Experienced Childhood Sexual Abuse Research Articles

The relations between C-reactive protein and trauma exposure, PTSD and depression symptoms, and PTSD psychotherapy treatment response in treatment seeking veterans and service members

While inflammatory markers have been implicated in the link between PTSD and poor health outcomes, there is a paucity of research investigating C-reactive protein (CRP) and psychotherapy treatment response for posttraumatic stress disorder (PTSD). The present study utilized a large, well-characterized sample of veterans and service members (N = 493) engaged in intensive psychotherapy to investigate the associations between CRP, trauma exposure, related variables, and PTSD and depression, as well as investigating if CRP was associated with PTSD psychotherapy treatment response. Bivariate correlation results indicate that CRP was significantly associated with BMI (r = 0.48) and severity of experiences of childhood physical and sexual abuse (r = 0.14 and 0.15, respectively) and was not significantly associated with baseline PTSD total symptom severity, PTSD symptom clusters, or depression symptom severity (rs ranging from -0.03 to 0.04). In multivariate regression models investigating if CRP and related variables were associated with PTSD baseline symptom severity, CRP was not a significant predictor (β = -0.03). Hierarchical linear modeling did not identify CRP as a significant predictor of PTSD psychotherapy outcome. Given that findings indicate that CRP was broadly elevated in this treatment seeking sample but not associated with PTSD and depression symptom severity, results suggest CRP may not be a specific biomarker for PTSD or depression but may be elevated in psychiatric disease more generally.

Szaleństwo i rodzina. Obraz relacji rodzice–dzieci w anglojęzycznych patografiach poświęconych chorobom psychicznym

Many English-language illness narratives dealing with the experience of madness address the issue of parent-child relationships and their role in the development of mental disorders and their treatment. These texts closely reflect psychological theories about the aetiology of mental health problems dominant in the time of writing. Thus, the aim of this study is to compare the way family relationship are depicted in illness narratives written in the last fifty years. The article first looks at the pathographies penned during the popularity of anti-psy­chiatry, which blamed faulty parenting for the rise of psychosis (such as Mary Barnes’s auto­biography co-authored with her psychiatrist Joseph Berke, R.D. Laing’s collaborator). Later, it analyses texts which reflect the controversial findings of the so-called recovered memory movement, which claimed the experiences of childhood sexual abuse are often repressed and lead to multiple splitting of personality. The classic example of such a book is Flora Rheta Schreiber’s Sybil. Finally, more contemporary memoirs are presented, such as the works of Elizabeth Wurtzel or Marya Hornbacher as well as books written by parents whose children have been diagnosed with mental illness and who often had to battle prejudice attributing their children’s problems to neglect or cruelty on their part. Comparing these pathographies proves that writers interpret their life experiences according to the prevailing cultural script.

Suicidal ideation among Chinese survivors of childhood sexual abuse: Associations with rumination and perceived social support

BackgroundAlthough previous studies have shown that childhood sexual abuse (CSA) experiences might be related to suicidal ideation in later life, its associations with rumination and perceived social support (PSS) remain unclear. ObjectiveThe present study aimed to expand prior findings among Chinese survivors of CSA to investigate rumination's effect on the association between CSA and suicidal ideation, and the potential moderating role of PSS in this relationship. MethodsThe Childhood Sexual Abuse Questionnaire, the Ruminative Response Scale, the Multi-dimensional Scale of Perceived Social Support, and the Symptom Checklist were completed by 6834 college students (56.61% females). Results: In all, 1400 (20.76%) students reported experiences of CSA. The rate of CSA in males was higher than that in females (24.23% vs. 18.10%). Students with CSA experiences reported a higher level of suicidal ideation than those without such experiences. CSA and rumination were positively related to suicidal ideation, and PSS were negatively related to CSA, rumination and suicidal ideation. CSA predicted suicidal ideation both directly and indirectly through rumination. PSS moderated the effect of rumination on suicidal ideation. ConclusionsThis study provides evidence for the effects of rumination on the association between CSA and suicidal ideation, and the buffering role of PSS on the relationship between rumination and suicidal ideation in Chinese survivors with CSA experiences. These findings suggest that developing adaptive emotional regulation strategies and enhancing the level of PSS might contribute to the alleviation of negative influences from CSA.

