Sexual Abuse Trauma Research Articles

The Meaning of Sexual Abuse

Introduction: There is a high prevalence of sexual abuse among mental health patients. Survivors of sexual abuse suffer a broad range of psychological, psychiatric disorders and physical problems. The trauma and healing of sexual abuse is addressed on the level of the individual, the family and society. Objective: This paper will explore the meaning of sexual abuse on the level of the individual, the family and society. Methods: A literature review was conducted on sexual abuse and selected resources were explored. The prevalence, epidemiology, family and social etiology and psychodynamics, and psychopathology in survivors are presented. Results: Sexual abuse results in the '3 D syndrome': depression in the individual, disintegration in the family and degeneration in the society. The meaning of sexual abuse is organized around loss and guilt. The healing process has to take place on all three levels. Conclusions: Sexual abuse continues to be a pervasive problem. Up to one out of three females and one out of seven males have been sexually abused. Clinicians are obliged to inquire about sexual abuse in a sensitive, non-judgmental way. Mental health services need to assume leadership of organized social action that addresses the legal, correctional, cultural and social management of sexual abuse. Individuals need specialized treatment including the introduction of hope and help in finding meaning in their suffering. Families need access to family therapy and psychoeducation. Society needs to send a message to families and communities that sexual abuse will not be tolerated. Mental health services need to promote prevention and early intervention in dysfunctional families, communities and individuals.

Child sexual abuse: is it a risk factor for pregnancy?

This paper is a report of a study of the relationship of post-traumatic stress symptoms, depression, and health status to high risk pregnancy status in survivors of childhood sexual abuse. Studies examining the long-term effects of childhood sexual abuse have delineated diverse psychological, cognitive, and social difficulties in adult survivors that often manifest somatically. A random sample of 1835 mid-pregnant Jewish women was recruited in Israel over an 18-month period in 2005-2007. Participants were divided into three sub-groups consisting of the different combinations between pregnancy at risk (yes/no), childhood sexual abuse (yes/no), other than childhood sexual abuse trauma (yes no), and no trauma (yes/no). They completed a self-administered questionnaire consisting of five scales: a demographic variables scale, the Post-traumatic Stress Disorder Symptom Scale, Center for Epidemiologic Studies Depression Scale, Traumatic Events Questionnaire, and Childhood Sexual Experiences Scale. Pregnant survivors of childhood sexual abuse suffered higher distress levels which heightened poor health, hence increasing the probability of high risk pregnancy compared to women who had had other than sexual abuse trauma or reported no trauma. Post traumatic stress symptoms and avoidance (a sub-category) were found to explain chronic illnesses, whereas depression was found to explain gynecological problems in pregnant sexually-abused survivors. Healthcare workers need to recognize and address the psychological state of pregnant child sexual abuse survivors. Screening of pregnant women for child sexual abuse is needed to assess survivors' psychological well-being and recognize their unique concerns during pregnancy monitoring.

1001 Psychological Distress is a Major Risk Factor for the Continuation of Functional Gastrointestinal Disorders (FGIDs) 12 Years Later in the General Population

Background and aims: Visceral pain sensitivity is influenced by psychological bias in perception reflected in the sensory decision theory index “B”. We sought to develop a noninvasive questionnaire to identify patients with visceral hyperalgesia by identifying questions correlated with the B index.Methods: 107 Rome III positive, clinically diagnosed IBS patients completed a barostat test of rectal pain sensitivity and the following questionnaires: Clinical symptoms of pain and bloating, Recent Physical Symptoms Questionnaire (RPSQ) somatization scale, Pennebaker Inventory of Limbic Languidness (PILL), Pain Vigilance and Awareness Questionnaire (PVAQ), Somatosensory Amplification Scale (SAS), Tellegen Absorption Scale, Visceral Sensitivity Index, and Dissociation, Anxiety, Depression, Sexual Abuse Trauma Index, and Sleep Disturbance subscales of the Trauma Symptoms Checklist 40. The B index and corrected pain threshold (subtracted pressure required to minimally inflate bag) were computed from barostat data. As planned a priori, we also pooled all 218 questions from all scales and used t-tests to identify items which separated the lowest from the highest third of B Index scores. The 26 non-redundant items so identified formed the Visceral Perception Bias Questionnaire (VPBQ), which was scored by summing individual items. Results: The sample was 79% females with average age of 37.2 years. The mean and range for the IOP-adjusted pain threshold was 15.9 (0-44) mmHg and for the B Index 3.3 (0.9-5.5). Clinical pain was not significantly correlated with the B Index or pain threshold, but bloating severity was correlated with pain threshold (-0.22, p<0.05). Conventionally computed scores for some questionnaires (RPSQ, Tellegen Absorption Scale, Dissociation scale, anxiety, depression, and sexual abuse) were significantly correlated with the B Index and pain threshold (PVAQ, Dissociation Scale); however, no correlation exceeded 0.27, which was not strong enough to permit identification of patients with low pain thresholds. The empirically derived VPBQ performed better: it correlated -0.31 with pain threshold and -0.48 with the B Index. A VPBQ score of 35 or higher (67th percentile) identified 51.5% of patients with pain thresholds below 12 mmHg and 64.5% of patients with B Index scores below 2.71 (most sensitive third of patients). Conclusion: The empirically derived VPBQ identified more than half of the most pain sensitive IBS patients, indicating that this is a promising approach. However, further refinement and testing in a new sample of subjects including healthy controls is needed. [Supported by a grant from Takeda Pharmaceuticals and R24 DK067674]

