Disclosure Of Child Sexual Abuse Research Articles

Disclosure of child sexual abuse: Directions for breaking new ground

Disclosure of child sexual abuse: Directions for breaking new ground

A retrospective approach to examining child abuse disclosure

BackgroundOften times, a child’s disclosure is the only forensic evidence available in child abuse cases. Therefore, understanding disclosure patterns of suspected child abuse victims plays a critical role in the forensic investigations of both child physical abuse (CPA) and child sexual abuse (CSA) cases. ObjectiveTo explore adults’ retrospective reports about childhood disclosure of CPA and CSA. Participants and settingCollege students (N = 907) were screened for reported histories of CSA (n = 94) or CPA (n = 109). MethodsThrough an online survey, participants provided anonymous information regarding CSA and CPA experiences along with information about any disclosure events or opportunities that they have encountered since the abuse. ResultsAmong the adults reporting CSA histories, 50 % indicated disclosing the abuse during childhood; 80 % indicated any lifetime disclosure. Among the adults indicating CPA histories, 32 % reportedly disclosed the abuse to someone during childhood with 52 % reporting any lifetime disclosure. For both groups, length of delay until disclosure was bimodal with many individuals reporting immediately and many waiting considerable time. Among adults reporting CSA, a minority (16 %) indicated the abuse came to the attention of authorities, with even fewer CPA cases (8%) reporting authorities were aware of their abuse. Denial and recantation in a formal setting was infrequent regardless of abuse type reported. ConclusionsGiven that participants experiencing CSA and CPA both reported low levels of denial and recantation, forensic investigators and practitioners may benefit from considering consistent interviewing approaches and protocols, regardless of the type of abuse suspected.

Parents' Experiences of Their Child's Disclosure of Child Sexual Abuse.

A child's disclosure of sexual victimization is a difficult experience for parents and has been associated with traumatization, disbelief, denial, self-blame, and clinical difficulties. To date, most studies on parents' responses have been quantitative assessments of the psychological impact of disclosure on parents. A paucity of research has qualitatively explored mothers' experiences of their child's disclosure of child sexual abuse (CSA) and fathers' experiences have been even further neglected. The current study seeks to characterize parents' experiences of their child's disclosure of CSA and to uncover the process-oriented nature of parental responses. This qualitative study, using a grounded theory approach to analysis, involved interviews with 10 mothers and four fathers whose children (3-18years) had experienced sexual abuse. Three themes emerged from the analysis. The first theme-making sense of the abuse in retrospect-captured the process through which parents sought to make sense of their child's disclosure, focusing on why their child had not disclosed the abuse to them earlier, and how they had noticed something was wrong but misattributed their child's behavior to other factors. The second theme-negotiating parental identity as protector-reflected how parents' identity as a protector was challenged, their perception of their world had been forever altered, and they now experienced themselves as hypervigilant and overprotective. The final theme-navigating the services-pertained to parents' struggle in navigating child protection and police services, and feelings of being isolated and alone. These findings highlight the need for empathy and parental support following child disclosure of sexual victimization.

Recipients of children’s and adolescents’ disclosures of childhood sexual abuse: A systematic review

Disclosure of childhood sexual abuse (CSA) is a complex, multifaceted process with many barriers that are largely shaped by individual, familial, and systemic characteristics. Children and youth tend to withhold or delay disclosure for many years, such that most CSA goes unreported. This systematic review aimed to synthesize evidence regarding the pathways and recipients of CSA disclosures and to identify potential developmental and gender differences in the recipients of disclosures. Thirty-seven studies conducted between 1990 and 2017 were selected for review. Results indicated that children and youth follow a gradual pattern of disclosure, whereby they first disclose to peers before disclosing to a parent or trusted adult, who can then help the child report to a person of authority. Key developmental patterns in CSA disclosure were identified, whereby older children and adolescents are significantly more likely to turn to peers, keeping the abuse largely hidden from adults. Gender differences were also found, whereby girls are more likely to seek emotional support by disclosing to peers, whereas boys are significantly less likely to disclose the abuse all together; when boys do disclose, they tend to do so for practical reasons, such as protection or accessing services. This review contributes to our understanding of the various pathways of CSA disclosure and highlights the importance of further understanding youth-directed disclosures and how the reactions of informal recipients of disclosures may impact further disclosures to authorities and professionals. Research and clinical implications of the findings are discussed.

