Beyond fight, flight, and freeze: Towards a new conceptualization of peritraumatic responses to child sexual abuse based on retrospective accounts of adult survivors

"One Day It Will Be Over, and You Will See Other Landscapes. . . You Are Not Alone": Adult Survivors' Messages to Children Undergoing Child Sexual Abuse

Child sexual abuse (CSA) has received considerable attention from scholars, contributing to policy, intervention, and prevention efforts worldwide. However, survivors' involvement in this research is limited. This study was designed to delve into the messages of adult CSA survivors to abused children. In all, 371 written testimonies were provided to the Israeli Independent Public Inquiry on CSA by survivors from diverse communities in Israel. The Inquiry aimed to promote change in policies related to CSA. The testimonies were analyzed using the qualitative thematic analysis method. The results revealed five main messages emphasized by survivors to children experiencing CSA: (a) transferring the responsibility and guilt from children to perpetrators and society; (b) turning toward the light and continuing on; (c) disclosure is essential; (d) a happy life is possible; and (e) together we can survive. The discussion emphasizes how various systems in survivors' lives have profound impacts following the abuse. Although survivors were from diverse backgrounds, their messages to abused children were consistent. Through their messages to the children, the survivors emphasized their wish to transfer responsibility and guilt from children experiencing abuse to the society that is supposed to see, listen, protect, and validate. Implications for practice are discussed, focusing on the importance of making room for survivors' voices and experiences in the processes of shaping policies in the area of CSA. Moreover, the survivors' desire to be there for the children emphasized the urgent need to promote the perception of survivors as key stakeholders in the field of child abuse and to integrate their experiences and perceptions into the formal and informal systems for children.

Why neuroscience changes some things but not everything for the law

Neuroenthusiasts and neuroskeptics both exaggerate the strength of their positions. Neuroscience is already having a significant impact in the courts in many jurisdictions and as knowledge from the cognitive sciences expands, that knowledge, wherever relevant, should continue to inform legal systems. However, neuroscience will only ever be one influence among many. In certain areas, for example, our understanding of fear responses or the reliability of memory evidence, the cognitive sciences may help challenge errors of folk psychology and assist the law to adopt better approaches. In other areas such as juvenile responsibility, developmental neuroscience may prove decisive in reinforcing messages from educational psychology and the behavioral sciences both in persuading legislators and judges but also importantly in altering public attitudes. Drawing on examples from a range of countries including Argentina, Australia, Canada, England, the Netherlands, Scotland, Slovenia, and the United States, we argue that legal systems must be open to and learn from science and must not be afraid to engage with science even where there is no clear scientific consensus.

"Not understanding but feeling guilty at the same time": The peritraumatic responses of CSA survivors from the Muslim Arab community in Israel

BACKGROUND

Studies on child sexual abuse (CSA) have greatly contributed to theoretical and empirical developments, advancing policy and practice. However, studies on CSA in closed societies are still scarce.

OBJECTIVE

The current study focuses on CSA in the Muslim Arab community in Israel while delving into the peritraumatic responses of survivors to CSA.

PARTICIPANTS AND SETTING

Twenty-eight Muslim Arab survivors of CSA provided written testimonies for an independent inquiry.

METHODS

The exploration of the Muslim Arab survivors' peritraumatic responses to CSA, according to their testimonies, was guided by an inductive thematic analysis and Braun and Clarke's (2006) six steps of analysis.

RESULTS

The results indicated that, as most of the abusive incidents were committed by an extended family member, the survivors experienced an inability to understand what had happened to them while simultaneously feeling guilt and self-blame. Furthermore, the survivors discussed feeling trapped by all of the systems and social expectations in their lives, leaving them feeling extremely lonely and with the understanding that seeking help and disclosing the abuse was not relevant for them.

CONCLUSION

The discussion addresses the developments in the research on peritraumatic responses that require further examination. This includes top-down processes that might explain survivors' peritraumatic responses, which are not merely instinctual. In addition, when perpetrators are family members, survivors are expected to stay in contact with them, which demands enormous resources and survival strategies from the survivors.

"The most shocking thing was that I didn't respond to the abuse": The peritraumatic responses and transitions as conveyed by survivors of continuous child sexual abuse

BACKGROUND

Child sexual abuse (CSA) is a worldwide phenomenon with ongoing and far-reaching consequences for millions of children worldwide. It is a consensus among researchers that continuous CSA represents a unique challenge.