Managing ethical issues in sexual violence research using a pilot study

Conducting research in the area of sexual violence has complex ethical and practical challenges for the researcher. Managing ethical issues in sexual violence is important and can be achieved through the use of pilot studies. The primary purpose of the pilot study was to identify and manage potential ethical and practical problems that could jeopardise the main study or violate the ethical and human rights of participants in the main study on women's journey of recovery from sexual assault. The secondary purpose was to collect preliminary data in order to determine the human, financial and time resources needed for a planned study. The methods and processes used in conducting the pilot study in the study on women's journey of recovery are discussed according to each of the objectives of the pilot study, methods used to achieve the objective, observations or findings made during the pilot study, and implications for the main study. This article aims to demonstrate how a pilot study was used to manage identified potential ethical and practical research issues during the recruitment of participants and data collection for the research that was conducted by the first author to investigate women's journey of recovery from sexual assault trauma within the first week following sexual assault.

From the Margins to the Center

The trauma of sexual assault is heightened for many women by the interlocking experience of societal traumas such as racism, sexism, and poverty. The mental health effects of sexual assault are mediated by race and ethnicity. The investigators explore the experiences of African American, Asian American, Latina, and Native American female survivors of sexual assault. The sociohistorical context of intergenerational trauma in the lives of ethnic minorities is a part of the context for the contemporary experience of sexualized violence. Racial and ethnic dynamics related to sexual assault prevalence, mental health effects, and disclosure are examined. Literature related to cultural beliefs, community attitudes, and perceived social support in relation to sexualized violence are also reviewed. Finally, practice, research, and policy implications are discussed.

Supervising helpers who work with the trauma of sexual abuse

ABSTRACT This paper contributes to the ongoing discussion in this journal about counsellors’ experiences of vicarious traumatisation (Sexton, 1999; Dunkley & Whelan, 2006a, b). It builds on my previous paper (Etherington, 2000a) that focused on the role of supervision in moderating the potential impact on helpers, and on the helping relationship, of working with survivors of sexual abuse. It examines the role of unconscious empathy and counter-transference in the development of vicarious traumatisation, and uses psychodynamic, narrative, neuroscience, and resilience literature, woven together with the author's reflexive engagement as a counsellor, supervisor, and researcher. The paper suggests that supervision, at its most useful for people working in this field, might best be focussed on the inter-relationship between the trauma itself, the person of the counsellor, the helping relationship, and the context in which the work is offered. It suggests ways that supervisors might support helpers to sustain themselves whilst working in the difficult field of abuse and trauma

Health-Related Quality of Life and Trauma History in Adults With Schizophrenia Spectrum Disorders

Many with schizophrenia report exposure to trauma which may reduce health-related quality of life (HRQOL). To explore whether different forms of trauma are linked to different domains of HRQOL, and whether multiple trauma experiences have a cumulative effect, trauma history was gathered along with a measure of HRQOL among 102 adults with schizophrenia spectrum disorders. Participants were divided into those with and without report of sexual trauma, assault trauma, and trauma related to harm to others. Analysis of variance revealed that participants endorsing sexual trauma had poorer levels of general health, vitality, emotional-related role function, and mental health. Participants endorsing trauma related to harm to others reported poorer physical-related role function, general health, social function, and emotional-related role function. No evidence was found linking assaulted-related trauma to HRQOL. Greater numbers of trauma were related to poorer HRQOL. Results suggest differing forms of trauma may individually and cumulatively impact HRQOL in schizophrenia.

