Symptoms and long-term outcomes for children who have been sexually assaulted

Losses Associated With Childhood Sexual Abuse in Women Survivors: A Scoping Review

METHOD

This article reports the findings of a scoping review designed to identify research exploring the losses associated with childhood sexual abuse in women survivors. A systematic search of databases for articles published between 1983 and 2019 were conducted using keywords related to loss and women survivors of childhood sexual abuse.

FINDINGS

Twenty studies were selected for review using predefined inclusion criteria: studies that include adult women survivors of childhood sexual abuse, studies that include child/childhood sexual abuse, studies that include stigmatized loss, studies that indicate stigmatized loss in adult women survivors of childhood sexual abuse. Sources were subject to quality appraisal and data were extracted in line with the review question.

DISCUSSION AND CONTRIBUTION

Findings acknowledged and extended on Bloom's model of stigmatized loss and suggested that female survivors of childhood sexual abuse may experience an overall loss of self-efficacy, presenting as a loss of personal agency, interpersonal agency, and sexual agency. The results of this research suggest that loss be considered in support interventions with women self-reporting childhood sexual abuse. It is recommended that further research be conducted to confirm these findings so that they may advocate for inclusion in childhood sexual abuse treatment interventions.

Perceived Needs for Support Program for Family With Child Sexual Abuse Victim in South Korea: Focus Group Interview With Therapists and Mothers

This study assessed perceived needs for psychological support program for family with victim of child sexual abuse in South Korea. We conducted two separate focus group interviews with five therapists who served child sexual abuse victims and families as well as four mothers of a child sexual abuse victim. Consensual qualitative research analysis revealed four domains: Emotional support for parents, psychoeducation, family therapy, and tailored and flexible service delivery. Core ideas of the four domains were identified. The results were consistent with the family support program contents developed in Western countries and suggested culture-specific contents and culturally sensitive service delivery. Clinical implications for developing family support program in South Korea were discussed.

Training Mental Health Professionals in Child Sexual Abuse: Curricular Guidelines

Given the incidence of child sexual abuse in the United States, mental health professionals need training to detect, assess, and treat victims and should possess a clear understanding of the process of victimization. However, many mental health professionals who work with children and families have not been exposed to any training in child sexual abuse during their formal education. This article will examine the need for such training, suggest critical components of child sexual abuse training, and describe various methods of training (e.g., in person, Web-based, and community resources).

Sexual victimization using latent class analysis: exploring patterns and psycho-behavioral correlates

Sexual victimization is prevalent in the United States and overrepresented among adolescents. Research typically assesses victimization on a continuum of severity and rarely examines patterns of victimization within an individual. Using latent class analysis, the present study investigated whether meaningful classes of sexual victimization could be found based on the tactic used and severity of sexual behavior. Personal characteristics and psycho-behavioral outcomes were explored as they related to victimization classes. Peer sexual coercion experiences were examined among 657 racially diverse high school and college students, and four classes were identified: non-victims (54%), manipulated and forced fondle/intercourse (27%), poly-victimization (9.5%), and forced fondling (9.5%). Sexual victimization classes were significantly characterized in regards to childhood sexual abuse, gender, and age. The poly-victimization class (i.e., verbal coercion, substance facilitated, and physical force resulting in completed intercourse) showed the greatest level of psycho-behavioral consequences with significantly lower self-esteem, higher psychological distress, and more sexual risk taking than all other classes. The manipulated and forced class also showed significantly lower self-esteem than non-victims. Findings provide important implications for understanding patterns of sexual victimization and related consequences to help target interventions more effectively.

Support and profiles of nonoffending mothers of sexually abused children

Maternal support offered to sexually abused children following disclosure may be a crucial factor in children's recovery. A person-centered approach was used to examine how profiles of nonoffending mothers could better describe their ability to support their children after disclosure. Cluster analyses based on a total of 226 nonoffending mothers recruited from child protective services yielded four distinctive groups of mothers: resilient, avoidant-coping, traumatized, and anger-oriented reaction. These profiles differed on measures of support, parenting, and variables related to attitude following disclosure. The discussion underscores the relevance of adopting a tailored approach to intervention with mothers of sexually abused children.

Sexual Coercion Among Black and White Teenagers

The relations between type of sexual coercion (i.e., verbal, substance-facilitated, physical) and psychological and behavioral health were examined among Black ( n = 107) and White ( n = 114) young women. We also explored the moderating role of sexual stereotypes in understanding the relations between sexual coercion and health. Over half (53%) of the total sample reported experiencing at least one sexually coercive incident. Direct relations were found between sexual coercion type and psychological and behavioral health correlates. Specifically, for both Black and White young women, greater verbal coercion was related to increased risky sexual behaviors. Substance-facilitated sexual coercion was related to lower levels of two indicators of mental health among Black participants (i.e., psychological distress and self-esteem). Endorsement of sexual stereotypes moderated the relations between total sexual coercion experiences and self-esteem for Black young women and between total sexual coercion experiences and psychological distress for White young women.

Profiles of school adaptation: social, behavioral and academic functioning in sexually abused girls

OBJECTIVES

The short-term outcomes of child sexual abuse (CSA) on academic, behavioral and social adaptation at school were examined in order to: (1) document the proportion of sexually abused (SA) girls struggling in school and define the nature of their difficulties, (2) explore whether different profiles of school adaptation could be identified, and (3) examine the different constellations of contextual, personal, and familial correlates of abuse for each profile.

METHOD

The sample consisted of 100 French-speaking mother-daughter dyads. Girls (aged 7-12, M= 8.64) were administered cognitive functioning tests and completed self-report measures to assess symptomatology, perception of abuse, and support provided. Mothers and teachers completed questionnaires to assess child's emotional, social, behavioral, and academic functioning in school.

