Predictors of attributions of self-blame and internalizing behavior problems in sexually abused children

Psychological aftereffects experienced by sexually abused children: Psychopathological characteristics revealed by the K-CBCL

Children who have been sexually abused may experience various short- and long-term psychological sequelae and behavioral problems. This study assessed the mental health of sexually abused children using the Korean-Child Behavior Checklist (K-CBCL) and examined differences from a control group. The participants were 97 children who had been sexually abused and who visited a local Sunflower Center, and 178 control participants. Data were collected via the K-CBCL and analyzed using SPSS version 25.0. T-tests, cross-tabulation, and logistic regression analyses were performed. Scores from the K-CBCL Problem Behavior Syndrome scale were compared between sexually abused children and the control participants. Significant differences were observed between the 2 groups in all the subscales. Compared to the control group, children who were sexually abused showed statistically significant differences in the total problem behavior, internalization, anxiety/depression, withdrawal/depression (withdrawn), somatic symptoms, externalization, rule-breaking behavior (delinquency), aggressive behavior, social immaturity, thought problems, attention problems, and other subscale scores. Sexual violence hurts the overall mental health of children who are abused, including their emotional, behavioral, and social factors. Our findings suggest that multidisciplinary assessment and treatment are required for children who have experienced sexual abuse.

Gender Differences in Behavioral Problems in Child Victims of Sexual Abuse: Contribution of Self-Blame of the Parent and Child

The consequences associated with child sexual abuse are well known. However, factors exacerbating child behavior problems following sexual abuse (SA) deserve further attention. Self-blame following the abuse has been identified as a predictor of negative outcomes in adult survivors, however there is limited evidence regarding the impact of self-blame on consequences in child victims of sexual abuse. This study assessed behavioral problems in a sample of sexually abused children and tested the mediating role of children's internal blame attributions in the association between the parent's self-blame and the internalizing and externalizing difficulties of the child. A sample of 1066 sexually abused children between 6 and 12 years of age and their non-offending caregiver completed self-report questionnaires. Parents completed questionnaires related to the child's behavior following the SA and their own feelings of self-blame regarding the SA. Children completed a questionnaire assessing their level of self-blame. Results showed that parents' self-blame was associated with a higher level of self-blame in the child which, in turn, was linked to more child internalizing and externalizing behavior problems. In addition, parents' self-blame was directly associated with a higher level of internalizing difficulties in children. These findings underscore the importance of considering the non-offending parent's self-blame in interventions aiming the recovery of child victims of SA.

Non-supportive responses to adolescents who have experienced sexual abuse: Relations with self-blame and trauma symptoms

BACKGROUND

Youth who have experienced sexual abuse sometimes also experience non-supportive responses, such as accusations of lying, from people in their family and social environment. Little is known about how such responses from different sources (caregivers, friends, other adults) correlate with one another and operate together in the prediction of youth problematic thinking, such as self-blame, and trauma symptoms.

OBJECTIVE

To better understand how non-supportive responses from different sources relate to one another and contribute to youth problems following sexual abuse.

PARTICIPANTS AND SETTING

Participants were 475 youths (M_age = 13.57, SD = 1.77) brought to a children's advocacy center in the southern United States.

METHODS

Participants completed measures of non-supportive responses from caregivers, friends, and other adults. They also completed measures of abuse-specific self-blame and trauma symptoms.

RESULTS

Non-supportive responses from caregivers, friends, and other adults correlated with each other and with abuse-specific self-blame and trauma symptoms (correlations ranged from 0.12 to 0.18; all p values <.001). Results of regression analyses indicated that only non-supportive responses from caregivers contributed independently to abuse-specific self-blame, whereas non-supportive responses from caregivers and friends contributed to trauma symptoms.

CONCLUSIONS

In the aftermath of sexual abuse, non-supportive responses from caregivers and friends relate to youth trauma symptoms. Assessing non-supportive responses broadly across the social network can be useful in understanding youth adjustment following sexual abuse.

Women Selling Sex in Russia: Analyzing Women’s Appraisal of Exploitation and Mistreatment Using Cognitive Dissonance and Cultural Sex Script Frameworks

Globally, over a third of women have experienced physical or sexual violence in their lifetime. In Russia, human trafficking, sexual exploitation, and physical abuse of women are amongst the world’s highest. Applying cognitive dissonance theory and sexual script theory, this study explores whether women (n = 654) trading sex in Russia appraise their experiences of entering the commercial sex trade as voluntary or forced. Contributing client factors were also analyzed, including beatings (66%), rape (66%), and humiliation (86%) by clients. Multiple logistic regression assessed whether women who reported voluntarily entering the commercial sex trade were more likely to experience physical abuse but less likely to experience rape (AOR:1.37); were more likely to perceive men using them as decent/caring (AOR = 2.54); were more likely to sell sadistic/masochistic services (AOR: 2.31); and less likely to stop selling sex (AOR: 5.84). Implications of this study reveal the importance of intervention strategies that account for a woman’s unawareness of her own exploitation and mistreatment as well as the psychological barriers that prevent her from seeking help. The necessity of recognizing women selling sex as sufferers of coercion and abuse is also emphasized.

Comparison Between Male and Female Survivors of Sexual Abuse and Assault in Relation to Age at Admission to Therapy, Age of Onset, and Age at Last Sexual Assault: Retrospective Observational Study

BACKGROUND

Sexual abuse and sexual assault are complex phenomena that involve many factors (or correlates) and have many health and financial implications for individuals, families, and society. Every correlate needs to be studied in detail, individually and in relation to other correlates. Only with a thorough understanding of these correlates can more efficient and targeted prevention and intervention programs be designed.

OBJECTIVE

The purpose of this study was to examine the differences between male and female survivors of sexual abuse and sexual assault regarding the correlates of the survivors' age of onset of assault, age at the last assault, and age at which they entered therapy.

METHODS

Therapists at eight sexual assault centers in the province of Alberta, Canada, completed a questionnaire on each of their clients over a period of 7 years. A total of 3302 participants, of whom 2901 (87.86%) were female and 401 (12.1%) were male survivors of sexual abuse and assault, were included in this study. Mostly descriptive analyses were carried out on the 4 variables of concern in this study.

RESULTS

Regarding the number of survivors who sought therapy, female survivors outnumbered male survivors by a ratio of 7:1, with different ratios for different age groups. As children age, their risk of being sexually assaulted for the first time decreases. Male children are more likely to be sexually abused at a younger age, whereas female children are more vulnerable to being assaulted at all ages, particularly in adolescence. The mean age of onset of sexual abuse was found to be 6.71 (SD 2.86) years, and the odds of experiencing the first sexual assault during childhood, as opposed to adolescence, were 4:1 for females and 9:1 for males. Male survivors were two times more likely than female survivors to experience their first sexual assault in childhood. The vast majority of survivors sought help many years after being sexually assaulted, and male survivors waited an average of 3 years longer from the last sexual assault before seeking therapy.

CONCLUSIONS

The majority of survivors of sexual abuse and sexual assault live with the consequences for many years before they seek help, and a large proportion of male survivors are not likely to seek help.