Telling a trusted adult: Factors associated with the likelihood of disclosing child sexual abuse prior to and during a forensic interview

BackgroundMany child sexual abuse (CSA) survivors delay or withhold disclosure of their abuse, even when presenting for formal investigation interviews. ObjectiveThis study examined factors that relate to the CSA disclosure process. Participants and SettingsParticipants were CSA victims (N = 1,732) presenting to a Child Advocacy Center (CAC) for a forensic interview. MethodWe tested a structural model to predict disclosure before and during a forensic interview using secondary data analysis. ResultsYouth were less likely to disclose before a forensic interview if they witnessed domestic violence (β = -.233, p < .05). Caregivers were less likely to believe the abuse allegation if the alleged perpetrator resided in the home β = -.386, p < .05) and more likely to believe if the youth made a prior disclosure (β = .286, p < .05). Youth were more likely to disclose during the forensic interview if they were older (β = .388, p < .05), if the alleged perpetrator resided in their home (β = .209, p < .05), if they disclosed prior (β = .254, p < .05), and if their caregiver believed the allegation (β = .213, p < . 05). The alleged perpetrator residing in the youth’s home (β = -0.082, p < .05) and making a prior disclosure (β = 0.060, p < .05) were both indirectly associated with forensic interview disclosure through caregiver belief. ConclusionsFindings highlight the importance of the family context and caregiver belief in the disclosure process for youth involved in formal CSA investigations.

Sexual Abuse Disclosure Mediates the Effect of an Abuse Prevention Program on Substantiation.

Although abuse prevention programs have proliferated, little research has explored the direct effects of such programs on actual child sexual abuse disclosure rates, and no research has explored the effects of such programs on child sexual abuse substantiation. Employing a quasi-experimental design, the present research reflects an exploration of the effects of exposure to the Think First and Stay Safe™ abuse prevention program on abuse disclosure rates of 319 children who underwent a child forensic interview within 2015-2018 in a Midwestern child advocacy center. Supporting our mediational hypotheses, children exposed (vs. not exposed) to the Think First and Stay Safe™ program were significantly more likely to disclose abuse during the forensic interview, which in turn predicted significantly increased abuse substantiation likelihood.

“I felt like I was thrown into a deep well”: Educators coping with child sexual abuse disclosure

Children's educators are on the front line of child sexual abuse (CSA). By confronting cases in their everyday work in the school, they hold the potential to be agents of social change – to promote detection, disclosure and intervention. However, research on the experience of such educators contending with CSA is limited both conceptually and methodologically. The purpose of the present study was to describe and analyze the experiences of Israeli educators coping with CSA disclosure. The following research questions were explored: (1) How is CSA disclosure perceived and experienced by children's educators in their daily work? (2) How does CSA disclosure affect these educators in their professional and personal lives? The findings are based on semi-structured interviews conducted with 20 children's educators. Results indicate that their core experience is loneliness when facing the victim, when confronting his or her parents, when facing authority figures inside and outside of school, and when dealing with the effect on their personal lives. In coping with this loneliness, educators adopt three main styles: “lone rider” (self-coping); “layperson” (experiencing themselves as lacking the ability and knowledge to cope); and “buck-passer” (rapid shifting of responsibility). Implications for future research, policy, and practice are discussed.