RESULTS

Descriptive analyses showed that a substantial number of girls (54%) presented clinical school adaptation difficulties in at least one of the three domains evaluated. Cluster analysis revealed four distinctive school functioning profiles: (1) academic-specific, (2) acting out/withdrawn, (3) polyclinical, and (4) resilient. These were distinguished by degree of school functioning difficulties and number of domains affected. The profiles were further discriminated by elements of the CSA experience and contextual, familial, and personal factors. The number of spheres of functioning affected was proportional to the number of risk factors to which girls were exposed.

DISCUSSION

Results suggest the need for a systematic and thorough assessment of SA child functioning at school and may guide mental health professionals in providing differential treatment on the basis of the emerged typology.

PRACTICE IMPLICATIONS

Sexually abused children demonstrate a wide variability of responses, rendering the elaboration of a "one size fits all" treatment rather difficult. The emerged typology underscores the complex heterogeneity of school adjustment profiles and suggest that secondary effects of abuse on child's level of school functioning require specific assessment and close monitoring. This study raises practical questions as to whether such secondary effects could best be addressed as a primary treatment objective, or in addition to a trauma-focused approach, or as the sole treatment objective.

Association of child sexual abuse and dating victimization with mental health disorder in a sample of adolescent girls

The study's aim was to assess the association between adolescent girls' recall of child sexual abuse (CSA) and prevalence of dating victimization in early romantic relationships and to explore the link between multiple trauma history and mental disorders. When demographics and teacher-reported behavioral problems during childhood were controlled, the risk of presenting with at least one internalized or externalized mental health disorder was higher for adolescent girls with multiple victimization (history of CSA and dating victimization) than for adolescents with no multiple trauma history. Results highlight a strong association between reports of multiple traumatic experiences and mental health disorders of teenaged girls and the need to assess for a broader range of victimization experiences in the design of intervention services.

Exploring the relations among the nature of the abuse, perceived parental support, and child's self-concept and trauma symptoms among sexually abused children

This study examined two resiliency factors: self-concept and perceived parental support, in conjunction with abuse factors that impact psychological functioning. Data were collected on 61 sexually abused children prior to treatment. Findings indicate that a child's self-concept was associated with all the trauma symptoms except sexual concerns and did account for a significant amount of variance in relation to trauma symptomatology. Parental support was only associated with the Dissociation and was not found to account for variance in relation to trauma symptoms. Factors specific to the sexual abuse found that when a child endured a lengthy abuse period, their self-concept was more negative.

Factors linked to outcomes in sexually abused girls: a regression tree analysis

Children who report sexual abuse (SA) have been found to display a range of internalizing and externalizing behavior problems. In the present study, a tree-based analysis was used to derive models predicting the variability of internalizing and externalizing behavior problems as well as dissociation symptoms in SA girls. Participants were 150 girls aged 4 to 12 years referred to a specialized pediatric clinic after disclosure of SA. The potential predictors taken into account included sociodemographic and abuse-related variables as well as maternal and family characteristics. The models obtained point to prior abuse as a salient variable in predicting outcomes of SA girls. Implications for the treatment for children disclosing SA are discussed.

Survivors of Childhood Sexual Abuse Diagnosed with Cancer

The incidence of survivors of childhood sexual abuse (CSA) diagnosed with cancer is unknown. It is estimated that one in three women and one in six men in the United States are survivors of CSA. Survivors of CSA diagnosed with cancer are presented with multiple and potentially accumulating traumas. The re-traumatizing nature of a cancer diagnosis and treatment affects all elements of the CSA survivor's care and may impede her/his treatment. To date, the impact of CSA on the medical treatment of people with cancer has been unexplored with the existing studies on female survivors of CSA with cancer focusing on the post-treatment experience and their higher incidence of sexual dysfunction. This article describes the impact of CSA on the cancer treatment of 18 survivors of CSA and the clinical interventions used to address the unique psychosocial needs of this population. Anecdotal information suggests that the survivors of CSA may find aspects of the cancer experience reminiscent of their history of abuse. All 18 survivors of CSA experienced distressing memories of their abuse during their cancer treatment. Fifteen CSA survivors presented traumatic memories that were inaccessible to conscious thought processes prior to their cancer diagnosis. Psychodynamic interventions address issues of disruption in the cancer treatment, non-adherence, and difficulties in relationships with the health care team. Containment of intense affect and distressing thoughts rather than exploration improved CSA survivors' adherence with cancer treatments. The acquisition of self-comforting skills helped CSA survivors feel less re-victimized by their cancer experience. The establishment of an environment of internal and external safety improved communication with the health care team. Health care/psychosocial clinicians' awareness and use of appropriate interventions can minimize the affects of re-traumatization and enhance the CSA survivor's treatment experience.

A typological analysis of behavioral profiles of sexually abused children

A cluster analysis is used to explore differential outcomes in 123 French Canadian children reporting sexual abuse contrasted with 123 control children. Mothers' reports of behavioral problems on the Child Behavior Checklist, abuse-related variables, personal factors, and family characteristics are used as potential variables discriminating clusters. Results reveal four clusters: (a) anxiety constellation group refers to children displaying behavior problems on a subset of scales, (b) the severe distress group refers to children showing a broader array of behavior problems, (c) victims of less severe sexual abuse (SA) group consists of children disclosing mostly extrafamilial SA, and (d) resilient children refers to children who, while disclosing severe abuse, rely less on avoidance coping. Findings underscore the need to go beyond abuse-related variables to orient treatment for children disclosing sexual abuse and for tailoring interventions to distinct subgroups.