Experienced Childhood Sexual Abuse Research Articles

Child sexual abuse and social identity loss: A qualitative analysis of survivors' public accounts.

Emerging evidence suggests that social identities are an important determinant of adaptation following traumatic life experiences. In this paper, we analyse accounts of people who experienced child sexual abuse. Using publicly available talk of people who waived their right to anonymity following successful conviction of perpetrators, we conducted a thematic analysis focusing on trauma-related changes in their social identities. Analysis of these accounts highlighted two themes. The first highlights the acquisition in these accounts of unwanted and damaging identity labels. The second presents child sexual abuse as a key destructive force in terms of important identity work during childhood. Discussion of this analysis centres on the pathological consequences of social identity change. Both the loss of valued identities and the acquisition of aberrant and isolating identities are experienced and constructed as devastating by those affected by child sexual abuse. This has important implications, not only for those impacted by child sexual abuse but for how abuse is discussed in society, and how it is approached by policy makers, educators and individuals working with survivors and their families.

Gender Differences in the Characterization of Child Sexual Abuse

ABSTRACT Research on child sexual abuse (CSA) has increased in recent decades. However, the study of gender differences in this field is still scarce. The aim of this study was to analyze the differences in the characterization of CSA between Spanish adult men and women. The Juvenile Victimization Questionnaire was administered to 162 cisgender victims of CSA aged 18–63. Most of the abuses involved physical contact and were committed by a known person. Twenty percent of the victims indicated that they had developed a mental health problem that they believed was due to the CSA experience. Women suffered more CSA with physical contact and penetration, more types of abuse and more abuse by men, and were abused more frequently by a family member. Compared to women, men suffered more sexual abuse by women. Exploring gender differences in CSA could help to improve preventive strategies and interventions aimed at reducing the occurrence of this type of abuse and sequelae resulting from it.

The Role of Childhood Violence in Adult Victimization Among Women Experiencing Homelessness in Spain.

Persons experiencing homelessness represent one of the principal manifestations of the phenomenon of social exclusion, with homeless women constituting a group in a particularly vulnerable situation. The article analyzed the experience of violence in childhood and adolescence, and its implications in terms of violence experienced as an adult, in a sample of women experiencing homelessness in Madrid (Spain) (n = 138). All participants were of legal age and had spent the night before the interview in a shelter or other facility for the homeless, on the street, in public spaces or in places not suitable for sleeping. Information was gathered through a structured interview. The results show that the interviewees had experienced a high percentage of physical, psychological, and/or sexual violence, both in their childhood and adolescence and throughout their lives, with a strong correlation between the experience of violence in childhood and the experience of violence in adulthood, particularly sexual assaults, intimate partner violence, and sex work. The experience of childhood sexual abuse among women experiencing homelessness appears to have had particularly negative consequences in adulthood. Public policies, prevention programs, and care mechanisms with a gendered perspective must be implemented, aimed at reducing the number and intensity of situations of violence experienced by women and girls at risk of social exclusion or in a homeless situation.

Child Sexual Abuse and Wellbeing Among LGBTQ + Individuals: The Role of Family in Healing

The present study was undertaken to understand the prevalence of child sexual abuse and its association with the wellbeing of a sample of LGBTQ + individuals in India. A total of 206 respondents took part in the study. The WHO-5 wellbeing scale developed by the World Health Organization was used to assess the wellbeing of the respondents. The prevalence of child sexual abuse among the respondents was high (46.1 per cent). In general, the level of wellbeing of the respondents was found to be below average. Among those who had experienced child sexual abuse, the majority of the respondents were cisgender women. Cisgender women respondents were also more likely to have a much lower mean rank of wellbeing compared to the other groups and similarly, respondents who identified as lesbians were also found to have a lower level of wellbeing compared to respondents who identified themselves as bisexual, pansexual, and gay. Other associated factors have been discussed in the full paper. The role of family in supporting and helping the individuals heal, has also been discussed in detail. There is a need for families to be more empathetic toward the victims.

