What Do We Know About Gender in the Disclosure of Child Sexual Abuse?

The well-being of young adults: The implications of multi-type child maltreatment and the mediating role of betrayal trauma

BACKGROUND

Research indicates that the nature of the relationship between a victim-survivor and perpetrator of child maltreatment can influence well-being experienced during young adulthood. However, further research is required to substantiate the possible mediating role of betrayal trauma following child maltreatment.

OBJECTIVE

To explore the relationship between child maltreatment and psychological well-being experienced during young adulthood by examining the extent of maltreatment, the importance of the type of perpetrator, and the potential mediating role of betrayal trauma following child maltreatment.

PARTICIPANTS AND SETTING

The self-selected sample comprised 468 young adults (aged 18-25 years; M = 21.74 years, SD = 2.47) from Australia and internationally.

METHOD

Information regarding participants' current well-being, the extent of enduring five types of maltreatment (witnessing family violence, neglect, physical abuse, psychological abuse, and sexual abuse) by their mother, father and other adults during childhood, multi-type maltreatment, and severity of betrayal trauma were obtained via an online survey.

RESULTS

Using multiple regression analysis, it was found that higher levels of multi-type maltreatment were associated with poorer current well-being. Maltreatment by one's mother or father predicted poorer well-being, maltreatment by another adult did not. Hierarchical regressions revealed young adults' sense of betrayal trauma in close relationships partially mediated the relationship between current well-being and child maltreatment by one's mother, father, and another adult.

CONCLUSION

Findings show that the extent of child maltreatment experienced, one's sense of betrayal, and the relationship of the child/adolescent to the perpetrator can influence well-being experienced during young adulthood. These findings highlight the therapeutic benefit of clinicians supporting young adults who have endured child maltreatment to process betrayal trauma, to improve their well-being.

The safeguarding capability of adults in Catholic Church ministries: A global perspective

BACKGROUND

In the wake of historical sexual abuse across the Catholic Church globally, the Church continues to develop policies and processes to prevent and respond to child sexual abuse, including supporting the skills, knowledge, and confidence of members of the Church.

OBJECTIVE

We investigated the safeguarding capabilities of a range of people with different roles within Catholic Church ministries in various countries.

PARTICIPANTS AND SETTING

Our 184 participants included lay people, religious men and women, school staff, safeguarding officers and tertiary students associated with the Catholic Church. Data were collected across seven different countries.

METHODS

We measured the awareness, confidence, attitudes, and knowledge of participants and examined differences between participants in different roles within the Church and different countries through General Linear Models.

RESULTS

We found varying levels of awareness, confidence, attitudes, and knowledge regarding sexual abuse prevention and safeguarding. We pinpointed the significant differences in three of these domains (confidence, attitudes, and knowledge) both between people with different roles in the church worldwide, but also between the countries from which participants came from.

CONCLUSIONS

We found that people in various countries and roles within the Church are at different stages of their safeguarding journey. Some are still understanding their roles (attitudes), some are still learning about how it is operationalised (awareness), and others are acquiring skills that will prepare them for enacting safeguarding policies and practices (confidence).

A systematic review of factors associated with disclosure of child sexual abuse

BACKGROUND AND OBJECTIVE

Disclosure of CSA is key to victims having access to support and protection, but the current understanding of what factors play a key role is still limited. The present review aims to understand a range of socio-ecological factors that can either facilitate or obstruct the disclosure of CSA.

METHODS AND RESULTS

Through a systematic review of 27 quantitative studies published from 2000 to 2022, the current review identified 17 significant predictors of CSA disclosure. Facilitators of disclosure included older age, being female, higher IQ, recent abuse, resistance during abuse, clergy perpetrator, non-offending caregiver support, and acculturation. Barriers to disclosure included intellectual disability, avoidant coping, romantic relationships with the perpetrator, family criminality, domestic violence, adherence to traditional Asian values, and ethnic minority identity. The findings also suggested that the relationship between predictors and disclosure tends to be mixed, contradictory, or indirect/interactional, emphasizing the importance of situating the findings in specific social-ecological contexts.

