Fracturing the façade : exploring the impact of childhood sexual abuse

Examination of previous empirical literature illustrates how researchers have concentrated on documenting the impact of childhood sexual abuse (CSA) on the later psychological functioning of survivors, through comparisons with those who have not had such a history. Only more recently has there been a focus on assessing the relationship between aspects of the abuse and specific psychological difficulties. This thesis investigated the relationships between CSA characteristics and women’s later psychological adjustment. The role of attributions, coping methods, parenting competency and marital satisfaction were also investigated. Qualitative data on perception of benefit and general reflections of participants were used to explore participants’ self-esteem, locus of control, decisions relating to parenting, disclosure experiences, and attributions in relation to their abuse, including the search for meaning. Recruitment through newspapers and counselling services led to 118 women volunteering to complete a questionnaire evaluating the characteristics of their CSA and their current psychological adjustment. Of this group, 33 subsequently volunteered to participate in a telephone interview that explored in greater depth issues related to the long-term impact of their CSA. Both quantitative and qualitative analyses were conducted on the data. The women reported a high prevalence of dysfunction in their families of origin. Abuse had generally commenced by middle childhood, and lasted for a number of years and often involved a number of perpetrators. Perpetrators were most likely to be intrafamilial, with stepfathers being over-represented. Sexual activities generally involved physical contact, with participation often induced by the use of coercion. Participants demonstrated significant difficulties in psychological adjustment, but attributions regarding the abuse improved over time. Some concerns were expressed regarding parenting competency, and avoidant coping methods were favoured. In general, participants were satisfied with their current marital relationship. Significant associations were found between coping methods, attributional style, beliefs and various psychological adjustment measures. Participants, in general, demonstrated low self-esteem and displayed an external locus of control. As a consequence of their experience of CSA, many participants reported they had decided not to have children. For those who did have children, CSA was almost universally seen as having had an impact on their parenting. Disclosure of CSA was usually delayed for a number of years, with poor outcomes generally resulting from disclosure when it occurred. Women with current partners rated them as very caring and not controlling. Participants were generally still searching for meaning in their abuse, despite many having accepted it. Survivors outlined an extensive range of long-term effects of CSA, and nominated a number of strategies that would assist in reducing these effects. The results of the study indicated that there are a number of characteristics associated with CSA which signal a higher risk of difficulties in psychological adjustment. Concerns of survivors regarding parenting were confirmed according to those who undertook this role. Unfortunately, concerns expressed by survivors that disclosure of their CSA would have had negative consequences was usually the case when they did finally disclose. However, the accessing of social and family support appeared to have an important role in changing the attributions of survivors regarding their CSA. Furthermore, change of attributions in relation to abuse may provide the key to resilience in survivors against the negative impact of CSA on later psychological adjustment.

An exploratory qualitative study of the self-reported impact of female-perpetrated childhood sexual abuse

The limited findings on the impact of female-perpetrated sexual abuse of children are often contradictory, particularly in relation to males. In this exploratory qualitative study, a sample of nine men and five women who reported that they had been sexually abused by women in their childhood were recruited from the general community. They completed a questionnaire that asked them to describe various aspects of their abuse experiences and the perceived consequences. For both men and women, the abuse was associated with negative outcomes across a range of functional areas in both childhood and adulthood. Many impacts were similar to those reported by victims of male-perpetrated sexual abuse. It is argued that the consequences of female-perpetrated child sexual abuse are serious, and further research is required to bring these issues to the awareness of both the public and professionals working in the field of child protection and counseling.

Assessment of first sexual intercourse in young women with a history of childhood sexual abuse

Women reporting childhood sexual abuse (CSA) that involved actual or attempted penetration may not identify this as their first sexual intercourse. Data were drawn from a population-based, prospective cohort study spanning adolescence to adulthood. CSA prior to age 16 and age of first sexual intercourse with a male were assessed retrospectively. More than half of women reporting CSA in the form of actual or penetrative abuse reported an age of first sexual intercourse at or beyond 16 years. Direct questioning about CSA is needed to accurately ascertain sexual history.

