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Ganson KT, Nguyen L, Ali ARH, Nagata JM, Rodgers RF, Murray SB, Alaggia R. "Eat more protein, build more muscle": A grounded theory study of muscle-building behaviors among Canadian adolescents and young adults. Body Image 2023; 47:101635. [PMID: 37806066 DOI: 10.1016/j.bodyim.2023.101635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 09/11/2023] [Accepted: 09/24/2023] [Indexed: 10/10/2023]
Abstract
Unique risk factors for the development of muscle dissatisfaction and engagement in muscle-building behaviors have been described by theoretical frameworks and supported by empirical research. What remains unknown are the unique processes, including catalysts and facilitators, which underpin engagement in muscle-building behaviors. Therefore, this study used a grounded theory methodology to elucidate the process of engagement in muscle-building behaviors. Thirty-three individual semi-structured interviews with Canadian adolescents and young adults ages 16-30 years were conducted. Transcripts were analyzed using initial and focused coding to identify themes that explained the grounded theory. The core theme underpinning the grounded theory was balancing aesthetic, health, and functional goals in relation to participants' engagement in muscle-building behaviors. Participants described experiences that encompassed several unique phases of muscle-building engagement, including the initiation phase, beginner phase, preservation phase, and intensification phase. Participants also described unique methods of gathering information on muscle-building behaviors, and their own analysis and decision-making processes driving their behaviors. Findings from this study extend prior theory and research by conceptualizing a novel process theory of engagement in muscle-building behaviors among adolescent and young adults, resulting in important implications for research and practice.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada.
| | - Lynn Nguyen
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Ali Raza Hasan Ali
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Rachel F Rodgers
- Department of Applied Psychology, Northeastern University, Boston, MA, USA; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, Montpellier, France
| | - Stuart B Murray
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
| | - Ramona Alaggia
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
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2
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Lateef R, Alaggia R, Collin-Vézina D, McElvaney R. The Legacy of Shame following Childhood Sexual Abuse Disclosures. J Child Sex Abus 2023; 32:184-203. [PMID: 36656278 DOI: 10.1080/10538712.2022.2159910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 11/23/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
Shame has been recognized as a barrier to child sexual abuse (CSA) disclosures, but there has been less focus on the impact of shame on post-disclosure. This study explores how shame is experienced by CSA survivors following disclosure. Semi-structured interviews were conducted with eleven CSA survivors aged 14-25 years on their CSA disclosure experiences. Thematic analysis of the transcripts produced four themes that highlight the various impacts of shame post-disclosure: 1) struggles with identifying as a sexual abuse survivor; 2) manifestations of shame; 3) shaming responses to disclosures; and 4) strategies to overcome shame. Clinical implications are presented using a social ecological perspective.
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McElvaney R, Lateef R, Collin-Vézina D, Alaggia R, Simpson M. Bringing Shame Out of the Shadows: Identifying Shame in Child Sexual Abuse Disclosure Processes and Implications for Psychotherapy. J Interpers Violence 2022; 37:NP18738-NP18760. [PMID: 34459692 PMCID: PMC9554283 DOI: 10.1177/08862605211037435] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Child sexual abuse (CSA) has been described as a highly stigmatizing experience. Despite the recognition of shame as a significant contributor to psychological distress following CSA, an inhibitor of CSA disclosure, and a challenging emotion to overcome in therapy, limited research has explored the experience of shame with young people who have been sexually abused. This study is unique in examining the transcripts of 47 young people aged 15-25 years from a large-scale study conducted in Ireland and Canada and exploring manifestations of shame in CSA disclosure narratives. Using a thematic analysis of both inductive and deductive coding, the data were examined for implicit, as distinct from explicit, manifestations of shame. Three key themes were identified in this study: languaging shame, avoiding shame, and reducing shame. The study supports previous authors in highlighting the need for nuanced measures of shame in research that takes account of the complexity of this emotion. Conceptualizations in the literature of the distinction between shame and guilt are challenged when these emotions are explored in the context of CSA. Finally, recommendations for working therapeutically with young people who have experienced CSA are offered with a view to addressing shame in therapeutic work.
