Abuse and parental characteristics, attributions of blame, and psychological adjustment in adult survivors of child sexual abuse

Psychological symptoms of adolescent survivors of sexual abuse and characteristics of survivors displaying suicidal and/or self-harming behaviors

We examine the psychological symptoms and suicide attempts and/or self-injury behaviors of survivors of childhood sexual abuse (CSA) according to individual and familial characteristics. The participants of this study included 80 adolescents aged 14-17 years. We show that high psychological symptom scores may indicate that the perpetrator was a family member and that penetration occurred. In addition, most of the participating survivors have experienced numerous problems, largely related to psychological symptoms. Considering the results regarding survivors who had previously attempted suicide, we demonstrate that the perpetrators in these cases were mostly reliable/loved people, while these survivors generally hid the events and were exposed to penetration more often. We conclude that survivors exposed to CSA by a reliable/loved person, blaming themselves, having low social support, and displaying certain symptoms should be followed closely and necessary psychosocial interventions for suicide should be applied.

Mimicry Deception Theory applied to sexual abuse of children

Sexual abuse of children remains a widespread problem with well-documented, adverse consequences. Often, abuse ending is contingent on a disclosure made by the victim, but victims delay disclosure if they tell someone at all. The factors associated with (non)disclosure are complex and interrelated. In this paper, we propose a new theoretical framework (Mimicry Deception Theory; MDT) to explore various aspects of the grooming process, using a qualitative content analysis of US court appeal cases (N = 25). Specifically, we focus on how MDT components contribute to the likelihood of a CSA disclosure. MDT is made up of five components: Victim Selection, Community Integration, Complexity of Deception, Resource Extraction, and Detectability. These five components allow us to look at several characteristics of abuse in tandem and examine how they interact to impact various outcomes, such as (non)disclosure. We provide a detailed codebook for this framework, that can be used to systematically extract relevant information from large amounts of data. Through the application of this framework, we were able to identify several factors that may play a role in delayed or non-disclosure. Further, we found repeat offenders were likely to use the exact same methods of access, grooming, and remaining undetected across victims. Implications for prevention, as well as clinical interventions with perpetrators as well as victims are discussed.

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.

Experiences of Women Survivors of Childhood Sexual Abuse in Relation to Nonsupportive Significant Adults: A Scoping Review

Childhood sexual abuse (CSA) is a complex trauma with devastating long-term, negative effects on survivors. This study extended the understanding of experiences of women survivors of CSA in relation to nonsupportive significant adults documented in literature, as to date, there exists no summary in literature on this particular topic. As such, a scoping review was conducted on publications between 1980 and January 2020. A total of 26 733 were selected for analysis in accordance with the search terms. After duplicates were removed and the exclusion criteria were applied, a total of 58 articles were selected for inclusion in the review. Thematic analysis was conducted on the studies included, and three themes were developed pertaining to the experiences of women survivors of CSA in relation to nonsupportive significant adults. Theme 1 identified nonsupportive behaviors experienced before disclosure or discovery of abuse. Theme 2 identified nonsupportive behaviors experienced during or after disclosure or discovery of abuse. Theme 3 identified the long-term negative consequences of nonsupportive experiences. These three themes support the findings of Freyd's betrayal trauma theory and Bowlby's attachment theory, extend on the global knowledge base of this topic, and identify gaps for further exploration.

Examining Parental Expectations and Fault Attributions for Child Sexual Abuse

Previous research has demonstrated that nonoffending mothers are held at fault when their child is sexually abused and this fault is directly linked to a decrease in help-seeking behavior. It is unclear, however, whether similar fault is applied to nonoffending fathers, as little such research on fathers exists. What does exist is marked by methodological limitations. Using an experimental vignette design, 154 participants were randomly assigned to read one of two hypothetical abuse scenarios (i.e., nonoffending mother or nonoffending father) depicting the sexual abuse of a female child by an adult male perpetrator. Participants rated levels of fault attributions assigned to either parent and then provided open-ended responses outlining their reasons for their attribution ratings. Quantitatively, both mothers and fathers were assigned similar amounts of fault for the sexual abuse. Thematic analysis of participants' justifications for their assigned fault attributions revealed both mothers and fathers are subject to similar expectations that either increase or decrease assigned fault, with the exception of one theme, Disbursement, in which participants distributed fault away from fathers toward others (e.g., the nonoffending mother). By understanding parent blaming and the reasons behind parent blaming attributions, future research can work to improve these attitudes.

Grooming Hurts Too: The Effects of Types of Perpetrator Grooming on Trauma Symptoms in Adult Survivors of Child Sexual Abuse

There are a multitude of behaviors that child sexual abusers use to 'groom' children into becoming vulnerable to abuse. In this study of 277 adult survivors of child sexual abuse, participants advised the many ways they were groomed into being abused by up to three perpetrators. The effects of three categories of grooming (Verbal Coercion, Grooming that used Drugs/Alcohol, and Threatening/Violent Grooming) were examined for their effects on trauma symptom severity. Using Linear Regressions, each grooming category had a significant predictive effect on trauma symptom severity. Multiple Linear Regressions revealed that for most trauma symptoms, Threatening/Violent Grooming was a significant predictor of trauma symptom severity, even when other more well-known variables were controlled for (including age at onset of abuse, relationship to perpetrator, and severity of abuse), with a notable exception of verbal coercion as a significant predictor of sexual problems in adulthood (i.e. not satisfied, low drive, overactivity, confusion, bad thoughts or feelings).

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.