PTSD Symptoms Among College Students: Linkages with Familial Risk, Borderline Personality, and Sexual Assault

ABSTRACT College students have high rates of post-traumatic stress disorder (PTSD) symptoms as well as high rates of sexual assault. What is less clear, however, is whether different sexual assault types (e.g. coercive, physically forced, and incapacitation) are associated with greater PTSD symptoms. Moreover, understanding early familial and mental health histories of college students is important for explaining PTSD symptoms. As such, we use a social stress framework to examine the relationships between early familial risk (i.e. child abuse, perceived maternal rejection), borderline personality (BP) symptoms, and three sexual assault types with PTSD symptoms among college students. A total of 783 undergraduate students (65.4% female) completed paper and pencil surveys in fall 2019 and spring 2020 at a large public university. Results revealed that females were more likely to experience child sexual abuse and all three forms of sexual assault, while males experienced higher rates of child physical abuse. OLS regression results showed positive associations between child sexual abuse, perceived maternal rejection, BP symptoms and all three types of sexual assault with PTSD symptoms. Females also experienced more PTSD symptoms compared to males. Findings have implications for targeted interventions to improve mental health outcomes.

Invitations to think and feel in forensic nursing; the role of clinical supervision and reflective practice

Providing nursing care to people who have experienced child sexual abuse, assault and rape is a highly specialised and psychologically demanding task. Necessarily much focus is on the technical aspects of the task of providing care to patients. The specialist administrative and nursing team in the Sexual Assault and Treatment Units (SATUs) in Ireland provide complex treatment to a particularly vulnerable group of people from various backgrounds in Irish Society. The service is open to all genders and gender identities, aged 14 and over. The care is free and it is a recognised safe place to go to if you have been raped or sexually assaulted. In the Department of Health’s Policy Review of the SATUs in Ireland they recognised the challenging nature of the work and recommended the provision of high quality emotional supports for all staff (core and on-call).
 This paper considers the provision of reflective practice to members of the SATU team, with a particular emphasis on their emotional and psychological experience at work. The introduction of reflective practice into a nursing setting will be discussed including opportunities and challenges that emerged, and how the service gained momentum over a year. The paper will reflect on one case example in the form of a supervisee/supervisor relationship in an effort to deepen and broaden our understanding of the need for professional spaces in which to consider ones experience at work.

Sex differences in the association of childhood sexual abuse severity with premarital sex among Chinese college students in Luzhou, China

PurposeThe adverse health consequences of premarital sex and childhood sexual abuse (CSA) are both global public health problems. Based on a random sample of college students from a Chinese city, this study investigated the relationship between CSA severity and premarital sex among students, focusing on sex differences.MethodsA total of 2722 college students from 4 schools in Luzhou were recruited by multistage random sampling. Self-administered questionnaires were used to measure CSA experiences and premarital sex. Binary logistic regression analyses were conducted to analyse the relationship between CSA and premarital sex.ResultsThe prevalence of CSA was 9.39%, and that of mild, moderate and severe CSA was 4.04%, 2.90% and 2.46%, respectively. The premarital sex reporting rate was 22.42%. After adjusting for confounding variables, CSA was positively associated with premarital sex. Notably, a cumulative effect of CSA on premarital sex was observed among students. Further stratification analyses showed that males who experienced CSA had a higher premarital sex rate than females, and this sex difference was also observed among students with different CSA severities.ConclusionCSA and its severity were associated with premarital sex among college students. Furthermore, this association was stronger for males than females. Therefore, it is important to emphasize CSA prevention, especially for boys. These findings can promote understanding of the effects of CSA on premarital sex, and CSA prevention and intervention strategies should consider CSA severity and sex differences.

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.

A first look at childhood abuse in women with obstructive sleep apnea

Study objectivesWomen who experienced childhood sexual abuse have higher rates of obesity, a risk factor for obstructive sleep apnea (OSA). We assessed if prior childhood sexual abuse was more common in women with OSA vs. those in the control group, with possible mediation by obesity.MethodsIn a secondary analysis of a larger project, we studied 21 women with OSA (age mean ± SD 59 ± 12 years, body mass index [BMI] 33 ± 8 kg/m2, respiratory event index [REI] 25 ± 16 events/hour, and Epworth Sleepiness Scale [ESS] score 8 ± 5) and 21 women without OSA (age 53 ± 9 years, BMI 25 ± 5 kg/m2, REI [in 7/21 women] 1 ± 1 events/hour, and ESS score, 5 ± 3). We evaluated four categories of trauma (general, physical, emotional, and sexual abuse) with the Early Trauma Inventory Self-Report–Short Form (ETISR-SF). We assessed group differences in trauma scores with independent samples t-tests and multiple regressions. Parametric Sobel tests were used to model BMI as a mediator for individual trauma scores predicting OSA in women.ResultsEarly childhood sexual abuse reported on the ETISR-SF was 2.4 times more common in women with vs. without OSA (p = 0.02 for group difference). Other trauma scores were not significantly different between women with and without OSA. However, BMI was a significant mediator (p = 0.02) in predicting OSA in women who experienced childhood physical abuse.ConclusionChildhood sexual abuse was more common in women with vs. without OSA. BMI was a mediator for OSA of childhood physical but not sexual abuse. This preliminary hypothesis-generating study suggests that there may be physiological impacts of childhood trauma in women that predispose them to OSA.