CONCLUSIONS

The findings can inform future research and practice by providing a comprehensive understanding of the predictors of CSA disclosure and highlighting the importance of considering the socio-ecological context when interpreting findings. Moreover, the review provides a valuable resource for professionals who work with victims of CSA, helping them better identify factors that may facilitate or hinder disclosure and allowing for tailored interventions.

Women Receive More Positive Reactions to Childhood Sexual Abuse Disclosure and Negative Reactions are Associated With Mental Health Symptoms in Adulthood for Men and Women

Although disclosure of sexual abuse has become more socially acceptable for both men and women in recent years, there is much yet to be understood about differences in the disclosure process and associated pathology between men and women. The current study aimed to (a) investigate differences in aspects of the childhood sexual abuse (CSA) disclosure process between adult men and women and (b) explore how timing of disclosure, perceived parental style, and negative social reactions to disclosure relate to various mental health symptoms. Using a cross-sectional, quasi-experimental design, adult men and women in the United States recruited through Amazon's Mechanical Turk (N = 299) completed self-report surveys. Women reported disclosing to a significantly greater number of people than men, and were more likely to disclose to parents, while men were more likely to tell friends. Results revealed that women reported receiving significantly more positive responses and emotionally supportive responses to their CSA disclosures than men. Negative reactions to disclosure were positively associated with internalizing symptoms and externalizing symptoms, while both negative reactions to disclosure and perceived parental dysfunction were positively associated with substance use symptoms. Results signify a need for resources to aid individuals in supporting survivors of CSA, as reactions have the potential to impact recovery trajectory and for clinicians to consider how disclosure experiences impact survivor cognitions and symptom exacerbation.

Child sexual abuse in Kaduna State, Northwestern Nigeria: A review of 420 police-reported cases

Child sexual abuse affects millions of children globally but in Nigeria, hospital-based studies continue to report few cases, making it difficult to assess the magnitude and quality of care. This study aimed to overcome this challenge by reviewing police medical reports instead of hospital records. A total of 420 reports were retrieved from one police area command in Kaduna State, Northwestern Nigeria, between 2018 and 2021. The majority of the victims were females (65.5%), 5-14 years (70.2%), and familiar with their assailants (71.4%). Most of the assailants were men (99.0%), 20-40 years (29.1%), who acted alone (86.7%). Most of the reports contained history (79.3%), physical examination (49.6%), and laboratory results (>90%). Among female victims, the commonest genital findings were absent hymen (25.6%) and normal findings (17.6%). Among male victims, the commonest anal findings were normal findings (41.7%) and anal dilatation (23.6%). The victims tested positive for HIV (0.5%), hepatitis B (4.7%), hepatitis C (1.0%), and syphilis (0.8%). Higher positivity rates were noted among assailants. Treatments offered to the victims included antibiotics (30.2%), analgesics (11.9%), emergency contraception (6.7%), and psychotherapy (67.4%). The review calls for improved reporting, use of comprehensive treatment guideline, and training of service providers to improve the quality of care.

"It was Really Hard for Me to Tell": The Gap between the Child's Difficulty in Disclosing Sexual Abuse, and their Perception of the Disclosure Recipient's Response

Disclosure of child sexual abuse (CSA) is essential to its mitigation and the protection of children. Previous studies have greatly contributed to the understanding of disclosure rates both in childhood and adulthood, in addition to delayed disclosure and disclosure barriers. In acknowledging the relevancy of the ecological framework, researchers have illustrated how the various systems in the children's lives have a role in their decision to disclose the abuse. The current study was designed to delve into the disclosure stories shared by children during their forensic interviews. Fifty children, 30 girls and 20 boys, from diverse communities in the Jewish society in Israel (15 secular, 15 Orthodox and 20 ultra-Orthodox) were forensically interviewed for the first time following CSA. Thematic analysis was carried out on their narratives, focusing on two main themes. The first was the children's descriptions of their difficulties to disclose, which were embedded in their own perceptions and experiences, their fear of the disclosure recipient's response, and their dynamic with the perpetrator. The second theme provided a glance into the children's descriptions of the disclosure recipients' responses, which highlighted the children's central experience of loneliness in the context of the abuse. Theoretical and practical ramifications pertaining to these crucial gaps will be discussed. In addition, specific religious-cultural elements raised in relation to the disclosure will be highlighted. Limitations of the study as well as further recommendations and implications will be introduced.