Pathways to Understanding – How Adult Survivors of Child Sexual Abuse Came to Understand that they had been Sexually Abused

ABSTRACTWhile child sexual abuse is recognized as a global challenge in need of attention, all too often it takes years before sexual abuse is disclosed. We therefore need to understand more of the process leading to disclosure of child sexual abuse. The purpose of this study was to investigate how adult survivors of child sexual abuse came to understand that they had been sexually abused. We conducted semi-structured interviews with 8 women and 3 men (18–57 years old) and analyzed the interview transcripts using a hermeneutic-phenomenological approach to thematic analysis. Our analysis resulted in three main themes: The ambiguity of memory: “To remember the catastrophic”; The language of the body: “Let the body speak”; and Encountering an observant other: “The significance of being seen and recognized”. The findings highlighted the complexity of the individual process of understanding that one has been sexually abused. The availability and intrusiveness of traumatic memories, bodily sensations and symptoms, and encounters with others proved to be contributing factors in the process. The findings give insights into why disclosure of sexual abuse can be difficult and have important implications for health professionals and policy makers working to help victims of child sexual abuse.

The Unique Contribution of Attachment Theory in Understanding the Role of Nonoffending Fathers in the Care of Children Who Have Been Sexually Abused: A Historical Lens

Changing gender roles and caretaking roles in the family have resulted in increased father involvement in the day-to-day care of their children. As a result, there is a need to better understand the nature of father–child relationships within the context of multiple circumstances. One specific example is the role of nonoffending fathers in the care of children after child sexual abuse disclosure. This article first reviews how the attachment theory has evolved to include fathers and then reviews the unique contribution of paternal attachment to the care of child victims of sexual abuse. Implications for practice include enhanced engagement and intervention strategies that incorporate fathers effectively in services, better utilizing fathers as allies in the care of their children.

Childhood disclosure of sexual abuse and mental health outcomes in adulthood: Assessing merits of early disclosure and discussion.

Empirical research on the impact of early disclosure of child sexual abuse (CSA) on survivor health is limited and mixed. One recent study found that early disclosure may actually be detrimental for abuse cessation and adult symptomatology (Swingle et al., 2016). The current study re-examined the effects of early disclosure and related variables on long-term mental health for men with histories of CSA. The primary aims of this study were to: a) investigate whether early disclosure and response to early disclosure were related to mental distress in adulthood, and b) examine whether having an in-depth discussion and timing of that discussion were related to mental distress in adulthood. Data were collected from a large, non-clinical sample of male survivors (N = 487), ranging in age from 19 to 84 years, through an online, anonymous survey. Hierarchical regression analyses were conducted by entering groups of variables in four steps: control variables, CSA severity, disclosure, and discussion. Overall, models explained between 24-28% of the variance in mental distress. None of the CSA severity variables reached significance. Both early disclosure (β = -0.126, p = 0.003) and response to first disclosure (β = -0.119, p = 0.006) were significant protective factors in Model 3. In the final model, having an in-depth discussion (β = -0.085, p = <0.036) and years until discussion (β = 0.102, p = 0.029) were also related to mental distress. Results support the merits of early disclosure and discussion on long-term mental health. Implications for future research and practice are presented.

Child sexual abuse, disclosure and PTSD: A systematic and critical review.

Child sexual abuse (CSA) is a prevalent exposure with potentially serious, negative health consequences, including post-traumatic stress disorder (PTSD) and its symptomatology. To conduct a systematic and critical review in order to investigate the relationship between CSA disclosure patterns and PTSD. Studies included clinical, college and community-based samples of adults' and children's experiences of CSA. We conducted systematic searches in five databases (Medline, Embase, PyscINFO, CINAHL, ERIC, Sociological Abstracts) from database inception to October 17, 2017 using index terms and keywords for CSA, disclosure, and PTSD. We included any English-language, primary studies involving children or adults with experiences of CSA that used quantitative research designs to explore the relationship between disclosure and PTSD. We used systematic critical review methodology in order to investigate the relationship between disclosure and PTSD symptoms and disorders. We also investigated factors that explained the relationship between disclosure and PTSD, such as individual, exposure or environmental factors. Twenty-two articles reporting 20 studies were included in this review. Studies assessing the relationship between CSA and PTSD tended to account for personal (e.g., gender) and CSA exposure variables (e.g., severity of CSA) only. While authors generally used validated measures to assess for PTSD symptoms and disorders, they tended to use author-generated or unvalidated measures to assess for disclosure process variables. The relationship between factors that affect disclosure, and responses to disclosure, are not well theorized in quantitative literature. Study findings suggest important avenues for future research, such as the need to assess disclosure longitudinally.