A relational understanding of the needs of siblings of children who have been sexually abused

AbstractThis participatory research project highlighted the views and experiences of young people who are the brothers and sisters of children and young people who have experienced child sexual abuse. By working with young people who had experienced sexual abuse and their siblings, this practitioner research sought to give these young people a voice. The research involved a group process with young people who have experienced sexual abuse and have siblings, and one‐to‐one online consultations with the brothers and sisters of young people who have experienced abuse. All the young people spoke of their sibling and family relationships as unique and requiring unique responses to these relationships by services and health‐care professionals. Siblings’ needs in the aftermath of a child sexual abuse discovery are often overlooked. This research describes how just as children who have experienced sexual abuse may feel anger, fear, guilt, shame, anxiety, and confusion, so do their siblings. Brothers and sisters of young people who have experienced sexual abuse describe significant relational trauma with intense emotional experiences of isolation, confusion, sadness, and anger. There is a real need to support young people and families to find words and develop capacities to talk about child sexual abuse ‐‐ a need to find supportive ways to speak about what has occurred and understand its impact on all. The study clearly demonstrated the significant level of need and impact on brothers and sisters of young people who have experienced sexual abuse.

Sexual misconduct among elementary and middle school‐aged children in partial hospitalization setting

Often discussions of sexual misconduct of minors center on adult‐on‐child incidents; however, the frequency of student‐on‐student sexual misconduct has been on the rise. Sexual misconduct is defined as any conduct which is sexual in nature and is unwelcome and engaged in without consent. Sexual misconduct can include a range of behaviors including sexual harassment and unwanted touching. Recent data indicates that one‐half to three‐quarters of child sexual abuse and assault victimization experiences are committed by other children.

Surviving child sexual abuse in women's artistic gymnastics: ‘It's beautiful, because had I stayed in the past, I wouldn’t have evolved as a person’

The USA Gymnastics sex abuse scandal raised global awareness about child sexual abuse (CSA) in women's artistic gymnastics. The ensuing media coverage also centre-staged victims’ survivorship stories, a process that for many moved from dissociating, recognising and disclosing CSA to feeling comfort when connecting with survivors and accepting CSA as part of their life history. However, scholarship on what survivorship from CSA in sport entails, and importantly, what it means to athletes, is limited. In this article, we frame the survival of CSA using Arthur Frank’s socio-narratological conceptualisation of people being able to process the devastating consequences of a life-threatening and/or a life-altering event, and present the survivorship stories of two former gymnasts, Maria and Lucia (pseudonyms). For these two women, survivorship was facilitated by hearing others’ stories of sexual abuse, purposefully facing their CSA experiences and connecting with one another later in life to raise awareness about sexual abuse in sport. Thus, in addition to presenting Maria and Lucia's stories for the purpose of providing CSA victims with a survivorship narrative, we outline and reflect on the role hearing and telling stories have in CSA survivorship.

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.

"I Was Trying to Be the Mother to Her That I Didn't Have": Mothers' Experiences of Child Sexual Abuse and Intergenerational Maltreatment.

Child sexual abuse (CSA) can have lasting negative impacts on one's sense of safety and trust, ultimately affecting the quality of relationships, and increasing the likelihood of future victimization experiences. The present study provides a qualitative description of the themes that were generated through interviews conducted with 23 mothers who experienced CSA (dis)continuity (12 continuity, 11 discontinuity). The mothers described a variety of experiences related to parent-child and romantic relationships and parenting behaviors, which could be further researched and targeted by interventions to reduce the risk of intergenerational cycles of maltreatment.

How Do Survivor and Mandatory Reporter Status Correlate with Program Outcomes for an Adult-Focused Child Sexual Abuse Prevention Program?