Spiritual Formation and Sexual Abuse: Embodiment, Community, and Healing

As a distortion of God's created designs, sexual abuse (SA) carries a unique devastation-factor. Abuse that is sexual in nature damages a spectrum of internal and external aspects of personhood. In particular, the core realities of: (1) self-identity, (2) community, (3) and spiritual communion with God can be deeply fractured through SA. In light of the significance of the image of God, movement toward healing includes strengthening personal agency, processing profound boundary ruptures, and managing disillusionment with God. Due to the multi-faceted trauma of sexual abuse (i.e., physical, social, spiritual) spiritual formation programs must not only plan for the unique profile of abuse victims, but also need to incorporate a fuller understanding and praxis of the realities of embodiment, ritual, and theocentric metaphor into their transformational goals. Analysis includes first-person experience, anthropological science, and theological reflection.

“It Wasn’t God Who Made Honky-Tonk Angels”: Musical Salvation in Dorothy Allison’s Bastard Out of Carolina

The thing that did keep me safe, that gave me a feeling of comfort growing up, was music. Music took me somewhere safe--a place where I was happy and free and comfortable being myself. I knew from a very young age that was something I wanted to be a part of. It was something that made me feel good and helped me escape to a place where life was how I always dreamed it should be. Where life was like the movies. Fairy-tale endings and unconditional love. --Melissa Etheridge I believe in a higher power. I believe we all need to be connected spiritually ... Music is a very supernatural thing. --Mark Collie Melissa Etheridge and country singer Mark Collie endow with an almost mystical power. For Etheridge becomes a place where she finds love and happiness, and for Collie represents a spiritual where human beings come together. For these singers (as for many musicians, scholars, and avid listeners), holds a saving power, even if it is only imaginary, like Etheridge's fairy-tale endings. In her novel Bastard Out of Carolina, Dorothy Allison interrogates the notion of musical salvation offered to Ruth Anne Boatwright in the gospel and country communities of the American in the 1950s and 1960s. A mature narrator recalling the childhood trauma of sexual, physical, and emotional abuse inflicted by her stepfather Glen, Bone tells a story enveloped in that grants her a safe, spiritual not unlike Etheridge and Collie's descriptions of musical power. Allison's fervent depictions of gospel revival tents and country radio stars invite readers to recover a musical portion of southern history where acts not only as a to reflect on the trauma of childhood abuse but also as a site to criticize and revise the exclusivity of an imagined southern community dependent on the hierarchies of race, class, and gender. Through these musical tropes, Allison unfolds Bone's developing realization that (as Kitty Wells's song suggests) it isn't God who constructs roles for men and women, but instead patriarchal southern social structures. (1) Since the novel's publication in 1992, scholars have effectively discussed Bone's white trash status and its history in the South, the shame it brings to Bone in particular, and the different ways Bone challenges her assigned place in the community through her masturbatory fantasies, story-telling, and visual re-makings. (2) Few of these critics consider the musical elements in the novel, though James R. Giles intimates that these are aspects worthy of exploration in his mention of southern Christian fundamentalism as an inoperative escape from trauma: one of the most fascinating aspects of Bastard Out of Catalina is its exploration of the gospel subculture and especially of the close connections between gospel and 'popular' in the South (91). Giles' quick parenthetical reference to Allison's use of echoes Deborah Horvitz, who recognizes how Bone infuses her passion for with her extreme self-loathing when she awakens to the pleasure of art in the form of live gospel music and how this artistic passion represents transcendence from physical trauma (5). Also incorporating music, Ann Cvetkovich explores the intersections of Bone's sadomasochistic masturbatory fantasies, incest, sexual trauma, and queerness, beginning with an analysis of the lesbian band Tribe 8 and their openness in performing sexually deviant tendencies on stage. While Giles and Horvitz connect story-telling and in the novel, Cvetkovich (on a more general level) recognizes the ways and story-telling create a safe space for queer women to express themselves. While these scholars note such connections in passing, I turn further attention to Allison's use of as more than a site of escape from physical trauma. While Allison employs gospel and country as a safe space for an expression of personal trauma, she also asks readers to recover the history of southern (of which Giles hints in his chapter) to subvert the patriarchal narrative of the South. …

Trauma-Focused Cognitive Behavioural Therapy for Children and Parents.

