A comparison of physical and sexual abuse: histories of sexual and non-sexual offenders with intellectual disability

OBJECTIVES: To review patterns of physical and sexual abuse in cohorts of sexual offenders and nonsexual offenders with intellectual disability. METHOD: Forty-six sexual offenders were compared with 48 male nonsexual offenders in relation to their experiences of sexual and physical abuse in childhood. Comprehensive assessments were taken over a period of at least one year, and were conducted independently by a range of professionals. RESULTS: Thirty-eight percent of the sexual offenders and 12.7% of the nonsexual offenders had experienced sexual abuse, while 13% of the sexual offenders and 33% of the nonsexual offenders had experienced physical abuse. CONCLUSIONS: Sexual abuse seems a significant variable in the history of sexual offenders, while physical abuse seems a significant variable in the history of nonsexual offenders. The results support the view that the "cycle of abuse" is neither inevitable nor an adequate explanation of future offending.     

Ego development in women with histories of sexual abuse.

As many as a third of the women in this culture experience sexual abuse prior to reaching age 18. Recent literature and research have presented divergent views related to the impact of early abuse on ego development, with arguments supporting both ego fragmentation and ego acceleration. This preliminary study compared the level of ego development, as measured by Loevinger's Washington University Sentence Completion Test (SCT), of 30 women with histories of childhood sexual victimization, and 30 women with no history of abuse. Results indicated no significant difference between the ego levels of the sexually abused and nonabused groups, with a slight trend toward higher ego development in the abused group. Factors contributing to these findings are discussed and recommendations for future research are suggested.     

Men with childhood sexual abuse histories: Disclosure experiences and links with mental health

BackgroundThere is limited research on the disclosure experiences of men who have experienced childhood sexual abuse and on how such experiences might impact mental health outcomes.ObjectiveThe current study described men’s disclosure experiences and examined the role of disclosure characteristics on mental well-being (internalizing and externalizing behaviors, substance use, resilience).Participants and settingMen (N = 253) from across Canada and the U.S. were recruited through websites for males with sexual abuse histories. Men aged 18–59 years anonymously completed an online study on their sexual abuse, disclosure experiences, and mental health outcomes.ResultsFindings indicated that 77.9% of men disclosed their sexual abuse, although they waited an average of 15.4 years before sharing their experience. Once disclosed, 64.4% of the men reported a positive response (e.g., support), while 35.6% reported a negative response (e.g., blame). Regression analyses indicated that a greater delay in disclosure predicted greater externalizing behaviors (B = .49, p < .05), although this was a small effect (Cohen’s f ² = 0.02). Additional disclosure variables were associated with components of externalizing (aggressive and rule-breaking behaviors) and internalizing (somatic complaints) behaviors.ConclusionsThese results require replication in future studies. However, they do suggest that efforts need to be undertaken to address the barriers that hinder men from disclosing their sexual abuse and to ensure that men are supported once they disclose.     

Child sexual abuse as reported by Israeli adolescents: Social and health related correlates

The objectives of the study were to assess the prevalence of child sexual abuse (CSA) in a nation-wide representative sample of 14–17 year old Israeli adolescents, and to examine the associations between CSA, socio-demographic correlates and various measures of physical and mental health. The study population consisted of 906 mother–adolescent dyads, belonging to a community based, representative sample of Israeli 14–17 year olds, interviewed in 2004–5. Response rate was 68%. Subjects provided demographic data, and information about CSA, physical symptoms, body image, well-being and use of mental health services. DAWBA was used to obtain information regarding mental disorders and suicidality. SDQ was used to obtain data on bullying. Statistical analyses were conducted using an SPSS-17 complex sample analysis module and multivariate analyses were conducted to assess the associations between CSA and risk factors and social and health related correlates. Findings show that CSA was reported by 3.3% of adolescents. Higher risk of exposure to CSA was found among girls, among adolescents living in a one-parent household and among adolescents with a chronic disability. In multivariate models adjusting for gender, learning disabilities and depression, CSA was associated with suicidal attempts, stomach ache, dizziness, sleep problems, well being at home and bullying behaviors. No association was found with suicidal ideation or other physical symptoms. Our findings confirm that the associations between CSA and different outcomes vary depending on the socio-psychological context, and underline the importance of addressing the complexity of variables associated with CSA.     