Boys Abused in a Community Setting: An Analysis of Gender, Relationship, and Delayed Prosecutions in Cases of Child Sexual Abuse

ABSTRACTPrevious research on gender differences and delay of disclosure of child sexual abuse is inconclusive; some research has found that male victims are more likely to delay disclosure than female victims, while other studies have found no gender difference. The present archival study investigated this inconsistency by examining factors that interact with delay. Judicial outcomes of child sexual abuse cases were coded (N = 4237) for variables related to the offense, the complainant-accused relationship, and court proceedings. Males and females differed with respect to delay only when the relationship between the complainant and the accused was established in the community (e.g., sports coach) or was a stranger to the child. When the accused was a parent, other relative, or a non-relative connected to the child through the family, there was no difference in delay between males and females. Further, males were more vulnerable in the community, as evidenced by a higher proportion of accused community members with male than female complainants, even though males represented fewer than 25% of cases in the database. These findings may help explain inconsistencies in gender differences in delayed disclosure. Implications regarding education about child sexual abuse are discussed, with a focus on male victims.

"They were the ones that saw me and listened." From child sexual abuse to disclosure: Adults' recalls of the process towards final disclosure.

When child sexual abuse (CSA) is not disclosed, children run the risk of being subjected to longer or repeated abuse, not receiving necessary treatment, and being re-victimized. This study examines what adults exposed to child sexual abuse in hindsight evaluate as important for disclosure. The aim was to explore exposed own experiences of steps towards final disclosure. Data were obtained from adult users of Norwegian Sexual Abuse Support Centers. Included were users exposed to CSA before the age of 18 (N=23). Data were collected through anonymous questionnaires at each support center. The material was transcribed and analyzed in the tradition of Interpretative Phenomenological Analysis. The study illustrates a process towards disclosure as a dialogically anchored process evolving over time and along life-course inside encounters with important others towards whom the exposed pays attention, attunement, and adjustment whether to tell, delay, re-try, turn towards others, or actually disclose. Their experiences elucidate processes towards exploring and telling through direct and indirect hints and signs, decisions to tell, re-decisions and delaying, or withholding until adulthood, and the dependency on trusted confidants who ask and listen for final disclosure to occur. Thus, the present study sends an important message to exposed, confidants, and professionals when questions of CSA appear. That is to know of, facilitate, trust, and tolerate the dialogical dependency on being asked and heard by trusted persons and the many steps a process towards disclosure of CSA may entail in order to succeed.

A meta-analysis of the prevalence of child sexual abuse disclosure in forensic settings.

Identification, substantiation, prosecution, and treatment of child sexual abuse often rely heavily on a disclosure from the victim in the absence of corroborating evidence. For some, disclosure can be impeded by developmental or motivational barriers, thus compromising child safety and wellbeing. The literature on disclosure prevalence and mitigating influences does not yield a coherent picture. A more accurate estimate will help to inform investigation strategies to facilitate disclosure. This study provides a meta-analysis of available research examining the prevalence of sexual abuse disclosure in forensic interviews with children under 18 years, and examines a range of factors that may influence the likelihood of disclosure. Databases were searched for published and unpublished studies up to May 2017. In total, 2393 abstracts were assessed for eligibility, 216 full-text articles were reviewed, and 45 samples (with 31,225 participants) provided estimates of effect sizes. The mean prevalence of child sexual abuse disclosure in forensic settings was 64.1% (95% CI: 60.0-68.1). Between-study variability was explained by: (1) child age and gender, with higher prevalence in older children and females; (2) prior disclosure, with higher prevalence when present; and (3) study year, with higher prevalence in more recent studies. This meta-analysis confirms an upward trend in child sexual abuse disclosure prevalence. However, more than a third of children do not disclose when interviewed, with those who are younger, male, and without a prior disclosure at greatest risk. Important implications for forensic interviewing protocols and future research are discussed.