Childhood sexual abuse and adolescent eating disorder : findings from the Victorian Adolescent Health Cohort study

Objective: To examine the relationship between childhood sexual abuse (CSA) before the age of 16 years and later onset of bulimia and anorexia nervosa symptoms in females.

Design: A longitudinal cohort study of adolescents observed from August 1992 to March 2003. The cohort was defined in a 2-stage cluster sample using 44 Australian schools in Victoria.

Setting: Population based.

Participants: A total of 1936 persons participated at least once and survived to the age of 24 years, including 999 females. The mean (SD) age of females at the start of follow- up was 14.91 (0.39) years; and at completion, 24.03 (0.55) years.

Main Exposure: Self-reported CSA before the age of 16 years was ascertained retrospectively at the age of 24 years.

Outcome Measures: Incident Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition)–defined partial syndromes of anorexia and bulimia nervosa were identified between waves 4 (mean age, 16.3 years) and 6 (mean age, 17.4 years) using the Branched Eating Disorder Test.

Results: The incidence of bulimic syndrome during adolescence was 2.5 (95% confidence interval, 0.80-8.0) times higher among those who reported 1 episode of CSA and 4.9 (95% confidence interval, 1.9-12.7) times higher among those who reported 2 or more episodes of CSA, compared with females reporting no episodes, adjusted for age and background factors. The association persisted after adjusting for possible confounders or mediators measured 6 months earlier, including psychiatric morbidity and dieting behavior. There was little evidence of an association between CSA and partial syndromes of incident anorexia nervosa.

Conclusion: Childhood sexual abuse seems to be a risk factor for the development of bulimic syndromes, not necessarily mediated by psychiatric morbidity or severe dieting.

Resistance and reconstruction: Older women talk about childhood sexual abuse

Research which explores the experiences of women, who have experienced childhood sexual abuse is, in the main, focused on young and middle aged women. The perspectives of older women is often absent or hidden in the literature. This study explores the experiences of 16 Australian women aged 57 years and older who have experienced childhood sexual abuse. It aims to privilege their views and highlight their particular contexts in order to redress professional assumptions regarding the notions of recovery. Additionally, in discussing their experiences, the women contribute to insights regarding the patterns of inequality which are produced as a result of dominant discourses that promote ageist and sexist prescriptions in the construction of the self. These insights demonstrate how the women have resisted a range of oppressive patterns in their everyday lives. The study follows a feminist research framework and aims to contribute to the fields of social work practice and critical feminist gerontology.

Resistance and reconstruction: older women talk about childhood sexual abuse

 This research explores personal stories of 16 Australian women aged 57 years and older who have experienced childhood sexual abuse. It privileges their views and examines how they managed the impact during their lives. The project contributes to professional knowledge by developing anti-ageist practices for social work and human services.

Professional response and attitudes toward female-perpetrated child sexual abuse : a study of psychologists, probationary psychologists and child protection workers

Previous studies have suggested that lay people and professionals both tend to deny or minimise female-perpetrated sexual abuse of children. However, such abuse has been shown to have negative impacts on the victims. This study investigated whether professionals who might work with victims or perpetrators of childhood sexual abuse show a bias in processing scenarios and making decisions when confronted such abuse. A sample of 231 psychiatrists, psychologists, probationary psychologists and child protection workers responded to variations in vignettes in which women and men offended against children, and completed a questionnaire assessing attitudes to women's sexually abusive/offending behaviour toward children. All professional groups regarded cases involving female perpetrators of child sexual abuse as serious and deserving of professional attention. However, while there were some differences between groups, female perpetrators were more likely than male perpetrators to be considered leniently, suggesting that minimisation of female-perpetrated sexual abuse of children may persist in the professional arena. As a result, both female perpetrators of sexual abuse and their victims may go untreated, and in the case of perpetrators, their behaviour may go unsanctioned. Training for professionals to enhance their understanding of the seriousness of sexual abuse perpetrated by women is indicated.

Delayed allegations of sexual abuse, complainant credibility and juror verdict

This study investigated laypersons' perceptions of memory evidence in a mock childhood sexual abuse trial. Results indicated that delay, memory type (continuous vs. recovered) and the nature of the alleged sexual assault (penetrative vs. fondling) influenced both how witnesses were perceived and the outcome of the trial.