Limitations of the protective measure theory in explaining the role of childhood sexual abuse in eating disorders, addictions, and obesity: an updated model with emphasis on biological embedding

In addition to its immediate negative consequences, childhood sexual abuse is associated with lifelong deleterious mental and physical health outcomes. This review employs a biopsychosocial perspective to better understand pathways from childhood sexual abuse to eating disorders, food and drug addictions, and obesity across the life course. Guided by an updated conceptual model, this review delineates how the biological embedding of childhood sexual abuse triggers a cascade of interrelated conditions that often result in failed attempts at weight suppression and eventually obesity. Such biological embedding involves pathways such as inflammation, allostatic load, reward sensitivity, activation of the hypothalamic-pituitary-adrenal axis, epigenetics, and structural and functional changes in the brain. These pathways are in turn theorized to lead to food addiction, substance use disorder, and eating disorders-each with potential pathways toward obesity over time. Predisposing factors to childhood sexual abuse including gender, culture, and age are discussed. This model calls into question the longstanding "protective measure" theory that purports individuals exposed to sexual abuse will deliberately or subconsciously gain weight in attempt to prevent future victimization. A more comprehensive understanding of the mechanisms by which childhood sexual abuse becomes biologically embedded may help clinicians and survivors normalize and/or address disordered eating and weight-related outcomes, as well as identify intervention strategies.Level of evidence: Level V: opinions of respected authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.

Adverse Childhood Experiences among Reproductive Age Women: Findings from the 2019 Behavioral Risk Factor Surveillance System

INTRODUCTION

Adverse childhood experiences (ACEs) are associated with many negative health outcomes. Despite this well-documented association, most research on how health conditions affect women's preconception and perinatal health overlooks ACEs.

METHODS

This study analyzes self-reported ACE history and health outcomes among young adults (ages 18-39) using data from the 2019 Behavioral Risk Factor Surveillance System. Our aims were to 1) assess differences by gender in overall ACE scores and specific ACEs; 2) identify trends in women's ACE scores by birth cohort; and 3) estimate the association of ACE scores with health conditions that increase risk for adverse perinatal outcomes.

RESULTS

Findings include that women had higher overall ACE scores than men and that women were more likely to report experiencing seven of the eight ACEs queried. More than 23% of women respondents reported an ACE score of 4+, with a 3-percentage point difference between the youngest and oldest women in our sample. Compared with those reporting zero ACEs, women with four or more ACEs were almost four times as likely to report a history of depression and more than twice as likely to report fair or poor health, even after accounting for sociodemographic characteristics. Women with four or more ACEs were 62% more likely to have obesity, 41% more likely to report a hypertension diagnosis, and 36% more likely to report a diabetes diagnosis than those with zero ACEs.

CONCLUSIONS

ACEs are a root cause in the development of adverse health conditions in young women, and their prevention should be central to policies aimed at improving women and children's well-being.

Association Between Early Trauma and Ideal Cardiovascular Health Among Black Americans: Results From the Morehouse-Emory Cardiovascular (MECA) Center for Health Equity

BACKGROUND

Early trauma (general, emotional, physical, and sexual abuse before age 18 years) has been associated with both cardiovascular disease risk and lifestyle-related risk factors for cardiovascular disease, including smoking, obesity, and physical inactivity. Despite higher prevalence, the association between early trauma and cardiovascular health (CVH) has been understudied in Black Americans, especially those from low-income backgrounds, who may be doubly vulnerable. Therefore, we investigated the association between early trauma and CVH, particularly among low-income Black Americans.