The Demographics Behind the Courage to Tell for Survivors: Child Sexual Abuse Experiences in Kenya

Child Sexual Abuse (CSA) is both a global and national social issue, as well as an epidemic in various societies. Non-disclosure of CSA only worsens and extends survivors’ suffering, and CSA’s long-term effects can be devastating. Several studies have been done in the field of CSA and its health implications but rarely have previous studies addressed child sexual abuse disclosure (CSAD). The current study aimed at examining child factors of CSAD at Thika Level 5 Hospital (TL5H) in Kiambu County, Kenya. The study is a case study using a phenomenology approach where the primary data was collected from the sexual abuse survivors and caregivers using a mixed-method analysis. Interviews were conducted with 30 CSA survivors, 25 girls, and 5 boys: 5-17 years. The study utilised the convergent QUAL (investigative open-ended questions and storytelling) design with a Quan component (structured survey) to identify CSA survivors’ experiences while receiving medical treatment and therapeutic intervention at TL5H. Descriptive and thematic approaches were applied to analyse qualitative data that revealed survivors’ lived experiences with CSA. Informed by Bronfenbrenner’s Socio-Ecological Model (SEM), saliency analysis was applied to code the recurring and important themes from the data in order to identify which child factors. Survivors gave detailed accounts of types of threats and manipulation applied by perpetrators to stop them from disclosing abuse. Survivors said disclosing or not disclosing helped them cope with abuse trauma. Quantitative results revealed that 58% of the survivors who completed the disclosure process aged between 9-13 years, 83.3% were female, and 70% had achieved a lower level of education.

“Psychologically and emotionally, it affects me ‘til this day”: exploration of childhood sexual abuse perspectives among older adults living with HIV in South Carolina

ABSTRACT: Objectives The influence of childhood sexual abuse (CSA) may be seen immediately or across the life course. CSA is also associated with increased HIV-risk behavior, and greater likelihood of an HIV/STI diagnosis. The aim of this study was to explore the perspectives of CSA among older adults living with HIV. Methods Twenty-four adults living with HIV aged 50 to 67 years (mean age = 58.5 years), with a history of CSA, receiving care from an HIV clinic in South Carolina, participated in the study. In-depth semi-structured interviews were conducted, audio recorded and analyzed using a thematic analytic approach. The iterative analytic process included a three-step approach: discussion of initial thoughts and key concepts, identification and reconciliation of codes, and naming of emergent themes. Results Four themes emerged: Psychological issues due to CSA, relationship challenges due to CSA, self-blame, and reliving childhood trauma (subtheme: lack of influence of CSA today). Some participants reported feeling the influence of CSA several years after the event while others noted that that there was a lack of influence of CSA at present. Conclusions Trauma-informed intervention programs are needed for older adults living with HIV who still experience the influence of their CSA experience. Future research should delve into the design and feasibility of implementing these programs.

The relationship between commercial sexual exploitation of children (CSEC) and childhood sexual abuse (CSA) among boys and girls in Haiti

To test the hypothesis that childhood sexual abuse (CSA) is a risk factor for commercial sexual exploitation of children (CSEC), we analysed data from the Haiti Violence Against Children Survey (VACS), a population-based sample of adolescents and young adults ages 13–24 (1459 males and 1457 females). Twenty-one percent of males and 25% of females reported CSA; 6% of males and 4% of females reported CSEC. The adjusted odds ratios (AORs) for CSEC based on exposure to CSA were 5.6 (95% confidence interval/CI: 3.1–10.2) for males and 5.9 (CI: 2.6–13.0) for females. For each year earlier that males first experienced CSA, the odds of CSEC increased 60% (AOR 1.6, CI 1.2–2.0). In this first nationally-representative study of lifetime CSEC, both boys and girls victimised by CSA in Haiti were more likely to have also experienced CSEC than other youth, with children who experienced CSA at younger ages at the greatest risk.

