Survivors Of Childhood Sexual Abuse Research Articles

Identifying radiation therapists’ perceptions of potentially triggering aspects of care for survivors of sexual violence undergoing radiotherapy

IntroductionResearch shows that for survivors of sexual violence (SV), cancer procedures can be retraumatizing due to perceived similarities to the original SV. To date, there is no training program designed specifically for the radiation therapist (RTT) on how to deliver care sensitively to survivors of SV. A key component of sensitive practice is working with patients to identify and develop strategies to manage situations that could be triggering. The goal of this study was to understand the RTT recognition of potential sensory/environmental, relational, and mixed triggers in radiation oncology settings. MethodsThis quantitative research study conducted a secondary analysis on RTT responses to a learning activity from an online cancer education training program. The first section of the activity asked trainees to identify two potential triggers in a brachytherapy video, and the second portion of the activity asked trainees to describe two potential triggers in their own work. ResultsDescriptive statistics, χ2 tests, and t tests were used to analyze 50 RTT responses. RTTs tended to identify different types of triggers depending on the question (brachytherapy video vs. self-reflection). Data indicated that despite a lack of formal didactic training in trigger management, RTTs could identify triggers, and were most likely to recognize “mixed” type triggers. DiscussionTriggers identified are consistent with past research on childhood sexual abuse survivors’ healthcare retraumatization in obstetrics and gynecology, and cancer care. As in past research, invasive techniques, and situations where the patient was in a submissive position were identified as triggering aspects of care. It is interesting to note when reflecting on their own practice, the least identified triggers all fell under the environmental/sensory trigger category. RTTs may not fully appreciate a variety of potential triggers such as sounds of treatment or silence because they are outside of the room administering the beam when the machine is delivering treatment. Thus, they may not hear certain sounds or silence during their daily routine. ConclusionsRelatively few trainees identified sensory/ environmental triggers (e.g., restricted visibility and sounds of treatment, including silence) when reflecting on their own practice, which could potentially reduce their likelihood of helping patients minimize the impact of (or avoid) such triggers. Future research should identify a comprehensive list of triggers and then develop a training specific to the RTT focused on identifying environmental/sensory triggers from the perspective of the patient in the often unfamiliar and frightening radiotherapy suite.

Testimonies about child sexual abuse in the family. Challenges of addressing the private sphere

BackgroundThis article is based on a study analysing survivors' testimonies (n = 870) about child sexual abuse (CSA) within the family. The context of the study is the Independent Inquiry into Child Sexual Abuse in Germany (IICSA). The Inquiry's work is based on the concept of witnessing and supporting mainly survivors of CSA to share their stories. Since 2016 the Inquiry has collected more than 2000 written and oral reports. ObjectiveThe article explores the challenges of working through and coming to terms with past and present aspects of child sexual abuse (CSA) in the private space of the family. The main focus here is on findings from the statistical analysis on perpetrators and bystanders. Participants and settingThe study involved an evaluation of 870 reports by survivors and third parties. MethodsDescriptive analysis was carried out on mentions of perpetrators, strategies of perpretators, climate in the family, bystanders in the family. ResultsSignificantly more female than male survivors have contacted the Inquiry. The youngest people who approached the Inquiry were adolescents and young adults between 16 and 21 years of age. The oldest people were between 76 and 80 years old (for reasons of secure pseudonymisation, spans of five years are given). The results pointed to insights about male and female perpetrators and the situation of the affected children in the family. In 47 % of the mentions of perpetrators, fathers and stepfathers were named, in 9 % it was the mother or stepmother, and in 11 % biological siblings were named. There is a proportion of cases in which more than one perpetrator is mentioned. ConclusionsOne aim was to identify common characteristics in the actions of perpetrators within families as well as insights into the structures in families that promote child sexual abuse. The discussion shed light on the importance of the third party and the possibilities for the perpetrators to shape the environment of the family as a whole.Witnessing by survivors is an important epistemological, ethical, and political instrument for creating knowledge.

