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Given the alarming increase in incidences of child sexual abuse (CSA), the present study was conceived to conduct a feasibility trial for a brief CSA-focused cognitive-behavioral intervention for children. A quasi-experimental single-group pre-post design with convenient sampling was adopted. The intervention module was administered to 20 children aged 7–13 years (M = 10.4, SD = 1.3) with a CSA history. The intervention was spread across a minimum of six required sessions and a maximum of 12 sessions held weekly for approximately 90 to 120 minutes' duration to restore the child's functioning and to assist the child in processing and managing trauma effectively along with initiating the process of growth. Child PTSD Symptom Scale (CPSS), Children's Impact of Events Scale−13 (CRIES-13), Developmental Psychopathology Checklist (DPCL), Multidimensional Scale for Child Sexual Abuse (MSCSA) and Children's Global Assessment Scale (CGAS) were used to measure the impact of the intervention on the children. Estimation of improvement was done using Wilcoxon signed rank test, effect size and subjective feedback from children. Feasibility assessment was done across five parameters: recruitment, data collection, attrition, adherence and improvement. We found that the intervention led to significant improvement in scores of all scales with a large effect size of.50 for MSCSA and CRIES-13 and medium effect size for CGAS, CRIES-13 (Intrusion & Avoidance), CPSS, and DPCL. Feasibility was estimated to be high across all five parameters of the assessment. Thus, the newly developed intervention was found to be helpful in restoring the child's functioning, and assisting the child in processing, and managing trauma effectively. [ABSTRACT FROM AUTHOR]

Programs aimed at preventing child sexual abuse typically focus on skilling up young children and, to a lesser extent, parents by imparting a range of protective messages. Many sexual abuse prevention programs include a focus on identifying or vetting "safe" or "trustworthy" people. The authors qualitatively analyzed the content of narratives from individuals with childhood experience of intrafamilial sexual abuse, an under-represented voice in the development of child sexual abuse prevention programs. The analysis of impediments to protection indicated that, within the family context, reductionistic judgments of familiar individuals' perceived safety or trustworthiness impaired child safety. In addition to adults and children being unable to recognize sexually abusive behavior and warning signs, child-victim survivor narratives highlighted the barriers for prevention in family environments characterized by maltreatment, a lack of child rights or that were unsupported by external authorities. Implications for the content of messages young children and their parents need to prevent child sexual victimization in the context of everyday family life are discussed. [ABSTRACT FROM AUTHOR]

A healing and recovery perspective related to child sexual abuse (CSA) has gained attention in the past two decades, a concept that accurately refers to the process is posttraumatic growth (PTG). Scarce empirical research on PTG in clergy-perpetrated CSA survivors shows evidence of the presence of growth after the abusive experience and a tendency to create accounts of trauma as a way to heal. The general aim of the study is to explore the experiences and meanings of PTG as lived by survivors of clergy-perpetrated CSA. Seven clergy-perpetrated CSA survivors were interviewed with semi-structured in-depth interviews conducted in person. Using reflexive thematic analysis, we identified three dominant themes in the participants' stories: (a) the hindering of PTG; (b) the meanings of PTG, and (c) the internal and contextual and facilitators of PTG. The present study brings new insights into the meanings of PTG, the close relationship between damage and growth, and the mechanisms (both internal and contextual) that are involved in healing from clergy-perpetrated CSA in Spanish culture. [ABSTRACT FROM AUTHOR]

