Forms of Social Support That Moderate PTSD in Childhood Sexual Abuse Survivors

Although social support has been found to attenuate psychological symptoms in victims of sexual abuse, literature does not identify the specific forms of social support that mitigate maladjustment following a sexual abuse experience. This study sought to distinguish the specific types of perceived social support that buffer the development of post-traumatic stress disorder (PTSD) in victims of childhood sexual abuse (CSA). One hundred and seventy-two adult females reporting CSA were administered the Interpersonal Support Evaluation List (ISEL) and the Impact of Events Scale (IES). The ISEL measures the perceived availability of 4 support types. The IES measures core PTSD symptoms of intrusion and avoidance. Regression analysis indicated that social support significantly buffered PTSD development. The best model was one which contained self-esteem and appraisal support. Tangible and belonging support added little to prediction. Further, self-esteem support was identified as the most important variable in preventing PTSD development.     

Scale 8 Elevations on the MMPI-2 among Women Survivors of Childhood Sexual Abuse: Evaluating Posttraumatic Stress, Depression, and Dissociation as Predictors

This paper investigated elevations on Scale 8 of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) in women survivors of childhood sexual abuse (CSA) in order to assess whether symptoms of posttraumatic stress disorder, depression, or dissociation account for such elevations. Participants were 73 women seeking outpatient treatment for CSA after-effects at a university-based community mental health center. A stepwise multiple regression analysis was conducted, including measures of commonly reported symptoms in CSA survivors: depression, posttraumatic stress, and dissociation. Regression analyses revealed that the Beck Depression Inventory (BDI) and Dissociative Experiences Scale (DES) accounted for the most variance in Scale 8 scores (59%), with the BDI as the best predictor. The Impact of Event Scale (IES) did not predict Scale 8 scores significantly above that achieved by the model above. Cross-validation results indicated good generalizability. Results suggest that depression and dissociation contribute most to scores on Scale 8. Implications of these findings for the clinical and empirical use of the MMPI-2 with CSA survivors are discussed.     

Trauma Characteristics and Posttraumatic Stress Disorder among Adolescent Survivors of Childhood Sexual Abuse

This study examined the relationship between the characteristics of childhood sexual abuse (CSA) and the severity of consequent posttraumatic stress disorder (PTSD), depression, suicidal ideation, and substance use in a sample of 83 female adolescents aged 13–18 years seeking treatment for PTSD. Nearly two-thirds of the sample (60.7 %, n?=?51) reported the perpetrator of the CSA was a relative. A large portion (40.5 %, n?=?34) of the sample reported being victimized once, while almost a quarter of the sample reported chronic victimization (23.8 %, n?=?20). PTSD and depression scores were in the clinical range, whereas reported levels of suicidal ideation and substance use were low. The frequency of victimizations was associated with suicidal ideation. Contrary to expectation, CSA characteristics including trauma type, perpetrator relationship, and duration of abuse were unrelated to PTSD severity, depressive symptoms, or substance abuse.     

Wanted and Unwanted Sexual Experiences and Family Dysfunction During Adolescence

The goal of this study was to examine the relationship between family dysfunction and wanted, unwanted, and illegal sexual experiences that occurred during childhood and adolescence. Three hundred fifty-three subjects from a sexual abuse clinic, a family practice clinic, and a family planning clinic anonymously completed a survey on childhood sexual experiences and physical violence, family substance abuse, violence toward others, and family quality. Overall, 50% had had unwanted (USE) and wanted sexual experiences (WSE) before they turned 18. Subjects in the sexual abuse clinic had the highest percentage (90%) of unwanted or illegal sexual experiences, followed by the family planning subjects (40%) and the family practice subjects (30%). Both USE and WSE were related to family dysfunction scores, even when they were controlled for demographic influences. Family dysfunction scores were highest for those who reported USE and legal WSE and were lowest for those who reported no USE or WSE.     

Relationship Between Dissociative and Medically Unexplained Symptoms in Men and Women Reporting Childhood Sexual Abuse

The relationship between the dissociative and somatic symptoms in a clinical sample of 216 women and 35 men survivors of childhood sexual abuse (CSA) was examined. Symptom patterns were measured by the Dissociative Experiences Scale, the Somatization Scale of the Symptom Checklist 90-Revised (SCL-90-R), and the Hypochondriasis, Hysteria, Health Concerns, and Harris–Lingoes Somatic Complaints Scales of the Minnesota Multiphasic Personality Inventory-2. Somatization and dissociation were related, but not at a great enough magnitude to suggest that somatic symptoms as a generic category are an integral component of dissociation. With the exception of one of the measures of somatization, the SCL-90-R somatization scale, no significant differences were found between men and women CSA survivors in symptom levels. However, the relationship between somatization and dissociation was stronger in women than in men. The findings of this study should be considered preliminary and interpreted with considerable caution, since the scales used probably are of limited validity.     