Intervention program needs for older adults living with HIV who are childhood sexual abuse survivors

Objectives Childhood sexual abuse (CSA) prevalence estimates range from 8-11% among older adults and may range from 16 to 22% among older adults living with HIV (OALH). CSA experiences can still impact the quality of life of older adults. To the best of our knowledge, however, there are no CSA-focused interventions tailored for OALH. Using a qualitative approach, this study characterized the desired components of a trauma-focused intervention for OALH who are CSA survivors. Methods Twenty-four (24) adults aged 50 years of age or older who were living with HIV and had experienced CSA were recruited from a large HIV immunology center in South Carolina. Participants completed in-depth, qualitative, semi-structured interviews. We iteratively examined verbatim transcripts using thematic analysis. Results Three main themes emerged: program format and modality, program content, and program coordinator. Most participants expressed a desire for a trauma-focused intervention program in which the CSA experience was addressed and they could talk to someone either individually, as a group, and/or both. Conclusion A trauma-focused intervention addressing CSA may be helpful for OALH who are CSA survivors. Future research should focus on designing and implementing age-appropriate interventions addressing the CSA experience, increasing resilience, and developing adaptive coping skills.

Psychiatric, Substance Use, and Structural Disparities Between Gay and Bisexual Men with Histories of Childhood Sexual Abuse and Recent Sexual Risk Behavior

Sexual minority men disproportionately experience childhood sexual abuse (CSA) compared to heterosexual men, resulting in greater risk of psychiatric and substance use diagnoses, sexual risk taking, and HIV acquisition later in life. However, little is known about psychiatric and substance use disparities between gay and bisexual men who have experienced CSA. We recruited a purposive convenience sample in Boston and Miami, involving self-report and clinical interview data from 290 sexual minority men (M age = 38.0years) who reported CSA, defined as unwanted sexual contact before 13years of age with an adult or person five years older, or unwanted sexual contact between 13 and 16years of age with a person 10years older (or any age with the threat of force or harm). We compared those who self-identified as gay (n = 199) versus bisexual (n = 64) on demographic and structural variables (i.e., government benefits, unstable housing, and neighborhood crime) as well as psychiatric and substance use diagnoses. Across 15 unique diagnoses, three were more common in bisexual men than gay men in unadjusted models: bipolar disorder (OR = 2.90, 95% CI: 1.01-8.34), obsessive compulsive disorder (OR = 2.22, 95% CI: 1.01-4.88), and alcohol use disorder (OR = 1.86, 95% CI: 1.03-3.38). Bisexual men were also more likely to meet criteria for "any substance use disorder" than were gay men (OR = 1.99, 95% CI: 1.10-3.59). However, when race, education, and income were included as covariates, the odds ratios reduced significantly (bipolar disorder: aOR = 1.98, 95% CI: 0.59-6.61; obsessive compulsive disorder: aOR = 1.56, 95% CI: 0.64-3.77; alcohol use disorder, aOR = 1.54, 95% CI: 0.80-2.98; any substance use disorder, aOR = 1.79, 95% CI: 0.93-3.45, respectively). Our results highlight the mental health needs, including problematic substance use, of bisexual men with histories of CSA, as well as the importance of accounting for potential confounding demographic variables that may influence disparities in mental health and substance use.

Prevalence of Child Sexual Abuse in Spain: A Representative Sample Study.

The prevalence of child sexual abuse (CSA) is difficult to assess, and rates vary widely across studies due to methodological and sample differences. In Spain, prevalence data from representative samples are lacking. The objective of this study was to determine the prevalence of different CSA experiences in a sample that was representative of the Spanish population in terms of gender, age, and region. The sample comprised 1,071 (539 male and 532 female) Spanish adults (Mage = 45.37; SD = 14.84). Participants completed an anonymous online survey about different types of CSA and were asked whether they had disclosed the experience at the time. Prevalence was analyzed as a function of gender and generation. Results indicated prevalence rates ranging from 2.8% to 18.5%, depending on the type of experience. The most common experience suffered during childhood was being shown pornographic material, while that with the lowest prevalence was being forced to perform a sexual act involving penetration. Prevalence was higher in females than males for eight of the ten experiences considered. Young adults from Generation Z were the most likely to report having suffered three of the CSA experiences, two of them related to technology. Only 27.5% of respondents said that they had told someone about the abuse at the time, mainly their mother (more common among females) or a friend/peer (more frequent among males). The results suggest that CSA is prevalent in Spain, with considerable rates for several types of abusive experience, especially among females and the youngest generation. The implications of the results are discussed. The findings may inform social policy and the development of effective prevention programs.