Analysis of caretaker histories in abuse: comparing initial histories with subsequent confessions

OBJECTIVE: We hypothesize that perpetrators of abuse include elements of truth in their initial history and that an analysis of perpetrator confessions can teach professionals how to identify these initial truths. METHODS: The information from a consecutive sample of perpetrators' confessions concerning 41 children hospitalized because of injuries caused by child abuse was reviewed. The details about the injuries contained in the confessions were compared with the details provided when these children initially presented for medical care. Information about the perpetrator's gender and relationship to the child, the victim's age and gender, type of injury, family risk factors, the trigger of the abusive event, the circumstances surrounding the event, and the type of trauma were collected. RESULTS: A total of 45 perpetrators abused 41 children; 76% of perpetrators were male; 56% were the child's father; 34% were the child's mother. The perpetrators initially provided no explanation about how 68% of the children received an injury. In 91% of their initial histories, the perpetrators provided some element of truth about the circumstances or triggering event for the abuse. In 67% of confessions, crying was the circumstance that triggered the abuse. Mothers were more likely to describe the situation that triggered the abuse (85% of mothers versus 58% of fathers, p=ns), while fathers were more likely to describe accurately the circumstances surrounding the abuse (79% of fathers versus 62% of mothers, p=ns). CONCLUSIONS: Perpetrators of abuse provide initial truths in their presenting history. Child abuse professionals must take a careful history from all caretakers and "listen" for the "elements of truth." These truths are the child's behavior or circumstance that increased stress and triggered the abuse. Employing this method in a careful analysis of confessions can make a significant contribution to the capacity to identify child abuse. In addition, more information about the role of triggers may help to focus child abuse prevention strategies.     

Mental health indicators fifty years later: A population-based study of men with histories of child sexual abuse

Childhood sexual abuse (CSA) is a widely acknowledged trauma that affects a substantial number of boys/men and has the potential to undermine mental health across the lifespan. Despite the topic’s importance, few studies have examined the long-term effects of CSA on mental health in middle and late life for men. Most empirical studies on the effects of CSA have been conducted with women, non-probability samples, and samples of young or emerging adults with inadequate control variables. Based on complex trauma theory, the current study investigated: a) the effect of CSA on mental health outcomes (depressive symptoms, somatic symptom severity, hostility) in late life for men, and b) the moderating effects of childhood adversities and masculine norms in the relationship between CSA and the three mental health outcomes. Using a population-based sample from the 2004–2005 Wisconsin Longitudinal Study, multivariate analyses found that CSA was positively related to both depressive and somatic symptoms and increased the likelihood of hostility for men who reported a history of CSA. Both childhood adversities and masculine norms were positively related to the three outcomes for the entire sample. Among CSA survivors, childhood adversities exerted a moderating effect in terms of depressive symptoms. Mental health practitioners should include CSA and childhood adversities in assessment and treatment with men. To more fully understand the effects of CSA, future studies are needed that use longitudinal designs, compare male and female survivors, and examine protective mechanisms such as social support.     

Exploring parent sexuality profiles and links with the sexuality profiles of adolescents who have engaged in sexual abuse

BackgroundParents play an important role in children's development of sexual norms and behaviors. Regarding the family environment of adolescents who have engaged in sexual abuse (AESA), some studies have suggested potential factors of interest, although the sexuality of AESA parents has yet to be considered.Objectives(1) Explore sexual profiles among parents, (2) Examine if the sexual profiles of parents are related to the sexual profiles of AESA.Participants and settingParticipants include 201 parents (116 mothers, 85 fathers) of AESA recruited from specialized treatment and youth centers in Quebec.MethodsHierarchical and nonhierarchical methods were used to generate cluster solutions. Chi-square or Fisher's exact tests were then conducted to explore links between parents’ and AESA sexuality profiles.ResultsThree sexuality profiles emerged separately for mothers and fathers, showing similar patterns. Parents in the first two clusters (Overinvested and Atypical Sexuality – OAS and Overinvested and Non-Atypical Sexuality – ONAS) showed greater interest/investment in sexuality and an earlier sexual onset. However, they differed on their sexual interests: Most parents in the OAS cluster reported a greater variety of atypical fantasies and atypical sexual behaviors, while the sexual interests of parents in the ONAS cluster were mainly limited to non-atypical sexuality. Parents in the third cluster (Constrictive Sexuality – CS) were less interested and invested in sexuality. A link between the exacerbated sexuality of mothers (OAS cluster) and of adolescents was also found.ConclusionsThis study represents a first step in showing a potential correspondence between parents’ and AESA sexuality profiles.     