The effect of victim age on police authorisation of charges in cases of child sexual abuse

In the study, a cohort of 440 child sexual abuse cases were used to model the effect of victim age on police authorisation of charges. Linear and quadratic effects of age were modelled in a logistic regression that controlled for case characteristics and evidence. The quadratic effect of victim age was strengthened when control variables were included in the model and the linear effect of age was not significant in the final model. The results indicated that cases involving victims in middle childhood had a higher proportion of suspects charged than cases involving victims in early childhood and adolescence. Possible mediators of the relationship between victim age and charges were explored and it was found that cases with older victims had a higher prevalence of extra-familial abuse and suspect confessions, and these factors had a positive effect on the proportion of suspects charged. Possible explanations for the quadratic effect of victim age and mediation are discussed.

The relationship between child sexual abuse and academic achievement in a sample of adolescent psychiatric inpatients

Objectives:
To examine the relationship between sexual abuse and academic achievement in an adolescent inpatient psychiatric population. Individual factors expected to influence this relationship were measured to explore the way they each interacted with sexual abuse and its relationship to academic achievement.

Method:
Eighty-one adolescent psychiatric inpatients participated in the study (aged 12–18 years: M = 16.0). Participants were administered tests of academic achievement (dependent variable) and intelligence, and completed a number of self-report measures of their experience of different types of maltreatment, their perception of the parenting they received, socio-economic status, substance abuse, and psychopathology.

Results:
Hierarchical regression analysis revealed that intelligence was the main predictor of academic achievement (uniquely explaining 26% of the variance). A number of interaction effects were also significant indicating that intelligence, substance abuse, internalizing behavior problems, externalizing behavior problems all influenced the relationship between sexual abuse and academic achievement.

Spiritual direction and survivors of sexual abuse

In recent years, both catholica and protestant churches in Australia, the US and elsewhere have found themselves embroiled in allegations of sexual abuse-allegations which have often been substantiated.  Reports in the secular and the religious press of these allegations have been so numerous as to have become a constant blur on the horizon.  We have heard much about investigations, about the tragedies affecting individuals and communities, about financial settlements, and about clergy being ousted from pastoral roles.  But after the public scandals have died down, the paim for many lives on.

Spirituality and sexual abuse: issues and dilemmas for survivors

Sexual abuse profoundly affects survivors to the extent that they are unable to maintain previously held viewpoints or ways of being, including those relating to their spirituality. Certainly the experience has considerable potential to complicate the spiritual lives of survivors. For Christian survivors, this may include how they perceive and relate to both themselves and God as well as affect participation in sacraments such as eucharist and reconciliation. Spiritual traditions often promote the embracing of silence, but this may be problematic for survivors who have been silenced and unable to give expression to their experiences. Similarly, socialization resulting in beliefs that Christians should always forgive and/or never be angry needs to be overcome. While negotiating these pitfalls may result in explorations of spirituality being even less straightforward for survivors of sexual abuse than it is for others, a transformative spirituality within a Christian framework can be realized.

Describing individual incidents of sexual abuse: a review of research on the effects of multiple sources of information on children's reports

Objective: For successful prosecution of child sexual abuse, children are often required to provide reports about individual, alleged incidents. Although verbally or mentally rehearsing memory of an incident can strengthen memories, children’s report of individual incidents can also be contaminated when they experience other events related to the individual incidents (e.g., informal interviews, dreams of the incident) and/or when they have similar, repeated experiences of an incident, as in cases of multiple abuse.

Method: Research is reviewed on the positive and negative effects of these related experiences on the length, accuracy, and structure of children’s reports of a particular incident.

Results: Children’s memories of a particular incident can be strengthened when exposed to information that does not contradict what they have experienced, thus promoting accurate recall and resistance to false, suggestive influences. When the encountered information differs from children’s experiences of the target incident, however, children can become confused between their experiences—they may remember the content but not the source of their experiences.

Conclusions: We discuss the implications of this research for interviewing children in sexual abuse investigations and provide a set of research-based recommendations for investigative interviewers.