Maternal Support and Attrition from Child Trauma-Focused Therapy

Many children prematurely terminate from trauma-focused therapy (TFT), and attrition is a critical barrier in addressing the impacts of childhood sexual abuse (CSA). The field's knowledge of risk factors for dropout is growing; however, one aspect of the child's environment that remains unexamined is maternal support following the CSA disclosure/discovery. Maternal support has been theorized to play a valuable role in influencing children's outcomes after CSA and may be relevant in understanding attrition. The objective of the current study was to investigate the associations between children's symptoms, relationship to the perpetrator, and maternal support in relation to premature termination from TFT among 186 sexually abused children (M_age = 9.24 years, SD = 3.72, 67.3% female). Two operational definitions of attrition were used: (a) clinician-rated dropout (i.e., clinician's ratings of whether the child completed treatment) and (b) whether the child received an adequate treatment dose treatment (i.e., ≥12 sessions). Maternal marital status was the only factor associated with clinician-rated treatment dropout, OR = 2.35, whereas maternal support and blame/doubt were unrelated. Living farther from the clinic was tied to an increased risk of receiving an inadequate treatment dose, OR = 0.96. Replication of these findings is needed, particularly using a clinician-administered measure of caregiver support; yet, maternal emotional support and blame/doubt may not evince strong ties to dropout from TFT among sexually abused children. Additional work is needed to discern if there are key subgroups for whom support is more strongly related to the risk of premature termination following CSA.

Childhood Loss Experiences, Religiousness/Spirituality, and Hope as Predictors of Adult Life Satisfaction

Purpose The purpose of this study was to explore how adaptive patterns of religiousness/spirituality and hope predict adult life satisfaction in adults, even if they had childhood loss experiences.Design and Methods Using a cross-sectional survey design with132 adult participants (mean age 33.8 ± 15.2, 82% female, 78% Caucasian) we estimated two hierarchical regression models to examine how dimensions of religiousness/spirituality (Brief Multidimensional Measure of Religiousness/Spirituality) and hope (Herth Hope Index) predicted adult life satisfaction (Satisfaction with Life Scale) after controlling for effects of adverse childhood experiences (Adverse Childhood Experiences Study Questionnaire) or chronic sorrow from childhood loss (Kendall Chronic Sorrow Instrument).Results When effects of adverse childhood experiences (ACE) were controlled, higher levels of hope (β = .416, p < .001) and forgiveness (β = .273, p = .023) and lower levels of religious/spiritual values/beliefs (β = -.298, p = .014) predicted higher levels of adult life satisfaction. ACE remained a significant predictor of adult life satisfaction in the final model. When controlling for effects of chronic sorrow, higher life satisfaction was predicted only by forgiveness (β = .379, p = .003), values/beliefs (β = -.354, p = .007), and hope (β = .357, p < .001), with chronic sorrow not a significant predictor of adult life satisfaction in the final model.Conclusion: Greater life satisfaction for adult survivors of childhood loss experiences could be promoted by interventions to enhance hope and foster forgiveness. These adult survivors may also need support as they engage with religious/spiritual struggle to reconcile their values and beliefs with childhood loss.

"I Can't Blame Mum": A Qualitative Exploration of Relational Dynamics in Women With Female Genital Mutilation (FGM) in the United Kingdom

Female genital mutilation (FGM) is conceptualized as an interpersonal act, commonly initiated by mothers. This study investigates relational dynamics among adult women who experienced FGM in childhood and have since migrated to the United Kingdom. A qualitative research design was employed, using semi-structured interviews and interpretative phenomenological analysis (IPA) with nine women. Three superordinate themes emerged: (a) “The ‘who to blame?’ conflict: Preserving goodness in parents”; (b) “Better or worse? Positioning the self in relation to others”; and (c) “Regaining power: Righting the wrongs.” Implications for understanding the relational consequences of FGM and the discontinuation of its intergenerational transmission are considered.

Child Sexual Abuse and Suicidal Ideation: The Differential Role of Attachment and Emotional Security in the Family System

The objective of this study was to analyze the effects of attachment style and emotional security in the family system on suicidal ideation in a sample of young adult female victims of child sexual abuse (CSA). The possible effects of CSA characteristics and other types of child abuse on suicidal ideation were controlled for. The sample consisted of 188 female college students who had been victims of sexual abuse before the age of 18, as well as 188 randomly selected participants who had not experienced CSA. The results showed that both attachment and emotional security were associated with suicidal ideation, even when controlling for both the characteristics of abuse and the existence of other abuses. The strong relationships of emotional security and attachment style with suicidal ideation suggest the importance of early intervention with children who have been sexually abused and their families, in an effort to optimize their attachment style, as well as to decrease emotional insecurity to prevent the onset of symptomatology related to suicidal ideation.

Emotion Dysregulation in Sexually Abused Preschoolers: Insights from a Story Completion Task

Child sexual abuse (CSA) during the preschool period can seriously undermine children's ability to develop emotional competency. Narrative tasks, such as the MacArthur Story Stem Battery (MSSB), are particularly adapted to gain a better understanding of young children's self-regulation processes. To explore the emotion regulation competencies of sexually abused preschoolers, we developed a coding grid and undertook a detailed analysis of abused and non-abused children's narratives using the MSSB. A sample of 62 sexually abused and 65 non-abused preschoolers 3½ to 6½ years old was recruited and children were presented with nine stories and an expressive vocabulary test. Analyses were performed to compare abused and non-abused children's narratives and to assess the contribution of CSA to children's narratives. CSA was associated with fewer demonstrations of empathy, help, and comfort, and less coherent and resolved stories. The narratives of CSA victims also included less emotions and emotional variations. The influence of CSA appeared the strongest in the stories involving fear. These findings suggest the presence of emotion dysregulation among sexually abused preschoolers, but also insecure attachment, and a sense of betrayal, isolation, and powerlessness.

Does Maternal Support Mediate or Moderate the Relationship between Sexual Abuse Severity and Children's PTSD Symptoms?

Maternal support and abuse severity are often considered to be vital factors in predicting children's functioning following childhood sexual abuse (CSA); however, much of the prior research has examined support and abuse severity as main effects, without consideration of how these factors may interrelate to predict children's post-CSA functioning. Further, even though mediators and moderators are conceptually distinct, maternal support has been theorized to be both a mediator and a moderator of symptoms, and it is unclear if support acts as either among sexually abused children. The aim of the present study was to investigate whether caregiver-reported maternal support mediates or moderates the relationships between sexual abuse severity and children's trauma-related symptoms. The study included 235 treatment-seeking children ages 3-16 (M = 8.85, SD = 3.77) and their non-offending mothers. Contrary to expectations, caregiver-rated maternal support did not mediate nor moderate the relationship between abuse severity and children's symptoms (range r² =.002 -.03). Caregiver-rated maternal support may play a small role in mitigating sexually abused children's trauma symptoms. Irrespective of abuse severity, children with less supportive mothers may not be at heightened risk for experiencing higher levels of trauma-related difficulties.

Posttraumatic cognitions, childhood sexual abuse characteristics, and posttraumatic stress disorder in men who have sex with men

BACKGROUND

High rates of experience of childhood sexual abuse (CSA) among in men who have sex with men (MSM) place this population at increased risk for posttraumatic stress disorder (PTSD).