Acts of Childhood Sexual Abuse: An Empirically Derived Typology

A clinical sample of 165 women survivors in outpatient therapy was surveyed about whether their childhood sexual abuse (CSA) included each of 17 sexual acts. Factor analysis of these acts was conducted. A typology of CSA acts consisting of three factors emerged. Inspection of the acts loading on each factor suggested that they differed primarily in terms of the type of abuse of power implied by them rather than in the nature of the sexual behavior involved. The three factors were named Coerced Complicance (Coercion), Subjugation and Humiliation (Subjugation) and Invasive Objectification (Objectification). Implications for research, theory, and clinical practice, and the need for evaluating the generalizability of the typology to other subpopulations of survivors, are discussed.     

Symptom Overreporting and Recovered Memories of Childhood Sexual Abuse

The authenticity of recovered memories is a much debated issue. Surprisingly, no study has systematically looked at symptom overreporting in people claiming recovered memories of childhood sexual abuse (CSA). In a first sample we administered the Structured Inventory of Malingered Symptomatology (SIMS) to individuals who said they had recovered CSA memories (n=66), individuals who said their CSA had always been accessible (continuous CSA memory group; n=119), and controls who said they had no CSA experiences (n=83). In a second sample individuals reporting recovered (n=45) or continuous (n=45) CSA memories completed the Morel Emotional Numbing Test (MENT). Our aim was to compare these groups with regard to their tendency to overreport symptoms. The results indicate that people with recovered memories do not score higher on the SIMS and the MENT than other CSA survivors suggesting that symptom overreporting is not typical for people reporting recovered memories.     

Interpersonal rejection sensitivity in childhood sexual abuse survivors: mediator of depressive symptoms and anger suppression

This study investigated whether interpersonal rejection sensitivity serves a mediating role between childhood sexual abuse (CSA) and three long-term psychological correlates of CSA in adult female survivors: depressive symptoms, anger suppression, and attenuated emotional expression. Interpersonal rejection sensitivity has been shown to be a risk factor for the development of depression and is elevated in CSA survivors. Similarly, attenuated emotional expression, particularly anger, has been related to adjustment difficulties in CSA survivors. Participants in this study were 355 female undergraduates, 34 of whom reported a history of CSA. Results demonstrated that interpersonal rejection sensitivity mediates the relationship between CSA and later depressive symptoms. Interpersonal rejection sensitivity partially mediated the relationship between CSA and anger suppression; however, it did not mediate the relationship between CSA and attenuated emotional expression. These results are examined within the context of the current literature on adult CSA survivors and their implications are discussed.     

Perceived Parenting Competencies following Childhood Sexual Abuse: A Moderated Mediation Analysis

Childhood sexual abuse (CSA) survivors may face specific challenges in their parental role because of the negative sequelae of their abuse. This study explored factors that might heighten or buffer the risk for problems in parenting for intrafamilial CSA survivors. A community sample of 54 CSA mothers completed questionnaires assessing the severity of their CSA experiences, current depressive symptoms, partner support, and key parenting dimensions. Six moderated mediational models revealed that CSA severity indirectly impacted the survivor’s bond with her child, limit setting ability, communication, and parental involvement through depressive symptoms at high levels of partner support. Partner support was protective against many difficulties in parenting at low levels of depressive symptoms, but did not promote, and at times hindered, effective parenting at high depressive symptoms. This study’s findings highlight the importance of attending to risk and protective factors in understanding parenting among CSA survivors.     

Sexual Harassment and Posttraumatic Stress Disorder: Damages Beyond Prior Abuse

This study examined the extent to which harassment experiences correlate with posttraumatic stress disorder (PTSD) symptoms, and whether diagnosable PTSD on the basis of sexual harassment occurs after accounting for prior PTSD, prior sexual abuse, and prior psychological dysfunction. The sample consisted of a two-wave panel of 445 women who had received a domestic violence protective order from a Kentucky court. Hierarchical linear and logistic analyses confirmed that sexual harassment experiences were significantly correlated with PTSD symptoms after controlling for an extensive set of trauma variables measured in both the baseline and follow up interviews. Our findings lend further evidence that claims of PTSD from sexual harassment may be credible even if claimants have been victims of other forms of trauma.     

