Degrees of Memory of Childhood Sexual Abuse Among Women Survivors in Therapy

Past and current memory for childhood sexual abuse reported by a clinical sample of 160 women survivors was assessed utilizing a structured clinical interview. Response alternatives for memory were ordered along a continuum. To minimize treatment effects, participants were interviewed as early in therapy as possible. Fairly complete recollection both in the past and currently was reported by 26.3% of the sample, 36.9% apparently lost and subsequently recovered sexual abuse memories, and 36.9% endorsed intermediate degrees of memory. Only 2.5% indicated a decrease in degree of recollection over time. Age at onset was the only abuse characteristic found to differentiate participants with fairly complete memory from the rest of the sample. Findings are interpreted as illustrating that conclusions about memory for abuse are highly dependent on the way inquiries are conceptualized and worded.     

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.     

Exploring the Relationship Between Childhood Sexual Abuse and Adult Sexual Perpetration

Empirical findings indicate that many adult sexual offenders experienced sexual abuse during childhood. It has been suggested that characteristics of offenders' sexual perpetrating behaviors may resemble their own victimization experiences, although there has been minimal empirical investigation in this area. The purpose of the present study was to provide preliminary data on the relationship between childhood sexual abuse and characteristics of sexual offending behavior. A sample of adult male sexual offenders with histories of sexual abuse completed the Sexual Victimization Survey as well as a measure on their sexual offenses. Such characteristics as the nature of sexual activities, duration and frequency of experiences, and age and relationship of participants were examined. Results showed trends in the hypothesized direction and revealed a variety of similarities between childhood sexual abuse and adult sexual perpetration. Findings of this exploratory study suggest the importance of addressing the nature of victimization in the treatment of sexually abused boys and offenders with histories of sexual abuse.     

Childhood Sexual Abuse and HIV Risk Among Men Who Have Sex with Men: Initial Test of a Conceptual Model

Childhood sexual abuse has been associated with HIV transmission risk behavior in men who have sex with men. This study examined an adapted model that was originally developed to explain the relationship between childhood sexual abuse and HIV risk behavior among women in a sample of men who have sex with men. Men attending a large gay pride event (n=647) completed anonymous surveys that assessed demographic characteristics, childhood sexual abuse, symptoms of dissociation, trauma-related anxiety, borderline personality characteristics, hopelessness, substance use, and sexual risk behavior. A latent variable partial least squares analysis was conducted to test the interrelationships between childhood sexual abuse, exchanging sex for money or drugs, emotional disturbances, drug use, substance use in the context of sexual behavior, and sexual risk behavior. The model fit the data well and accounted for 10% of the total variance in sexual risk behavior. History of childhood sexual abuse predicted exchanging sex for money or drugs and this relationship was partly accounted for by active drug use. Substance use proximal to sexual behavior also emerged as a key factor in predicting sexual risk behavior. Findings from this study, therefore, indicate a direct association between history of child sexual abuse and high risk for HIV infection related to engaging in sex trade.     

Adult Survivors of Childhood Abuse: An Analysis of Coping Mechanisms Used for Stressful Childhood Memories and Current Stressors

Coping mechanisms used to deal with stressful childhood memories and current stressors were assessed for 196 women in each of 4 groups: no abuse history, sexual abuse history, physical abuse history, and both sexual and physical abuse history. Current psychological adjustment was also examined. Discriminant function analyses revealed a variety of significant differences between the groups in use of strategies for coping with memories of abuse or another childhood stressor. There was no relationship between childhood history of abuse and the manner in which women coped with a current stressor. Women with an abuse history reported significantly poorer adult adjustment than did nonabused women, and different coping strategies were predictive of adjustment for abused and nonabused women.     

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.     

Recounting Graphic Sexual Abuse Memories in Therapy: The Impact on Women's Healing

This retrospective study investigates the impact on women's functioning of recounting during their therapy the graphic details of sexual abuse they had experienced in childhood. Fifty-nine participants residing in Southern Ontario were divided into two groups: those who spent more time (N=19) versus less time (N=40) in therapy recounting graphic abuse details. Results revealed that the group who had spent more time recounting abuse memories: (a) had mean functioning scores that were significantly lower before and during therapy, but that did not significantly differ after therapy; (b) recovered more memories of abuse during therapy, and (c) were more likely to have participated in hypnosis, and to report having been encouraged to remember details of abuse. Participants rated as most therapeutic those approaches that assisted them to increase their understanding of the abuse. Strategies related to acceptance, understanding, and making meaning were most important in promoting healing.     