Convergence and divergence in reports of maternal support following childhood sexual abuse: Prevalence and associations with youth psychosocial adjustment

This study examined the convergence and divergence in mothers’ and children's reports of maternal support following disclosures of childhood sexual abuse (CSA). One hundred and twenty mothers and their children (ages 7–17 years) reported on two aspects of support following CSA disclosures: mothers’ belief in the child's disclosure and parent–child discussion of the abuse incident. Whereas 62% of mothers’ and children's reports on mothers’ belief of the disclosure positively converged (i.e., both reported that mothers “completely believed” the child's disclosure), 37% of mothers’ and children's reports diverged, and the remaining 1% negatively converged (i.e., both reported that the mother only believed the child “somewhat”). Positively convergent responses were associated with youths’ lower risk for tobacco and illicit drug use. Forty-four percent of mothers’ and children's reports on whether details of the CSA were discussed positively converged (i.e., both reported that details were discussed), 33% diverged, and 23% negatively converged (i.e., both reported that details were not discussed). Relative to other patterns of reporting, negatively convergent responses were associated with higher levels of trauma symptoms. Findings have implications for identifying high-risk mother–child dyads based on patterns of informant reporting following CSA.     

Reporting possible sexual abuse: a qualitative study on children's perspectives and the context for disclosure

OBJECTIVE: The present study investigated the context in which children were able to report their child sexual abuse experiences and the children's views as to what made it difficult to talk about abuse and what helped them in the disclosing process. The aim was to study disclosures as they were occurring in their natural settings. METHOD: Data were obtained from therapeutic sessions and follow-up interviews from 20 families with 22 children. These children had said something that made their caregivers concerned about ongoing child sexual abuse. Qualitative analysis was conducted to capture the children's and caregiver's perspectives of the disclosure process. RESULTS: The children felt it was difficult to find situations containing enough privacy and prompts that they could share their experiences. They also were sensitive to others reactions, and whether their disclosures would be misinterpreted. When the children did disclose they did it in situations where the theme of child sexual abuse was in some form addressed or activated. The results indicate that disclosure is a fundamentally dialogical process that becomes less difficult if the children perceive that there is an opportunity to talk, and a purpose for speaking, and a connection has been established to what they are talking about. CONCLUSIONS: It is difficult for children to initiate a conversation about something secret, confusing and distressful, and where there are few conversational routines in a family for talking about such themes. Children also are sensitive to the needs of their caregivers and fear consequences for their family and offender. Children need a supportive structure or scaffold in order to reveal their experiences of child sexual abuse.     

Masculine norms,disclosure, and childhood adversities predict long-term mental distress among men with histories of child sexual abuse

Child sexual abuse (CSA) can have a profound effect on the long-term mental health of boys/men. However, not all men with histories of CSA experience psychopathology. To improve prevention and intervention services, more research is needed to understand why some male survivors experience mental health problems and others do not. The purpose of this study was to examine factors related to mental distress among a large, non-clinical sample of men with histories of CSA (N = 487). Using a cross-sectional design with purposive sampling from three national survivor organizations, data were collected through an anonymous Internet-based survey. Multivariate analyses found that only one of the four CSA severity variables—use of physical force by the abuser—was related to mental distress. Additional factors that were related to mental distress included the number of other childhood adversities, years until disclosure, overall response to disclosure, and conformity to masculine norms. Overall, the final model predicted 36% of the variance in the number of mental health symptoms. Mental health practitioners should include masculine norms, disclosure history, and childhood adversities in assessments and intervention planning with male survivors. To more fully explicate risk factors for psychopathology in this population, future studies with probability samples of men that focus on mediational processes and use longitudinal designs are needed.     

Exploring sexuality profiles of adolescents who have engaged in sexual abuse and their link to delinquency and offense characteristics

Very few studies have taken a specific interest in the various sexual dimensions, beyond delinquent sexual behavior, of adolescents who have engaged in sexual abuse (AESA). Those that went beyond delinquent sexual behavior have report mixed results, suggesting they are a heterogeneous group. The current study used cluster analysis to examine the sexuality profiles of AESA, which included information on several sexual dimensions (atypical and normative fantasies and experiences, drive, body image, pornography, first masturbation, onset of sexual interest and first exposure to sex). Participants (N = 136) are adolescents who have engaged in sexual abuse involving physical contact, for which at least one parent also participated in the study. They were recruited from six specialized treatment centers and three youth centers in Quebec (Canada). Cluster analyses were performed to identify specific sexual profiles. Results suggest three clusters of AESA: 1- Discordant sexuality pertaining to adolescents who show mostly normative sexual interests, 2- Constrictive sexuality, characterizing adolescents who seem to be less invested/interested in their sexuality and 3- Overinvested sexuality for adolescents showing an exacerbated sexuality, including atypical sexual interest. Additional analyses (ANOVAs and Chi-square tests) reveal that five delinquency and offense characteristics were significantly more likely to be present in the Overinvested than the Constrictive cluster: non-sexual offenses, three or more victims, peer victims and alcohol and drug consumption. Advancing our knowledge on this topic can provide relevant data for clinicians to better target interventions.     