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Manay N, Collin-Vézina D, Alaggia R, McElvaney R. "It's Complicated Because We're Only Sixteen": A Framework for Understanding Childhood Sexual Abuse Disclosures to Peers. J Interpers Violence 2022; 37:NP1704-NP1732. [PMID: 32552189 DOI: 10.1177/0886260520933052] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The process of disclosing childhood sexual abuse (CSA) is very difficult for young people. Researchers have consistently found that young people disclose CSA to other youth at much higher rates than to familiar adults or authorities and indicate that CSA remains largely unknown to adults. However, no study to date has focused exclusively on understanding the process of youth-directed disclosures from young people's perspectives. Using grounded theory methodology, this qualitative study aimed to understand the process of CSA disclosures to peers based on interviews with 30 young people from Canada and Ireland who have experienced CSA. The findings reflect the iterative and dialogical nature of the peer disclosure process and provide a framework for youth-directed disclosures that is centered on the theme of uncertainty. An underlying sense of uncertainty permeated the entire disclosure experience as participants' narratives reflected six stages that were interrelated in a cyclical process: experiencing internal conflict, needing to tell and choosing to confide in peers, expecting emotional support from peers, gradual telling and making sense of the abuse, burden on peers, and assessing peer responses and further disclosures. In addition, this model was not static, as with time, participants reinterpreted their peers' responses. The presented framework is consistent with previous conceptualizations of CSA disclosures, but the focus on youth-directed disclosures from the perspective of young people also allowed for a model that explains processes that are unique to peer disclosures. Practice and policy implications as well as limitations and future research directions are discussed.
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Baird SL, Alaggia R, Jenney A. "Like Opening Up Old Wounds": Conceptualizing Intersectional Trauma Among Survivors of Intimate Partner Violence. J Interpers Violence 2021; 36:8118-8141. [PMID: 31092090 DOI: 10.1177/0886260519848788] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Despite increasing acknowledgment of intimate partner violence (IPV) as a potentially traumatic experience, there is a gap in research investigating women's perspectives of trauma related to their experiences of IPV from an intersectional lens. Intersectionality, which illuminates interconnected inequalities due to constructions of race, gender, sexuality, class, and culture, is particularly important for exploring the broader contexts of women's experiences of IPV and trauma. In response to this dearth in research, this paper presents qualitative findings from a constructivist grounded theory study of 15 women's experiences of IPV and trauma. To conceptualize IPV-related trauma from an intersectional lens, this study addressed the following research questions: (a) How do women who have experienced IPV understand and view trauma? (b) What do women who have experienced IPV indicate are experiences of trauma? and (c) How do women's differing identities, experiences of oppression, or other hardships or adversities relate to their experiences of IPV? Through analysis, six distinct themes were identified: (a) changing perceptions of trauma; (b) the pain of trauma; (c) fear, anxiety, and triggers; (d) lasting impact of trauma; (e) struggle for acceptance; and (f) growth and insight. Implications from these findings illustrate the pervasiveness of IPV and other forms of trauma among women who have been abused by a partner, the long-lasting traumatic impacts of IPV, and the multiple experiences of being blamed and not believed that many women have experienced. These findings represent first steps in understanding the relationship between IPV and trauma from the perspectives of women who have survived IPV, offering an important contribution to previous knowledge on IPV. As well, this study provides first steps in understanding the interacting, intersectional effects of multiple forms of adversity, oppression, and IPV, and their relationships to trauma.
