Predictors of resilience in abused and neglected children grown-up: the role of individual and neighborhood characteristics

PURPOSE: This paper examines individual, family, and neighborhood level predictors of resilience in adolescence and young adulthood and describes changes in resilience over time from adolescence to young adulthood in abused and neglected children grown up. METHOD: We use documented cases of childhood physical and sexual abuse and neglect (n=676) from a Midwestern county area during the years 1967-1971 and information from official records, census data, psychiatric assessments, and self-reports obtained through 1995. Analyses involve logistic regressions, replicated with Mplus to test for possible contextual effects. RESULTS: Almost half (48%) of the abused and neglected children in adolescence and nearly one-third in young adulthood were resilient. Over half of those who were resilient in adolescence remained resilient in young adulthood, whereas 11% of the non-resilient adolescents were resilient in young adulthood. Females were more likely to be resilient during both time periods. Being white, non-Hispanic decreased and growing up in a stable living situation increased the likelihood of resilience in adolescence, but not in young adulthood. Stressful life events and a supportive partner promoted resilience in young adulthood. Neighborhood advantage did not exert a direct effect on resilience, but moderated the relationship between household stability and resilience in adolescence and between cognitive ability and resilience in young adulthood. CONCLUSIONS: Ecological factors appear to promote or interfere with the emergence and stability of resilience following childhood maltreatment.     

Resilience factors in the victims of sexual abuse: state of affairs

OBJECTIVE: The aim of this literature review is to examine factors leading to the recovery of child sexual abuse survivors. METHOD: This paper provides a definition of resilience and presents the individual and environmental protective factors. A methodological examination of the studies is carried through. RESULTS: Researchers have documented that 20% to 44% of adult who were sexually abused during their childhood show no apparent signs of negative outcome. However, very few studies as been interested in resilient women and their protective mechanisms. Recent research on protective factors reveal that searching for support, disclosing the abuse and giving a meaning to the abuse are all adaptative cognitive strategies. Furthermore, the perception of benefits and having an external attributional style are both related to less psychological distress. Social support, in general and after the revelation, also appears as a determinant of resilience. However, avoidance, even if victims find it very useful, proves to be a non-adaptative strategy, which may lead to be a catalyst to victims' symptomatology. Definitional problems and the lack of longitudinal studies limit the conclusions that can be drawn. CONCLUSION: The rare studies involving resilient victims show that social support as well as certain cognitive coping strategies may lead to recovery. However the extent of their contribution remains unknown.     

Treatment effects with an adolescent abuse survivor's group.

OBJECTIVE: The goal of the study was to demonstrate the efficacy of a structured group therapy intervention in reducing the negative emotional and behavioral sequelae of adolescent girls' who are survivors of sexual abuse. It was hypothesized teens would show an increase in adaptive behaviors and knowledge of positive coping strategies. METHOD: A 7-session structured group treatment protocol based on Solution Focused and Ericksonian interventions was used. Forty-one teens between the ages of 13 and 18 years old participated in the groups. Each group session included a didactic presentation. an art activity and development of a positive associational cue. Pre- and post-test assessment was done using the Solution Focused Recovery Scale, a measure of adaptive functioning; and the Skill Mastery Test, designed to evaluate teens knowledge of the concepts and strategies taught throughout the group. RESULTS: Overall, there was a significant change in pre- to post- measurements of adaptive functioning as assessed by the Recovery Scale. At this time, no statistically significant pre- to post- changes were evident for scores on the Skill Mastery Test. However, there was a trend toward improvement on visual inspection of the Skill Mastery scores. CONCLUSIONS: This study demonstrates emphasizing competence and skill development in the treatment of adolescent abuse survivors can aid teens in improving their daily functioning and positive recovery behaviors. In addition, early findings regarding the efficacy of this intervention suggest theory driven research methodology can be applied in a clinical setting with standardized treatment protocols.     