ABSTRACT This exploratory study investigated group differences and pre-post changes in knowledge, beliefs, and behavior by mandatory reporters and Child Sexual Abuse (CSA) survivor status for a CSA prevention training designed for the general public. Of the 8,114 study participants, 32% identified as having experienced CSA, and 77% indicated they were mandatory reporters for child abuse and neglect. Mandatory reporters had higher baseline knowledge about CSA than those who were not mandatory reporters and reported more CSA preventative behaviors. Mandatory reporters continued to have higher levels of knowledge following the training. Survivors of CSA also had higher baseline knowledge about CSA and preventative behavior scores than individuals who are not survivors of CSA. Unlike mandatory reporters, they experienced fewer increases in knowledge. At posttest, there was no evidence of a difference in knowledge between CSA survivors and non-CSA survivors. For items related to beliefs, mandatory reporters had higher baseline scores than other participants. However, they had smaller gains, so mandatory reporters and non-mandatory reporters had more similar beliefs related to CSA after the training. There were few differences between CSA survivors and non-survivors on baseline beliefs related to CSA, though CSA survivors reported greater increases in beliefs that CSA prevention is their responsibility and in the idea that they know what to do to prevent CSA. These results have significant results for the development and evaluation of trauma-informed prevention programming.

Pathways from childhood sexual abuse to sexual aggression victimization and perpetration in adolescence and young adulthood: a three-wave longitudinal study

ABSTRACT Background: Childhood sexual abuse (CSA) has been identified as a risk factor for later sexual aggression perpetration and vulnerability factor for sexual victimization. However, the use of cross-sectional designs, the focus on female victimization and male perpetration, and the lack of evidence from outside North America limit the existing knowledge base. Objective: The study was designed to examine pathways from CSA to sexual revictimization and sexual aggression perpetration after the age of consent. Method: A total of 588 university students in Germany (308 female) took part in a three-wave longitudinal study covering 23 months. At each wave (T1–T3), all participants completed measures of sexual aggression victimization and perpetration. Experiences of CSA were measured at T1. Results: The rate of CSA was significantly higher for women (20.8%) than for men (12.4%). Rates of sexual victimization for women were 60.9% at Time 1 (since age 14), 22.3% at Time 2 (since T1), and 17.4% at Time 3 (since T2). For men, the rates were 39.2% at Time 1, 15.9% at Time 2, and 14.1% at Time 3. Rates of sexual aggression perpetration for women were 10.6% at Time 1 (since age 14), 3.5% at Time 2 (since T1), and 3.6% at Time 3 (since T2). For men, the rates were 18.0% at Time 1, 6.2% at Time 2, and 3.8% at Time 3. The gender differences in victimization and perpetration were significant only at T1. CSA predicted higher odds of sexual aggression victimization and perpetration cross-sectionally at T1 and indirectly at T2 and T3 via T1. Gender did not moderate the associations. Conclusion: The results confirm previous findings of elevated rates of sexual aggression victimization and perpetration in adolescence and young adulthood in victims of CSA. The implications for understanding and preventing adverse sexuality-related outcomes of CSA are discussed.

Exploring Sexual Orientation Disparities Regarding the Interplay of Childhood Sexual Abuse, Self-Reported Diabetes Status, and Depression Among Adults in the United States

ABSTRACT Previous research has revealed a strong link between the experience of childhood sexual abuse (CSA) and diabetes in adulthood. Moreover, research has shown that sexual minorities (SM) are exposed to adverse childhood experiences (ACEs) (i.e. CSA) and experience depression at higher rates than their heterosexual counterparts. Thus, it is imperative to further investigate the role of depression and the differential associations of exposure to ACEs with diabetes prevalence by sexual orientation. We explored sexual orientation disparities regarding the relationship between CSA and diabetes and examined the moderating role of depression. A total of 29,903 participants from the 2021 Behavioral Risk Factor Surveillance System (BRFSS) were included in this study. Secondary data analysis was conducted using the survey data, and weighted logistic regression and moderation analysis were performed. Heterosexuals who experienced CSA (AOR = 1.25; p < .05) and SM who experienced CSA (AOR = 2.13; p < .05) reported higher odds of having diabetes. Among heterosexuals, depression (AOR = 1.38; p < .001) was significantly associated with having diabetes. Additionally, depression was a significant moderator among heterosexuals with and without CSA. Further understanding of the impact of ACEs on diabetes among specific subgroups of SM should be assessed in future studies.

What do adults who experienced child sexual abuse want to convey about therapy?