OBJECTIVE

This study explores how specific characteristics of CSA relate to posttraumatic cognitions (PTCs) and explores the role that specific PTCs play in the relationship between CSA and PTSD in MSM.

METHODS

Two-hundred and ninety MSM completed a CSA interview, the Davidson Trauma Scale, and the Posttraumatic Cognitions Inventory.

RESULTS

Controlling for sociodemographic factors, CSA involving physical injury and CSA with intense fear were associated with higher levels of PTCs about the self and world, but not with self-blame. We did not find significant associations for CSA involving a family member, CSA with penetration, or duration or frequency of CSA with any subscale on the PTCI. Experiencing CSA for the first time during adolescence was associated with higher self-blame. Analyses revealed that physical injury and intense fear each had indirect effects on PTSD symptoms through negative cognitions about the self and world. First CSA episode during adolescence had an indirect effect on PTSD symptoms through self-blame. CSAs accounted for 16.7% and PTCs accounted for 31.7% of the variance in PTSD, underlining the importance of PTCs.

CONCLUSIONS

Assessing for physical injury, intense fear, and age at first CSA are particularly relevant to PTCs and of critical importance to advancing assessment and treatment strategies for PTSD in MSM.

Pathways from childhood sexual abuse to trait anxiety

BACKGROUND

Children exposed to sexual abuse are at risk for developing several psychological and behavioral difficulties during adulthood. Here, direct and indirect effects of family conflict, insecurity within the family system (manifested as disengagement and/or preoccupation), and negative feelings provoked by childhood sexual abuse (CSA) on trait anxiety scores were analyzed with structural equation modeling. Both Finkelhor and Browne's traumagenic dynamics model and Davies and Cummings Emotional Security Theory were applied.

METHODS

A total of 168 female college student survivors of CSA participated in this study. Information regarding each participant's abuse was obtained from a self-reported questionnaires. Emotional security was assessed with the Security in the Family System scale. To assess negative feelings regarding abuse and trait anxiety, Children's Impact of Traumatic Events Scale-Revised and State-Trait Anxiety Inventory were applied, respectively.

RESULTS

Level of family conflict was found to directly relate to emotional insecurity and trait anxiety. In addition, preoccupation strategies were found to be directly related to trait anxiety. Conversely, disengagement strategies were indirectly related to anxiety through the negative feelings provoked by abuse. Experience with other types of abuse and/or neglect was also related to emotional insecurity and feelings provoked by CSA. Meanwhile, continuity of abuse only correlated with feelings provoked by abuse.

CONCLUSIONS

Strong relationships between family conflict, emotional insecurity, negative feelings provoked by CSA and trait anxiety were observed. These results suggest that treatment of CSA survivors should focus on improving security within the survivors' family system and reducing negative feelings provoked by abuse.

Overcoming Disclosure Reluctance in Youth Victims of Sex Trafficking: New Directions for Research, Policy, and Practice

An alarming number of youth worldwide are victims of commercial sexual exploitation, particularly sex trafficking. Normative developmental processes and motivations across the adolescent period-the age when youth are at greatest risk for trafficking-combined with their history, make them highly likely to be reluctant to disclose their exploitation to police, who often encounter victims because they are suspected of delinquency and crime and who interrogate the victims as suspects. Little scientific and policy attention has been devoted to understanding how to question these victims in a way that reduces their disclosure reluctance and increases their provision of legally relevant information. In the current review, we describe research concerning trafficking victims' histories and exploitative experiences, juvenile suspects' and victims' encounters with the legal system, and best-practice forensic interviewing approaches to elicit disclosures from child victims. We highlight the implications of these areas for understanding the dynamics between how police encounter and interact with adolescent trafficking victims and whether and how the victims disclose trafficking details during these interactions. We close with an agenda for research to test interviewing methods for suspected victims of sex trafficking and with policy and practice recommendations for interviewers.

The effects of the putative confession and evidence presentation on maltreated and non-maltreated 9- to 12-year-olds' disclosures of a minor transgression

The current study examined the influence of the putative confession (in which children are told that the suspect told them "everything that happened" and "wants [the child] to tell the truth") and evidence presentation on 9- to 12-year-old maltreated and non-maltreated children's disclosure (N = 321). Half of the children played a forbidden game with an adult confederate that resulted in a laptop computer breaking (no transgression occurred for the other half of the children), followed by coaching to conceal the forbidden game and to falsely disclose the sanctioned game. Children were then interviewed about the interaction with the confederate. Among the 9- and 10-year-olds, the putative confession led to a higher rate of breakage disclosure (62%) than the control condition (13%) and to a higher rate of leakage of incriminating details during recall (47% vs. 9%). Older children were more likely to disclose than younger children and to be uninfluenced by the putative confession. Among all ages, evidence presentation elicited disclosures from 63% of children who had not previously disclosed without eliciting any false disclosures.

Association between parental visitation and depressive symptoms among institutionalized children in Japan: a cross-sectional study

BACKGROUND

Mental health problems are an important issue among institutionalized children. Although positive communication with parents is essential for children's well-being, it has not been sufficiently verified how interactions with parents affect mental health among institutionalized children, who have experienced childhood adversity and likely lack secure attachment formation with their parents. The objectives of this study were to investigate the association between parental visitation and depressive symptoms among institutionalized children in Japan, and to explore whether the established security of attachment interacts with that association.

METHODS

A cross-sectional data from 399 institutionalized children aged 9 to 18 in Japan was used for the analysis. A mixed effects regression analysis was conducted to investigate the associations.

RESULTS

Institutionalized children who had parental visitation showed higher depressive symptoms than those who did not. In particular, father's visitations were significantly associated with higher depressive symptoms. There was a significant interaction with score of secure attachment; children with low scores on secure attachment showed higher levels of depression with their father's visitation, whereas children with high scores on secure attachment did not.

CONCLUSIONS

Findings suggested that parental visitation and the frequency of visitation were not actually associated with better psychological status, but that instead, father's visitations were associated with higher depressive symptoms among institutionalized children. It should be noted that our cross-sectional results cannot infer any causal relationship and do not emphasize that parental visitation should be avoided. However, it may be important to conduct careful assessment before starting parental visitation, especially when children seem to have problems with attachment formation.

Attributions of Blame among Victims of Child Sexual Abuse: Findings from a Community Sample

According to the attribution theory, negative outcomes of child sexual abuse (CSA) are thought to vary depending on whether CSA victims attribute the abuse to internal or external factors, respectively, self-blame and perpetrator-blame. Therefore, the purpose of this study was to identify abuse characteristics and attitudes that influence blame attributions among CSA victims from a community sample. Data from respondents with a history of CSA (N = 1,496) have been used in predicting blame attributions; perpetrator-blame, self-blame, or both. Results from a multinomial logistic regression analysis showed that attitudes toward gender roles had a significant effect on blame: victims were more likely to blame themselves when they endorsed more conservative gender attitudes than victims with more liberal attitudes. Implications for this finding are discussed.