Childhood Sexual Abuse and Relationship Satisfaction: The Moderating Role of PTSD and Sexual-Related Posttraumatic Stress Symptoms

Research on childhood sexual abuse (CSA) has consistently demonstrated the long-term effects of such abuse, not only on survivors’ development, but also on the nature and quality of their adult relationships, particularly romantic ones. In this study we examined the moderating role of posttraumatic stress disorder (PTSD) and sexual-related posttraumatic stress symptoms (sexual-related PTSS) between CSA and relationship satisfaction. Survey data from 529 individuals who reported being currently in a romantic relationship were analyzed. In the first set of analyses, results demonstrated that participants with CSA reported significantly lower relationship satisfaction and significantly greater severity of PTSD and sexual-related PTSS than participants without CSA. Sexual-related PTSS but not PTSD moderated the association between CSA and participants’ relationship satisfaction, with the model of sexual-related PTSS explaining 20.8% of the variance in relationship satisfaction and the model of PTSD explaining 11.3% of this variance. In the second set of analyses conducted among survivors of CSA only, higher sexual-related PTSS severity was linked with ongoing abuse and with abuse by a non-family member. This study points to the potential contribution made by sexual-related PTSS to relationship satisfaction among survivors of CSA.

Finding a voice: Art therapy as a path to disclosure – a South African perspective

This article examines the use of art therapy for facilitating disclosure among those who have experienced childhood sexual abuse (CSA) in South Africa. Disclosure of CSA is a difficult and complex process, and traditional therapeutic approaches are not always effective. Traditional talk therapy approaches in South Africa are often hampered by cultural barriers, a lack of knowledge and resources, and a tendency to view disclosure as a once-off event rather than a process. Art therapy can provide a safe and non-threatening space for survivors to express their emotions, communicate their experiences, and process the complex feelings associated with CSA. This study sheds light on the mechanisms of change in art therapy and is a valuable resource for mental health professionals working with survivors of CSA and researchers interested in the potential of art therapy as a therapeutic intervention. This article argues that art therapy can be a powerful tool to help CSA survivors find their voice to disclose and initiate the healing process.

"One Day It Will Be Over, and You Will See Other Landscapes. . . You Are Not Alone": Adult Survivors' Messages to Children Undergoing Child Sexual Abuse.

Child sexual abuse (CSA) has received considerable attention from scholars, contributing to policy, intervention, and prevention efforts worldwide. However, survivors' involvement in this research is limited. This study was designed to delve into the messages of adult CSA survivors to abused children. In all, 371 written testimonies were provided to the Israeli Independent Public Inquiry on CSA by survivors from diverse communities in Israel. The Inquiry aimed to promote change in policies related to CSA. The testimonies were analyzed using the qualitative thematic analysis method. The results revealed five main messages emphasized by survivors to children experiencing CSA: (a) transferring the responsibility and guilt from children to perpetrators and society; (b) turning toward the light and continuing on; (c) disclosure is essential; (d) a happy life is possible; and (e) together we can survive. The discussion emphasizes how various systems in survivors' lives have profound impacts following the abuse. Although survivors were from diverse backgrounds, their messages to abused children were consistent. Through their messages to the children, the survivors emphasized their wish to transfer responsibility and guilt from children experiencing abuse to the society that is supposed to see, listen, protect, and validate. Implications for practice are discussed, focusing on the importance of making room for survivors' voices and experiences in the processes of shaping policies in the area of CSA. Moreover, the survivors' desire to be there for the children emphasized the urgent need to promote the perception of survivors as key stakeholders in the field of child abuse and to integrate their experiences and perceptions into the formal and informal systems for children.

The truth project- paper two- using staff training and consultation to inculcate a testimonial sensibility in non-specialist staff teams working with survivors of child sexual abuse.

This paper explores how trauma informed training and consultation for non-specialist staff at the Independent Inquiry into Child Sexual Abuse in England and Wales enabled them to work with survivors of non-recent child sexual abuse in the Truth Project and other areas of the Inquiry. The paper draws on data gathered from 32 semi-structured interviews with a range of Inquiry staff, including civil servants, legal professionals, senior operational managers, and researchers. The interview questions mapped on to the trauma informed principles embedded in the Inquiry and considered the efficacy and implementation of this training for engaging with survivors' voices, working with challenging testimonies and materials, and contributing to epistemic change. Findings included all staff having an awareness of what it meant to be trauma informed in an Inquiry context, talking about the principles in terms of value-based positions. Staff described an awareness of needing to attend to the idiosyncratic experiences of the individual survivor, and there was recognition that previous damage to survivor trust, through institutional failure, meant that demonstrating trustworthiness was a central task. Staff talked about the impacts of participation on some survivors, and the impacts it had on them to be exposed to trauma-related materials. There was acknowledgment of the limitations of the trauma informed approach but also recognition of the wider applications of this learning for other areas of their personal and professional lives. There is some support for the therapeutic culture developed at the Inquiry leading to what Fricker refers to as a testimonial sensibility, a quality of listening necessary for the establishment of epistemic justice. The discussion focuses on how this way of working can be applied to other public service settings and how epistemic justice concepts can be included in more traditional trauma informed care models to encourage an ethic of listening that has political and social, in addition to therapeutic, outcomes.