BackgroundChild sexual abuse (CSA) studies have significantly advanced the understanding of its prevalence and adverse consequences. Tremendous efforts worldwide have been devoted to CSA interventions. However, surprisingly, there is a lack of research dedicated to learning about experiences with therapy among adults who experienced CSA. ObjectiveThis study was designed to address this gap by exploring the perspectives and experiences with therapy among adults who experienced CSA. MethodsThirty-nine written testimonies comprised the current sample. All of the testimonies were provided to the Israeli Independent Public Inquiry into CSA by adults who experienced CSA and received therapy at one point in their lives. A qualitative inductive thematic analysis guided the exploration of the testimonies. ResultsThe testimonies provided an important glance into significant characteristics of therapy, such as the timing and reasons leading to therapy, and perceptions regarding what constitutes appropriate therapy. Although beneficial and rehabilitating therapy experiences were mentioned by some of the participants, the majority of the testimonies focused on experiences related to the obstacles and challenges to accessing and engaging in therapy faced by those who experienced CSA. ConclusionsThe testimonies not only addressed essential aspects of therapy, but also highlighted the importance of thoroughly comprehending the broad context of a person's life that leads them to seek therapy. The discussion points to grave social and policy lacunas that prevent people who experienced CSA from receiving therapy that is accessible, timely, subsidized, stigma-free and multifaceted.

Anxiety and Depression Symptoms among Youth Survivors of Childhood Sexual Abuse: A Network Analysis

BackgroundPrevious studies have frequently reported a high prevalence of co-occurring anxiety and depression among people who experienced stressful events in childhood. However, few have noted the symptomatic relationship of this comorbidity among childhood sexual abuse (CSA) survivors. Therefore, this study’s objectives were as follows: (1) to examine the relationship across symptoms between anxiety and depression among CSA survivors; (2) to compare differences between male and female network structures among CSA survivors.MethodsA total of 63 Universities and Colleges in Jilin Province, China, covered 96,218 participants in this study, a sub-set data of which met the criteria of CSA was analyzed with the network analysis. The Childhood Trauma Questionnaire-Short Form (CTQ-SF), measured CSA. Anxiety was measured by the seven-item Generalized Anxiety Disorder Scale (GAD-7), and depression was measured by the Patient Health Questionnaire (PHQ-9). The sex difference between anxiety and depression among CSA survivors was compared.Results3,479 college students reported the experience of CSA (CTQ-SF total scores ≥ 8), with a prevalence of 3.62% (95% CI: 3.50–3.73%). Among CSA survivors, control worry, sad mood, and energy were central and bridge symptoms of the anxiety and depression network. Meanwhile, male CSA survivors appeared to have a stronger correlation between guilt and suicide, but female CSA survivors seemed to have a stronger correlation between control worry and suicide. Moreover, the edge of control worry-relax-afraid was stronger in the male network, while the edge of restless-relax was stronger in the female network.ConclusionControl worry, sad mood, and energy are crucial to offer targeted treatment and to relieve anxiety and depression symptoms for CSA survivors. Guilt needs more attention for male CSA survivors, while control worry remains more important for female CSA survivors to reduce suicidal ideation and suicide attempts.

Development of a Brief Psychological Trauma Intervention for Child Sexual Abuse in India

ABSTRACT Despite the alarming increase in incidences of child sexual abuse (CSA) in India, intervention research remains preliminary and generic. Although Cognitive Behavior Therapy (CBT) has been found to be consistently effective in addressing the adverse consequences of CSA, none of the cultural adaptations of CBT have been evidenced in India so far. Hence, the present study was conceived to develop a CSA-focused brief CBT intervention for children between 7 and 13 years of age. Intervention development progressed through four steps: 1) a systematic review of literature; 2) a qualitative study, including focused group discussions, conducted with 19 mental health professionals; 3) development of the intervention; 4) expert evaluation and finalization. We developed the intervention with three key elements: restoring the child’s functioning, assisting the child in processing, and managing trauma effectively and initiating the process of growth. The intervention predominantly followed the CBT framework while integrating culturally specified techniques. The intervention contains 8 modules and 18 sub-modules structured around three phases of intervention. The intervention is spread across a minimum of 6 required sessions and a maximum of 12 session held twice weekly for approximately 90–120 min duration. A list of 35 activities corresponding to each phase and sub-module of the present intervention has been designed as an intervention workbook. In conclusion, the newly developed intervention is a manualised, culturally competent, psychological intervention developed within the CBT framework for children aged 7–13 years with experience of CSA. The next phases include piloting intervention for feasibility.