"I Still Feel Like I Am Not Normal": A Review of the Role of Stigma and Stigmatization Among Female Survivors of Child Sexual Abuse, Sexual Assault, and Intimate Partner Violence

Child sexual abuse (CSA), sexual assault (SA), and intimate partner violence (IPV) occur within social contexts that shape how survivors judge themselves and are evaluated by others. Because these are gendered sexual and intimate crimes that violate social norms about what is appropriate and acceptable, survivors may experience stigma that includes victim-blaming messages from the broader society as well as specific stigmatizing reactions from others in response to disclosure; this stigmatization can be internalized among survivors as self-blame, shame, and anticipatory stigma. Stigma and stigmatization play an important role in shaping survivors' thoughts, feelings, and behaviors as they recover; their risk of revictimization; and their help-seeking and attainment process. In this review, we synthesize recent CSA, SA, and IPV research ( N = 123) that examines female survivors' self-blame, shame, internalized stigma, and anticipatory stigma as well as negative social reactions in response to survivors' disclosure. We highlight critical findings as well as implications for research, practice, and policy, and we note gaps in our current knowledge.

Blame, PTSD and DSM-5: an urgent need for clarification

DSM-5 substantially revised the PTSD criteria relating to exposure, redrawing symptom clusters and introducing additional symptom criteria, among them a newly defined criterion of persistent distorted blame of self or others. This commentary argues that there are fundamental problems with the current DSM-5 formulation of the blame criterion for PTSD. Most critically, there is conflation of self-blame and other-blame, which are two distinct phenomena, and there is heterogeneity in the research findings regarding the association between both kinds of blame and PTSD. Secondly, distortion of blame may be complex to determine. Finally, standard assessment tools fail to accurately represent the criteria as currently formulated. Despite the conceptual ambiguity in the diagnostic criteria and the lack of clarity regarding the assessment of this item in commonly-used measures, there is also evidence that blame is associated with other PTSD symptoms, is clinically relevant and may be an important intervention target in therapy. It is crucial, therefore, to clarify the blame criterion, differentiating aspects of self-blame and other-blame and, even more importantly, delineating the boundaries between normal and pathological blame.

The Secret of Intrafamilial Child Sexual Abuse: Who Keeps It and How?

This article analyzes how women survivors of intrafamilial child sexual abuse perceive the family members who took part in keeping it secret and their tactics for doing so. Analysis of 20 in-depth interviews with Jewish Israeli women revealed unique ways of guarding the secret. These were attributed to the perpetrator, the mother and the family. Secret-keeping tactics included presenting a normative public identity or an unstable psychological identity, presenting multiple personas, reframing the abuse, concealing any trace of the secret after it was disclosed, as if the abuse had never happened, and making a monument of the abuser. These tactics are discussed in the context of silencing, the interpersonal relations orientation model, and the wider concepts of secrecy in society. Implications for professional practice and for society are considered, and new attitudes toward intrafamilial child sexual abuse secrecy are suggested.

"I Am Not A Victim. I Am A Survivor": Resilience as a Journey for Female Survivors of Child Sexual Abuse

This study was designed to expand our understanding of the positive aspects of coping and resilience in female survivors of child sexual abuse. Research questions focused on women's lived experiences of being survivors of child sexual abuse and how they have experienced resilience, developed healthy intimate relationships, and viewed themselves as sexual beings. Using a qualitative research lens of phenomenology, we captured the essence of survivors' experiences of resilience. Although each woman's experience was unique, similar patterns of processes and outcomes emerged as meaningful in their development of resilient and healthy sexuality and relationship functioning. However, participants emphasized resilience as a process or journey-recovery from trauma, reconceptualization of self, and development of healthy sexuality included deliberate efforts occurring over time. Implications for future research and practice using a positive lens of resilience are provided.

Contributions of Child Sexual Abuse, Self-Blame, Posttraumatic Stress Symptoms, and Alcohol Use to Women's Risk for Forcible and Substance-Facilitated Sexual Assault

Child sexual abuse and adult sexual assault have been linked to increased self-blame, posttraumatic stress symptoms, and alcohol use. The current study aims to examine (a) whether these constructs explain women's risk for later adult sexual assault and revictimization, (b) whether such factors differentially confer risk for specific types of adult sexual assault (i.e., substance-facilitated and forcible), and (c) if self-blame confers risk indirectly through other risk factors. Multiple types of self-blame, posttraumatic stress, and alcohol use were examined among 929 female college students as serial mediators of the relationship between child sexual abuse and adult sexual assault and as risk factors for sexual revictimization among child sexual abuse survivors. In the model predicting risk for substance-facilitated adult sexual assault, child sexual abuse indirectly predicted greater risk for substance-facilitated adult sexual assault mediated through two separate paths: global blame-to-posttraumatic-stress and global blame-to-alcohol use. In the model predicting risk for forcible adult sexual assault, child sexual abuse directly predicted greater risk for forcible adult sexual assault, and this relation was mediated by the global blame-to-posttraumatic-stress path. Among child sexual abuse survivors, child sexual abuse specific characterological and behavioral self-blame directly predicted greater risk for forcible and substance-facilitated revictimization, but the pathways were not mediated by posttraumatic stress or alcohol use. Results emphasize the importance of assessing different types of self-blame in predicting posttraumatic stress symptoms as well as examining risk for sexual victimization and revictimization. Findings did not support hypotheses that increased posttraumatic stress would predict increased alcohol use but did indicate that heightened self-blame is consistently associated with heightened posttraumatic stress and that heightened global self-blame predicts increased alcohol use. Implications for future research and intervention are discussed.