This exploratory study investigated group differences and pre-post changes in knowledge, beliefs, and behavior by mandatory reporters and Child Sexual Abuse (CSA) survivor status for a CSA prevention training designed for the general public. Of the 8,114 study participants, 32% identified as having experienced CSA, and 77% indicated they were mandatory reporters for child abuse and neglect. Mandatory reporters had higher baseline knowledge about CSA than those who were not mandatory reporters and reported more CSA preventative behaviors. Mandatory reporters continued to have higher levels of knowledge following the training. Survivors of CSA also had higher baseline knowledge about CSA and preventative behavior scores than individuals who are not survivors of CSA. Unlike mandatory reporters, they experienced fewer increases in knowledge. At posttest, there was no evidence of a difference in knowledge between CSA survivors and non-CSA survivors. For items related to beliefs, mandatory reporters had higher baseline scores than other participants. However, they had smaller gains, so mandatory reporters and non-mandatory reporters had more similar beliefs related to CSA after the training. There were few differences between CSA survivors and non-survivors on baseline beliefs related to CSA, though CSA survivors reported greater increases in beliefs that CSA prevention is their responsibility and in the idea that they know what to do to prevent CSA. These results have significant results for the development and evaluation of trauma-informed prevention programming. [ABSTRACT FROM AUTHOR]

This exploratory study sought a deeper understanding of the perspectives of self-defined ritual abuse (RA) survivors, who had experienced sexual victimization, on participation in research. A mixed-methods qualitative design involving online survey and follow-up virtual interviews included 68 adults across eight countries. Content and thematic analysis of responses indicated that RA survivors were keen to be involved in a range of research activities to share their experience, knowledge, and support for other survivors. Having a voice, gaining knowledge, and feeling empowered were reported as advantages of participation, while concerns included exploitation, researcher ignorance, and emotional dysregulation caused by content discussed. To enable their engagement in the future research, RA survivors identified participative research designs, anonymity, and increased opportunities for inclusion in decision-making. [ABSTRACT FROM AUTHOR]

A large body of research reveals that child sexual abuse is an adverse experience associated with many negative socioemotional and behavioral consequences during adolescence. Notably, adolescent victims of child sexual abuse are more likely to engage in delinquent behavior, which has importance for their adaptation later in life. While research on the psychological antecedents of delinquent behavior has independently considered each core feature of silencing the self (i.e., low assertiveness and self-expression, conflict avoidance, presenting a non-authentic self, anger, and hostility), it has failed to jointly consider these as potential predictors of delinquent behaviors in adolescent victims of child sexual abuse. The purpose of this study was to examine the associations between the two dimensions of self-silencing (i.e., divided self and silencing the self) and delinquency in adolescent victims of child sexual abuse. A sample of 110 adolescents seeking services following child sexual abuse completed self-reported questionnaires, and case files were analyzed to gather information regarding child sexual abuse severity. Hierarchical regression analyses revealed that, after controlling for the effect of age, gender, parental monitoring, and child sexual abuse severity, self-silencing was positively associated with delinquent behaviors, affiliation with delinquent peers, as well as alcohol and drug use. Divided self contributed to the prediction of aggressive behaviors. Implementing interventions aimed at increasing adolescents' assertiveness, conflict management skills, and emotion regulation and promoting congruence between their behaviors and authentic selves may lower their involvement in delinquency. [ABSTRACT FROM AUTHOR]

Disclosing child sexual abuse (CSA) is a necessary first step to access the legal, health, and psycho-social services that survivors and their families need. However, disclosure rates are low: of young women who experienced CSA in Zimbabwe, only 9% disclosed the first incident. The purpose of this qualitative study was to explore and describe perceived barriers to disclosing CSA in Zimbabwe. We conducted focus group discussions with children aged 10–14 years (n = 40) and their parents/caregivers aged 20–62 years (n = 40), participating in an intervention trial in Chitungwiza, Zimbabwe. We found that potential retaliation against survivors and their families is a major barrier to disclosing CSA. These retaliatory acts, which we refer to as "re-victimization," arise from stigma or the victim feeling blamed or doubted and manifest through physical violence, emotional violence, and deprivation of family life and education. Our findings suggest that addressing social and cultural norms related to sex and strengthening legal protection for CSA survivors and their families could encourage CSA disclosure and could help end this violence. Our findings also highlight a need to increase children's awareness of their rights and to create safe systems for disclosure of sexual abuse. [ABSTRACT FROM AUTHOR]