METHODS

We recruited 457 Black adults (age 53±10, 38% male) without known cardiovascular disease from the Atlanta, GA, metropolitan area using personalized, community-based recruitment methods. The Early Trauma Inventory was administered to assess overall early traumatic life experiences which include physical, sexual, emotional abuse, and general trauma. Our primary outcome was the American Heart Association Life's Simple 7, which is a set of 7 CVH metrics, including 4 lifestyle-related factors (smoking, body mass index, physical activity, and diet) and three physiologically measured health factors (blood pressure, total blood cholesterol, and blood glucose). We used linear regression models adjusting for age, sex, socioeconomic status, and depression to test the association between early trauma and CVH and tested the early trauma by household income (<$50 000) interaction.

RESULTS

Higher levels of early trauma were associated with lower Life's Simple 7 scores (β, -0.05 [95% CI, -0.09 to -0.01], P=0.02, per 1 unit increase in the Early Trauma Inventory score) among lower, but not higher, income Black participants (P value for interaction=0.04). Subtypes of early trauma linked to Life's Simple 7 were general trauma, emotional abuse, and sexual abuse. Exploratory analyses demonstrated that early trauma was only associated with the body mass index and smoking components of Life's Simple 7.

CONCLUSIONS

Early trauma, including general trauma, emotional abuse, and sexual abuse, may be associated with worse CVH among low-, but not higher-income Black adults.

When Did I Become a Victim? Exploring Narratives of Male Childhood Sexual Abuse

This report presents narrative data of adult men self-identifying as victims of sexual abuse occurring in childhood or adolescence (CSA). Preliminary data were derived from written public stories posted by men to the Internet (n = 90). Many of these accounts indicate same-sex sexual abuse (male victim, male perpetrator). The primary research question: "how have adult male victims of childhood sexual abuse constructed written narratives of victimization?" The men in this study who posted public narratives about their sexual abuse demonstrated evidence in of two (turmoil and taking control) of six life course themes uncovered by Draucker and Martsolf (2010). Two temporally related additional subthemes emerged within the category "taking control": during the abusive event/relationship and after abuse in adulthood. Understanding how male victims organize and make sense of the trajectory of their victim and/or survivor identity may contribute to a more integrated healing for victims. This could also shape programs for outreach and support. The result of the study would aid in the development of diagnostic tools and frameworks for interviewing abuse victims who are not publicly presenting or formally reporting their stories.

"The whole wall fell apart, and I felt free for the first time": Men's perceptions of helpful responses during discussion of child sexual abuse

BACKGROUND

There is a growing awareness of the prevalence and consequences of childhood sexual abuse (CSA) for boys. Disclosure experiences often impact long-term functioning following CSA. Current understanding around disclosure has evolved from a singular act of telling to a broader, reciprocal process that can include discussion. However, there is limited empirical evidence about what constitutes a helpful response from others during the discussion of CSA for men.

OBJECTIVE

This study examines the characteristics of a helpful response during the discussion of CSA among a large sample of men with histories of CSA.

PARTICIPANTS AND SETTING

Participants included 487 men ranging in age from 19 to 84 years (mean = 50.1) who completed an anonymous, one-time online survey as part of a larger project on men's health and well-being. Participants were recruited through research announcements on web sites and discussion boards of national organizations that support adult survivors of CSA.

METHODS

Narrative data from an open-ended prompt were analyzed using qualitative content and inductive thematic analyses over eleven months.

RESULTS

The analysis yielded five superordinate themes on men's perceptions of helpful responses from others during discussions of CSA: (1) experience; (2) personal characteristics; (3) specific actions; (4) therapeutic interventions; and (5) insights.

CONCLUSIONS

Clinicians and health care professionals should convey an awareness of CSA for boys, reach out to men dealing with difficulties tied to early trauma, and implement helpful response strategies in discussions of CSA. Family members, friends, and colleagues within men's social networks can also support recovery with helpful response strategies.