Maternal Support as a Predictor of Children's Sexualized Behaviors Following Childhood Sexual Abuse

Although previous studies have concluded that maternal support following children's sexual abuse disclosures is an important predictor of children's symptoms, the empirical data to support this is limited. Much of the small prior literature has used measures of maternal support without adequately reported psychometric properties, which may obscure the true relationship between support and children's sexual behaviors. Further, it is unclear whether maternal support is related to children's sexual acting out in the context of known predictors of sexual behaviors. The purposes of the current study were to (1) examine the relationships between support and children's sexual behaviors and (2) determine whether support is related to sexual behaviors after controlling for known predictors among 161 treatment-seeking children (6-12 years old; M = 8.70, SD = 2.69) and their nonoffending mothers. In the bivariate analyses, emotional support was negatively related to children's sexual behaviors, whereas maternal blame/doubt was positively correlated with sexual behaviors. Nonetheless, after controlling for other predictors, emotional support predicted developmentally related sexual behaviors but not sexual abuse-specific sexual behaviors. Levels of emotional support and blame/doubt predicted children's total sexual behaviors, after accounting for identified predictors, suggesting that support may play a small role in understanding children's sexual behaviors.

Effects of Interviewer Support on Children's Memory and Suggestibility: Systematic Review and Meta-Analyses of Experimental Research

The accuracy of children's reports of abuse has been hotly debated in the press, academia, and the courtroom. Yet, children's accuracy depends, in part, on the context in which children are interviewed. Guidelines often recommend creating a supportive psychosocial context to promote open, honest responding; however, there is also concern that support promotes social desirability and acquiescence to suggestion, leading children to report more of what they perceive adults want to hear than the truth. The question remains as to whether there is a sufficient body of scientific research to determine whether interviewer supportiveness improves interview outcomes while minimizing children's stress or whether it increases suggestibility and impairs accuracy. Using a systematic search strategy and meta-analyses, this study identifies and reviews findings from experimental studies of the effects of interviewer supportiveness on the accuracy of children's reports. Although the number of studies in the evidence base is small ( n = 15), the studies are of relatively good quality. Results suggest noncontingent interviewer support bolsters children's accuracy. Children are more resistant and less acquiescent to suggestive questions when interviewers are supportive as compared to nonsupportive or neutral. Effects are in the moderate range. Interviewer support is also associated with fewer errors on nonsuggestive questions. Discussion focuses on implications for practice; directions for future research; identifying vulnerable subgroups; and underlying cognitive, social, and emotional mechanisms.

The Diagnostic Utility of the Child Sexual Behavior Inventory for Sexual Abuse: A Systematic Review

Children with alleged child sexual abuse (CSA) need to be assessed systematically. The use of validated instruments during the assessment, like the Child Sexual Behavior Inventory (CSBI), could add diagnostic value. We aim to assess the diagnostic utility of the CSBI to differentiate between sexually abused and non-abused children. We conducted a systematic review. We searched the electronic databases MEDLINE and PsychInfo for studies comparing CSBI scores in sexually abused children and non-abused children (2-12 years old). Two independent reviewers extracted data and assessed the methodological quality. We included 7 (out of 1048) articles. The CSBI total scores were significantly higher in CSA-victims compared with non-abused children (in case-control settings). However, in children with suspected CSA, the results were ambiguous. One study reported significant differences. Another study reported weak diagnostic ability for the CSBI-3 in children with suspected CSA (a sensitivity and specificity of 0.50, with a positive predictive value of 0.28, and a negative predictive value of 0.72). Research on the diagnostic utility of the CSBI for suspected CSA is limited and shows disappointing results. Until more research is done, the CSBI should not be used on its own to differentiate between sexually abused and non-abused children.

Recantation of Sexual Abuse Disclosure Among Child Victims: Accommodation Syndrome

BACKGROUND

Disclosing the sexual abuse may be related on many individual and/or environmental factors in all age groups. The sociocultural context is the most influential factor of the disclosing process especially for those living in patriarchal cultural values. This study compares the impacts of sexual abuse and other sociodemographic variables between recanting and non-recanting victimized groups in Adana city from Turkey.

METHODS

The samples attending our department were divided into two groups: group 1 comprised victims who recanted their first abuse disclosure, and group 2 comprised victims who insisted on the veracity of their first report at further evaluations. The characteristics of the child, family, and abuser were compared between recanting victims and non-recanting victims by retrospective data.

RESULTS

Each group included 27 children, for a total of 54 subjects. All adverse social reactions after the sexual abuse, including keeping secrets and a repressive family attitude, were higher among group 1 victims than group 2 victims (p < 0.0001).

CONCLUSIONS

Although they are victimized by protecting family integrity, victims may show a tendency to keep secrets and to not immediately disclose an abuse event.

Are shame and self-esteem risk factors in prolonged grief after death of a spouse?

Although many single factors of prolonged grief have been identified in the literature, a comprehensive understanding of predictors is still lacking. This article argues that shame and low self-esteem, present risk factors in prolonged grief after spousal loss, based on a review of correlational studies. Using a practitioner-scientist approach, a developmental model of shame as a core factor in prolonged grief is proposed, outlining the progression from childhood relational trauma, to insecure attachment, shame, self-esteem contingent on spousal approval to eventual prolonged grief.

Maternal support following childhood sexual abuse: Relationships to child-reported

Maternal support has been conceptualized as a key factor in predicting children's functioning following sexual abuse; however, empirical evidence for this assumption is rather limited. Prior studies may have failed to find a relationship between maternal support and children's outcomes due to the methodological weaknesses of the prior literature such as the use of maternal support measures without adequately reported psychometric properties. Moreover, relatively few studies have investigated whether maternal support corresponds with children's own self-reported symptoms. The aim of the present study was to utilize the only published measure of maternal support with sufficient psychometrics, the Maternal Self-Report Support Questionnaire (MSSQ; Smith et al., 2010), to determine if levels of pre-treatment support are associated with children's self-reported trauma-related symptoms among 165 treatment-seeking children (M=10.85, SD=3.09) and their non-offending mothers. Levels of maternal emotional support corresponded with few of children's outcomes, and when relationships were observed, emotional support was related to higher levels of symptoms. Maternal levels of blame and doubt were only associated with dissociative symptoms. Maternal support therefore appears to be an ineffective predictor of children's post-disclosure trajectories and raises the possibility that maternal support is linked with poorer functioning.

Sensitive periods for the effect of childhood interpersonal violence on psychiatric disorder onset among adolescents

BackgroundAlthough childhood adversity is a strong determinant of psychopathology, it remains unclear whether there are 'sensitive periods' when a first episode of adversity is most harmful.AimsTo examine whether variation in the developmental timing of a first episode of interpersonal violence (up to age 18) associates with risk for psychopathology.MethodUsing cross-sectional data, we examined the association between age at first exposure to four types of interpersonal violence (physical abuse by parents, physical abuse by others, rape, and sexual assault/molestation) and onset of four classes of DSM-IV disorders (distress, fear, behaviour, substance use) (n = 9984). Age at exposure was defined as: early childhood (ages 0-5), middle childhood (ages 6-10) and adolescence (ages 11-18).ResultsExposure to interpersonal violence at any age period about doubled the risk of a psychiatric disorder (odds ratios (ORs) = 1.51-2.52). However, few differences in risk were observed based on the timing of first exposure. After conducting 20 tests of association, only three significant differences in risk were observed based on the timing of exposure; these results suggested an elevated risk of behaviour disorder among youth first exposed to any type of interpersonal violence during adolescence (OR = 2.37, 95% CI 1.69-3.34), especially being beaten by another person (OR = 2.44; 95% CI 1.57-3.79), and an elevated risk of substance use disorder among youth beaten by someone during adolescence (OR = 2.77, 95% CI 1.94-3.96).ConclusionsChildren exposed to interpersonal violence had an elevated risk of psychiatric disorder. However, age at first episode of exposure was largely unassociated with psychopathology risk.