TRAUMA-INFORMED VAGINAL EXAMINATIONS FOR CHILDHOOD SEXUAL ABUSE SURVIVORS

Childhood sexual abuse (CSA) is widespread in the UK. Childbirth is a known trigger for CSA survivors due to the high potential for re-traumatisation, and vaginal examinations (VE) are particularly distressing. By offering VEs in a trauma-informed way that promotes the survivor’s autonomy, consent and bodily integrity, midwives can reduce the negative impact of VEs for survivors and promote positive, empowering birth experiences.

Challenges That Vhavenḓa Child Victims of Sexual Abuse Endure as a Result of Delayed Disclosure

While child sexual abuse (CSA) has been declared a public health concern worldwide, the continuous problem is the delayed disclosure that affects child victims in many ways. It poses profound health, psychological and social challenges for child victims. This qualitative study explored and described the challenges that Vhavenḓa child victims of CSA endure as a result of delayed disclosure. Five adult survivors of CSA, seven caregivers of survivors of CSA, four social workers, two educators and two traditional leaders were purposefully selected to participate in the study. Data was collected through semi-structured interviews and thereafter it was arranged and analysed thematically with the assistance of the NVivo software. Findings reveal that, due to the emotional implications of the abuse, the Vhavenḓa child victims of sexual abuse endure a number of behavioural, social and academic challenges that tremendously affect their well-being, even in their adulthood. It is therefore recommended that vigorous awareness campaigns on CSA within the Vhavenḓa communities be conducted to mitigate the delayed disclosure of sexual abuse.

Experiences of maltreatment in childhood are associated with increasing anxiety and lower body acceptance over pregnancy

ObjectivePrior studies have established that childhood sexual abuse (CSA) survivors are at increased risk for anxiety during pregnancy. Less is known about the course of anxiety throughout pregnancy for CSA survivors as well as underlying mechanisms linking CSA and perinatal anxiety. We assessed change in anxiety over the course of pregnancy for CSA survivors and examined whether acceptance and awareness of pregnancy-related body changes mediated this change. Methods299 pregnant participants from two larger longitudinal cohort studies were grouped into CSA (n = 67), “other Maltreatment” (OM; n = 111); and “no abuse” (NA; n = 121) based on responses to the Adverse Childhood Events scale. We used a general linear mixed model with repeated measures to examine change in anxiety (Hamilton Anxiety Scale) at two time points (MEGA = 26.2 weeks and 34.9) by abuse/maltreatment group and then examined whether group differences in anxiety were mediated by body awareness/acceptance (from Maternal Fetal Attachment Scale) using structural equation modeling. ResultsThe CSA group demonstrated higher anxiety at both gestational time-points and significantly greater increase in anxiety over gestation compared to OM and NA groups (F(1, 280) p = .046). CSA and OM groups reported significantly lower body acceptance than those without abuse/maltreatment (F(2, 287) = 3.486, p = .032). A small proportion of the total effect of CSA on change in anxiety (0.5%) was attributable to body acceptance. ConclusionPregnant CSA survivors experienced a greater increase in anxiety over pregnancy compared to other groups. Both abuse/maltreatment groups exhibited lower body acceptance, yet this contributed little to the association between CSA and anxiety.