Children’s trauma-related symptoms following complex trauma exposure: Evidence of gender differences

Complex trauma exposure has been operationalized as multiple or chronic interpersonal traumas that begin early in life and is thought to result in widespread self-regulation difficulties across several domains of functioning. Prior research has demonstrated that there are gender differences in trauma exposure as well as trauma-related symptoms; however, gender discrepancies have not previously been examined in the context of child survivors of complex trauma. The aim of the present study was to determine whether there are gender differences in both caregiver and child-reported trauma exposure and symptoms among 167 children who have experienced complex trauma (3–18 years, M = 9.90, SD = 3.92; 61.67% female). Male children were somewhat more likely to have been exposed to domestic violence, while female children were more likely to have experienced sexual abuse as well as more likely to have been abused by a caregiver. Gender differences were observed for several of the caregiver-reported symptom domains, with female children exhibiting higher levels of depression, dissociation, posttraumatic stress disorder (PTSD) hyperarousal symptoms, and total PTSD symptoms. Female children also self-reported higher levels of sexual concerns, and marginally more re-experiencing and total PTSD symptoms. Secondary analyses utilizing only children who experienced sexual abuse revealed that gender differences largely remained, again with females manifesting higher levels of symptoms. Thus, following complex trauma, female children may be at higher risk for trauma-related difficulties, which has implications for research and clinical interventions.     

Childhood sexual abuse and abuse-specific attributions of blame over 6 years following discovery

OBJECTIVE: The purpose of this study was to examine patterns of change in attributions for childhood sexual abuse (CSA) over a 6-year period and whether such patterns were related to abuse severity, age, gender, and subsequent symptoms of depression and PTSD. METHODOLOGY: One-hundred and sixty children, 8-15 years old, were interviewed within 8 weeks of the time the CSA was reported to child protective services (i.e., the time of abuse discovery). Follow-up interviews were conducted 1-year later on 147, and 6 years later on 121 of the original participants. Abuse-specific attributions were obtained using two methods. Participants first responded to an open-ended interview question about why they believed the CSA had happened to them and then completed a rating scale about the extent to which possible attributions for the CSA applied to them (e.g., "Because I was not smart enough"). RESULTS: Over time, perpetrator-blame attributions were consistently more common than self-blame attributions for CSA (using both interview and rating measures). Youth were more likely to report self-blame attributions on the rating measure than the open-ended interview question. The interview method indicated that youth often felt confused about why the abuse happened up to a year following discovery but this response diminished by the third assessment. On average, ratings of perpetrator-blame attribution remained high over time (p<.05), whereas ratings of self-blame decreased (p<.01). Penetration was related to more self-blame (p<.05) and less perpetrator-blame (p<.05), and the use of force was related to more perpetrator-blame. The initial level of self-blame attribution ratings predicted subsequent symptoms of depression (p<.05) and intrusive experiences (p<.05) after controlling for age at abuse discovery, gender, and self-blame attributions for common events. Perpetrator-blame attributions were not related to symptoms. CONCLUSIONS: The findings of this study suggest that assessing responses to open-ended interview questions about the perceived reasons for the abuse and ratings of attributions are important for understanding how youth make sense of their abuse. Abuse-specific self-blame attributions at abuse discovery have a persistent effect on internalizing symptoms and should be assessed and the target of treatment as soon as possible after CSA has been reported to the authorities.     

Examining the relationship between higher educational attainment,trauma symptoms,and internalizing behaviors in child sexual abuse survivors

The trauma symptoms of child sexual abuse (CSA) survivors don’t end with the abuse, or even with the advent of adulthood. Instead, these symptoms can persist into all the realms of a survivor’s life, including education, which sets the foundation for career advancement. This retrospective study of adult survivors of childhood sexual abuse (n = 260) examined the relationships between trauma symptoms, dissociation, dissociative amnesia, anxiety, depression, sleep problems and higher education attainment. The purpose of this study was to determine if these factors are associated with higher education completion for childhood sexual abuse (CSA) survivors. Linear regressions and ANOVAs suggest that many of these variables are significantly associated with survivors’ educational trajectory, and multiple linear regressions show that trauma symptoms (as measured by the Trauma Symptom Checklist-40), caregivers’ education levels, and age at onset of abuse are significant predictors of decreased education levels. This information can provide insight into additional risk and protective factors for CSA survivors in order to enhance acute and long-term management of trauma symptoms to increase levels ofattainment of higher education.     