Reasons for Returning to Abusive Relationships: Effects of Prior Victimization

Studies have demonstrated that women with a history of childhood sexual abuse (CSA) are at increased risk of revictimization, but research has not yet examined whether a history of CSA may affect patterns of remaining in or returning to abusive relationships in adulthood. This study examines the impact of a CSA history on decisions to return to abusive relationships in a sample of 104 adult domestic violence survivors. Participants were interviewed about the number of times that they had previously separated from and returned to their abusive partner, the factors that influenced their decision to return (both psychological/internal and environmental/external factors), and their perceived likelihood of returning in the future. As predicted, CSA survivors (n = 34) reported a significantly greater number of past separations than non-CSA survivors (n = 70). CSA survivors were also significantly more likely to report that their decisions to return were influenced by emotional attachment to the batterer. CSA survivors did not perceive themselves to be at greater risk of returning in the future, suggesting that they may be more likely to underestimate their vulnerability to returning to the battering relationship. Clinical implications of the findings are discussed.     

Sexual Orientation,Race, and Trauma as Predictors of Sexual Assault Recovery

Sexual minorities and racial minorities experience greater negative impact following sexual assault. We examined recovery from sexual assault among women who identified as heterosexual and bisexual across racial groups. A community sample of women (N?=?905) completed three yearly surveys about sexual victimization, recovery outcomes, race group, and sexual minority status. Bisexual women and Black women reported greater recovery problems. However, Black women improved more quickly on depression symptoms than non-Black women. Finally, repeated adult victimization uniquely undermined survivors’ recovery, even when controlling for child sexual abuse. Sexual minority and race status variables and their intersections with revictimization play roles in recovery and should be considered in treatment protocols for sexual assault survivors.     

Positive Resolution of Childhood Sexual Abuse Experiences: The Role of Coping,Benefit-Finding and Meaning-Making

Resolution of the trauma of childhood sexual abuse (CSA), and the current adjustment of 60 adult female CSA survivors were explored through qualitative and quantitative analyses of their coping strategies, perceived benefits, and meaning-making attempts. While the majority of the women (87%) perceived at least some benefit resulting from coping with the CSA experience, many (29%) found it impossible to make any meaning of their trauma. Specific benefits that were associated with various aspects of positive adjustment (marital satisfaction, better physical health, less isolation) included improved relationships with others, religious or spiritual growth, and improved parenting skills. Some perceived benefits were actually associated with a negative outcome. Increased knowledge of sexual abuse was associated with more isolation and lower marital satisfaction. When positive meaning could be derived from the coping process, the women reported less isolation. Avoidant coping was strongly associated with more depressive symptoms and poorer resolution of abuse issues. Results highlight the importance of considering coping strategies and cognitive restructuring efforts in designing therapeutic interventions with this population. Portions of this paper were presented at the annual meeting of the Midwest Psychological Association, May 2004, Chicago, IL.     

Attributions in a Hypothetical Child Sexual Abuse Case: Roles of Abuse Type,Family Response and Respondent Gender

The present study examines the impact abuse type, family response, and respondent gender have on attributions of blame in a hypothetical child sexual abuse (CSA) case. Three hundred and ninety three respondents read a hypothetical CSA scenario describing the sexual assault of a 14 year old girl by a 25-year-old man and completed 14 attribution items. Overall, the assault was deemed more serious, the perpetrator more culpable, and the family less culpable when CSA involved (vaginal) penetration. Contrary to expectations, respondents were more negative towards a family who denied the abuse took place versus one which blamed or supported the victim. Finally, male respondents deemed the abuse to be less serious, were more negative towards the victim and their families, and more positive towards perpetrators than were female respondents. The role these factors play in CSA attributions, together with ideas for future research, are discussed.

Self-injurious behaviors, PTSD arousal, and general health complaints within a treatment-seeking sample of sexually abused women

Eighty-nine adult female survivors of childhood sexual abuse, presenting for psychological treatment, were assessed for self-reported rates of self-injurious behaviors (SIB), health complaints, and posttraumatic stress disorder (PTSD) symptoms of physiological arousal. A composite measure of current SIB was significantly and positively associated with health complaints, PTSD arousal, and three measures of sexual abuse severity: age of onset for sexual abuse, injury experienced during the sexual abuse, and perceived life threat. Tests of mediation revealed that symptoms of PTSD arousal mediated the relationship between earlier age of onset for sexual abuse and SIB. PTSD arousal moderated the relationship between sexual-abuse-related injury and SIB. SIB was a unique predictor of health complaints, even after controlling for sexual abuse severity and PTSD arousal.     