Attachment Representations of Female Child Sexual Abuse Survivors Reflected in the Bird’s Nest Drawing Assessment

The study examined the Bird’s Nest Drawing (BND) of 14 adults who experienced child sexual abuse perpetrated by females, primarily their mothers. Descriptive analysis revealed the prevalence of insecure attachment and mainly an ambivalent representation. The drawings reflected vulnerability and under-protectiveness. Almost one-third of the drawings did not include caregiving and were suggestive of loneliness, abandonment, and rejection. When maternal caregiving was depicted, it was intrusive and characterized by a lack of separation, abandonment, or unsatisfying caregiving. The survivors’ narratives (n = 4) revealed themes of sadness, lack of protection, and vulnerability related to their mothers’ lack of competence. These findings suggest that the BND can serve as a valuable art therapy assessment tool to better understand attachment representations.

Comparing female- to male-perpetrated child sexual abuse as presumed by survivors – A qualitative content analysis

BackgroundFemale-perpetrated child sexual abuse (CSA) is taboo topic in society and an under-recognized issue in research and mental health care. ObjectiveThe aim of the present study was to examine perspectives of individuals surviving female-perpetrated CSA (in parts in addition with male-perpetrated CSA) on the question whether female-perpetrated CSA and its sequelae were considered different compared to male-perpetrated CSA. Participants and settingThe perspectives of 212 survivors of female-perpetrated CSA were captured in a cross-sectional online study. MethodsAnswers to the questions “How does female-perpetrated CSA differ from male-perpetrated CSA?” and “How do consequences of female-perpetrated CSA differ from those of male-perpetrated CSA?” were analyzed using qualitative content analysis. ResultsThe analyses reveal ten categories of differences, such as a more subtle approach, different levels of violence, and more psychological manipulation. Further, the analyses suggest ten categories of different personal consequences, such as less belief and support, more psychological sequelae, and disturbed relationships with women. ConclusionsApproaches to raise awareness about gender stereotypes in the context of CSA are needed and special needs of survivors of female-perpetrated CSA in psychotherapeutic treatment can be derived from the results of this study.

The impact lingers well beyond childhood: Child sexual abuse, trauma symptoms, and income for adult survivors

Child sexual abuse (CSA) is a traumatic experience, and this kind of trauma has far-reaching effects. While it is known that CSA affects mental, emotional, and physical well-being, its relationship to income is still being explored. Objective: The current study examined the relationships between child sexual abuse, trauma symptoms, education, and income levels in adult survivors of CSA (n = 260). The participants in this study were gathered anonymously online by posting links to the study on adult survivor of CSA support group websites. While the participants’ incomes ranged from about $20,000 to over $100,000, the mean household income was between $40,000 and $59,000. There were no significant differences in income by gender or ethnicity. Regressions suggest that while education and marital status were of course significantly related to income, both frequency and severity of abuse were also significantly connected with income (all p's <0.05). Furthermore, trauma symptoms of anxiety, depression, sleep problems, and dissociation were significantly linked with income (all p's <0.05). Path analysis showed that the effects of trauma on income were mediated through education levels. However, trauma symptoms still negatively affected income.

The truth project paper one-how did victims and survivors experience participation? Addressing epistemic relational inequality in the field of child sexual abuse.

The last 30 years has seen an exponential increase in Historical Institutional Abuse Inquiries. One feature of these has been to place adult survivor voices at the center of Inquiry work, meaning that child abuse victims and survivors are engaging with Inquiries, sharing their experiences, with this participation often presented as empowering and healing. This initiative challenges long held beliefs that child sexual abuse survivors are unreliable witnesses, which has led to epistemic injustice and a hermeneutical lacunae in survivor testimony. However to date there has been limited research on what survivors say about their experiences of participation. The Truth Project was one area of work of the Independent Inquiry into Child Sexual Abuse in England and Wales. It invited survivors of Child Sexual Abuse to share their experiences including the impacts of abuse and their recommendations for change. The Truth Project concluded in 2021 and heard from more than 6,000 victims of child sexual abuse. The evaluation of the Trauma Informed Approach designed to support survivors through their engagement with the project was a mixed methods, two phase methodology. A total of 66 survey responses were received. Follow-up interviews were conducted with seven survey respondents. The Trauma Informed Approach was found to be predominantly helpful in attending to victim needs and minimizing harm. However, a small number of participants reported harmful effects post-session. The positive impacts reported about taking part in the Truth Project as a one-off engagement challenges beliefs that survivors of child sexual abuse cannot safely talk about their experiences. It also provides evidence of the central role survivors should have in designing services for trauma victims. This study contributes to the epistemic justice literature which emphasizes the central role of relational ethics in the politics of knowing, and the importance of developing a testimonial sensibility when listening to marginalized groups.