Childhood sexual abuse, attachment, and trauma symptoms in college females: the moderating role of attachment

OBJECTIVE: The present study tests a model linking attachment, childhood sexual abuse (CSA), and adult psychological functioning. It expands on previous work by assessing the degree to which attachment security moderates the relationship between a history of child sexual abuse and trauma-related symptoms in college females. METHOD: Self-reports of attachment, childhood sexual abuse, and adult psychological functioning were obtained from 324 female undergraduate students attending a Southeastern U.S. university. Separate analyses were conducted examining the potential moderating role for close-adult, parent-child, and peer attachment styles. RESULTS: In this sample, 37.7% of participants reported sexually abusive experiences prior to age 16. History of child sexual abuse was consistently associated with higher levels of trauma-related symptoms and lower levels of attachment security in close-adult, parent-child, and peer relations. Additionally, attachment security was consistently associated with trauma-related symptoms. Close-adult, parent-child, and peer attachment differentially moderated trauma-related symptoms. Specifically, in peer relationships, the strength of the relationships between attachment measures and trauma symptoms were greater for CSA survivors than for non-abused participants. The opposite pattern of results was found for attachment in parental and close-adult relationships. CONCLUSION: Results suggest that attachment security in peer and parent relationships protects against the negative effects of CSA, while only weak, marginally significant protective effects were observed for close-adult relationships. Only modest support was found for the conceptualization of attachment as a moderator of the relationship between CSA and trauma-related symptoms. However, the results suggest that attachment security at least partially protects against negative CSA outcomes.     

Effects of childhood trauma exposure and cortisol levels on cognitive functioning among breast cancer survivors

Cognitive functioning difficultiesin breast cancer patients receiving chemotherapy are common, but not all women experience these impairments. Exposure to childhood trauma may impair cognitive functioning following chemotherapy, and these impairments may be mediated by dysregulation of hypothalamic-pituitary-adrenal (HPA) axis function and cortisol slope. This study evaluated the association between childhood trauma exposure, cortisol, and cognition in a sample of breast cancer survivors. 56 women completed measures of trauma exposure (the Traumatic Events Survey), salivary cortisol, and self-reported cognitive functioning (the Functional Assessment of Cancer Therapy – Cognitive). We examined correlations between childhood trauma exposure and cognitive functioning, then used linear regression to control for factors associated with cognition (age, education, time since chemotherapy, depression, anxiety, and insomnia), and the MacArthur approach to test whether cortisol levels mediated the relationship between trauma and cognitive functioning. 57.1% of the sample had experienced at least one traumatic event in childhood, with 19.6% of the sample witnessing a serious injury, 17.9% experiencing physical abuse, and 14.3% experiencing sexual abuse. Childhood trauma exposure and cognitive functioning were moderately associated (r = −0.29). This association remained even when controlling for other factors associated with cognition; the final model explained 47% of the variance in cognitive functioning. The association between childhood trauma and cognitive functioning was mediated by steeper cortisol slope (partial r = 0.35, p = 0.02). Childhood trauma exposure is associated with self-reported cognitive functioning among breast cancer survivors and is mediated by cortisol dysregulation. Trauma should be considered, among other factors, in programs aiming to address cognition in this population.     

Early career teachers’ resilience and positive adaptive change capabilities

This research is an investigation of the link between adaptive functioning and resilience in early career teachers (ECT). Resilience is considered an important capability of teachers and research has shown that teachers who are resourceful, demonstrate agency and develop positive management strategies overcome adversity. In this research, we aim to examine more closely the strategic processes associated with resilience and whether these vary in a cohort of ECT. A sample of ECT (n = 160; M = 31.09, SD = 6.92) participated in the study. The findings showed that, consistent with previous research on adaptive change, three groups emerged from the cohort: stabilisers, adapters, and innovators. Stabilisers were the least resilient, adapters were more resilient, and innovators were most resilient. Length of service was not significantly associated with resilience, while a weak interaction was found between years of service and adaptive functioning. Resilience was strongly associated with adaptive functioning. Findings are discussed in relation to resilience and ECT’s self-care.     