Exploring Variations in Individuals' Relationships to Sexual Fantasies: A Latent Class Analysis.

Sexual fantasies represent a vast and highly personal dimension of human sexuality that remains understudied empirically. This article used a person-oriented approach to examine the reactions of arousal and discomfort that individuals experienced in response to four proposed fantasy scenarios depicting themes of romance, power dynamics (i.e., submission and domination), pain (i.e., sadism and masochism), and sexual violence. Using an online sample of 566 adult participants (250 men and 291 women) from the general population of Canada and the U.S., four classes were identified based on reactions of arousal and discomfort toward the proposed scenarios: Indifferent (relatively low arousal and discomfort to all scenarios, 37%), Romantic (high arousal solely for the romance scenario, high discomfort toward other scenarios, 22%), Enthusiastic (high arousal and low discomfort in response to all scenarios, 26%), and Dissonant (relatively high arousal and discomfort toward all scenarios, 15%). These classes were then compared to examine differences in terms of the following psychosexual characteristics: gender, experiences of childhood sexual abuse, sexual compulsion, and romantic attachment. Findings illustrated distinct patterns of reactions toward fantasies and confirmed the presence of links between reactions toward sexual fantasies, psychosexual characteristics, and traumatic life experiences. This suggests that the relationship between individuals and their sexual fantasies may be indicative of their overall relationship with sexuality.

(Re)activation of survival strategies during pregnancy and childbirth following experiences of childhood sexual abuse

ABSTRACT Objectives To explore the pregnancy and childbearing experiences of women-survivors of childhood sexual abuse [CSA]. We aimed to generate a theory explaining those experiences for this population (women), this phenomenon (pregnancy and childbirth), and this context (those who have survived CSA). Method Participants (N=6) were recruited to semi-structured interviews about their experiences of CSA and subsequent pregnancy and childbirth. Data saturated early, and were analysed using Grounded Theory (appropriate to cross-disciplinary health research). Coding was inductive and iterative, to ensure rigour and achieve thematic saturation. Results Open and focused coding led to the generation of super-categories, which in-turn were collapsed into three distinct, but related themes. These themes were: Chronicity of Childhood (Sexual) Abuse; Pregnancy and Childbirth as Paradoxically (Un)safe Experiences; Enduring Nature of Survival Strategies. The relationship between these themes was explained as the theory of: (Re)activation of Survival Strategies during Pregnancy and Childbirth following Experiences of Childhood Sexual Abuse. Conclusion Pregnancy and childbirth can be triggering for women-survivors of CSA. Survival strategies learnt during experiences of CSA can be (re)activated as a way of not only coping, but surviving (the sometimes unconsented) procedures, such as monitoring and physical examinations, as well as the feelings of lack of control and bodily agency.

Victims and Perpetrators of Child Sexual Abuse: Abusive Contact and Penetration Experiences.

Child sexual abuse (CSA) includes abusive contact experiences, which habitually impact the victim’s whole life. This study aims to analyze the characteristics of six CSA experiences with physical contact, including penetration, in a representative sample of the Spanish population. Participants were 1071 Spanish adults (53% males; Mage: 45.37) who completed the Child Sexual Abuse Experiences Questionnaire. The victim’s age at the first episode, the perpetrator’s characteristics, and the number of times that each experience occurred were analyzed, taking into account gender differences. Results were reported for every experience independently. The most prevalent age at the first experience was from 6 years old onwards, but with differences in some experiences. The abuses usually happened more than once, committed by the same person. The most prevalent perpetrator is a male, although a female perpetrator is more prevalent in male victims. Most of the abuses were committed by an adult acquaintance, a strange adult, and other minors, with some gender differences. The implications of the results concerning every CSA experience are discussed, highlighting their value for future research and practice, the design of preventive programs, and early detection of CSA.