A taxonomy of duties to report child sexual abuse: Legal developments offer new ways to facilitate disclosure.

Child sexual abuse is undisclosed for many reasons that are resistant to change. Citizens can play an important role in disclosing cases of child sexual abuse to authorities. Professionals who deal with children also play a crucial role. Office-holders in organisations have a clear responsibility to prevent cover-ups of sexual abuse. Recently, some countries have created important new legal duties for adults to disclose child sexual abuse. This article creates a contemporary taxonomy of duties to disclose cases of child sexual abuse, and explains their nature and justification. Citizens, professionals dealing with children in the course of their work, and managers of child and youth-serving organisations. Legal analysis created a taxonomy of reporting duties. Analysis of these duties from perspectives of criminal jurisprudence, public health law, children's rights and ethics considered their justification. Seven legal duties now exist, in criminal law, civil law and child protection law. Some apply to all citizens; others to managers in organisations; others to professionals dealing with children in the course of their work. All the duties are directed to early detection of cases; some are directed towards prevention; and some are focused on avoidance of institutional corruption. These developments represent historic progress in overcoming normally intractable barriers to disclosure of cases of child sexual abuse. New legal duties are consistent with principles from criminal jurisprudence, public health law, children's rights and ethics. Where adopted, societies should ensure the creation and maintenance of ecological conditions in which these duties can be observed.

An Exploration of Coping with Childhood Sexual Abuse in Arab American Women

ABSTRACTThis research used a descriptive qualitative approach to explore coping with childhood sexual abuse (CSA) and to identify long-term psychological outcomes among Arab American women. Ten Arab American women participated in the study. Data were collected by individual semi-structured interviews and analyzed using content analysis. Five categories emerged for CSA experience among the participants: CSA characteristics, social support, Arabic culture, coping, and long-term psychological outcomes. Most of the women had experienced familial and contact CSA . and had disclosed their CSA and received different reactions from family and friends. Arabic cultural values influenced the women’s experience of CSA and their coping strategy, especially regarding the CSA disclosure and seeking mental health services. The women used a spectrum of strategies to cope with their abuse including seeking support, positive reappraisal,,, accepting responsibilities, avoidance and protective coping. All women experienced negative long-term psychological outcomes of CSA such as flashbacks and low self-esteem. Prior to this research, no known studies have explored coping with CSA experience among Arab American women. Thus, this study can be used to inform practice guidelines to minimize the stigma of CSA and to promote help-seeking behavior for Arab American female CSA survivors and their families.

Maternal Emotional Support following the Disclosure of Child Sexual Abuse: A Qualitative Study

ABSTRACTNon-offending maternal (NOM) support is considered one of the most important protective factors in facilitating better victim adjustment following the disclosure of child sexual abuse (CSA). However, recent findings have led authors to conclude that NOM support has yet to be properly conceptualized and operationalized within the CSA literature. Emotional support is one dimension that has consistently emerged in studies attempting to reconceptualize NOM support but is a concept which also requires further theoretical investigation. Researchers interviewed 22 mothers of children aged 6–12 years about their experience and provision of emotional support following their child’s disclosure of CSA. Data were analyzed using a method inspired by grounded theory. Mothers reported feeling initially overwhelmed and lost about how to emotionally support their child but described an improvement in their support capabilities following conjoint therapy. Furthermore, three overarching categories emerged outlining maternal emotional support strategies, each serving a specific emotional function: (a) elaborating, encouraged children to talk about their CSA experience; (b) soothing, attempted to comfort children’s distress; and (c) orienting, attempted to guide children’s recovery process. Authors discuss implications for offering improved and more rapid clinical services following the disclosure of CSA, and considerations for the operationalization of NOM emotional support.