Trauma-focused cognitive behavioural therapy (TF-CBT) for children and parents is an evidence based treatment approach for traumatised children. Evaluation of TF-CBT includes several randomised controlled trials, effectiveness studies and ongoing studies for children experiencing sexual abuse, domestic violence, traumatic grief, terrorism, disasters and multiple traumas. The model of TF-CBT described here is a flexible, components-based model that provides children and parents with stress management skills prior to encouraging direct discussion and processing of children's traumatic experiences. TF-CBT components are summarised by the acronym PRACTICE: Psychoeducation, Parenting skills, Relaxation skills, Affective modulation skills, Cognitive coping skills, Trauma narrative and cognitive processing of the traumatic event(s), In vivo mastery of trauma reminders, Conjoint child-parent sessions, and Enhancing safety and future developmental trajectory. Currently this model of TF-CBT is being adapted and implemented both within the USA and internationally.

Introduction to Special Issue on Betrayal and Recovery: Understanding the Trauma of Clergy Sexual Abuse

ABSTRACT The sexual abuse of children can leave profound emotional and psychological scars that reverberate through the entire lifecycle. In this volume, the sexual abuse of children and adults perpetrated by clergy is considered. The editors have provided a cross section of authors to examine the unique aspect of this form of trauma, with particular emphasis on providing a voice for the survivors of such abuse.

Clinicians' understanding of International Statistical Classification of Diseases and Related Health Problems, 10th Revision diagnostic criteria: F62.0 enduring personality change after catastrophic experience

International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) has included a diagnostic category of “enduring personality change after catastrophic experience” (EPCACE). Preliminary investigation suggests that there is considerable endorsement in principle for this new category among experts in the field of intentional human trauma, yet many aspects of the diagnosis remain contentious. Criticisms leveled at EPCACE raised issues that question the reliability, validity, and clinical utility of this diagnostic category. In ICD-10, there are 2 sets of documents describing EPCACE criteria. These are Diagnostic Criteria for Research (DCR) and Clinical Descriptions and Diagnostic Guidelines (CDDG). This study examines how clinicians described the symptoms that conform to or exceed the criteria of EPCACE that they observed in their clients. No other published research examining the descriptive validity of this category has emerged. A qualitative approach from social phenomenology and applied policy research perspectives was used to gather the views and experiences of clinicians. Twenty-four clinicians working in the area of torture and refugee trauma, war trauma, and sexual assault trauma were interviewed in depth. Using the CDDG, clinicians were able to typify the characteristic symptom criteria of EPCACE. Hostile or mistrustful attitude was identified as a prominent symptom. Somatization, self-injurious behaviors, sexual dysfunction, and enduring guilt are suggested additional features that are not encompassed by current EPCACE criteria. This study contributes to the descriptive validity of EPCACE. It demonstrates the utility of a qualitative approach to descriptive validation of diagnostic criteria. Participation of clinicians as members of working parties in the development and review of diagnostic criteria is recommended. The symptom descriptors generated from this study could be used to enhance CDDG.