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.     

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.     

Long-Term Effects of Witnessing Marital Violence for Women: The Contribution of Childhood Physical and Sexual Abuse

A sample of 313 college women completed a questionnaire about experiences with violence in childhood and adulthood and adult adjustment and relationship functioning. Nine percent of the women reported having witnessed some type of physical conflict between their parents. Witnessing marital violence was associated with other family mental health risks, childhood physical and sexual abuse, and adult physical assaults by strangers. Women who witnessed marital violence reported more symptoms of posttraumatic stress disorder than other women, after family background and abuse variables were accounted for. Significant interactions between witnessing marital violence and childhood physical abuse were observed for measures of social avoidance and predictability in partner relationships, indicating that the effects of witnessing marital violence depended on the presence of childhood abuse. Implications of these results for research and interventions are discussed.     

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.     

The Relationships Between Childhood Sexual Abuse,Social Anxiety,and Symptoms of Posttraumatic Stress Disorder in Women

The relationships between childhood sexual abuse, social anxiety, and symptoms of posttraumatic stress disorder were examined in a sample of 313 undergraduate women. Thirty-one percent of the women reported some form of sexual abuse in childhood. Women with a history of sexual abuse reported more symptoms of anxiety, distress in social situations, and posttraumatic stress disorder than other women. Women who experienced attempted or actual intercourse reported more avoidance than women with no history of abuse and women with exposure only, and more PTSD symptoms than all other groups of women. Women who experienced fondling reported more PTSD symptoms than women with no history of abuse. Pressure, age of onset of abuse, abuse by a family friend, and abuse by other perpetrators were all significant abuse characteristics in predicting adult social anxiety. Implications of these results for research and interventions are discussed.     

Risk Factors Associated with the Chronicity of High Potential for Child Abuse and Neglect

The present 4-year follow-up study involves 56 mothers who were evaluated by social agencies as being abusive and neglectful or at high risk for child abuse and neglect. The aim of the study is to analyze the relationship between psychosocial risk factors (relating to the history and current situation of the mothers) that were present at the time the families were initially recruited and the fact that some of the mothers continue to show a high potential for child abuse and neglect (chronic abuse and neglect), whereas others were able to overcome the problem (transitory abuse and neglect). Results indicate that the following variables are particularly associated with situations involving chronic problems of abuse and neglect: initial level of severity of potential for abuse and neglect; dual-parent status; a large number of children at the time of intervention (3.13 times more risk of chronicity for large families); the fact that as a child the mother herself had been placed in a foster home (3.7 times more risk); that she had been sexually abused (3.5 times more risk); and that as an adolescent she had run away from home (3.02 times more risk). Our results indicate that mothers who have a combination of more than eight risk factors are four times more likely to be in the chronic group.     

Factors Associated with Domestic Violence and Sexual Assault Victimization

This study explored factors associated with a lifetime history of domestic violence and sexual assault in a sample of welfare recipients in Illinois. Results indicate that childhood exposure to domestic violence is a risk factor for both sexual assault and domestic violence victimization, but that childhood physical abuse is only a risk factor for domestic violence. Increased education and employment skills and having more children were also risk factors for domestic violence victimization. Domestic violence was significantly associated with depression, while sexual assault was associated with low social support and a greater perceived need for mental health services. Frequent alcohol and drug use were not associated with either type of victimization. Research implications are discussed.     

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.     

Childhood Sexual Abuse and Intimate Partner Violence among Women in Methadone Treatment: A Direct or Mediated Relationship?