Why do child sexual abuse victims not tell anyone about their abuse? An exploration of factors that prevent and promote disclosure

Disclosure rates of child sexual abuse (CSA) to both social supports and law enforcement are concerningly low, although more research is needed to understand factors that impact disclosure. Thus, the present study examined rates of informal (i.e., to a social support) and formal (i.e., to law enforcement) disclosure of CSA, as well as victims' self-reported experiences with telling others about their own abuse and their perceptions of the overall advantages and disadvantages of disclosure. In all, 76 undergraduate women (who collectively experienced 105 instances of abuse) participated in a semi-structured interview regarding their history of CSA. Results revealed that approximately 50% of cases involved the victim informally disclosing, and only 10% of cases being formally disclosed to authorities. The quantitative and qualitative data shed light on a number of factors that lead victims to not disclose, as well as the identification of factors that may promote a victim to share their abuse with others. The implications for improved prevention and responses to CSA disclosure are discussed.

Early Sexual Experiences, Mental Health, and Risk Behavior among Black Non-Hispanic and Hispanic / Latino Men Who Have Sex with Men (MSM)

Black and Latino men who have sex with men (MSM) are disproportionately affected by childhood sexual abuse (CSA). Investigating these histories is often confounded by underreporting and varied definitions of abuse. Unrecognized abuse may manifest in unhealthy ways, specifically psychological distress, substance use, and high-risk sexual behaviors. Black and Hispanic/Latino MSM in New York City discussed formative sexual experiences in in-person interviews. Eligible men reported a sexual experience occurring before age 16 with a man or woman 18 or older at the time. Among interviewees (n = 61), men living with HIV were significantly younger at the time of their first sexual experience with a male partner compared to HIV-negative men. Approximately half of interviewees (47.5%) scored at or above the diagnostic cutoff for post-traumatic stress disorder (PTSD). Hispanic/Latino men had increased odds of scoring at or above the diagnostic cutoff for PTSD compared to Black non-Hispanic men. Further, nearly half of interviewees (46%) scored at or above the diagnostic cutoff for harmful drug use or possible drug dependence. Study findings have implications for future research using an indirect approach to uncovering potential sexual abuse during childhood, and associations with adult health outcomes.

School and program related factors influencing disclosure among children participating in a school-based childhood physical and sexual abuse prevention program

BACKGROUND

School-based child abuse prevention programs were created to provide knowledge so that children can recognize abuse, teach skills that decrease children's risk for abuse, normalize the disclosure process, and provide a pathway for children who may be experiencing abuse to report the abuse.

OBJECTIVE

The purpose of this study was to explore school and program factors that trainers in a school-based prevention program believed were associated with disclosure among youth from kindergarten through 12th grade.

PARTICIPANTS AND SETTING

This study is based on eighteen trainers and administrators who work with the Play it Safe!® school-based program in Dallas-Fort Worth area.

METHODS

Using the qualitative case study method, in-depth interviews were conducted.

RESULTS

Data analysis revealed three factors that influenced disclosure: school, school personnel, and program features. The school-related factor was time allotted to the training. The school personnel-related factors were disengagement, ambiguity concerning abuse, prior history with children, and professionals' personal history of abuse. Finally, the program-related factors were the core messages of the training, providing specific examples, and repetition of the program. To date, there is a dearth of studies that explore the role that schools and school personnel play in the disclosure process.

CONCLUSION

Child abuse has devastating effects on children's physical, social, emotional, and psychological well-being. Understanding more about schools, personnel, and program-related factors that lead to disclosure, which are more amenable to change, is critical to ensuring the safety of children.

Understanding the Impact of Childhood Sexual Abuse on Men's Risk Behavior: Protocol for a Mixed-Methods Study

Background

Childhood sexual abuse (CSA) remains a critical public health issue among black and Latino men who have sex with men (MSM), as it is associated with multiple negative outcomes including substance misuse, poor mental health, revictimization, and high-risk sexual behavior. Most CSA research with MSM relies on quantitative assessment that often precludes consideration of cultural variations in how formative sexual experiences are understood and is based on inconsistent or overly restrictive definitions of abuse, and therefore may fail to detect certain abusive experiences (eg, those involving female perpetrators), which can have harmful health consequences if they remain unrecognized.