Overcoming Challenges of Intimacy: Male Child Sexual Abuse Survivors’ Experiences of Achieving Healthy Romantic Relationships in Sweden

PurposeStudies on sexual health following male child sexual abuse (CSA) have identified the negative effects of such experiences on body functioning, but little is known about male CSA survivors’ ability to create emotional and physical closeness in romantic relationships. The purpose of this article is to explore how male CSA survivors perceive, experience and develop intimacy in romantic relationships, including both the challenges they face and the positive changes that enable them to grow and achieve healthy relationships.MethodThe study has employed a qualitative research approach and is based on in-depth interviews conducted among adult male CSA survivors residing in Sweden. Participants were recruited through civil society organizations and an ad in a daily newspaper. Using reflexive thematic analysis, the results are presented in relation to two themes: (a) challenges of intimacy; and (b) building trust and close relationships.ResultsThe results show that participants desired couple relationships that included both sexual and emotional intimacy. The challenges of intimacy were related to compromised sexual identity, sexual dysfunctions and compulsions, emotional dysregulation, and body shame. Efforts to achieve intimacy were facilitated by disclosing abuse experiences, developing emotional bonds or awareness, embracing sensitivity, and having an empathetic and supportive partner.ConclusionsReconstructions of abuse histories were both challenged and facilitated by the accessibility of various and shifting ideas about masculinities that co-exist in Sweden, which were important sources for meaning making and assisted the men in developing positive valuations of themselves as men.

Gender and coping with HIV: a qualitative study of older childhood sexual abuse survivors living with HIV

ABSTRACT People living with HIV often have complex identities and histories. Understanding how these experiences influence adherence to treatment and quality of life are critical to the HIV care. The experiences of older adults living with HIV are uniquely embedded within biology and aging as well as gender. This study described the gendered strategies for coping with HIV among older adults who are childhood sexual abuse survivors. Audio-recorded semi-structured interviews were performed with 24 adults who are 50 years and older from a clinic in South Carolina. Thematic analysis approach was used to discuss key concepts, reconcile codes, and name emergent themes. Overall, the participants used a spectrum of coping strategies including spirituality, seclusion, social support, substance use, engagement in HIV care, information acquisition and sharing, and cognitive reframing. Our findings suggest the potential for growth and recovery is heightened if the interplay of HIV diagnosis, aging, coping, and mental health is considered. Healthcare providers should assess the ways in which individuals interpret their HIV diagnosis and other lived experiences to better understand their patients' mental health. Knowledge of gender-based coping strategies used in HIV-relevant outcomes can be translated into more effective treatment plans to improve the overall quality of life.

Coping strategies among older adults living with HIV/AIDS with history of childhood sexual abuse.

Background: Childhood sexual abuse (CSA) may be a risk factor for poor mental health in adulthood. Survivors may experience emotions detrimental to their social and mental wellbeing. Some of these emotions may include anger, fear, rage, helplessness, guilt, shame, which may impact their coping strategies. The aim of this study was to determine the association between CSA and coping among older adults living with HIV (OALH). Method: Data were obtained from 91 OALH via convenience sampling. The participants were recruited from an immunology clinic and were at least 50 years or older and living with HIV. CSA was operationalized using questions from the Adverse Childhood Experiences Questionnaire. Coping was assessed using the Brief COPE Inventory. Crude and adjusted linear regression models, controlling for age, sex, race, gender, and income were used to determine the association between CSA and each coping subscale. The analyses were conducted in SAS version 9.4. Results: Crude analyses showed statistically significant associations between CSA and specific coping strategies: humor (β = 1.244; p = 0.0018), religion (β = 1.122; p = 0.0291), Self-blame (β = 1.103; p = 0.0154), planning β = 1.197; p = 0.0196), venting (β = 1.218; p = 0.0063), substance use (β = 0.828; p = 0.0335) and instrumental support (β = 0.949; p = 0.0416) After adjusting for sociodemographic characteristics, there was a statistically significant association between CSA and humor (β = 1.321; p = 0.0048) and self-blame (β = 1.046; p = 0.0382). Conclusion: OALH with a history of CSA were more likely to use humor and self-blame as coping strategies. Trauma-informed interventions should be geared towards decreasing self-blame for OALH who are CSA survivors.

