Experienced Childhood Sexual Abuse Research Articles

‘Flow’: A Film About the Disclosure of Childhood Sexual Abuse

Trauma-informed care is growing in importance in health and social care, with disclosure as a vital first step. Yet evidence suggests that individual interactions with professionals may not facilitate trauma disclosure. ‘Flow’ aimed to address this. The film represents a high-quality, behaviour change resource that can be utilised in a wide range of circumstances. It was co-produced by representatives from the University of Sheffield, NHS England, the Department of Health and people with lived experience of childhood sexual abuse. The film follows the story of Amy, who is preparing for her art exhibition when a comment reignites traumatic childhood memories. She wants to approach her General Practitioner for help but is hindered both by family loyalty and barriers to disclosure within the NHS. ‘Flow’ has been used both in statutory services and non-governmental organisations, as well as being selected for inclusion in two film festivals. It represents an innovative way to communicate research results and foster change.

Incidence and Correlates of Husband-Perpetrated Rape Among Currently Married Women in Nigeria.

Husband-perpetrated rape (HPR), which implies every form of unwilling sex with a husband as a result of force, threat or drug, is rarely discussed or reported, and it has been quite understudied in Nigeria. Hence, this study answers two questions: What is the incidence of HPR, and what are the correlates among currently married women in Nigeria? Descriptive and multi-level logistic regression tools are used to analyze data from a sub-sample of 1,583 currently married women (16 years and above) surveyed in a larger survey conducted in mid-2022. The results suggest that the national incidence rate of HPR among currently married women in Nigeria is 20%. Although any married woman could experience HPR anywhere, the main correlates that are likely to elevate the risk in Nigeria are childhood sexual abuse experience (OR = 3.9, p < .001, 95% CI [2.9, 5.2]), membership in Yoruba ethnic group (OR = 2.7, p < .001, [1.7, 4.3]), and having husbands who smoke (OR = 2.4, p < .001, [1.7, 3.4]). Other minor risk factors are minority ethnic groups membership (OR = 2.1, p < .01, [1.4, 3.3]), husband's substance use (OR = 1.7, p < .001, [1.3, 2.2]), childhood family situation wherein parents separated/divorced (OR = 1.8, p < .01, [1.3, 2.6]) and membership of the Igbo ethnic group (OR = 1.7, p < .05, [1.1, 2.8]). Therefore, to reduce HPR experience in Nigeria, appropriate organs should design and implement an invigorated child protection law targeting childhood sexual abuse reduction. An aggressive campaign against smoking and substance consumption among married men is also imperative. Also, a sustained campaign against HPR using multiple media all over Nigeria is crucial.

Latent classes of adverse childhood experiences and adult health and behavioural outcomes in Haiti’s Cité Soleil

Exposure to adverse childhood experiences (ACEs) is associated with harmful biopsychosocial and behavioral outcomes in adulthood and with reduced community capacity. We investigated the prevalence of ACEs and differential risk of adverse adult outcomes based on latent class assignment in a resource- limited, high violence, and understudied setting of urban Haiti, i.e., Cité Soleil. 100% (N = 673; 41.4% men, 58.6% women, mean age 28.5) reported at minimum one ACE; 70% reported physical and emotional abuse as ACEs, and 47% reported experience of child sexual abuse (CSA). We identified 3 distinct latent classes and evaluated associations between class membership and correlates (e.g., experience of non-partner sexual violence as adults [NPSV], suicidal ideation [SI], substance use to manage stress). Family dysfunction (domestic violence, substance abuse, mental illness, divorce, or incarceration of caregivers) existed across all three classes. Patterns of ACEs reported by members of Class 2 support their identification as a distinct class that is at greatest risk for adverse adult outcomes. Specifically, the increased odds of exposure to CSA distinguished members of Class 2 from Classes 1 and 3. Members of Class 2 also had increased odds of substance use, SI, fear of going outside, NPSV experience, and hypervigilance. Class 2 members further showed reduced odds of education, access to health care, and being men survivors of NPSV. The prevalence of ACEs in this sample is unprecedented. Haiti needs ACE prevention and compassionate trauma-informed care at the population level.

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.

Childhood maltreatment as predictor and moderator for treatment outcome in patients with major depressive disorders treated with metacognitive therapy or behavioral activation

BackgroundChildhood maltreatment (CM) is a risk factor for developing and maintaining depression. It is unclear whether CM influences the effect of treatments for depression. This study examined CM's predictor and moderator effect in Behavioral Activation (BA) and Metacognitive Therapy (MCT). MethodCM was analyzed in a trial comparing a six months treatment program of either BA or MCT for 122 outpatients with major depressive disorder (MDD). Depression was assessed by the Hamilton Rating Scale for Depression (HRSD-24). CM was assessed using the Childhood Trauma Questionnaire (CTQ). ResultsLinear mixed models showed no predictor or moderator effects for the CTQ total score (all p > .58) but revealed a moderator effect for ‘sexual abuse’ on the reduction of depressive symptoms (β = 10.98, SE = 4.48, p = .015) indicating that patients with experiences of childhood sexual abuse benefited more from BA. There also was a predictor effect for ‘physical neglect’ (β = −3.35, SE = 1.70, p = .049): patients without the experience of physical neglect benefited more from treatment regardless of condition. Exploratory analyses indicated no predictor or moderator effects for the onset or persistence of depression, comorbid anxiety disorders or Cluster-C PDs (all p > .28). LimitationsLimitations include small sample sizes for some of the subsamples. ConclusionChildhood sexual abuse seems to moderate treatment effectiveness in a sample of severely affected outpatients with MDD treated with MCT or BA. If confirmed in further trials, a history of sexual abuse might guide the choice between MCT and BA. Trial registrationGerman Clinical Trials Register DRKS-ID: DRKS00011536 (retrospectively registered on February 13, 2017, without changes to the study protocol).