Objective

The objective of this study is to overcome existing limitations in the literature by drawing on perspectives of black and Latino MSM and men who have sex with men and women (MSMW), as well as relevant service providers to better understand the role of, and the need to include, sexual abuse histories (eg, CSA) in treatment and counseling settings, with the long-term goal of improving assessment and health outcomes.

Methods

We will conduct mixed-methods interviews, framed by an intersectionality approach, with 80 black and Latino men (40 MSM and 40 MSMW) in New York City (NYC), exploring appraisals of their formative sexual experiences, including those described as consensual but meeting criteria for CSA. We will also interview 30 local service providers representing substance abuse treatment, mental health care, and HIV prevention and outreach.

Results

The study was launched in May 2017.

Conclusions

This formative research will inform testable approaches to assessing and incorporating sexual abuse history into substance abuse treatment and other health and mental health services used by men with such histories.

Examining the role of attachment in the relationship between childhood adversity, psychological distress and subjective well-being

Childhood adversity is associated with a wide range of detrimental psychological consequences. This study examined the mediating role of relationship-specific attachment (avoidance and anxiety) in the associations between childhood adversity and both psychological distress and subjective well-being. University students (N=190) across the Republic of Ireland completed self-report measures including the Adverse Childhood Experiences scale, Experiences in Close Relationships - Relationship Structures scale, Depression Anxiety and Stress scales and measures of subjective well-being. One hundred and twenty-eight participants (67.4%) reported experiencing at least one adverse childhood experience. Childhood adversity was associated with symptoms of psychological distress and subjective well-being. All such associations were mediated by certain relationship-specific attachment dimensions. Of these, attachment anxiety in general relationships was the most prominent mediator for both psychological distress and subjective well-being. Attachment to one's father and to one's romantic partner did not mediate any association. These findings indicate that attachment, in particular relationships, is an important factor in the associations between childhood adversity and both psychological distress and subjective well-being as an adult. One's attachment anxiety in general relationships is particularly important in these associations. Therapeutic interventions addressing these attachment domains may offset the detrimental effects of childhood adversity. Future research is required using a longitudinal design.

Interpersonal trauma and hoarding: The mediating role of aggression

BACKGROUND

A growing body of literature indicates that exposure to interpersonal trauma contributes to the onset or exacerbation of hoarding symptoms. However, little research has explored psychosocial factors that may help to explain the relationship between interpersonal trauma and hoarding symptoms. One outcome of trauma exposure that may be associated with hoarding symptoms is aggression, defined as the tendency to experience and express hostility and anger, and to engage in aggressive behavior. Therefore, the current study examined the relationship between hoarding and aggression, as well as the mediating role of aggression in the relationship between exposure to interpersonal trauma and hoarding symptoms.

METHODS

Community participants (n = 258) completed a battery of questionnaires assessing trauma exposure, hoarding symptoms, aggression, and negative affect.

RESULTS

Results revealed that when accounting for negative affect, hoarding symptoms were associated with greater aggression, and the relationship between exposure to interpersonal trauma and hoarding symptoms was mediated by aggression. Specificity analyses indicated that depression symptoms and emotion dysregulation did not mediate the relationship between interpersonal trauma exposure and hoarding, providing further support for the importance of aggression.

LIMITATIONS

Findings should be interpreted in light of limitations, including the use of cross-sectional and self-report data, and a general community sample.

CONCLUSIONS

Taken together, our findings suggest that interpersonal processes, such as aggression toward others, may be associated with increased hoarding symptoms.