With evidence suggesting that females are more likely to be victims of child sexual abuse (CSA), much of the literature – including that on disclosure – focuses on females. Thus, male victims remain "under-studied". Given this, the aim here is to contribute to the scant knowledge base on the sexual abuse of males and disclosure by focusing on males whose voices are even more rarely heard than those in the general male population: those who have perpetrated CSA. The men whose stories are told here had been convicted of, and imprisoned for, CSA in the United Kingdom (UK). They were part of a sample of 101 incarcerated males, 40 of whom reported at interview that they had been sexually abused in childhood. Eighteen of those 40 men are focused on here as they provided some detail as to whether they had disclosed that abuse in childhood or adulthood, the responses they had received, and also why they had not disclosed. Their narratives shed some much-needed light on the nature of sexual abuse experienced by males, its onset and duration, sexual re-victimization, relationships with perpetrators, the diverse nature of disclosure, the extent to which victims disclose and when, the responses received, and why they do not tell. Little is known of these aspects of male CSA. The implications of the findings are considered together with future research directions. [ABSTRACT FROM AUTHOR]

Child sexual abuse (CSA) is a complex and often traumatic experience that can impact youth's emotional and psychological well-being. Many clinicians do not feel adequately prepared to work with youth around topics of sexuality. In this qualitative study, we examine how licensed therapists treat youth between ages 5 and 16 who have experienced CSA. We asked participants how they incorporate sexuality into trauma work with this population. Although all participants discussed themes commonly reported in clinical work with survivors (i.e., working on trust, self-image challenges, the brain-body connection, confusion around touch and boundaries) additional themes arose that could impede the provision of sexually-competent treatment for the survivor including: considerations for gender identity and sexual orientation, youth being sexually invisible until puberty, and an inaccurate/narrow use of the term "sexuality." We discuss the need for further training on youth sexual development and the ways youth experience the many topics within the concept of sexuality in their therapeutic treatment. [ABSTRACT FROM AUTHOR]

Child sexual abuse is a prevalent phenomenon worldwide. However, a gap exists between its incidence and its disclosure rate. Furthermore, assessment tools and techniques capable to identify the source of symptoms are lacking. This study investigates the extent to which the validated Medical Somatic Dissociation Questionnaire (MSDQ) can differentiate between sexually and non-sexually abused children. A total of 794 children and youth between the ages of 8 and 18 (mean age: 12.2 (SD = 2.3); 42% female, 58% male) were recruited from the general population; other participants were residents of boarding schools and children who were referred to medical treatment. The anonymous online questionnaire included queries about demographics, a condensed version of the Traumatic Life Events Questionnaire, and the MSDQ. Findings indicate strong internal consistency, reliability, incremental validity, and predictive validity of the instrument, indicating the superiority of the MSDQ's ability to predict sexual abuse compared to physical abuse or the loss of a family member. It is concluded that the MSDQ can be integrated into the evaluation process performed by healthcare professionals in the diagnosis of minors with unexplained symptomatology. [ABSTRACT FROM AUTHOR]

Shame has been recognized as a barrier to child sexual abuse (CSA) disclosures, but there has been less focus on the impact of shame on post-disclosure. This study explores how shame is experienced by CSA survivors following disclosure. Semi-structured interviews were conducted with eleven CSA survivors aged 14–25 years on their CSA disclosure experiences. Thematic analysis of the transcripts produced four themes that highlight the various impacts of shame post-disclosure: 1) struggles with identifying as a sexual abuse survivor; 2) manifestations of shame; 3) shaming responses to disclosures; and 4) strategies to overcome shame. Clinical implications are presented using a social ecological perspective. [ABSTRACT FROM AUTHOR]