Women in substance use treatment report rates of childhood sexual abuse and intimate partner violence that far exceed those reported by women in the general population. Previous research with nonrandom samples of women in substance use treatment suggests that there is a statistically significant relationship between childhood sexual abuse and intimate partner violence; however, little is known about the mechanisms of risk between these two public health concerns among this population of women. To address this gap in knowledge and to inform intervention strategies, this study examined direct and mediated relationships between childhood sexual abuse and intimate partner violence risk among a random sample of 416 women in methadone treatment. In addition to high rates of childhood sexual abuse (57.9%), intimate partner violence (lifetime prevalence, 89.7%; 6-month prevalence, 78.4%), posttraumatic stress disorder (PTSD, 28.6%), and global psychological distress (19.5%), findings suggest that the relationship between childhood sexual abuse and intimate partner violence is mediated by mental health problems and that women experiencing PTSD or global psychological distress are 2.7 and 2.4 times more likely to experience intimate partner violence than women without such experiences, respectively. Although not a mediator in this relationship, financial independence reduced women's risk of partner violence by two-thirds. The paper includes discussion of social learning and stress and coping theories to explicate the findings and to inform intervention strategies. This study is based, in part, on the first author's dissertation. A previous version of this paper was presented at the Society for Social Work and Research Annual Conference held in January 2005 in New Orleans, Louisiana. The following grants provided funding for this study: R01DA11027 and 3T32MH014623-22S1.     

Eyewitness Memory,Suggestibility, and Repeated Recall Sessions in Children with Mild and Moderate Intellectual Disabilities

This study of eyewitness memory questioned children with mild and moderate intellectual disabilities (ID) about a live staged event 1 day later and, again, 2 weeks later. Children with mild ID performed as well as typically-developing children of the same age in response to free recall instructions, and they were just as able as same age peers to resist misleading questions. However, they performed more poorly on general questions, probing for further information after free recall. The children with mild ID also changed their responses to specific questions more often in the repeated interview. The group of children with moderate ID showed markedly lower performance than peers of the same age on nearly every type of eyewitness memory question. Comparisons of the children with ID to mental age-matched peers indicated that performance was similar, although children with ID gave more information in response to free recall instructions and changed their answers in the repeated interview more often. Standardized measures of verbal memory (TOMAL) and suggestibility (Gudjonsson Suggestibility Scale) were modest to moderate predictors of eyewitness memory performance.     

Trichobezoar in Vagina: Assessment for Child Sexual Abuse and Diagnostic Result of Forensic Science

Vaginal discharge and bleeding in children require a through and thoughtful evaluation to diagnose the underlying problem including infections, sexual abuse, and vaginal foreign bodies. We report a 6‐year‐old girl presenting with bloody vaginal discharge, carefully evaluated for sexual abuse, and finally diagnosed as a vaginal foreign body after vaginoscopy. A rolling hair ball was extracted from the vagina and was diagnosed as trichobezoar pathologically without any endo–ecto‐mesodermal residual tissue. The hair ball was genetically detected and diagnosed to belong herself by containing no foreign structure. Child sexual abuse was ruled out by forensic interview at CAC and report of forensic science that reported genetic structure belonging to the child. Medicolegal assessment helped in final diagnosis to exclude child sexual abuse.     

Sex,Statistics, Peacekeepers and Power: UN Data on Sexual Exploitation and Abuse and the Quest for Legal Reform

The UN Secretariat provides annual statistics on allegations of sexual exploitation and abuse made against peacekeeping personnel, with reduced numbers of allegations leading to claims of success for the UN's ‘zero tolerance’ policy. This article explores the use of data as ‘technologies’ of global governance, to examine the function that these annual statistics serve for the UN and the impact that they have on calls for legal reform. Thus far, the statistics have attracted little academic appraisal. Yet, they have been used to establish the UN's authority to resolve the ‘problem’ of sexual exploitation and abuse, diminishing the space for critique of UN policy and undermining the quest for improved legal arrangements.     

Using Video to Reduce Home Safety Hazards with Parents Reported for Child Abuse and Neglect

Safety hazards are frequent in the homes of families reported for child abuse and neglect. The effectiveness of a videotape intervention with two families involved with child abuse and neglect was examined, using a replicated multiple probe design across settings. Data were collected using the Home Accident Prevention Inventory — Revised, and the Checklist for the Video-Trained Parent's Behavior. Social validation and expert validation data are also presented.