OBJECTIVE

The current study aimed to explore the peritraumatic responses of survivors of continuous CSA as described in their written narratives of abuse. The transitions between the peritraumatic responses will also be examined, highlighting the unique context of continuous CSA.

PARTICIPANTS AND SETTING

Written narratives of CSA were recruited via an advertisement in the media inviting CSA survivors to share their stories of abuse on an anonymous online platform. The data collection was carried out under the Israeli Independent Public Inquiry on CSA.

METHODS

A qualitative thematic analysis was applied to 32 richly written accounts of abuse.

RESULTS

Three peritraumatic responses were identified: the adaptive response, hinting, and attempts to fight and flight. Transitions between these responses were described by the survivors and addressed the heavy load of the abuse, realization of the abuse, fear of consequences and the central role of the survivor's environment.

CONCLUSIONS

The current study provides a unique platform for the exploration of peritraumatic responses in continuous CSA. Alongside the identification of three peritraumatic responses described by the survivors, the current study provides an initial glance into transitions between peritraumatic responses. This insight strengthens the developing notion that peritraumatic responses in the unique context of CSA are a top-down process, often shaped by various contexts and multidimensional dynamics in the children's lives.

"Explode into small pieces": Suicidal ideation among child sexual abuse survivors

BACKGROUND

Child sexual abuse (CSA) has been acknowledged as predisposing survivors to an increased risk of suicidal ideation and attempts. Despite this risk being widely recognized, the study of suicidality has mainly focused on psychopathology, while less attention has been given to survivors' experiences and perceptions.

OBJECTIVE

This study aims to uncover the experiences and perceptions of suicidality among adult CSA survivors.

PARTICIPANTS AND SETTINGS

The sample consisted of 41 adult CSA survivors' written narratives of abuse that included references to suicide.

METHODS

Written narratives of CSA experiences were collected from 41 adult participants as part of the Israeli Independent Public Inquiry on CSA to change public policy. An inductive thematic analysis guided the exploration of the stories.

RESULTS

The findings portrayed several main themes regarding the survivors' experiences before, during and after suicidal thoughts and behaviors. These themes elucidated their motivations leading to suicidal attempts, including the wish to end one's self and suffering, self-blame, communicate the abuse and the request for recognition. Additionally, the survivors' stories illuminated their experiences following the suicidal attempts, depicting inadequate treatment and difficulties with the psychiatric labeling of a mental health disorder.

CONCLUSIONS

The findings of this study uncover new insights regarding the link between trauma, posttraumatic suffering, and suicidality within a social interaction context. Furthermore, these findings call medical and psychosocial health practitioners to view post-CSA suffering as trauma-related rather than personal psychopathology and to adjust practices to adapt to survivors' experiences and needs.

The role of stigmatization in developing post-traumatic symptoms after experiencing child sexual abuse by a female perpetrator

BACKGROUND

The context in which individuals are exposed to child sexual abuse (CSA) and reactions to the disclosure of such abuse experiences play a major role in post-traumatic mental health. Female-perpetrated CSA is an under-recognized issue in society and mental health care, and is therefore supposed to be a breeding ground for stigmatization.

OBJECTIVE

The aim of the current study was to examine the mediating role of internalized and anticipated stigma on the effects of so-called victim-blaming experiences and the perception of abuse in the childhood of survivors of female-perpetrated CSA on their post-traumatic symptom severity.

METHOD

A total of 212 individuals who reported experiences of female-perpetrated CSA were assessed in an anonymous online survey. The International Trauma Questionnaire (ITQ) served as the primary outcome parameter for detecting differences in post-traumatic symptom severity within mediation analyses, where victim-blaming and abuse awareness served as predictors and anticipated as well as internalized stigma served as mediator variables.

RESULTS

Internalized stigma fully mediated the deteriorating effect of victim-blaming on post-traumatic symptom severity, while abuse awareness and anticipated stigma showed no statistically significant effects as predictor and mediator variables. Yet, victim-blaming had a significant increasing effect on anticipated stigma.

CONCLUSIONS

Efforts to enhance awareness of female-perpetrated CSA in society are needed and mental health care professionals should pay attention to the adverse effects of victim-blaming and internalized stigma on post-traumatic symptoms in individuals affected by female-perpetrated CSA.