Protective factors associated with resilient functioning in young adulthood after childhood exposure to violence

Children may be subjected to many forms of violence and a significant number will experience multiple victimizations. These children are at high risk for developing psychological and emotional difficulties that may last into adulthood. Despite the increased risk for psychopathology, a substantial percentage of young adults exhibit resilient functioning following a history of childhood violence. This study examines the role of social support, spirituality, and emotional intelligence in promoting resilience during emerging adulthood. Participants included 321 young adult American college students, age 18–24, who experienced childhood violence, including community violence, interpersonal aggression, child maltreatment, peer/sibling victimization, and/or sexual assault. Findings revealed that this sample was highly victimized, with an average of 9 violent experiences reported during childhood. Hierarchical multiple regression analyses indicated that after controlling for exposure to childhood victimization, other potentially traumatic events, and current depression and anxiety symptoms, higher resilience during emerging adulthood was associated with greater spirituality, greater emotional intelligence, and support from friends (but not from family). Findings suggest that the potency of protective factors outweighs that of adversity and psychopathology when predicting resilient functioning. By identifying variables that can enhance resilience, this study offers unique insight into how functioning may be improved by both individual and environmental factors.     

Differences between accounts provided by witnesses and alleged victims of child sexual abuse

OBJECTIVES: To determine whether child witnesses of sexual abuse were more or less informative about the alleged incidents than alleged victims when interviewed similarly. METHOD: Twenty-six alleged victims of child sexual abuse (aged 5 to 14 years; M=9.8 years) and 26 children who had witnessed but not experienced similar events were interviewed by experienced youth investigators about the alleged abuse. Children in the two groups were matched with respect to their age, relationships with the alleged perpetrator, and seriousness of the alleged offenses. All children were interviewed using the NICHD investigative interview protocol. RESULTS: Witnesses and victims provided similar amounts of information about the incidents of abuse. Interviewers used more open-ended invitations and elicited more information using open-ended prompts from witnesses than from victims, whereas they used more risky (including suggestive) prompts when interviewing victims. DISCUSSION: These results confirm that young children can be informative witnesses about events that they have either experienced or witnessed.     

A situational crime prevention analysis of Anglican clergy’s child protective practices

To date, a predominant focus within the field of ‘clerical collar crime’ has revolved around institutional-level church responses to child sexual abuse events, survivors and offenders. Comparatively, little attention has been directed towards the micro-level and in particular, examining clerical responses to child sexual abuse. This article presents empirical findings concerning the ‘everyday’ child protective practices of Anglican clergy in the Diocese of Tasmania, Australia. Research data was acquired through open-ended qualitative interviews conducted with a sample of 34 clergy in a broader study of clerical culture, habitus and life amidst the ‘church abuse crisis’. The framework of Situational Crime Prevention is employed to evaluate the feasibility of clergy’s child-safe practices and comment on how these practices could be further altered through professional development. Research findings demonstrate that clergy possess an active awareness of risk, and execute a series of protective measures to minimise both sexual interactions with children and allegations of impropriety.     