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Lateef R, Alaggia R, Collin-Vézina D. A scoping review on psychosocial consequences of pandemics on parents and children: Planning for today and the future. Child Youth Serv Rev 2021; 125:106002. [PMID: 35990215 PMCID: PMC9375174 DOI: 10.1016/j.childyouth.2021.106002] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 02/16/2021] [Accepted: 03/21/2021] [Indexed: 05/16/2023]
Abstract
The COVID-19 worldwide pandemic has forced individuals into an unnatural way of life. Families with children experience unique stressors, such as school closures, disrupted childcare arrangements, requirement of parents to uptake additional responsibilities such as homeschooling, possible financial strain, and lack of breathing space between family members. The adjustments required of parents and children during a pandemic presumably impacts the psychosocial wellbeing of parents and children in different ways. To better under the psychosocial consequences of pandemics on parents, children, and youth, this scoping review used Arksey and O'Malley (2005) five-stage framework to examine the existing research literature on Severe Acute Respiratory Syndrome (SARS), Influenza Type A virus (H1N1), and COVID-19 to answer the following two research questions: (1) What are the psychosocial consequences of pandemics on parents of children and youth? (2) What are the psychosocial consequences of pandemics on children and youth? With the application of inclusion criteria, 29 articles were selected for analysis. Four major themes, including sub-themes emerged: 1) Each family members' emotions influence one another; 2) Parents experience greater levels of psychosocial problems than adults without children; 3) During a pandemic, parents require informal (social) and formal (specialized professional) support and; 4) Psychosocial consequences of pandemics on children/youth are understudied, indicating the need for more research on children/youth under the age of 20 years. Clinical prevention and intervention suggestions to support the psychosocial wellbeing of parents, children and youth during a pandemic are discussed.
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Affiliation(s)
- Rusan Lateef
- McGill University, 3506 University Street, Montreal, Quebec H3A 2A7, Canada
| | - Ramona Alaggia
- University of Toronto, 246 Bloor Street West, Toronto, Ontario M5S 1V4, Canada
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McCallum LA, Alaggia R. Achieving Recovery Through Resilience: Insights From Adults in Midlife Living With Anorexia Nervosa. Qual Health Res 2021; 31:619-630. [PMID: 33349161 DOI: 10.1177/1049732320978202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Despite the high percentage of adults living with anorexia nervosa (AN) over the life course, there is limited understanding of what it means to be living with AN in midlife when the majority of research has focused on adolescents and young adults. As such, clinical practice for individuals in midlife is informed by a severe and enduring AN (SE-AN) framework, which assumes that recovery is not necessarily feasible past young adulthood. This study used constructivist grounded theory methodology to understand the experiences of adults in midlife living with AN. In-depth analyses of 19 participant narratives in midlife show that individuals face barriers to seeking help or remaining in recovery; however, midlife can also act as a significant catalyst toward recovery. Subsequently, there is merit in revisiting the utility of the SE-AN framework in the context of life course theory and exploring resilience-informed approaches in supporting recovery from AN.
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Affiliation(s)
- Leslie A McCallum
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Ramona Alaggia
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
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Tarshis S, Alaggia R, Logie CH. Intersectional and Trauma-Informed Approaches to Employment Services: Insights From Intimate Partner Violence (IPV) Service Providers. Violence Against Women 2021; 28:617-640. [PMID: 33591243 DOI: 10.1177/1077801220988344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article presents qualitative findings from a constructivist grounded theory study that examines intimate partner violence and employment-seeking from the perspectives of 10 service providers. Three distinct themes emerge through analysis: (a) understanding the intersecting barriers to employment faced by survivors, (b) integrated approaches to employment services, and (c) barriers to providing employment services. Findings have important theoretical implications on the intersectional nature of employment-seeking and provide insight into IPV service responses.