Perceived Parental Attachment and Psychological Distress Among Child Sexual Abuse Survivors: The Mediating Role of Coping Strategies

Perceived Parental Attachment and Psychological Distress Among Child Sexual Abuse Survivors: The Mediating Role of Coping Strategies

Stories of childhood sexual abuse (CSA) among older adults living with HIV (OALH) in South Carolina: a qualitative study

ABSTRACT Childhood sexual abuse (CSA) devastatingly impacts an individual’s behavioral, psychological, and social health. Childhood, a developmental stage directly influenced by the home or school environment, leaves a life-long imprint. Compared with the general population, CSA prevalence is doubled among people living with HIV. Thus, the study aimed to explore CSA circumstances among older adults living with HIV (OALH) in South Carolina (SC). We included 24 OALH aged 50 and above who reported CSA. The data were collected at an immunology center in SC. In-depth semi-structured interviews were conducted, audio-recorded, transcribed, and analyzed using a thematic analysis approach. The iterative analytic process included a discussion of initial thoughts and key concepts, identification, and reconciliation of codes, and naming of emergent themes. Six themes emerged: known perpetrators, re-victimization, “nobody believed me”, “cannot live like others”, lack of CSA disclosure, and interconnections with other adverse childhood experiences (ACEs). CSA experiences and non-disclosure were found to be linked with shame, embarrassment, fear, and trust issues. Hence, trauma-focused interventions are required to resolve these issues and improve the quality of life of OALH with past trauma. Counseling or therapy programs should incorporate psychological and behavioral theoretical models to best target OALH who are CSA survivors.

Emotional Freedom Techniques for Childhood Sexual Abuse Survivors

Childhood Sexual Abuse (CSA) is a phenomenon that has affected the lives of many women and female adolescents. Eleven (11) residents of a center for abused females were included in this study. Using the case study research method of Yin, data was gathered from multiple sources. Findings were (1)emotion regulation skills were enhanced for some participants; (2) estrangement or hostility from family contributed to the prevalence of the symptoms; (3) some participants’ precursor to change characteristics may have hindered therapy progress; (4) EFTs lack an emphasis on building therapeutic alliance; (5)Cognitive Behavioral Theory when used with EFTs make the sessions more helpful; (6) outside factors may have affected the worsening or reduction of symptoms; (7) there is a need to distinguish between tapping for day-to-day management of emotions and tapping on core issues; and (8) assessment, case conceptualization, and the preparation of a treatment plan play an important role, if there is to be treatment success. Recommendations include suggestions to enhance the therapeutic process, considerations that need to be made in relation to symptomatology of CSA survivors, their precursor to change characteristics, standardizing the implementation of EFTs, and integrating Cognitive Behavioral Theory with EFTs so that a more structured therapeutic approach can be made.

Supporting survivors of institutional child sexual abuse during the COVID‐19 pandemic: A qualitative study of not‐for‐profit community and legal organisations in Greater Western Sydney

AbstractBefore, during and since the Australian Royal Commission into Institutional Responses to Child Sexual Abuse (2013–2017), not‐for‐profit community and legal services have been critical in supporting survivors of institutional child sexual abuse. This qualitative study aimed to explore the perspectives of community and legal service practitioners operating in Greater Western Sydney regarding the ongoing impact of the COVID‐19 pandemic on the service system for survivors of institutional child sexual abuse. Semistructured interviews were conducted with 21 practitioners at 15 community and legal services. Through thematic analysis, the study identified five areas of concern regarding service provision and COVID‐19, including difficulties in navigating shifts to remote service delivery; changes in service accessibility; complications in accessing the National Redress Scheme; safety challenges for clients; and safety challenges for practitioners. The research identified a need for services to finesse frameworks that ensure remote services can be delivered safely for clients and practitioners alike. Priorities include adequate funding for technology and infrastructure, supporting survivors of abuse perpetrated online and encouraging effective coping strategies for practitioners who undertake trauma support work from home. Future research should consider how shifts to remote service delivery have impacted survivors of different demographic groups and the survivor support workforce.