The impacts of institutional child sexual abuse: A rapid review of the evidence

While awareness of institutional child sexual abuse has grown in recent years, there remains limited understanding of its occurrence and outcomes as a distinct form of abuse. Drawing on research commissioned by the Australian Royal Commission into Institutional Responses to Child Sexual Abuse, this article presents a rapid review of available evidence on the impacts of institutional abuse on victim/survivors. Literature searches identified 75 sources spanning international peer reviewed work and reports to Government that document or quantify the impacts of mostly historical child sexual abuse occurring in religious, educational, sporting and residential or out-of-home care settings. Consistent with child sexual abuse in other contexts, institutional child sexual abuse is found to be associated with numerous, pervasive and connected impacts upon the psychological, physical, social, educative and economic wellbeing of victims/survivors. Further, institutional child sexual abuse is associated with vicarious trauma at the individual, family and community level, and with impacts to the spiritual wellbeing of victims/survivors of abuse that occurs in religious settings. The identified literature suggests the trauma of institutional child sexual abuse may be exacerbated by the interplay of abuse dynamics in institutional settings, which may reduce or impede circumstances supporting disclosure, belief, support and protection from future harm. Acknowledging the limitations of the present study and the available evidence, this narrative synthesis provides insights into the complex impacts of institutional child sexual abuse.     

Effects of mother-son incest and positive perceptions of sexual abuse experiences on the psychosocial adjustment of clinic-referred men

OBJECTIVE: The primary objective was to examine the long-term impact of mother-son incest and positive initial perceptions of sexual abuse experiences on adult male psychosocial functioning. METHOD: Sixty-seven clinic-referred men with a history of sexual abuse participated. The participants completed self-report measures regarding their current psychosocial functioning and described the nature of their sexual and physical abuse experiences during childhood. RESULTS: Seventeen men reported mother-son incest, and these men endorsed more trauma symptoms than did other sexually abused men, even after controlling for a history of multiple perpetrators and physical abuse. Mother-son incest was likely to be subtle, involving behaviors that may be difficult to distinguish from normal caregiving (e.g., genital touching), despite the potentially serious long-term consequences. Twenty-seven men recalled positive or mixed initial perceptions of the abuse, including about half of the men who had been abused by their mothers. These men reported more adjustment problems than did men who recalled purely negative initial perceptions. CONCLUSIONS: Mother-son incest and positive initial perceptions of sexual abuse experiences both appear to be risk factors for more severe psychosocial adjustment problems among clinic-referred men.     

Elements of Supervision in Sexual Violence Counselors' Narratives: A Qualitative Analysis

The literature on vicarious traumatization has suggested that traumasensitive supervision may help to minimize the effects of vicarious exposure to trauma; however, nothing from the perspective of trauma counselors was noted. The present qualitative study involved 1 male and 8 female sexual violence counselors who had worked with sexual violence survivors from 1 to 9 years. The use of semistructured interviews and basic interpretive analysis revealed 4 themes: counselor feelings, vicarious traumatization, helpful qualities of supervision, and organizational considerations.     

The link between the emotional consequences of child sexual abuse and school experiences

The present paper presents findings drawn from a qualitative study that investigated the impact of childhood sexual abuse on school functioning among young adult survivors in South Africa. Data were obtained by means of in‐depth individual interviews with 22 young adults. Analysing the interviews following procedures aligned to a grounded theory approach, the findings revealed the link between the emotional consequences of the experience and the individual's school performance. To provide a detailed explanation of the victims' responses, the discussion includes the multifaceted factors that trigger emotions and their interactions.     

Psychological functioning and family discord among African-American adolescent females with and without a history of childhood sexual abuse

OBJECTIVES: The aim was to examine the rate of childhood sexual abuse along with the factors (age of abuse onset, type of perpetrator, and duration of the abuse), as well as the relationship of these factors to psychological functioning among females with a history of childhood abuse. Second, to determine whether levels of psychological functioning and family discord differ among females with and without a history of childhood sexual abuse. METHOD: A cross-sectional design was used. Two hundred and forty-nine adolescent females were recruited from a community-based health program. Two trained female interviewers administered an anonymous survey that assessed childhood sexual abuse, psychological functioning, and family environment. RESULTS: Fifty-seven (22.9%) of those surveyed reported childhood sexual abuse, of which 44.3% were intrafamilial and 55.7% were interfamilial. Age at onset ranged from 3 years to 17 years; 62.5% reported that the sexual abuse occurred 1 to 4 times; 27.9% reported a duration ranging from 1 year to 13 years; and 9.6% reported a duration of 1 month to 7 months. Multiple regression analysis revealed that a greater duration predicted higher levels of depression and lower levels of self-esteem among females with a history of sexual abuse. Females with a history of childhood sexual abuse scored significantly lower on measures of self-esteem and mastery, and significantly higher on measures of physical and emotional abuse. CONCLUSIONS: Results indicate that adolescent females with a history of childhood sexual abuse suffer an array of negative sequelae that include psychological and family distress.     