Child sexual abuse (CSA) has been strongly associated with a range of psychological and physical problems in childhood and adulthood, such as anxiety, post-traumatic stress disorder (PTSD), and infectious diseases. Despite the strength of these associations, no studies to date have investigated psychobiological processes that might underlie the relationship between CSA and physical health problems occurring during childhood, such as infectious diseases. The goal of the current study is to evaluate PTSD as a potential mediator between CSA and the occurrence of infectious diseases among children and adolescents. Furthermore, we postulate that PTSD plays a specific role as an indicator of chronic stress during childhood, in comparison to other mental disorders, such as anxious and non-anxious disorders (e.g., depression). Via a prospective matched-cohort design, administrative data were used to document PTSD, anxious and non-anxious disorders, and infectious diseases. The sample size was 882 persons with a substantiated report of sexual abuse and 882 matched controls. Negative binomial regressions revealed that CSA is associated with a greater number of anxious diseases diagnoses that, in turn, predict more infectious diseases diagnoses. These findings highlight the importance of preventing and intervening among sexually abused youth with anxious disorder symptoms to limit negative outcomes on physical health. [ABSTRACT FROM AUTHOR]

Establishing trust is an important part of building the therapeutic relationships and achieving the goal of effective trauma treatment for individuals who have experienced childhood sexual abuse. The current study explored the associations between attachment style, therapeutic bond, distress, and interpersonal problems. This study investigated whether attachment style and therapeutic bond mediated the association between the level of early treatment emotional distress and later treatment interpersonal problems among two groups: clients reporting histories of childhood sexual abuse and clients not reporting histories of childhood sexual abuse. Research indicates that disruption of attachment security as well as the therapeutic relationship is common in survivors of childhood sexual abuse. We explored the mediating role of insecure attachment and the therapeutic bond on the predictive relationship between early treatment emotional distress and the interpersonal difficulties that one experiences in their daily life. For clients with histories of child sexual abuse, the model showed that anxious attachment and avoidant attachment mediated the associations between emotional distress and interpersonal relations. Therapeutic bond was not a significant mediator. For clients without histories of sexual abuse, results showed significant association between emotional distress and interpersonal relations, but insecure attachment or therapeutic bond did not mediate this relationship. [ABSTRACT FROM AUTHOR]

This article contextualizes new knowledge about forensically interviewing and assessing children when there are concerns about child abuse. The article references the impact of the Child Abuse Prevention and Treatment Act and the circumstance in the 1980s where investigators and clinicians had little guidance about how to interview children about alleged sexual abuse. It further speaks to the consequences of lack of interview guidelines and how videotaped interviews in the McMartin Pre-school cases served as the catalyst for the backlash against child interviewers and their interview techniques. Painful as the backlash was, it led to research and evidence-based practice in interviewing children about child sexual and other abuse. Principal among the practice innovations were forensic interview structures to be used when there is alleged child sexual and other abuse and the strong preference for one interview by a skilled interviewer, who is nevertheless a stranger to the child. Although these innovations satisfied many professionals in the child maltreatment field and critics of child interviewers, the new practices did not address a number of abiding issues: 1) how to meet the needs of children who are unable to disclose maltreatment in a single interview, 2) how to determine which children are suggestible in a forensic interview, and 3) how decisions are made about the likelihood of abuse, based upon the child's information during the interview. The articles in this special section address these cutting-edge issues. [ABSTRACT FROM AUTHOR]

While child sexual abuse is recognized as a global challenge in need of attention, all too often it takes years before sexual abuse is disclosed. We therefore need to understand more of the process leading to disclosure of child sexual abuse. The purpose of this study was to investigate how adult survivors of child sexual abuse came to understand that they had been sexually abused. We conducted semi-structured interviews with 8 women and 3 men (18–57 years old) and analyzed the interview transcripts using a hermeneutic-phenomenological approach to thematic analysis. Our analysis resulted in three main themes: The ambiguity of memory: "To remember the catastrophic"; The language of the body: "Let the body speak"; and Encountering an observant other: "The significance of being seen and recognized". The findings highlighted the complexity of the individual process of understanding that one has been sexually abused. The availability and intrusiveness of traumatic memories, bodily sensations and symptoms, and encounters with others proved to be contributing factors in the process. The findings give insights into why disclosure of sexual abuse can be difficult and have important implications for health professionals and policy makers working to help victims of child sexual abuse. [ABSTRACT FROM AUTHOR]