Prevalence, contexts, and correlates of child sexual abuse in Cyprus

It is well documented that child sexual abuse (CSA) may be one of the major public health problems in the world, especially due to the co-occurrence with other types of abuse and negative developmental outcomes. The aim of the current study was the comprehensive examination of CSA with respect to its prevalence, its contexts of occurrence and its correlates. The sample included 1852 adolescents and young adults (15-25 years old; 441 males), recruited through schools, universities and other youth organizations across Cyprus. Participants were administered an online questionnaire assessing multiple forms of abuse, with a focus on sexual abuse, solicitation, and trafficking, as well as personality traits. The study's results supported previous findings in Europe that 1 in 5 children may experience sexual abuse or solicitation, with females being more likely than males to be the victim of CSA. Findings also indicated that the different types of sexual abuse were more likely to occur during adolescence than other developmental stages. In addition, perpetrators were more often identified to be adolescent or adult males who were strangers or friends/acquaintances with the victims. Moreover, findings suggested that experiences of sexual abuse and solicitation co-occur with neglect, physical, and psychological abuse. Regarding personality traits, sexual abuse was found to be specifically related to grandiosity, whereas sexual solicitation was related to both impulsivity and grandiosity. The current study has practical and policy implications for intervening with sexually maltreated individuals.

Delay in disclosure of non-parental child sexual abuse in the context of emotional and physical maltreatment: A pilot study

The present pilot study sought to identify predictors of delays in child sexual abuse (CSA) disclosure, specifically whether emotional and physical abuse by a parental figure contributes to predicting delays over and above other important victim factors. Alleged CSA victims (N=79), whose parental figures were not the purported sexual abuse perpetrators, were interviewed and their case files reviewed, across two waves of a longitudinal study. Regression analyses indicated that experiencing both emotional and physical abuse by a parental figure was uniquely predictive of longer delays in disclosure of CSA perpetrated by someone other than a parental figure. Victim-CSA perpetrator relationship type and sexual abuse duration also significantly predicted CSA disclosure delay, whereas victim age at the time of the police report, victim gender, and victims' feelings of complicity were not significant unique predictors. Child abuse victims' expectations of lack of parental support may underlie these findings. Parent-child relationships are likely crucial to timely disclosure of CSA, even when a parent is not the CSA perpetrator.

A Psychosocial Understanding of Child Sexual Abuse Disclosure Among Female Children in South Africa

Child sexual abuse is endemic in South Africa, driven by high levels of gender-based violence and underscored by structural and social factors. This article aims to develop an understanding of the process of disclosure in a sample of female children and their caregivers. In-depth semistructured interviews were conducted with 31 female children aged 8-17 years and their caregivers at 3 intervals after presentation to a sexual assault treatment center. Nearly half of the children failed to disclose the sexual abuse immediately, fearing caregivers' reaction. Most children purposefully disclosed to a confidant through a process of identifying an intermediary to tell caregivers on their behalf. The process of disclosure was influenced by multiple factors, such as a fear of the caregiver's reaction and disbelief, which is related to parental style. Disclosure was found to be a dynamic process that unfolds and not a single or static event and influenced by multiple factors which all impact on recovery. Our findings highlight the need to address social norms on sexual abuse in order to improve responses to disclosure to facilitate post-sexual-abuse adjustment for the child and the family.

Attachment style as a mediator between childhood maltreatment and the experience of betrayal trauma as an adult

Previous research has demonstrated a positive association between child maltreatment and adult interpersonal trauma (Arata, 2000; Crawford & Wright, 2007). From a betrayal trauma theory perspective, evidence suggests that the experience of trauma high in betrayal (e.g., child maltreatment by parents or guardians) increases ones risk of betrayal trauma as an adult (Gobin & Freyd, 2009). However, the mechanisms explaining these associations are not well understood; attachment theory could provide further insight. Child maltreatment is associated with insecure attachment (Baer & Martinez, 2006; Muller et al., 2000). Insecure attachment is also associated with deficits in interpersonal functioning and risk for intimate partner violence, suggesting insecure attachment may mediate the relationship between child maltreatment and the experience of betrayal trauma as an adult. The current study tested this hypothesis in a sample of 601 college students. Participants completed online questionnaires including the Child Abuse and Trauma Scale (CATS), the Experiences in Close Relationships - Revised (ECR-R) and the Brief Betrayal Trauma Survey (BBTS). Results indicated that child maltreatment is associated with adult betrayal trauma and anxious attachment partially mediates this relationship.