A qualitative analysis of adult incest survivors' responses to sexual involvement with therapists

Six women who had histories of incest and had been sexually involved with therapists participated in qualitative research employing semi-structured, open-ended interviews. Transcribed interviews were content analyzed for recurrent regularities in topics, themes, events, and dynamics. Following content and cluster analyses of interviews, three overall themes emerged that appeared most salient in attempting to understand the development and maintenance of therapeutic relationships in which incest survivors experienced additional abuse. The themes were (1) early environment that prohibited the development of a sense of "personhood" in incest survivors, (2) repeated experiences of depersonalization inside and outside of therapy that reinforced a state of non-personhood, and (3) adoption of a "surrender pattern" to cope with violations, including therapist violations.     

Resilience to adult psychopathology following childhood maltreatment: evidence from a community sample

OBJECTIVE: Child abuse is an important risk for adult psychiatric morbidity. However, not all maltreated children experience mental health problems as adults. The aims of the present study were to address the extent of resilience to adult psychopathology in a representative community sample, and to explore predictors of a good prognosis. METHODS: Data are drawn from a follow-up of the Isle of Wight study, an epidemiological sample assessed in adolescence and at midlife. Ratings of psychiatric disorder, peer relationships and family functioning were made in adolescence; adult assessments included a lifetime psychiatric history, personality and social functioning assessments, and retrospective reports of childhood sexual and physical abuse. RESULTS: Ten percent of individuals reported repeated or severe physical or sexual abuse in childhood. Prospective measures revealed increased rates of adolescent psychiatric disorders in this group. Rates of adult psychopathology were also high. A substantial minority of abused individuals reported no mental health problems in adult life. Resilience of this kind was related to perceived parental care, adolescent peer relationships, the quality of adult love relationships, and personality style. CONCLUSION: Good quality relationships across childhood, adolescence and adulthood appear especially important for adult psychological well being in the context of childhood abuse.     

To a safer place? Victims of sexual abuse by females and their disclosures to professionals

OBJECTIVE: To explore the experiences of victims of female sex offenders with regard to disclosing sexual abuse to a professional, and importantly, the impact of professional responses on victims. METHOD: The data were derived from one-to-one semi-structured interviews with 14 (7 males, 7 females) victims of child sexual abuse by female perpetrators. Victims ranged in age from 23 to 59 years and were recruited through professional referrals or through poster advertisements in counseling services. Participants responded to questions on their family background, experience(s) of sexual abuse, experience(s) disclosing the sexual abuse to a professional, and the impact of professional responses. RESULTS: The majority of victims reported sexual abuse by their mothers. The average age of onset of the sexual abuse was age 5, lasting, on average, 6 years. Five participants reported experiencing severe, moderate and mild sexual abuse, four reported experiencing both severe and mild sexual abuse and five reported experiencing moderate and mild sexual abuse. The findings underscore the significance of professional intervention in relation to victim disclosures of sexual abuse by females. Professional responses to disclosures, whether positive or negative, appeared to have a crucial impact on the well-being of victims. Supportive professional responses including the acknowledgment and validation of victims' experiences of sexual abuse appeared to mitigate the negative effects of the abuse. In contrast, unsupportive responses where professionals minimized, or disbelieved victims' allegations of sexual abuse appeared to exacerbate the negative effects of the sexual abuse, ultimately inciting secondary victimization. CONCLUSION: The study highlights the need for the development and implementation of professional training initiatives to sensitize professionals to the issue of female sex offending and the intervention needs of victims. Failure to do so could have negative consequences for victims sexually abused by females.