Body duality.

This poem focuses on Body Duality and recounts the experience of child sexual abuse. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Universal precautions: the case for consistently trauma-informed reproductive healthcare

In the United States, about 1 in 5 women have experienced childhood sexual abuse, and a similar proportion experience rape as adults. Childhood sexual abuse and other forms of trauma have serious impacts on our patients' reproductive health. The American College of Obstetricians and Gynecologists recommends universal screening for a history of sexual abuse and universal application of a trauma-informed approach to care. Despite these recommendations, universal screening is far from universally practiced, and trauma-informed care, despite being the standard of care, is far from standard. Given the high prevalence of trauma in the United States, its impact on perinatal outcomes, the sensitive nature of reproductive healthcare, and the likelihood that many patients may not disclose their trauma history, we advocate for trauma-informed reproductive healthcare as the standard of care.

Assessing the Individual Interviewer Rapport-Building and Supportive Techniques of the R-NICHD Protocol.

The use of the rapport-building and supportive techniques formulated by the R-NICHD protocol is intended to support children and increase the quality of their statements as well as disclosures without possessing suggestive potential. While the effectiveness of the entire R-NICHD protocol for children who have actually experienced child sexual abuse (CSA) has been supported by research, to date no study assessed the effect of each individual socio-emotional interview technique in both interviewees with and without CSA experiences. The current study aimed to address this gap in research by means of an online vignette-study, asking participants to rate the identified rapport-building and supportive techniques on the scales well-being, willingness to talk, and perceived pressure. A total of 187 participants were randomly assigned to either a hypothetical “abused” or a hypothetical “not abused” group by means of a vignette-manipulation. The results suggest that many socio-emotional interview techniques were perceived as supportive and non-suggestive, while a number of techniques were perceived as not supportive but suggestive. Few differences emerged between the hypothetical “abused” group and the hypothetical “not abused” control group. To conclude, most but not all rapport-building and supportive techniques proposed by the R-NICHD protocol had a positive effect on interviewees.

Recollections of Childhood Sexual Abuse: Complexities of Religious Coping and Muslim Religious and Psychological Adjustment in Afghanistan.

Religious coping is a double-edged sword. Clarification of the psychological benefits for positive religious coping requires statistical controls for negative religious coping and vice versa. This study sought to further explore the complexities of Muslim religious coping by extending the analysis to Afghans who coped with the sufferings associated with recollections of childhood and adolescent sexual abuse. Two hundred Dari Persian-speaking Afghan university students (122 identified having experience of childhood sexual abuse) self-reported on variables that measure religious orientation, religious coping, Muslim experiential religiousness, mental health, and child abuse. Results showed that negative religious coping interfered with the possibly beneficial effects of positive religious coping on mental health and child abuse. After controlling for negative religious coping, the associations of positive religious coping became obvious. In addition, Muslim spirituality moderated the associations of religious coping with mental health outcomes and child abuse: for people with higher Muslim spirituality, positive religious coping associated with better mental health, and negative religious coping associated with less child abuse. Implications for religious coping and combating trauma in a religious context are discussed.

The Impact of National-Level Gender Inequality on the Sexual Abuse of Girls.

Feminist scholars from various social science disciplines posit that gender inequality (GI) is harmful to women's well-being. Feminist criminologists argue that GI is criminogenic, especially of sexual violence. I apply this framework to a specific form of sexual violence: child sexual abuse (CSA). Using multilevel generalized linear modeling to analyze the responses of 10,106 women from 27 countries in the International Dating Violence Study, I test for significant associations between national-level GI and self-reported retrospective reports of CSA. While controlling for other risk factors, I find that GI is significantly associated with increased odds of having experienced CSA among women.