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Affiliation(s)
| | - Ramona Alaggia
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Carmen H Logie
- Women's College Research Institute, Toronto, Ontario, Canada
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Collin-Vézina D, De La Sablonnière-Griffin M, Sivagurunathan M, Lateef R, Alaggia R, McElvaney R, Simpson M. "How many times did I not want to live a life because of him": the complex connections between child sexual abuse, disclosure, and self-injurious thoughts and behaviors. Borderline Personal Disord Emot Dysregul 2021; 8:1. [PMID: 33397506 PMCID: PMC7783974 DOI: 10.1186/s40479-020-00142-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 12/01/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Meta-analyses have confirmed an association between child sexual abuse (CSA) and non-suicidal and suicidal self-injurious thoughts and behaviors (SITB), yet the mechanisms linking these factors are, to date, poorly understood. The goal of the current study is to explore one potential influencing factor acting in the association between CSA and SITB, which is the disclosure experience. Disclosure has been identified as a prominent factor in the healing process of survivors, with a lack of support following disclosures heightening negative outcomes. Exploring the impact of CSA disclosure on SITB is necessary to build effective prevention and intervention strategies. METHODS This qualitative study is part of a larger initiative spanning diverse research sites in Canada and in Ireland and aiming to lend voice to young people who were sexually abused in childhood/adolescence. Participants were recruited from community-based sexual abuse/assault agencies, hospital-based specialized clinics and child advocacy centres. The Long Interview Method, based on a branch of phenomenology, was used to guide research design and data collection. The current thematic analysis, informed by a stress-diathesis model, is based on a sample comprised of 21 ethnically diverse youth aged 15 to 25 who self-reported a sexual abuse experience in their childhood or teenage years and who, as part of the interview on their disclosure processes, revealed past or current SITB. RESULTS The thematic analysis led to the identification of four main themes that both confirmed past research and conceptual models on SITB, and provided new insights. Participants perceived a clear link between their CSA experience and SITB and other mental health issues. They offered their views on the meanings of SITB for CSA victims: to cope with abuse; to end the abuse; to express self-hatred and loneliness; and to let people know about their suffering. They described how negative disclosure experiences led to more nonsuicidal and suicidal SITB. Yet, participants also revealed that receiving support for their SITB created opportunities for CSA disclosure and support. CONCLUSIONS This study showed complex connections between CSA experiences, disclosure and nonsuicidal and suicidal SITB. Understanding the reciprocal influences between SITB, CSA disclosure and help-seeking could better equip mental health professionals and caregivers to provide support and foster healing and recovery in CSA victims.
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Affiliation(s)
| | | | | | - Rusan Lateef
- McGill University, 3506 University St., Room 321B, Montreal, QC, H3A2A7, Canada
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Alaggia R, Wang S. "I never told anyone until the #metoo movement": What can we learn from sexual abuse and sexual assault disclosures made through social media? Child Abuse Negl 2020; 103:104312. [PMID: 32200194 DOI: 10.1016/j.chiabu.2019.104312] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 11/28/2019] [Accepted: 12/02/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Social media is providing new avenues for survivors to disclose sexual abuse and/or assault. Since the creation of #MeToo (2017), and the larger MeToo movement founded by American activist Tarana Burke in 2006, millions are disclosing sexual assaults and past childhood sexual abuse on-line. OBJECTIVE Social media for disclosing the highly stigmatized problem of sexual abuse/assault was studied to build knowledge about on-line disclosures. PARTICIPANTS AND SETTING Participants were tweeters and posters on Twitter and Reddit. Purposive sampling captured on-line sexual abuse/assault disclosures from September 28, 2018 to October 16, 2018 for thematic analysis. METHOD Using a phenomenological design 171 social media posts were analyzed for deeper understanding into new options for disclosing sexual abuse and/or sexual assault. Posts were independently coded by the authors. Sampling was stopped when categorical saturation was reached with no new information coming forward on the research question. RESULTS Themes that emerged showed the MeToo/#MeToo movement is precipitating sexual abuse/assault disclosures on social media in unprecedented ways; posters identified internal barriers, mixed responses from family, and friends/peers, as well as variable responses from professionals. While some conditions for sexual abuse/assault disclosures have improved, barriers still exist. CONCLUSION Social media represents an environmental shift for disclosing sexual violence. Sexual abuse/assault survivors have found voice through social media after periods of silence and being silenced, turning to posting on-line when people and systems have failed to validate and support them. Further investigation is needed on the impacts of on-line sexual abuse and/or assault disclosures.
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Affiliation(s)
- Ramona Alaggia
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, Ontario, M5S 1A1, Canada.
| | - Susan Wang
- VHA Rehab Solutions, University of Toronto, Canada.
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Alaggia R, Collin-Vézina D. Child sexual abuse and youth sexual assault: Environmental impacts on disclosure and response to disclosures. Child Abuse Negl 2020; 102:104284. [PMID: 32088007 DOI: 10.1016/j.chiabu.2019.104284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Ramona Alaggia
- Factor Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, M5S 1A1, Ontario, Canada.
| | - Delphine Collin-Vézina
- School of Social Work, McGill University, 3506 University Street, Room 321A, Montreal, H3A 2A7, Quebec, Canada.