Correlates and Predictors of Mothers' Adaptation and Trauma Symptoms Following the Unveiling of the Sexual Abuse of Their Child.

Child sexual abuse (CSA) can severely affect the mental health of children and their parents. While correlates of recovery have been documented in children, factors exacerbating parents' adaptation to their child's unveiling of CSA deserves further attention. Parents' history of abuse has been inconsistently identified as a predictor of their distress in reaction to their child's abuse disclosure. This study proposes a mediation model that explores various processes underlying mother's psychological distress (posttraumatic stress disorder [PTSD], dissociation, and their comorbidity) following their children's unveiling of CSA. It investigates the influence of mother's own CSA, as well as of her exposure to additional forms of past and current victimization, on her reaction to the child's CSA disclosure, while considering coping mechanisms as mediators (avoidance, problem solving, search for social support, and feeling of guilt). Data were collected through self-report measures completed by 298 mothers of children who had recently disclosed CSA. Path analyses revealed that mother's exposure to interparental violence as a child acted as a primary predictor of dissociation and of its comorbidity with PTSD, while a history of CSA was directly and exclusively linked to dissociation. Being exposed to recent partner violence was indirectly related to trauma symptoms, with coping mechanisms acting as mediators. This study outlines the relationship between mother's psychological distress and her cumulative, past, and current exposure to various forms of victimization. Exposure to interparental violence as a child represents a particularly important factor for identifying mothers most in need of support, as it is a significant predictor of dissociation and of its comorbidity with PTSD.

Barriers and facilitators affecting self-disclosure among male survivors of child sexual abuse: The service providers' perspective.

Research regarding child sexual abuse (CSA) indicates significant gender differences in disclosure rates, with males less likely to disclose their abuse compared to females. CSA can have lasting impact on a children's emotional, physical, and psychological wellbeing. While service providers play an instrumental role in providing care and support for male CSA survivors, little is known about their perceptions and experiences related to disclosure among these men. The aim of this qualitative study was to explore service providers' perceptions and awareness of disclosure-related barriers and facilitators amongst male CSA survivors. Individual interviews were conducted with eleven service providers. Study findings reveal four key themes related to the disclosure process among male CSA survivors: (a) personal characteristics, (b) interpersonal relations, (c) institutional elements, and (d) societal norms. Findings indicate that service providers understand and respond to complex challenges associated with disclosure of CSA among this marginalized population. Study findings demonstrate the need for additional research on the specific issues of gender bias and stigma associated with male sexual abuse. Along with their empirical significance, these findings can be used to develop more tailored public health and social service-related programming for male CSA survivors, their families, and the broader community to promote a safer and more supportive environment in which to discuss these sensitive and important issues. Recommendations to service providers are discussed.

The risk of Telling: A Dyadic Perspective on Romantic Partners' Responses to Child Sexual Abuse Disclosure and Their Associations with Sexual and Relationship Satisfaction.

Among 70 community couples who reported childhood sexual abuse (CSA) and disclosure to their partner, this study examined associations between survivors' perception of partner responses to their disclosure, and both partners' sexual and relationship satisfaction. Participants completed self-report questionnaires online. Results of path analyses within an actor-partner interdependence model indicated that survivors' perceived partner responses of emotional support to disclosure were associated with their own and their partners' higher sexual satisfaction. Survivors' perceived responses of being stigmatized/treated differently by the partner were associated with their own and their partners' poorer relationship satisfaction. Findings suggest that survivor-perceived partner responses to the disclosure of CSA can have a positive and a negative impact on the sexual and relationship satisfaction of both partners.