The impact of childhood sexual abuse and adverse childhood experiences on adult health related quality of life

BackgroundAdverse childhood experiences (ACEs) have been shown to be associated with adult physical, psychological, and socioeconomic well-being, indicative of poor health-related quality of life (HRQoL). However, the association between child sexual abuse (CSA) and adult HRQoL, independent of other ACEs, has been less well examined. ObjectivesTo examine associations between self-reported CSA, including the nature of CSA, and adult HRQoL. ParticipantsData are from 10,624 respondents to CSA and HRQoL questions on the 2015 Texas Behavioral Risk Factor Surveillance System survey. MethodsAnalyses included chi square and t-tests to compare sociodemographic and HRQoL differences among those with and without history of CSA. Multivariable logistic regressions were used to evaluate associations between nature of CSA and HRQoL, controlling for covariates. ResultsThe prevalence of self-reported CSA in the sample was 10.3%. Compared to the non-exposed group, individuals exposed to CSA were more likely to report their general health as poor (AOR, 1.51; 95% CI, 1.09–2.09), report 14 or more physical unhealthy days (AOR, 1.46; 95% CI, 1.06–2.02), 14 or more mental unhealthy days (AOR, 1.86; 95% CI, 1.30–2.64), and 14 or more activity limitation days (AOR, 2.22; 95% CI, 1.58–3.10) in a month. HRQoL outcomes were worse for respondents who reported being forced to have sex as a child compared with those who reported being touched or forced to touch someone. ConclusionsSelf-reported CSA is associated with lower HRQoL. The association varies by the nature of reported sexual abuse. Understanding the long-term impacts of CSA can inform adult treatment options and policies to prevent and treat CSA.

Factors associated with childhood sexual abuse and adolescent pregnancy

BackgroundPeople who experience childhood sexual abuse (CSA) have a higher rate of adolescent pregnancy than people who do not experience CSA. The purpose of this integrative review was to identify risk or protective factors that are associated with this group to help understand the high rate of adolescent pregnancy in people with CSA histories. MethodsThis review was conducted using strategies described by Whittemore and Knafl (2005). Five research articles met the following criteria: written in English, published in peer-reviewed journals in the past 10 years, and included the examination of predictors of adolescent pregnancy in any domain of the social ecological model of individual, relationship, community, or societal factors present among girls with CSA histories. ResultsStudies suggest that people who are abused in childhood through adolescence and are not believed when they report abuse may be at greater risk for pregnancy in adolescence. CSA was associated with a range of sexual risk taking behavior (e.g., ineffectual contraception use, drug and alcohol use prior to sex, multiple partners) which could lead to adolescent pregnancy. Individual-level behaviors where predominantly studied. There were no reports at the community or societal level of the model. ConclusionsIdentifying additional risk or protective factors at the relationship, community, and societal level may prove helpful in developing strategies tailored to this population. The unique characteristics that lead to higher rates of sexual risk-taking behavior that can lead to adolescent pregnancy have not been well documented and deserve further study to guide design and prevention/intervention modalities.

Association between childhood sexual abuse and patterns of HIV risky sexual behaviors among men who have sex with men in China: A latent class analysis

BackgroundIncreasing prevalence of risky sexual behaviors among men who have sex with men (MSM) exacerbate the transmission of HIV. Previous studies had demonstrated that childhood sexual abuse (CSA) was associated with one or more sexual behaviors, but few studies have been conducted among MSM in China. ObjectiveThis present study aimed to estimate latent classes of risky sexual behaviors and test for CSA differences in latent class memberships among Chinese MSM. Participants and settingThe eligible participants were MSM aged 16 years or older who reported ever having oral or anal sex with men in the past 6 months. MethodsData were obtained from an anonymous questionnaire between September 2017 to January 2018 in three cities in China, and contained questions about sexual-related behaviors and CSA experience. Latent class analysis (LCA) was used to classify the patterns of sexual behaviors and binomial regression was used to examine the relationships among these variables. ResultsAmong 628 MSM, 22.6% reported experiencing CSA. A two-classes pattern of sexual behaviors was identified, with 46.7% in the low-risk class and 53.3% in the high-risk class. MSM who experienced CSA were more likely to be high-risk group compared to those without CSA experiences [odds ratio (OR) = 1.981; 95% confidence interval (CI) =1.329–2.954)]. ConclusionsCSA was prevalent among Chinese MSM. And MSM with CSA experiences are more prone to be assigned to the high-risk group. Future HIV interventions need to focus on MSM who experienced CSA.