Ulcus Vulvae Acutum in a 13‐Year‐Old Girl After Influenza A Infection

A 13-year-old otherwise healthy premenarchal girl presented with acute onset of painful vulvar ulcerations. One day before developing vulvar ulcerations, she experienced flu-like symptoms, including a low-grade fever, cough, sore throat, and myalgia. Results of a throat swab were positive for influenza A infection (polymerase chain reaction [PCR] assay), and the patient was treated with oseltamivir. The patient's constitutional symptoms improved slightly, but within 2 days after her initial presentation, she returned to her primary care provider and described 24 hours of dysuria and vulvar swelling. She had a history of herpes labialis (cold sores) and rare episodes of minor oral aphthae (canker sores) that occurred less than twice a year. The patient denied a history of sexual activity, sexual abuse, or physical trauma. Physical examination showed ulceration and swelling of the labia minora, and the patient received an empiric dose of acyclovir (200 mg 4 times daily) for presumed autoinoculated herpes simplex virus (HSV) infection. An ulcer swab was performed, and urinalysis revealed no evidence of infection. Two days later, the patient presented to the emergency department with increasing vulvar pain and vaginal discharge. The previous ulcer swab findings were negative for HSV (PCR assay), and consequently, acyclovir was discontinued after 1 day of therapy. She received topical viscous lidocaine and an empiric dose of oral fluconazole. The lidocaine provided temporary symptomatic relief. Results of DNA amplification studies were negative for Chlamydia trachomatis and Neisseria gonorrhoeae. A potassium hydroxide preparation was negative for fungi, and an ulcer swab for bacterial culture revealed usual flora. Of note, the PCR assay for Epstein-Barr virus was not performed on ulcer cells. The patient was referred to the department of dermatology, and results of a physical examination showed copious white mucoid discharge and a 2-cm ulceration of the left labia minora (Figure, panel A). Two smaller pinpoint ulcerations and swelling of the left labia minora were also noted. The lesions were clinically indistinguishable from the genital aphthous ulcers of patients with complex aphthosis (recurrent, severe aphthous ulcers on oral or genital mucosa). A diagnosis of ulcus vulvae acutum was made, and treatment was started with clobetasol 0.05% ointment (4 times daily) and lidocaine gel as needed. Four days later, the patient reported marked symptomatic improvement. Physical examination showed near resolution of the large vulvar ulceration (Figure, panel B). The patient tapered use of clobetasol ointment over the next several days until the ulcerations healed completely. Two months after her initial episode, the patient again had 3 small vulvar erosions after symptoms that included low-grade fever, malaise, and vomiting. She did not receive oseltamivir for this illness; clobetasol ointment was applied 4 times daily, and the vulvar erosions ameliorated within a few days. Her constitutional symptoms resolved without treatment. The patient has not experienced any further episodes of vulvar ulcerations in the 18 months after the most recent treatment.

Difficulty Identifying Feelings Predicts the Persistence of Trauma Symptoms in a Sample of Veterans Who Experienced Military Sexual Trauma

The current study examined the prospective association between alexithymia and the persistence of trauma symptoms in a clinical sample of 175 male and female veterans who experienced sexual trauma during military service (military sexual trauma; MST). Trauma symptoms decreased significantly over the course of a specialized residential treatment program. Difficulty identifying feelings was related to persistence of the following trauma symptoms: overall symptoms, sexual abuse trauma symptoms, dissociative symptoms, and anxiety. Men exhibited more persistent symptoms overall, more persistent sexual problems, and more sexual abuse trauma symptoms compared with women (over and above controlling for symptoms at intake). The results speak to the significant role that difficulty identifying feelings has in the treatment of PTSD. In addition, the results suggest that MST has different implications for men compared with women. Specifically, men who were sexually abused in the military experienced greater persistence of symptoms compared with women, especially in the areas of sexual functioning.

Female Sex Offenders

Few studies have investigated the characteristics of female sex offenders and factors and/or causes of female deviance. Research to date has been descriptive in nature, with few comparison studies. Using a correlational design and three valid instruments, female sexual offenders and a matched group of female nonsexual offenders are compared in the areas of personality disorders, chemical dependency, childhood trauma, sexual trauma, emotional neediness, cognitive distortions, and social competence. A sample of 130 incarcerated females, 60 sex offenders, and 70 nonsexual offenders is used. Significant results are found in the areas of total childhood trauma and severity of sexual abuse suffered and social and sexual adequacy. No differences are found in abuse of substances, personality disorders, emotional neediness, or cognitive distortions.

Object Relations and Interpersonal Problems in Sexually Abused Female Patients: An Empirical Study With the SCORS and the IIP

In this study, we examined how retrospective reports of experiencing traumatic sexual abuse in childhood relates to both the development of self-representations and object representations and the occurrence of interpersonal problems. A total of 30 psychosomatic female patients who reported sexual abuse in childhood were compared with a corresponding number of eating-disordered patients and a nonclinical control group. The object relations technique (ORT; Phillipson, 1955), evaluated using the Social Cognition and Object Relations Scale (SCORS; Westen, 1985, 1991b), and the Inventory of Interpersonal Problems (Horowitz, Rosenberg, Baer, & Ureno, 1988) were used to measure the groups. The patients reporting sexual abuse achieved significantly lower scores in the cognitive scales of the SCORS; in the affective scales, they differed from the control group but not from the patients with an eating disorder. Concerning interpersonal problems, the patients reporting childhood sexual abuse reported interpersonal conflicts more frequently. The results of the study support the influence of traumatic sexual abuse on the formation of self-representations and object representations and on the occurrence of interpersonal conflicts.