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Alaggia R, Collin-Vézina D, Lateef R. Facilitators and Barriers to Child Sexual Abuse (CSA) Disclosures: A Research Update (2000-2016). Trauma Violence Abuse 2019; 20:260-283. [PMID: 29333973 PMCID: PMC6429637 DOI: 10.1177/1524838017697312] [Citation(s) in RCA: 155] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Identifying and understanding factors that promote or inhibit child sexual abuse (CSA) disclosures has the potential to facilitate earlier disclosures, assist survivors to receive services without delay, and prevent further sexual victimization. Timely access to therapeutic services can mitigate risk to the mental health of survivors of all ages. This review of the research focuses on CSA disclosures with children, youth, and adults across the life course. Using Kiteley and Stogdon's literature review framework, 33 studies since 2000 were identified and analyzed to extrapolate the most convincing findings to be considered for practice and future research. The centering question asked: What is the state of CSA disclosure research and what can be learned to apply to practice and future research? Using Braun and Clarke's guidelines for thematic analysis, five themes emerged: (1) Disclosure is an iterative, interactive process rather than a discrete event best done within a relational context; (2) contemporary disclosure models reflect a social-ecological, person-in-environment orientation for understanding the complex interplay of individual, familial, contextual, and cultural factors involved in CSA disclosure; (3) age and gender significantly influence disclosure; (4) there is a lack of a life-course perspective; and (5) barriers to disclosure continue to outweigh facilitators. Although solid strides have been made in understanding CSA disclosures, the current state of knowledge does not fully capture a cohesive picture of disclosure processes and pathways over the life course. More research is needed on environmental, contextual, and cultural factors. Barriers continue to be identified more frequently than facilitators, although dialogical forums are emerging as important facilitators of CSA disclosure. Implications for practice in facilitating CSA disclosures are discussed with recommendations for future research.
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Affiliation(s)
- Ramona Alaggia
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- Ramona Alaggia, Factor-Inwentash Chair in Children’s Mental Health, Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St. West, Toronto, Ontario, Canada M4K1W1.
| | - Delphine Collin-Vézina
- Centre for Research on Children and Families, School of Social Work, McGill University, Montreal, Qubec, Canada
| | - Rusan Lateef
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
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Truong C, Burnes D, Alaggia R, Elman A, Rosen T. Disclosure among victims of elder abuse in healthcare settings: a missing piece in the overall effort toward detection. J Elder Abuse Negl 2019; 31:181-190. [PMID: 30880608 DOI: 10.1080/08946566.2019.1588182] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Elder abuse remains a largely hidden problem in our society and only a small minority of victims are connected to formal support/protective services. Healthcare settings have been identified as a critical milieu to uncover cases of elder abuse; however, under-detection in these settings is a major issue. Victimization disclosure is an important component within the overall detection effort, yet it has received little attention in the elder abuse literature. Drawing on relevant literature from other domains of family/interpersonal violence, this article highlights the disclosure process, as well as disclosure barriers, facilitators, and competencies to consider when working with older adults.
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Affiliation(s)
- Carol Truong
- a Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Canada
| | - David Burnes
- a Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Canada
| | - Ramona Alaggia
- a Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Canada
| | - Alyssa Elman
- b Department of Emergency Medicine , Weill Cornell Medicine College/New York-Presbyterian , New York , NY , USA
| | - Tony Rosen
- b Department of Emergency Medicine , Weill Cornell Medicine College/New York-Presbyterian , New York , NY , USA
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Abstract
Most theories of child sexual abuse are, to some degree, gendered, with nonoffending mothers bearing the burden of blame, ideologically and legally, for the transgressions of predominantly male offenders. This article explores the social construction of blame for child sexual abuse via critical analyses of evolving theoretical perspectives on maternal culpability for the inception and maintenance of abuse dynamics. Drawing on selected conceptual and research knowledge that supports and refutes anecdotal claims, this synthesis of the literature culminates in the proposal of an evidence-informed, feminist-grounded, multitheoretical child sexual abuse framework that disrupts dominant mother-blaming discourse and guides socially just and ethically responsive policy, practice, and research.
