmative disclosure, Furthermore, a significant proportion of participants experienced repetitive abuse (73.77 %), and the prevalence of physical abuse was also notable, with 78.69 % reporting such experiences. To safeguard children and adolescents, parents as well as government stakeholders must be aware of male child sexual abuse. Public discourse regarding the subject is recommended. To stave off suicide and safeguard victims, experts advise seeking professional assistance.

Post-traumatic Effects in Survivors of Childhood Sexual Abuse: A Study Literature

Childhood sexual abuse can result in long-term effects that remain in the survivors to confront and encounter continually. This study aimed to examine behavioral indicators that indicate trauma, which is one of the long-term effects of child sexual violence against children. The study used a literature study technique. There were three behavioral indications developed as long-term consequences of trauma endured by survivors of child sexual abuse. The first indicator was cognitive distortions characterized by self-blame, self-criticism, and a sense of worthlessness. Then, concerns regarding emotional regulation, which present persistent feelings of anxiety or sadness, can appear as the second implication. The last behavioral indication was difficulties regarding the ability to resist impulsive urges, evidently via the engagement in substance misuse and the development of deviant sexual conduct.

Exploring the Meanings of Posttraumatic Growth in Spanish Survivors of Clergy-Perpetrated Child Sexual Abuse: A Phenomenological Approach

ABSTRACT A healing and recovery perspective related to child sexual abuse (CSA) has gained attention in the past two decades, a concept that accurately refers to the process is posttraumatic growth (PTG). Scarce empirical research on PTG in clergy-perpetrated CSA survivors shows evidence of the presence of growth after the abusive experience and a tendency to create accounts of trauma as a way to heal. The general aim of the study is to explore the experiences and meanings of PTG as lived by survivors of clergy-perpetrated CSA. Seven clergy-perpetrated CSA survivors were interviewed with semi-structured in-depth interviews conducted in person. Using reflexive thematic analysis, we identified three dominant themes in the participants’ stories: (a) the hindering of PTG; (b) the meanings of PTG, and (c) the internal and contextual and facilitators of PTG. The present study brings new insights into the meanings of PTG, the close relationship between damage and growth, and the mechanisms (both internal and contextual) that are involved in healing from clergy-perpetrated CSA in Spanish culture.

Child sexual abuse in Ghana: A multi‐methods exploratory study

AbstractUsing a qualitative multi‐methods approach, this study explored the offence, survivor and perpetrator characteristics, and the lived experiences of child and adolescent survivors of child sexual abuse (CSA) in Ghana. We analysed the contents of local media reports of CSA cases from January 2015 to December 2020 in Ghana, after which we conducted semi‐structured interviews involving five female child and adolescent survivors of CSA. The media content analysis identified 529 eligible reports involving female (n = 516) and male (n = 13) survivors aged 11–18 years who knew the perpetrators. The perpetrators were all‐male youth and middle‐aged adults employed in low‐income status occupations. Defilement was the most reported sexual offence; the survivors were more likely to come from single‐parent families experiencing poverty and economic hardship. The perpetrators employed multiple methods to coerce and elicit compliance from their victims: confidence approaches, violence (blitz methods) and gifts. Content analysis showed that most of the survivors attributed their victimisation to family poverty and dysfunctional parent–child relationships. These findings underscore a need to develop prevention strategies that empower young females and males to identify, escape or avoid (potential) sexual predators and encourage reporting and disclosure of CSA victimisation to formal support institutions.

Centring the voices of survivors of child sexual abuse in research: an act of hermeneutic justice.

Survivors of child sexual abuse (CSA) are known to hold silence and create distance between themselves and service providers for self-protection, as groomed behaviour or to protect the listener from vicarious trauma. Silence for many survivors has also been reinforced as a beneficial action by previous experiences of disclosing and being rejected, challenged, or disbelieved. How can researchers be sure the same dynamic is not playing out in research interviews? Generating reliable research data is an imperative and an act of epistemic justice that enables CSA survivors to testify to the suffering caused by abuse and subsequent trauma distress and to contribute to social discourse for change. Fricker, however, notes that the precursor to testimonial justice is hermeneutic justice. Hermeneutic justice pivots on the dual action of accurate understanding and interpretation, but CSA experiences may be beyond the comprehension of untraumatised listeners because their own frame of reference renders them unable or unwilling (even if unconsciously) to entertain the truth of such human depravity and cruelty. If survivors are not understood, their testimonies can be misconstrued or oftentimes excluded from the generation of epistemic knowledge, leaving the survivors unable to make sense of, and process, their experiences. These are crucial issues for researchers in the field of CSA and other crimes of sexual and gendered abuse. This study considers the operationalisation of a participatory research approach held within a lived experience research paradigm. Such methodologies advocate for peer involvement, which is becoming more widely recognised as supporting testimonial justice and the accurate understanding and interpretation of survivors' testimonies. The issue of validating the methodology and methods is considered, exploring a rigorous data audit and researcher reflexivity as contributors to trustworthy data. Peer and participant safety when researching through lived experience is addressed. Data from a doctoral research study are used to illustrate this article.