This study examined the assessment approach interviewers use while conducting interviews to assess truth as narratives are gathered in children's disclosure statements by examining 100 forensic interviews completed at a Children's Advocacy Center. A descriptive review was used to examine the steps engaged by interviewers as they followed a protocol and content analysis was used to identify interviewers' questioning strategies as they assessed children's disclosure narratives during interviews. Findings indicate that interviewers apply a protocol in order to support advancing to a phase of eliciting details in children's narratives. Questioning strategies included using a variety of question types to progress from general to specific, incorporating interview aids sparingly as necessary, and integrating multidisciplinary team feedback. Findings suggest that an assessment approach is inherent to the process of actively conducting a forensic interview. Rather than assessment beginning strictly upon completion of children's narratives, this paper describes how interviewers incorporate an assessment framework throughout interviewing. [ABSTRACT FROM AUTHOR]

Although substantial literature exists on child sexual abuse (CSA), little is known about abuses children encounter in northern Uganda, a post-conflict area. Media reports have indicated a high incidence for CSA. The study, firstly, explored boys' and girls' experiences of sexual abuse by adults in this post-conflict region and secondly, interventions directed at improving the current situation of children at risk of child abuse and the survivors were investigated as well. The study was guided by radical feminism and nested ecological framework theories. Semi-structured interviews were conducted involving 43 sexually abused children. Narrative responses were audio recorded and transcribed. Content qualitative analysis was used to understand sexual offenses from children's perspectives. Participants mentioned the following as the most perilous situations; laxity in parental roles, cultural norms, and practices, patriarchal attitudes, child sexual desires and attitudes, family breakdown and alcoholism. The study found many reported cases of CSA in the region. The results imply the exigent need of separate units specifically for reporting and handling child sexual offenses, need for personnel training on gender issues and filing system in child protection agencies and family programs for both fathers and mothers on child protection strategies for prevention and mitigation of CSA. [ABSTRACT FROM AUTHOR]

Despite extensive documentation of the adverse impacts of child sexual abuse (CSA), less is known about long-term effects of CSA, that is, the impact in middle and late adulthood, when one is further removed from the CSA. This study describes coping strategies and positive outcomes reported by adult female survivors of child sexual abuse ages 50+ (n = 58). Responses came from an anonymous online survey of adult survivors of CSA. We conducted a qualitative "RADaR" rapid analysis on the survey's open-ended questions. Survivors employed both internal attitudes and specific activities to cope with their childhood CSA. Most (n = 55) reported positive outcomes from CSA: self, others, and relational and/or emotive strengths. Due to survey limitations, we were unable to identify factors that contributed to survivors reporting positive outcomes and survivors who reported negative or no positive outcomes. This study suggests CSA survivors in middle and late adulthood may feel stronger as a result of abuse. More research is needed to identify factors that contribute to resilience. [ABSTRACT FROM AUTHOR]

Childhood sexual abuse (CSA) can result in devastating and long lasting consequences. Differences in the nature of the abuse differ for males and females and this difference potentially influences recovery. However, studies of recovery from CSA, especially among men, are relatively few, especially for ethnic minority men. The study explored the lived experience of recovery from CSA among African-Caribbean Black male survivors of CSA living in Canada, the United Kingdom and the United States. The theoretical framework was the transactional model of stress and coping, which proposes that stress is an ongoing transaction between the demands of life and a person's psychological ability to address those demands. The study was qualitative in design, using an interpretive phenomenological approach, involving purposeful sampling, in-depth semi-structured interviews, and interpretive phenomenological analysis of the data informed by a critical race theory lens. The results showed that Black male survivors are situated in unique historical/sociocultural interrelationships that complicate recovery from CSA, including institutional racism and discrimination, restrictive narratives of masculinity, and other cultural norms. These findings can be used to influence policy makers, service providers, and communities, to more effectively support and address the needs of CSA survivors and their affected families. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyze the prevalence and characteristics of child sexual abuse (CSA) in Andalusia, Spain's most populated region. A sample of 817 adults (281 male; M age = 34.7; SD = 13.86) completed the Child Sexual Abuse Experiences Questionnaire. Because the sample was unbalanced, we performed post-stratification by gender, resulting in 562 participants (50% male). Overall, 38.8% of the sample reported at least one type of contact abuse experience, with prevalence ranging from 22% for being fondled to 3.9% for being forced to perform a sexual act involving penetration. The first episode of CSA most commonly occurred between age 6 and 11 years, except for penetration. The majority of reported experiences were repeated and perpetrated by a male. More than half of the victims did not label their experience as sexual abuse, and this apparent lack of awareness about what constitutes abuse was particularly evident among male victims. The prevalence of CSA in Andalusia is higher than for Spain as a whole, highlighting the need to raise public awareness through prevention programs. [ABSTRACT FROM AUTHOR]