The effects of promising to tell the truth, the putative confession, and recall and recognition questions on maltreated and non-maltreated children's disclosure of a minor transgression

This study examined the utility of two interview instructions designed to overcome children's reluctance to disclose transgressions: eliciting a promise from children to tell the truth and the putative confession (telling children that a suspect "told me everything that happened and wants you to tell the truth"). The key questions were whether the instructions increased disclosure in response to recall questions and in response to recognition questions that were less or more explicit about transgressions and whether instructions were differentially effective with age. A total sample of 217 4- to 9-year-old maltreated and comparable non-maltreated children and a stranger played with a set of toys. For half of the children within each group, two of the toys appeared to break while they were playing. The stranger admonished secrecy. Shortly thereafter, children were questioned about what happened in one of three interview conditions. Some children were asked to promise to tell the truth. Others were given the putative confession, and still others received no interview instructions. When coupled with recall questions, the promise was effective at increasing disclosures only among older children, whereas the putative confession was effective regardless of age. Across interview instruction conditions, recognition questions that did not suggest wrongdoing elicited few additional transgression disclosures, whereas recognition questions that explicitly mentioned wrongdoing elicited some true reports but also some false alarms. No differences in disclosure emerged between maltreated and non-maltreated children. Results highlight the potential benefits and limitations of different interviewing approaches when questioning reluctant children.

Maternal support following childhood sexual abuse: Links to parent-reported children's outcomes

Maternal support is touted to play a critical role in predicting children's symptom trajectories following sexual abuse disclosure. Yet, a recent meta-analysis indicates that this widely held belief may actually have limited empirical support. The lack of correspondence between maternal support and children's symptoms may be the result of the limitations of the prior literature including the use of maternal support measures with inadequate psychometric properties. The aim of the present study was to utilize the only published measure with sufficient psychometrics properties, the Maternal Self-Report Support Questionnaire (MSSQ; Smith et al., 2010), to determine the relationships between maternal support and demographic and family characteristics, parent-reported children's symptoms, and aspects of the traumatic event in a treatment-seeking sample. The sample included 252 treatment-seeking children (M=8.86, SD=3.85; 67.5% female, 59.5% White) and their mothers, who completed the MSSQ and other measures at pre-treatment. Mothers of older children, White children, and mothers with greater educational attainment reported higher levels of Emotional Support. Single mothers were more likely to report higher levels of Blame/Doubt than married mothers. Characteristics of the traumatic event, such as sexual abuse duration and number of sexual abuse incidents were negatively correlated with Emotional Support. Maternal support was related to relatively few of children's symptoms and was not associated with levels of posttraumatic stress disorder (PTSD) symptoms. Although several demographic and family characteristics may be related to maternal support, it is a relatively weak predictor of children's outcomes.

[Sense of guilt in sexually abused children : Mediating role of avoidance coping on anxiety and self-esteem]

Prior studies have suggested self-blame and sense of guilt as important elements associated with the effects of childhood sexual abuse on adult survivors (Cantón-Cortés, Cantón, Justicia & Cortés, 2011). However, few studies have explored the potential impact of the sense of guilt on outcomes in child victims. This study examines the mediating role of avoidance coping on the relationship between sense of guilt and outcomes (anxiety and self-esteem) in sexually abused children. The sample consisted of 447 sexually abused children (319 girls and 128 boys) aged 6 to 12. Path analysis indicated that children with higher feelings of guilt about the abuse showed more anxiety and lower levels of self-esteem. Indirect effects also indicated that sense of guilt predicted avoidance coping, which in turn contributed to higher anxiety and lower self-esteem. This model, which fits the data well for both girls and boys, explains 24.4 % of the variance in anxiety and 11.2 % of the variance in self-esteem. Results suggest that sense of guilt is an important target for clinical intervention with sexually abused children.

The Effects of Secret Instructions and Yes/no Questions on Maltreated and Non-maltreated Children's Reports of a Minor Transgression

This study examined the effects of secret instructions (distinguishing between good/bad secrets and encouraging disclosure of bad secrets) and yes/no questions (DID: "Did the toy break?" versus DYR: "Do you remember if the toy broke?") on 262 maltreated and non-maltreated children's (age range 4-9 years) reports of a minor transgression. Over two-thirds of children failed to disclose the transgression in response to free recall (invitations and cued invitations). The secret instruction increased disclosures early in free recall, but was not superior to no instruction when combined with cued invitations. Yes/no questions specifically asking about the transgression elicited disclosures from almost half of the children who had not previously disclosed, and false alarms were rare. DYR questions led to ambiguous responding among a substantial percentage of children, particularly younger children. The findings highlight the difficulties of eliciting transgression disclosures without direct questions. Copyright © 2017 John Wiley & Sons, Ltd.

Reflection

In this paper, four researchers describe reflection as a component of a participatory action research cycle. We draw on our experiences and learning while undertaking three research inquiries. In the first inquiry we listen and respond to the voices of Australian Aboriginal people who live with diabetes and we share an alternate story, where fear is turned into courage, as told by these Elders. The second inquiry involves email communications with women and men who live with a chronic illness and gives a facilitator’s reflections. And the third study is a capacity building process with women who have experienced child sexual abuse. These women have used/misused alcohol, licit/illicit substances, or gambling, which has contributed to their homelessness. Confronted by many of life’s obstacles, we gain a glimmer of hope as women describe the way in which they use the participatory process to make sense of their lives.

It is argued that reflection occupies a central place is participatory action research cycles of ‘look, think and act’. ‘Look, think and act’ processes are appealing precisely because they are meaningful to research participants in their everyday lives. When these processes are internalised as modus operandi, they can be sustained throughout one’s life as a strategy for building capacity or ‘moving on’. ‘Moving on’ or transition is the theoretical focus that holds these inquiries together.

Sanctuary in a residential treatment center: creating a therapeutic community of hope countering violence

Purpose

– The purpose of this paper is to present insights into how and why the Sanctuary and SELF models are effective in decreasing trauma symptoms with a population of court-committed male adolescents in a residential treatment program. The Sanctuary model is a trauma-focussed, trauma-sensitive, organizational change model, and treatment protocol approach to working with clients who have experienced trauma, loss, and toxic stress to the degree that they interfere with social and personal functioning. The SELF model within Sanctuary is a treatment protocol that is an acronym for the organizing categories of safety, emotion management, loss, and the future. In essence, Sanctuary’s purpose is to create therapeutic community.