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Affiliation(s)
- Corry Azzopardi
- a Division of Pediatric Medicine , The Hospital for Sick Children , Toronto , Canada
- b Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Canada
| | - Ramona Alaggia
- b Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Canada
| | - Barbara Fallon
- b Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Canada
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15
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Logie CH, Alaggia R, Rwigema MJ. A social ecological approach to understanding correlates of lifetime sexual assault among sexual minority women in Toronto, Canada: results from a cross-sectional internet-based survey. Health Educ Res 2014; 29:671-82. [PMID: 24412812 PMCID: PMC4101185 DOI: 10.1093/her/cyt119] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 12/02/2013] [Indexed: 05/29/2023]
Abstract
Stigma, discrimination and violence contribute to health disparities among sexual minorities. Lesbian, bisexual and queer (LBQ) women experience sexual violence at similar or higher rates than heterosexual women. Most research with LBQ women, however, has focused on measuring prevalence of sexual violence rather than its association with health outcomes, individual, social and structural factors. We conducted a cross-sectional online survey with LBQ women in Toronto, Canada. Multivariate logistic regression analyses were conducted to assess correlates of lifetime sexual assault (LSA). Almost half (42%) of participants (n = 415) reported experiences of LSA. Participants identifying as queer were more likely to have experienced LSA than those identifying as lesbian. When controlling for socio-demographic characteristics, experiencing LSA was associated with higher rates of depression, sexually transmitted infections (STIs), receiving an STI test, belief that healthcare providers were not comfortable with their LBQ sexual orientation, and sexual stigma (overall, perceived and enacted). A history of sexual violence was associated with lower: self-rated health, overall social support, family social support and self-esteem. This research highlights the salience of a social ecological framework to inform interventions for health promotion among LBQ women and to challenge sexual stigma and sexual violence.
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Affiliation(s)
- C H Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, Canada M5S 1V4 and Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, ON, CanadaFactor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, Canada M5S 1V4 and Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, ON, Canada
| | - R Alaggia
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, Canada M5S 1V4 and Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, ON, Canada
| | - M J Rwigema
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, Canada M5S 1V4 and Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, ON, Canada
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Abstract
Cyberspace has added a new dimension to the ecology of children made the subjects of sexual abuse images distributed online. These images cannot be permanently removed and can continue to circulate in cyberspace forever. A review of the current literature suggests that helping professionals are not consistently aware of or do not probe possibilities of online sexual victimization in the investigation, assessment, and treatment of child sexual abuse. Nor is this issue adequately addressed in their education and training. There are gaps in the literature regarding how to identify and provide treatment for these children. New assessment and treatment targets are needed to enhance existing practice approaches. A contemporary ecological model that incorporates an explicit consideration of the cybersystem is provided as a starting point for practitioners to be aware of the possibility that images of child sexual abuse were recorded and distributed online.
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Affiliation(s)
- Jennifer Martin
- School of Child and Youth Care, Ryerson University, Toronto, Ontario, Canada.
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Alaggia R. An ecological analysis of child sexual abuse disclosure: considerations for child and adolescent mental health. J Can Acad Child Adolesc Psychiatry 2010; 19:32-39. [PMID: 20119565 PMCID: PMC2809444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/23/2009] [Accepted: 12/15/2009] [Indexed: 05/28/2023]
Abstract
OBJECTIVES Research continues to indicate a concerning number of children and youth, between 60-80%, withhold disclosure until adulthood suggesting that many children endure prolonged victimization or never receive necessary intervention. The study aim was to qualitatively identify factors that impede or promote child sexual abuse (CSA) disclosure. METHODS Using a phenomenological design, forty adult survivors of CSA were interviewed about their disclosure experiences to provide retrospective accounts of their childhood and adolescent abuse experiences, disclosure attempts, and meaning-making of these experiences. RESULTS Findings show that disclosure is multiply determined by a complex interplay of factors related to child characteristics, family environment, community influences, and cultural and societal attitudes. An ecological analysis is offered to understand these complexities. Unless barriers to disclosure are eradicated, negative effects of CSA can persist manifesting in serious mental health issues. CONCLUSIONS Practitioners can expect to work with children, adolescents and adults who have withheld disclosure or attempted to tell over time having experienced a wide range of responses. Multi-level intervention is recommended at the individual, community and macro-levels. Future investigations should focus on how to identify and measure the impact of community and macro level factors on disclosure, aspects that have received much less attention.