The Relationship between Traumatic Life Events and Hoarding Symptoms: A Multi-Method Approach

Hoarding Disorder is characterized by difficulties with discarding and frequently excessively acquiring possessions, resulting in substantial clutter. Previous research has implicated trauma in the development of hoarding, but no study to date has examined the relationship between trauma and hoarding using hypothetical hoarding paradigms. This study investigated the association between traumatic events and both self-report and hypothetical indices of hoarding symptoms. We predicted that frequency of trauma would be associated with greater hoarding symptoms (across self-report and hypothetical indices). Undergraduate students (N = 80) completed self-report measures of hoarding symptoms and trauma, and hypothetical measures of acquiring and saving tendencies. As expected, more frequent trauma, and physical/sexual trauma in particular, was associated with greater acquiring tendencies. However, frequency of trauma was not significantly correlated with saving tendencies or self-reported hoarding symptoms. Future research should replicate these findings using longitudinal designs to confirm whether trauma actually serves as a risk factor for hoarding. Replication in a clinical sample is needed to better understand the implications of these results for intervention.

Partner preferences among survivors of betrayal trauma

Betrayal trauma theory suggests that social and cognitive development may be affected by early trauma such that individuals develop survival strategies, particularly dissociation and lack of betrayal awareness, that may place them at risk for further victimization. Several experiences of victimization in the context of relationships predicated on trust and dependence may contribute to the development of relational schema whereby abuse is perceived as normal. The current exploratory study investigates interpersonal trauma as an early experience that might impact the traits that are desired in potential romantic partners. Participants in the current study were asked to rate the desirability of several characteristics in potential romantic partners. Although loyalty was desirable to most participants regardless of their trauma history, those who reported experiences of high betrayal trauma rated loyalty less desirable than those who reported experiences of traumas that were low and medium in betrayal. Participants who reported experiences of revictimization (defined as the experience of trauma perpetrated by a close other during 2 different developmental periods) differed from participants who only reported 1 experience of high betrayal trauma in their self-reported desire for a romantic partner who possessed the traits of sincerity and trustworthiness. Preference for a partner who uses the tactic of verbal aggression was also associated with revictimization status. These preliminary findings suggest that victimization perpetrated by close others may affect partner preferences.

Forensic nurses' experiences of receiving child abuse disclosures

PURPOSE

A child's self-disclosure of abuse is a critical component in initiating intervention to stop abuse and decrease the likelihood of long-term negative outcomes. This study described the context in which child abuse victims disclosed to forensic nurses.

DESIGN AND METHODS

Thirty interviews were conducted at the International Forensic Nurses Scientific Assembly 2007 and then analyzed using narrative inquiry methodology.

RESULTS

Five themes emerged: child-friendly environment, building rapport, engaged listening, believing unconditionally, and the potential for false disclosures.

PRACTICE IMPLICATIONS

  Nurses can provide an environment that allows a child the perception of limitless time to share their unique stories.

Differences in legal outcomes for male and female children who have been sexually abused

The goal of the present study was to determine whether or not there were sex differences in legal outcomes for children who were sexually abused. Using the methodology of Joa and Edelson (2004), the results indicated that males who were sexually abused had poorer legal outcomes than females. Specifically, it was found that cases involving male victims were less likely to be filed with the District Attorney (DA) than cases involving female victims and had fewer criminal counts charged. For those children seen at a Child Abuse Assessment Center, cases involving female victims were significantly more likely to be filed by the DA's office than were cases involving male victims. Finally, there were differences in whether guilty defendants pled guilty or were found guilty at trial depending on whether the defendant sexually abused a male or female. The implications of the findings are discussed.