Design/methodology/approach

– Qualitative research methods of observation of groups and meetings, content analysis of existing quantitative data and agency documents, focus groups with staff and residents, and individual interviews with staff were utilized.

Findings

– Data show that the Sanctuary model ameliorates the symptoms of complex trauma. The substantive theory that emerges is that relational and neurological integration and recovery occur in the lives of residents as shaped first by the therapeutic community that supports the level of interpersonal relationships experienced with staff within a therapeutic milieu, along with shaping the organizational culture.

Research limitations/implications

– As a complex intervention, it is evident that reducing the Sanctuary model into its component parts cannot capture fully the essence of the intervention. A complex system can never be understood fully by observing it at single points in time.

Practical implications

– It is suggested that future research and programmatic planning within this therapeutic community need to demonstrate how to continue enhancing staff-resident relational integration vis-à-vis staff training and vehicles that offer residents more of a representative voice while in placement.

Social implications

– It is suggested that future research and programmatic planning within this agency need to demonstrate how to continue enhancing staff-resident trauma-informed therapeutic milieus and relational integration vis-à-vis staff training and vehicles that offer residents more of a representative voice while in placement.

Originality/value

– This is a unique study in that it employs qualitative methods to explore how and why the Sanctuary model contributes to its working in a residential treatment facility. The Sanctuary model is the only trauma-informed organizational intervention of its kind, with limited published evaluations in the current literature (Esaki et al., 2013). This study used focus groups with residents and staff that allowed them to influence the research and its processes. The residents expressed their views about the experience of being placed outside of their homes and of living in a therapeutic community within the Sanctuary Network. Staff spoke of aspects of working in a trauma-informed milieu and its effect on clients, colleagues, and the organization as a whole.

Exploring the Impact of Childhood Abuse on HIV Social and Attitudinal Factors Among Adults With and Without this History in Sub-Saharan Africa: Findings from NIMH Project Accept (HPTN 043)

Using data from four sites in three African countries, this community randomized study examined the association between childhood sexual and/or physical abuse (CSA and/or CPA) and HIV disclosure, HIV-related stigma, stress, and social support among adults with and without a history of abuse. A history of abuse among men was associated with higher levels of adult-reported stress and HIV-related stigma, and with significantly lower rates of HIV test result disclosure to current partners. Women with a history of CSA and/or CPA had significantly higher perceived stigma, discrimination and stress. Although childhood abuse was significantly associated with adult stress and stigmatization, participants with histories of CSA and/or CPA also reported significantly higher perceived social support compared to people without such experiences. These findings may reflect support received in response to disclosure of CSA or CPA or emotional ambivalence in relationships that have been found to be associated with child abuse. We conclude that it is critical for HIV prevention interventions to advocate for the primary prevention of child abuse, for early identification of adolescents and adults who report experiencing childhood abuse, and to address stigma and stress-related attitudinal, behavioral and relationship difficulties experiences as an aftermath of early abuse that increase their risk of HIV.

Valence, Implicated Actor, and Children's Acquiescence to False Suggestions

Although adverse effects of suggestive interviewing on children's accuracy are well documented, it remains unclear as to whether these effects vary depending on the valence of and the actor implicated in suggestions. In this study, 124 3-8-year-olds participated in a classroom activity and were later questioned about positive and negative false details. The interviewer provided positive reinforcement when children acquiesced to suggestions and negative feedback when they did not. Following reinforcement or feedback, young children were comparably suggestible for positive and negative details. With age, resistance to suggestions about negative details emerged first, followed by resistance to suggestions about positive details. Across age, more negative feedback was required to induce acquiescence to negative than positive false details. Finally, children were less willing to acquiesce when they (versus the confederate) were implicated. Findings highlight the interactive effects of valence and children's age on their eyewitness performance in suggestive contexts.

Children's recantation of adult wrongdoing: An experimental investigation

Child maltreatment cases often hinge on a child's word versus a defendant's word, making children's disclosures crucially important. There is considerable debate concerning why children recant allegations, and it is imperative to examine recantation experimentally. The purpose of this laboratory analogue investigation was to test (a) how often children recant true allegations of an adult's wrongdoing after disclosing and (b) whether children's age and caregiver supportiveness predict recantation. During an interactive event, 6- to 9-year-olds witnessed an experimenter break a puppet and were asked to keep the transgression a secret. Children were then interviewed to elicit a disclosure of the transgression. Mothers were randomly assigned to react supportively or unsupportively to this disclosure, and children were interviewed again. We coded children's recantations (explicit denials of the broken puppet after disclosing) and changes in their forthcomingness (shifts from denial or claims of lack of knowledge/memory to disclosure and vice versa) in free recall and in response to focused questions about the transgression. Overall, 23.3% of the children recanted their prior disclosures (46% and 0% in the unsupportive and supportive conditions, respectively). No age differences in recantation rates emerged, but 8- and 9-year-olds were more likely than 6- and 7-year-olds to maintain their recantation throughout Interview 2. Children whose mothers reacted supportively to disclosure became more forthcoming in Interview 2, and those whose mothers reacted unsupportively became less forthcoming. Results advance theoretical understanding of how children disclose negative experiences, including sociomotivational influences on their reports, and have practical implications for the legal system.

Emotional security in the family system and psychological distress in female survivors of child sexual abuse

The Emotional Security Theory (EST) was originally developed to investigate the association between high levels of interparental conflict and child maladaptative outcome. The objective of the present study was to analyze the effects of emotional security in the family system on psychological distress among a sample of young female adult survivors of child sexual abuse (CSA). The role of emotional security was investigated through the interactive effects of a number of factors including the type of abuse, the continuity of abuse, the relationship with the perpetrator and the existence of disclosure for the abuse. Participants were 167 female survivors of CSA. Information about the abuse was obtained from a self-reported questionnaire. Emotional security was assessed with the Security in the Family System (SIFS) Scale, and the Symptom Checklist-90-Revised (SCL-90-R) was used to assess psychological distress. In the total sample, insecurity (preoccupation and disengagement) was correlated with high psychological distress scores, whereas no relationship was found between security and psychological distress. The relationship between emotional insecurity and psychological distress was stronger in cases of continued abuse and non-disclosure, while the relationship between emotional security and distress was stronger in cases of extrafamilial abuse and especially isolated or several incidents and when a disclosure had been made. No interactive effect was found between any of the three emotional variables and the type of abuse committed. The results of the current study suggest that characteristics of CSA such as relationship with the perpetrator and, especially, continuity of abuse and whether or not disclosure had been made, can affect the impact of emotional security on psychological distress of CSA survivors.

Effects of perpetrator identity on suicidality and nonsuicidal self-injury in sexually victimized female adolescents

PURPOSE

Child sexual abuse and sexual dating violence victimization are common problems that are known to have long-term negative consequences. This study aimed to compare the sociodemographic, abuse-related, and clinical features of female adolescents who were sexually abused by different perpetrators, and identify the factors associated with suicidality and nonsuicidal self-injury (NSSI) in these cases.

PATIENTS AND METHODS

Data of 254 sexually abused female adolescents between the ages of 12-18 years were evaluated. The cases were classified into three groups, namely "sexual dating violence", "incest", and "other child sexual abuse", according to the identity of the perpetrator. The three groups were compared in terms of sociodemographic, abuse-related, and clinical features.