Though prior research has demonstrated that survivors of childhood sexual abuse may experience a range of negative emotions following the abuse, studies have failed to consider the conflicting, ambivalent, or positive emotions being attributed to the experiences by survivors. The current study describes the development and piloting of two new scales to capture the positive and negative emotions that youth may attribute to experiences of childhood sexual abuse. A sample of youth (N = 136) were recruited and surveyed from community corrections and residential treatment centers in a Midwestern state. Item Response Theory was used to test the performance of the measures and their individual items with the subsample of youth who reported a history of childhood sexual abuse (n = 40). Both new measures demonstrated high internal consistency reliability and appropriately captured the range of positive and negative emotions youth may experience following childhood sexual abuse. Findings indicate that youth who have experienced childhood sexual abuse may have conflicting positive and negative emotions associated with the experiences. Implications for measurement refinement, future research directions, and clinical practice are discussed. [ABSTRACT FROM AUTHOR]

Given the high prevalence and severe consequences of childhood sexual abuse, it is essential to identify ways to support adult survivors. One potential and relatively unexplored resource available to survivors is the human-pet relationship. In the literature, the human-pet relationship is linked to many positive benefits to physiological regulation, mental health, physical health, and social support – areas of functioning where survivors of childhood sexual abuse may be particularly at risk. Despite existing evidence, there is little research on human-pet relationships among survivors of childhood sexual abuse. To help address this gap, this qualitative study explored the lived experience of human-pet relationships among adult survivors of childhood sexual abuse. Utilizing data collection and analysis methods from Interpretative Phenomenological Analysis, semi-structured interviews were conducted with 10 adult survivors of childhood sexual abuse. The following themes were developed from the data: (a) close bond with pet; (b) idiosyncrasies within the human-pet relationship; (c) moral responsibility; (d) fundamental differences between pets and humans; (e) safety in the human-pet relationship; (f) resource for coping with painful experience; (g) positive impact on well-being; (h) buttress for human-human social interaction; (i) medium for skill and knowledge development; and (j) shortcomings of the human-pet relationship. Findings are discussed in the context of the existing literature, along with considerations for practice and future research with childhood sexual abuse survivors. [ABSTRACT FROM AUTHOR]

The current mixed-method study aimed to 1) identify different childhood interpersonal trauma (CIT) and dispositional mindfulness (DM) profiles in an adult sample; 2) illustrate these profiles with qualitative data documenting childhood sexual abuse (CSA) and CIT survivors' perceptions of their own DM; and 3) examine profile differences on sexual and relational outcomes. Participants were 292 adults who completed an online questionnaire. A subsample of participants having reported a history of CSA (n = 51) also completed semi-structured interviews. Hierarchical cluster, comparison, and content analyses were performed. Analyses yielded three profiles: 1) Lower victimization, high mindfulness; 2) Psychological victimization, low mindfulness; and 3) Multi-victimization, low mindfulness. Participants in profile 1 presented the lowest frequency of CIT experiences and the highest levels of DM and sexual and relational well-being. Profile 2 participants presented higher sexual and relational well-being (i.e., higher sexual satisfaction, lower sexual depression, and fewer interpersonal conflicts) than those in profile 3. By documenting distinct CIT and DM profiles and tying them to different levels of relational and sexual well-being, this study could guide practitioners in designing tailored interventions. [ABSTRACT FROM AUTHOR]