Child sexual abuse and bulimic symptomatology: relevance of specific abuse variables

OBJECTIVE: This study examined specific aspects of child sexual abuse in relation to symptom severity among hospitalized patients diagnosed with bulimia nervosa. METHOD: Participants were 45 hospitalized bulimic women who reported a history of child sexual abuse. Structured interviews were conducted in order to obtain detailed information regarding specific features of the abusive event(s). Participants also completed instruments that measured depression and eating pathology. RESULTS: There were no significant differences in severity of depression or eating disturbance among women reporting differing abusive experiences including intrafamilial versus extrafamilial abuse, abuse with or without the use of physical force, one versus multiple incidents, early abuse versus abuse occurring after age 14, contact versus noncontact abuse, disclosed versus undisclosed, and combined physical/sexual abuse versus sexual abuse alone. CONCLUSION: The specific characteristics of child sexual abuse are not related to the level of symptomatology for hospitalized bulimic patients. This study suggests that differences in the nature of the abuse may not be as important as the fact that the abuse occurred in the first place.     

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.     

The sexual abuse of young people with disabilities: Treatment considerations

Research has indicated that sexual abuse of individuals with disabilities is frequently repeated and chronic, and often results in significant harm to the victim. Furthermore, while abusers are most often family members or acquaintances, many offenses are committed by paid service providers and occur in disability service settings. Findings indicate that victims with disabilities often experience difficulty in obtaining treatment services that are accessible and appropriately adapted to their needs. Based on the necessity of appropriate treatment, considerations and strategies are discussed for therapy adaptations to meet the special needs of sexually abused young people with developmental disabilities.     

Attitudes of health professionals to child sexual abuse and incest

While there has been increasing interest in the topic of child sexual abuse, few studies have focused on attitudes or the determinants of such attitudes held by professionals. To what extent concern is based on stereotyping or factual knowledge is not clear. The present study uses a combination of experimental and survey methodologies to address these issues. Sample case histories were issued to subjects who were then asked to complete a questionnaire on topics relating to the case and to incest in general. Results showed that the type of sexual activity involved influenced responses: type of relationship between adult and child, less so. Estimates of incest were low, but incest was considered, especially by female respondents, to be harmful to the victim.     

The family environment of sexual abuse: a comparison of natal and stepfather abuse

Data from 17 states, drawn from the 1983 National Study on Child Neglect and Reporting, were used to compare families in which a daughter had been sexually abused by a natal father or stepfather. While broad comparisons are made in terms of age and race of victims, as well as household composition, the primary focus is on familial stress factors. Given the lower incidence of natal father abuse and the assumption that natal fathers have stronger emotional links to their children and greater commitment to the father role, we predicted that when they did engage in sexual abuse, it would be in a family environment characterized by relatively high levels of personal, social, and economic stress. This was confirmed to the extent that natal father abuser families showed significantly higher levels of drug and/or alcohol abuse, marital problems, and insufficient income than did stepfather abuser families.     

Children hospitalized with child abuse and neglect: a case-control study

A case-control study of 45 hospitalized abused children was conducted to reassess the risk factors for child abuse when confounding by social class was minimized. Cases were matched for age, sex, family structure, and social class with children admitted to hospital for an acute illness. Abused children were more likely to have younger parents, fewer siblings, and to have been separated from their mothers during the first year of life. Their parents were more likely to have been abused as children and to have a poor relationship with the child's other parent. The families of abused children had encountered more stressful life events in the preceding 12 months. Other previously recognized "risk factors" were not shown to have a statistically significant association with child abuse. Because child abuse is more prevalent in lower socioeconomic families, the association with many of these factors has been accepted as implying a causal relationship. Matching procedures which attempted to eliminate confounding by social class and family structure cast doubts on some previously held beliefs about the risk factors for child abuse.