RESULTS

Major depressive disorder was the most common psychiatric diagnosis, which was present in 44.9% of the cases. Among all victims, 25.6% had attempted suicide, 52.0% had suicidal ideation, and 23.6% had NSSI during the postabuse period. A logistic regression analysis revealed that attempted suicide was predicted by dating violence victimization (adjusted odds ratio [AOR] =3.053; 95% confidence interval [CI] =1.473, 6.330) and depression (AOR =2.238; 95% CI =1.226, 4.086). Dating violence victimization was also the strongest predictor of subsequent suicidal ideation (AOR =3.500; 95% CI =1.817, 6.741). In addition, revictimization was determined to be an important risk factor for both suicidal ideation (AOR =2.897; 95% CI =1.276, 6.574) and NSSI (AOR =3.847; 95% CI =1.899, 7.794).

CONCLUSION

Perpetrator identity and revictimization are associated with negative mental health outcomes in sexually victimized female adolescents. Increased risk of suicidality and NSSI should be borne in mind while assessing cases with dating violence and revictimization histories, in particular.

EMDR With Sex Offenders: Using Offense Drivers to Guide Conceptualization and Treatment

Evidence shows that sexual offenders have higher levels of adverse childhood experiences (ACE) than either the general population or other criminal populations. Historically, it was considered standard practice for sex offender therapists to dissuade their clients from addressing childhood trauma or adversity for fear of excuse making for his offending. The pathways model, which highlights etiology, made room for trauma treatment for offender’s ACE as a legitimate treatment intervention. The adaptive information processing model inherent in eye movement desensitization and reprocessing (EMDR) trauma therapy is theorized to reorganize the maladaptively stored clustering of cognitions and emotions related to overwhelming or traumatic experiences such as childhood sexual abuse. We suggest EMDR therapy as a means of restructuring distorted implicit cognitions and personal vulnerability factors which are theorized to drive offending behavior. Through a comprehensive literature review, the authors considered 5 extant models in the sex offender literature and developed the offense drivers model. This model is designed to guide and inform EMDR therapy with sex offenders. A case example illustrates the implementation of this treatment process. A checklist of offense drivers is provided to assist in case conceptualization and treatment.

The Role of Sexual Abuse and Dysfunctional Attitudes in Perceived Stress and Negative Mood in Pregnant Adolescents: An Ecological Momentary Assessment Study

STUDY OBJECTIVE

Latinas have the highest rates of adolescent pregnancy in the United States. Identifying means to improve the well-being of these young women is critical. The current study examined whether a history of child sexual abuse-itself a risk factor for adolescent pregnancy-was associated with more perceived stress and negative mood over the course of pregnancy and whether dysfunctional attitudes explained these associations.

DESIGN AND SETTING

This mixed methods study involved laboratory-based assessments of perceived stress, sexual abuse history, and dysfunctional attitudes, as well as Ecological Momentary Assessments (EMA) of mood states every 30 minutes during a 24-hour period once during each trimester of pregnancy.

PARTICIPANTS

Pregnant adolescents (N = 204, 85% Latina).

MAIN OUTCOME MEASURES

EMA mood states and laboratory-based retrospective self-reports of perceived stress.

RESULTS

One in 4 pregnant adolescents had a history of sexual abuse. Sexually abused adolescents reported greater perceived stress during the first trimester relative to those without, though the groups did not differ on EMA negative mood ratings. Dysfunctional attitudes explained associations between sexual abuse and perceived stress. Sexual abuse was indirectly associated with the intercept and slope of negative mood through dysfunctional attitudes. Findings were circumscribed to sexual abuse and not other types of child abuse.

CONCLUSIONS

Identifying sexually abused pregnant adolescents and providing support and cognitive therapy to target dysfunctional beliefs may decrease stress during the first trimester as well as negative affect throughout pregnancy.

Indicadores de risco para tentativa de suicídio por envenenamento: um estudo caso-controle

RESUMO Objetivo Considerando o envenenamento como o método mais utilizado para a tentativa de suicídio e a escassez de evidências nacionais sobre o tema, investigamos alguns possíveis indicadores de risco nesse tipo de tentativa. Métodos Estudo do tipo caso-controle em uma emergência geral de um hospital público, na cidade do Recife com 220 indivíduos, distribuídos em dois grupos de 110 pacientes cada, que estavam em tratamento, sendo o grupo casos os sobreviventes de tentativa de suicídio por envenenamento e os controles, sem história de intoxicação/envenenamento nem tentativa de suicídio, pareados por gênero e idade. Resultados O gênero feminino predominou na amostra (70,9%), com idade média de 29 anos; 73% declararam etnia branca ou morena; menos da metade vivia em convívio marital; a maioria tinha religião; ambos tinham poucos anos de estudo. Houve diferença significativa (p = 0,003) para dependência financeira entre os grupos, com chance 2,25 vezes maior para tentar suicídio entre os casos. Ter sofrido fatos traumáticos e abuso sexual na infância revelou diferença significativa. Conclusões Foram considerados indicadores de risco no grupo caso: estar em dependência financeira de terceiros, ter sofrido abuso sexual na infância, ideação suicida, histórico de transtorno mental na família, possuir algum transtorno mental e, principalmente, comorbidade(s) psiquiátrica(s). No modelo de regressão, foi possível estimar uma chance de tentativa de suicídio por envenenamento de até 94,0% na presença conjunta de quatro fatores. A pesquisa representa uma das primeiras iniciativas para ampliação das discussões sobre os fatores de risco para tentativa de suicídio em âmbito nacional.

Simulating Memory Impairment for Child Sexual Abuse

The current study investigated effects of simulated memory impairment on recall of child sexual abuse (CSA) information. A total of 144 adults were tested for memory of a written CSA scenario in which they role-played as the victim. There were four experimental groups and two testing sessions. During Session 1, participants read a CSA story and recalled it truthfully (Genuine group), omitted CSA information (Omission group), exaggerated CSA information (Commission group), or did not recall the story at all (No Rehearsal group). One week later, at Session 2, all participants were told to recount the scenario truthfully, and their memory was then tested using free recall and cued recall questions. The Session 1 manipulation affected memory accuracy during Session 2. Specifically, compared with the Genuine group's performance, the Omission, Commission, or No Rehearsal groups' performance was characterized by increased omission and commission errors and decreased reporting of correct details. Victim blame ratings (i.e., victim responsibility and provocativeness) and participant gender predicted increased error and decreased accuracy, whereas perpetrator blame ratings predicted decreased error and increased accuracy. Findings are discussed in relation to factors that may affect memory for CSA information.