Taping Together Broken Bones: Treatment of the Trauma of Infant Physical and Sexual Abuse

To explore the ways in which the particular traumas of infant physical and sexual abuse affect early development, this paper presents the long-term treatment of a child physically and sexually abused at age 4 months. Clinical and empirical literatures are outlined and synthesized in order to elucidate the particular nature of preverbal trauma. Three specific orienting concepts from the literature that were particularly useful in the treatment of preverbal abuse are discussed: 1) Neurobiological sequelae of physical and sexual abuse in infancy and the implication of specific trauma for emotional and relational development, 2) Trauma symptoms and conceptualizations of PTSD specific to early childhood, and 3) Somatic expression and representations of trauma in child behavior and play. Clinical conceptualization of the nature of early play, and the meaning of repetitive play observed in children who have undergone early abuse, are briefly discussed and applied to the case material. The symptoms expressed by the child and the course of the play therapy treatment are considered as ways in which to understand the somatic, behavioral, and emotional, expression of the abuse.

Social Support Characteristics among Mothers with and without Childhood Sexual Abuse Trauma

Social Support Characteristics among Mothers with and without Childhood Sexual Abuse Trauma

Women’s journey of recovery from sexual assault trauma : a grounded theory - Part 1

Thousands of women and children experience sexual assault trauma annually in South Africa. The challenge posed by recovery from sexual assault trauma is a reality that confronts the survivors of sexual assault, their families and the larger community of service providers. Yet, little research has been conducted on recovery from sexual assault as a phenomenon. The purpose of the study was to explore and analyse the journey of recovery which is undertaken by women who have been sexually assaulted, with the aim of discovering and developing the grounded theory of recovery from sexual assault trauma within the first six months following the event of rape. The main research question was: What constitutes the journey of recovery undertaken by women within the first six months following sexual assault? A longitudinal qualitative study was conducted using the principles of grounded theory methodology as proposed by Strauss and Corbin (1990,1998). A series of indepth one-to-one interviews were conducted with a sample of ten women. The participants were selected through open, purposive and theoretical sampling procedures. The study was conducted over a period of six months following the event of sexual assault.

Women’s journey of recovery from sexual assault trauma : a grounded theory - Part 2

Thousands of women and children experience sexual assault trauma annually in South Africa. The challenge posed by recovery from sexual assault trauma is a reality that confronts the survivors of sexual assault, their families and the larger community of service providers. Yet, little research has been conducted on recovery from sexual assault as a phenomenon. The purpose of the study was to explore and analyse the journey of recovery which is undertaken by women who have been sexually assaulted, with the aim of discovering and developing the grounded theory of recovery from sexual assault trauma within the first six months following the event of rape. The main research question was: What constitutes the journey of recovery undertaken by women within the first six months following sexual assault? A longitudinal qualitative study was conducted using the principles of grounded theory methodology as proposed by Strauss and Corbin (1990, 1998). A series of in-depth one-to-one interviews were conducted with a sample of ten women. The participants were selected through open, purposive and theoretical sampling procedures. The study was conducted over a period of six months following the event of sexual assault. The substantive theory was discovered and constructed through the inductive and deductive analysis of data, grounded on the ten women's descriptions of their journey of recovery from sexual assault. The theory of women's journey of recovery that was discovered and developed consisted of eight theoretical concepts or categories. These included the following concepts: 1. Sexual assault trauma 2. Awakening 3. Pragmatic acceptance 4. Turning point 5. Reclaiming what was lost 6. Defining own landmarks of healing 7. Readiness for closure 8. Returning to self. The grounded theory of the journey of recovery from sexual assault is a contribution to the knowledge about women's journey of recovery from sexual assault. It provides a process and language for understanding women's experiences within the larger social context of recovery from assault. The findings suggested that women's journey of recovery from sexual assault trauma is an individual experience that is influenced by many and varied causal and intervening conditions. These included personal biographies, relationships, supportive and non-supportive environments at individual, family, community and societal levels. Recommendations for future research and clinical management of sexual assault are made based on the researcher's interpretation of the findings.