The role of victim-offender relationship in women's sexual assault experiences

This study's goal is to identify differences in background, assault, and postassault factors according to the victim-offender relationship. A mail survey is conducted with more than 1,000 female sexual assault survivors (response rate 90%) recruited from college, community, and mental health agency sources. Stranger assailants are associated with a greater victim perceived life threat, more severe sexual assaults, and ethnic minority victims. Positive social reactions do not vary according to the victim-offender relationship, but stranger victims report more negative social reactions from others than do victims of acquaintances or romantic partners. Assaults by strangers and relatives are associated with more posttraumatic stress disorder (PTSD) symptoms than assaults by acquaintances and romantic partners. As expected, survivors' social cognitive responses to rape and social reactions from support providers are stronger correlates of PTSD symptoms than demographic or assault characteristics in general, but correlates vary across victim-offender relationship groups.     

Family Context and Childhood Adjustment Associated with Intrafamilial Unwanted Sexual Attention

Unwanted sexual attention (UWSA) encompasses unsolicited verbal comments, gestures, stares, and other noncontact behaviors made regarding one's sexuality and physical appearance. The present study examined the correlates and impact of such UWSA perpetrated toward girls by family members. The first objective of the study was to explore whether family climate is associated with intrafamilial UWSA. This included looking at three types of dysfunctional parenting styles (unaffectionate, unavailable, and patriarchal) as well as exploring the co-occurrence of UWSA by adult and child relatives. The second objective was to then measure the impact of such intrafamilial UWSA on childhood emotional health, after controlling for parenting style and the experience of more traditional forms of child sexual abuse (CSA). Of the 296 university women (mean age = 19) who participated in the study, 70% (N = 206) reported UWSA from a family member prior to age 18. Whereas each dysfunctional parenting style was related to presence of UWSA, a simultaneous multiple regression analysis indicated that two of the parenting styles, patriarchal and parental unavailability, also predicted frequency of nonphysical UWSA within the family. Presence of UWSA from a child relative was significantly correlated with presence of UWSA from an adult relative. Additionally, a hierarchical multiple regression, entering the three parenting styles simultaneously in the first step, childhood sexual abuse in the second step, and familial UWSA in the last step, indicated that the frequency of UWSA by family members significantly predicted poorer childhood mental health when controlling for the other variables. Overall, results indicate that while the specific parenting styles which co-occur with UWSA may be detrimental in their own right, the impact of UWSA on girls appears to be above and beyond that of either parenting styles or CSA. Clinical implications are discussed.     

The association between childhood sexual abuse and sexual coercion in men: a test of possible mediators

ABSTRACT

We examined the associations between childhood sexual abuse (CSA), childhood physical abuse (CPA), sexual domain variables, antisocial tendencies, and sexually coercive behaviour in a non-forensic sample of 173 heterosexual men. CSA was associated with paraphilic interests and experiences, a more extensive sexual life history, and early antisocial tendencies. CPA was associated with paraphilic interests and experiences, more self-reported delinquency, higher sensation seeking, and early antisocial tendencies. Sexual domain variables (e.g. number of sexual partners, sexual interest in sadomasochism) mediated the link between CSA and sexually coercive behaviour, but antisocial domain variables (e.g. delinquency, sensation seeking) did not. Of the two sexual domains examined, extensive sexual life history rather than paraphilias mediated the association between CSA and sexually coercive behaviour. These results suggest CSA and CPA are associated with both sexual and antisocial outcomes, and that, for some victims of CSA, having an extensive sexual life history may account for the association between CSA and sexually coercive behaviour later in life.     

Relationship Between Childhood Sexual Abuse Characteristics and Dissociation Among Women in Therapy

This study investigated the relationship between 10 characteristics of childhood sexual abuse and dissociation in adulthood. A structured clinical interview, the Dissociative Experiences Scale, and the Dissociation Subscale of the Symptom Checklist 90 - Revised were administered to 118 women survivors seeking psychotherapy. Separate stepwise multiple regression analyses were conducted for each dissociation scale to determine which abuse characteristics were predictive of dissociation. In both analyses, the same four variables were significantly related to dissociation: age at onset, coercive sexual acts, objectifying sexual acts, and concurrent multiple perpetrators. Implications of findings for future research and clinical practice are explored.