A Meta-Analytic Review of the Relationship Between Nonoffending Caregiver Support and Postdisclosure Functioning in Sexually Abused Children

Postdisclosure caregiver support has long been considered a key factor in the functioning of children after their disclosure of sexual abuse, and numerous studies and reviews support this relationship. Yet, a closer look at this literature suggests that support for this relationship might not be as strong or consistent as reported. The purpose of this article is to review studies assessing the relationship between caregiver support of sexually abused children and postdisclosure functioning of their children. Studies were collected using various search engines, and the tables of contents of certain child maltreatment journals were reviewed. To be included, studies had to be published prior to 2012 and to quantitatively capture the bivariate relationship between a quantified assessment of nonoffending caregiver (NOC) support anytime after the child's sexual abuse disclosure and a quantified assessment of at least 1 of the 11 types of postdisclosure functioning in the children. Twenty-nine studies met the criteria to be included. In the meta-analysis, Pearson's Product Moment Correlation, transformed to a Fisher's Z, was used as the effect size. Potential moderators of effect size were also coded and assessed. Postdisclosure caregiver support was significantly related to 3 of the 11 different types of postdisclosure functioning in children. However, the largest effect size was .170, and 8 of the 11 types of postdisclosure functioning in children had effect sizes smaller than ±.100. Few moderators of the relationship between NOC support and postdisclosure functioning in children were found. Minimal support for the relationship between caregiver support of sexually abused children and children's postdisclosure functioning was found. At this time, it is impossible to determine whether this weak relationship can be attributed to the many methodological weaknesses in the measurement of caregiver support or whether caregiver support is not related to postdisclosure functioning in children.

Maternal support following childhood sexual abuse: Associations with children's adjustment post-disclosure and at 9-month follow-up

Maternal support has been widely cited as an important predictor of children's adjustment following disclosure of sexual abuse. However, few studies have examined these effects longitudinally. The current study examines the relationships between a multidimensional assessment of maternal support rated by both mothers and children and children's adjustment in various domains (internalizing, externalizing, anger, depression, and posttraumatic stress disorder symptoms) concurrently and longitudinally. Participants were 118 mother-child dyads recruited from a Child Advocacy Center where children were determined through a forensic evaluation to be victims of sexual abuse. Child and mother ratings of maternal support and child adjustment were collected shortly after the forensic evaluation and at 9-month follow-up. Results were consistent with findings from past studies that maternal support is significantly related to children's post-disclosure adjustment and extends these findings longitudinally. Additionally, the study sheds light on differential relations between dimensions of maternal support (Emotional Support, Blame/Doubt, Vengeful Arousal, and Skeptical Preoccupation) and child adjustment and suggests the importance of using both child and mother ratings of maternal support in future research.

Memory for child sexual abuse information: simulated memory error and individual differences

Building on the simulated-amnesia work of Christianson and Bylin (Applied Cognitive Psychology, 13, 495-511, 1999), the present research introduces a new paradigm for the scientific study of memory of childhood sexual abuse information. In Session 1, participants mentally took the part of an abuse victim as they read an account of the sexual assault of a 7-year-old. After reading the narrative, participants were randomly assigned to one of four experimental conditions: They (1) rehearsed the story truthfully (truth group), (2) left out the abuse details of the story (omission group), (3) lied about the abuse details to indicate that no abuse had occurred (commission group), or (4) did not recall the story during Session 1 (no-rehearsal group). One week later, participants returned for Session 2 and were asked to truthfully recall the narrative. The results indicated that, relative to truthful recall, untruthful recall or no rehearsal at Session 1 adversely affected memory performance at Session 2. However, untruthful recall resulted in better memory than did no rehearsal. Moreover, gender, PTSD symptoms, depression, adult attachment, and sexual abuse history significantly predicted memory for the childhood sexual abuse scenario. Implications for theory and application are discussed.

Child sexual abuse, attachment style, and depression: the role of the characteristics of abuse

The aim of the current study was to examine the effects of secure, avoidant, and anxious attachment styles on depressive symptomatology in child sexual abuse (CSA) among young female adult victims. The role of attachment style was studied by considering possible interactive effects with the type of abuse, the relationship with the perpetrator, and the continuity of abuse. Participants were 168 female victims of CSA. Information about the abuse was obtained from a self-reported questionnaire. Attachment style was assessed with the Attachment Style Measure (ASM), and the Beck Depression Inventory (BDI) was used to assess depressive symptomatology. Secure and anxious attachment styles were correlated with low and high depression scores respectively. The effects of attachment style were stronger in cases where the abuse consisted of oral sex/penetration, a non-family member as perpetrator, and in isolated, compared with continued, abuse. These results confirm that characteristics of CSA (type of abuse, relationship with the perpetrator, and continuity of abuse) can affect the impact of attachment style on depressive symptomatology.

Disclosing adult wrongdoing: maltreated and non-maltreated children's expectations and preferences

Little is known about the process by which children disclose adult wrongdoing, a topic of considerable debate and controversy. In the current study, we investigated children's evaluations of disclosing adult wrongdoing by focusing on children's preferences for particular disclosure recipients and perceptions of the consequences of disclosure in hypothetical vignettes. We tested whether children thought that disclosure recipients would believe a story child as a truth teller and what actions the recipients would take against the "instigator" who committed the transgression. Maltreated and non-maltreated 4- to 9-year-olds (N=235) responded to questions about vignettes that described a parent's or stranger's transgression. Older children preferred caregiver recipients over police officer recipients when disclosing a parent's transgression but not a stranger's transgression. Maltreated children's preference for caregiver recipients over police officer recipients developed more gradually than that of non-maltreated children. Older children expected disclosure recipients to be more skeptical of the story child's account, and older children and maltreated children expected disclosure recipients to intervene formally less often when a parent, rather than a stranger, was the instigator. Results contribute to understanding vulnerable children's development and highlight the developmental, experiential, and socio-contextual factors underlying children's disclosure patterns.

The interactive effect of blame attribution with characteristics of child sexual abuse on posttraumatic stress disorder

The present study examined the role of attributions of blame for child sexual abuse (CSA) in posttraumatic stress disorder (PTSD) symptoms. The interactive effects of attribution of blame with characteristics of abuse on PTSD were studied. A sample of 151 female victims of CSA participated in the study. Self-blame and family blame were related to higher PTSD scores, whereas perpetrator blame was not related to PTSD. The strength of the relationship between blame and PTSD score was higher in cases of more severe, isolated, and extrafamilial abuse. The findings suggest that diminishing self-blame attributions may be particularly advantageous in cases of isolated and extrafamilial CSA, whereas diminishing family blame would be more advantageous in cases of severe abuse.

The effects of perpetrator age and abuse disclosure on the relationship between feelings provoked by child sexual abuse and posttraumatic stress

The present study examined the relationship between feelings provoked by child sexual abuse (CSA) and posttraumatic stress disorder (PTSD) symptom scores in a sample of 163 female survivors of CSA. Finkelhor and Browne's traumagenic dynamics model was applied. The interactive effects of provoked feelings with perpetrator age and the existence of abuse disclosure were also studied. Results showed an overall relationship between feelings provoked by CSA and PTSD symptom scores. Feelings of stigma, betrayal, and powerlessness as a result of CSA were associated with PTSD symptom score when the entire group of CSA victims was analyzed. The role of traumatic sexualization was relevant only when analyzed in interaction with the age of the perpetrator and disclosure. The relationship between traumatic sexualization and PTSD symptom scores was only significant when the abuse was committed by an adult perpetrator and when a disclosure was made during the time of abuse, or a short time after the abuse had occurred.