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Affiliation(s)
- Ramona Alaggia
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario.
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Abstract
Immigrant women face numerous, and sometimes insurmountable, barriers in reporting and seeking services for intimate partner violence (IPV). A number of these obstacles relate to immigration laws, policies and legal processes they encounter due to their immigration status and sponsorship relationship. The present study was conducted in Canada, in an urban centre that boasts one of the largest immigrant populations in the world. Using a focus group methodology within a participatory action research framework, this investigation sought to identify factors that facilitate or impede women from coming forward and disclosing IPV, and traced their help-seeking actions. Qualitative data from helping professionals and women reveal that in cases of sponsorship breakdown due to IPV, the criteria required for a viable immigration application are unrealistic, and in many cases impossible to meet in situations of domestic abuse. These data indicate that despite claims to the contrary, laws and policies related to immigration have remained stable for over a decade. Systemic and structural barriers that these create for abused women are still clearly present in immigration laws and policies. The result is that many women stay in abusive relationships, often with their children, for prolonged periods of time accruing serious negative mental health effects. Implications are discussed to help inform policy and practice.
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Affiliation(s)
- Ramona Alaggia
- University of Toronto, Toronto, Ontario, Canada M5S 1A1.
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Alaggia R, Jenney A, Mazzuca J, Redmond M. In Whose Best Interest? A Canadian Case Study of the Impact of Child Welfare Policies in Cases of Domestic Violence. ACTA ACUST UNITED AC 2007. [DOI: 10.1093/brief-treatment/mhm018] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Abstract
Although the co-occurrence of woman abuse and child sexual abuse is high little research exists exploring the impact of woman abuse on maternal response to child sexual abuse (CSA). Findings from two qualitative studies indicate the form of woman abuse to have differential impact on maternal response. Mothers who were abused in non-physical ways, psychological, or emotional, displayed more ambivalent, less supportive responses. Mothers who were physically abused by their partners more often acted supportively to their children and displayed less ambivalence about separating from the perpetrator. Some survivors reported non-disclosure as children because of their fear of the perpetrator due to the woman abuse they were exposed to while being sexually abused. Practice and research implications are discussed.
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Affiliation(s)
- Ramona Alaggia
- Faculty of Social Work, University of Toronto, Toronto, ON, Canada.
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Alaggia R. Many ways of telling: expanding conceptualizations of child sexual abuse disclosure. Child Abuse Negl 2004; 28:1213-27. [PMID: 15567025 DOI: 10.1016/j.chiabu.2004.03.016] [Citation(s) in RCA: 92] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2002] [Revised: 02/20/2004] [Accepted: 03/02/2004] [Indexed: 05/08/2023]
Abstract
OBJECTIVE The aim of this study was to explore influences that inhibit or promote child sexual abuse (CSA) disclosure. METHOD Face-to-face in-depth interviews of 24 female and male survivors of CSA were conducted, using the Long-Interview method to trace disclosure processes. Verbatim transcriptions of the interviews were analyzed by hand and by using a computerized data analysis system (N*Vivo). The results of this investigation identified several patterns of disclosure. Prolonged engagement, persistent observation, negative case analysis, and peer debriefing were among the techniques used to ensure the trustworthiness of data. RESULTS Through analysis of the interview data, previously undefined dimensions of disclosure emerged. First, three frequently used categories of 'accidental, purposeful, and prompted/elicited' disclosure types accounted for 42% of disclosure patterns in the study sample. However, over half the disclosure patterns described by research participants did not fit these previously established definitions. Results of the study facilitated expanding conceptualization of additional disclosure patterns to include behavioral and indirect verbal attempts, disclosures intentionally withheld, and disclosures triggered by recovered memories. CONCLUSIONS The author concludes that these supplementary definitions integrate complex facets of disclosure derived within the context of human development, memory and environmental influences. This expanded conceptualization provides professionals with a broader framework to understand and respond to child victims and adult survivor's disclosures more effectively.