Originalarbeiten / Original Articles. Prävention sexualisierter Gewalt an Kindern und Jugendlichen: Präventionsmaßnahmen und Schutzkonzepte in den Bereichen Sport, Musik und Kirche

Prevention of Child Sexual Abuse: Prevention Programs and Safeguarding Concepts in the Context of Sports, Musical Education, and Religious Organizations Prevalence rates of child sexual abuse by caregivers in private and non-public institutions underscore the need for implementing safeguarding concepts. However, factors driving the implementation of prevention and safeguarding in the field are not well understood. What supportive and inhibiting factors can be identified in the implementation of safeguarding concepts and prevention programs? Content analysis of semi-structured interviews with professional and volunteer staff in clubs and institutions (n = 10, 69 % female) as well as with individuals who experienced child sexual abuse during their childhood (n = 3, 66 % female). Safeguarding concepts in clubs or religious institutions were primarily initiated by umbrella organizations. Current incidents of child maltreatment, public pressure, and media attention substantially increased the need for preventive actions. The provision of training, resources, and networking structures by umbrella organizations further facilitated their implementation. Main implementation challenges included limited personnel and time resources, lack of expertise, insufficient training opportunities, and absence of guidelines and support from umbrella organizations. Due to club leaders' limited knowledge and resources an independent implementation of safeguarding concepts is largely lacking without concrete guidelines and support from umbrella organizations. To upscale safeguarding, public policies or incentive systems such as state-funded child protection certifications are thus paramount.

Trust, entrusting and the role of trustworthiness for adult survivors of child sexual abuse

Background Survivors of Child Sexual Abuse (CSA) are reported to have difficulties in trusting. Yet no previous study investigating CSA survivors’ subjective experiences of trust exists and there is a paucity of clinical research into constructs and definitions of “trust.” Aims To use a phenomenological lens to investigate CSA survivors’ descriptions of trust relationships and trustworthy others by privileging their subjective experience. To better understand how trust can be built within therapeutic relationships. Methods A qualitative methodology using Interpretative Phenomenological Analysis was conducted within the survivor-research paradigm. The researcher was a person with lived experience of CSA who co-produced the study with CSA survivor advisors and co-constructed interviews with 17 adult CSA survivors. Results Findings present a “Survivor Trust Enactment Model” that delineates the process of building/repairing relational trust and advancing “transactional trust.” Trust is portrayed as nuanced and formed across and according to context, including the demarcation of generalised and relational trust. The findings emphasise that trustees’ trustworthiness is key to building trust which challenges assumptions that survivors are deficient in trust. Conclusion The foregrounding of subjective trust experiences challenges diagnostic and clinical views on trust deficiency in adult CSA survivors. The study develops clinical constructs of trust, considers implications for clinical practice, and indicates areas for further research into trust dynamics in therapeutic relationships.

An Examination of Social Work Interventions for Female Survivors of Sexual Abuse: Example of Türkiye

This study explores the life experiences of young women in northwest Türkiye, who were subjected to childhood sexual abuse. It considers the social services provided during their time in institutional care and their subsequent life experiences. The research adopts a holistic approach, encompassing the young women’s childhood experiences, the disclosure of abuse, the care received from statuary services, and the post-care challenges based on their narratives. The key research questions are: "How do institutional social work interventions affect the long-term recovery of young women who experienced childhood sexual abuse?" and "How effective is institutional care in preparing these women for life thereafter?" Employing a qualitative research methodology, semi-structured interviews were carried out with 12 women to retrospectively analyze their life experiences through the life history method. Furthermore, focus group discussions were conducted with social workers and representatives from non-governmental organizations. The findings emphasize that although institutional care caters to the immediate needs of children, it inadequately supports their development into well-adjusted adults capable of informed decision-making across different life contexts. Consequently, this deficiency leads to new and persisting challenges in family relationships, housing, partner choice, marriage, and motherhood, exacerbating the trauma resulting from sexual abuse. Results suggest a need to restructure social services in the field of child protection system in Türkiye to better address the long-term effects of trauma of child sexual abuse. Further research should assess the interventions for families of these children’s in care, to identify and meet specific needs, thereby enhancing intervention strategies.

The words may limit our understanding: reflexive research, affect and embodied writing

Drawing on a reflexive and embodied approach, this article examines the researcher’s narrative inquiry, consisting of the conflicting feelings and messy thoughts that arose through her interviews with adults who had experienced child sexual abuse. The article highlights how embodied writing can enable access to other worlds by activating the physical senses and bringing researchers back to core bodily ways of knowing; these latter may be evoked by preconceptions, entangled discourses and social views and taboos concerning child sexual abuse. The article speaks to the emerging field of Embodied Critical Thinking and the concept of emotional reflexivity in qualitative research on sensitive, challenging and difficult topics.

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.

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.

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).&#x0D; 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.