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Affiliation(s)
- Ramona Alaggia
- University of Toronto, 246 Bloor Street West, Toronto, Ont., Canada M5S 1A1
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Maiter S, Alaggia R, Trocmé N. Perceptions of child maltreatment by parents from the Indian subcontinent: challenging myths about culturally based abusive parenting practices. Child Maltreat 2004; 9:309-324. [PMID: 15245683 DOI: 10.1177/1077559504266800] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Clinicians and researchers emphasize the importance of recognizing differential cross-cultural definitions of child maltreatment, cautioning awareness that some ethnic groups may use harsher methods to discipline their children. Using a mixed-method research approach, based on questionnaire and focus group data, 29 parents of South Asian descent provided input on their attitudes toward child discipline, maltreatment, and neglect. Study findings suggest that South Asian parents do not differ significantly from other populations in their judgment of appropriate parenting approaches; that is, persistent and excessive use of physical discipline was considered to be inappropriate, behaviors of parents that may have negative emotional consequences for children were recognized as inappropriate, and lack of proper supervision of children was seen as a concern. Notably, though, participants voiced their reluctance to contact child protective services should they encounter families struggling with abuse. Implications for practice and directions for future research are suggested.
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Affiliation(s)
- Sarah Maiter
- Faculty of Social Work, Wilfrid Laurier University
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Alaggia R. Cultural and religious influences in maternal response to intrafamilial child sexual abuse:charting new territory for research and treatment. J Child Sex Abus 2001; 10:41-60. [PMID: 15149935 DOI: 10.1300/j070v10n02_03] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The role of culture when providing services for families in the wake of child sexual abuse disclosure is a charged issue although surprisingly little attention has been given in the research literature to this. This article reports the findings of a grounded theory study exploring facets of maternal response, and aspects of more and less supportive responses, to children who were sexually abused by the mother's intimate partner. Ten mothers, chosen on the basis of theoretical sampling, provided information through in-depth interviews to understand how they responded emotionally and behaviourally to their child's disclosure. As well, three service providers were interviewed as key informants. The research revealed cultural and religious influences as affecting how mothers made meaning of the sexual abuse and the actions they took. Mothers from cultural backgrounds that adhere to rigid patriarchal norms identified themes of intense value conflicts regarding family preservation, loyalty binds between the perpetrating partner and child victim, and anxieties around being alienated from their extended family and ethnic community. They also reported that their cultural belief systems were not well understood by service providers. In parallel, helping professionals identified cultural issues as presenting barriers for engaging with some clients. Practice implications and research directions are discussed.
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Affiliation(s)
- R Alaggia
- Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, M5S 1A1, Canada
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Alaggia R, Michalski JH, Vine C. The Use of Peer Support for Parents and Youth Living with the Trauma of Child Sexual Abuse: An Innovative Approach. J Child Sex Abus 1999; 8:57-75. [PMID: 28257269 DOI: 10.1300/j070v08n02_04] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This article describes and reports on an innovative intervention program for parents of sexually abused children and youth. Peer support provided by non-professional staff and volunteers, who have been personally affected by the trauma of child sexual abuse, is an approach with unique advantages. Many of these consumers have not been able to benefit from traditional service delivery approaches. Goals and objectives of the Peer Support Program (PSP) have been developed through inter-agency collaboration initiatives comprised of a coalition of existing social service agencies. This report examines characteristics of service delivery and level of consumer satisfaction of parents and youth who have participated in the peer support program. Implications for interventions with sexually abused youth and parents of sexually abused children are discussed.
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Affiliation(s)
| | | | - Cathy Vine
- c Central Agencies Sexual Abuse Treatment Progarm (CASAT)
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