Most research on child sexual abuse has been on survivors to the exclusion of service providers. This paper focuses on one group of findings from a larger qualitative study. The aim of the paper is to identify existing services and highlight the gaps in the current programs available for male CSA survivors from the perspective of service providers. Semi-structured interviews were conducted with 11 mental health service providers, recruited from two Southern and Central Ontario cities. Findings presented here report service providers' perspective of gaps in services for male CSA survivors. "Limited Male CSA Programs", "Institutional Barriers", "Attitudinal Barriers", and "Systemic Gaps" emerged as four major themes from the data analysis. Findings demonstrate the need to re-evaluate currently available service and highlights gaps in mental health service available for male CSA survivors. Implications for policy, practice, and research are discussed. [ABSTRACT FROM AUTHOR]

Although the global prevalence of childhood sexual abuse (CSA) is very high, the experience of healing after such abuse has not been well documented. The goal of this study was to characterize the healing experience among CSA survivors presented in the literature. Metaethnography was used to synthesize an integrative literature review. The CINAHL, PubMed, PsycINFO, and Web of Science databases were used as data sources. Eight articles that explored healing experiences from CSA, published between 2007 and 2017, were included in the analysis. After performing a quality assessment, line-of-argument synthesis was used to construct the integrating scheme of healing experiences from CSA. CSA healing experiences included dissociating oneself from the memories of CSA, finding peace by creating a comfort zone, disclosure as the start of healing, attempting to establish identity through ongoing self-reflective activities, feeling comfort by sharing experiences and connecting with CSA survivors, and accepting CSA as part of the life history and stepping forward. Healing experiences from CSA synthesized from the analysis focused on personal growth, supporting previous theory on CSA health in the broader literature. A tailored care plan could be developed for CSA survivors who are at varying stages of healing. [ABSTRACT FROM AUTHOR]

According to the attribution theory, negative outcomes of child sexual abuse (CSA) are thought to vary depending on whether CSA victims attribute the abuse to internal or external factors, respectively, self-blame and perpetrator-blame. Therefore, the purpose of this study was to identify abuse characteristics and attitudes that influence blame attributions among CSA victims from a community sample. Data from respondents with a history of CSA (N = 1,496) have been used in predicting blame attributions; perpetrator-blame, self-blame, or both. Results from a multinomial logistic regression analysis showed that attitudes toward gender roles had a significant effect on blame: victims were more likely to blame themselves when they endorsed more conservative gender attitudes than victims with more liberal attitudes. Implications for this finding are discussed. [ABSTRACT FROM AUTHOR]

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

The current systematic narrative literature review sought to discover the views of young child sexual abuse (CSA) survivors, unknown to child protection services, on confidentiality. Due to the paucity of research on young CSA survivors, the review was widened to include users of sexual health services. Seventeen databases were searched, and results were refined by reading titles and abstracts, followed by full text. Analysis involved an exploratory interpretist approach to identify conceptual themes and research methodologies. Fifteen published papers were identified. Research methods were narrow and included surveys, interviews, and focus groups, with limited youth participation. In addition to the theme of confidentiality essential to this study, themes identified included - needing accurate information about services, the importance of someone non-judgemental to talk to, control over decisions affecting their lives, and better access to services. Studies indicated young people were fearful of child protection involvement. In conclusion, studies suggest young survivors unknown to child protection services need a higher level of confidential services and more control of their information. Further research involving young survivors in participatory methods is needed to explore issues of confidentiality, survivor participation, and fear of child protection agencies. [ABSTRACT FROM AUTHOR]

Child Sexual Abuse Questionnaire was developed to assess Child Sexual Victimization experiences, and the associated characteristics and circumstances. The aim of the study is to evaluate the reliability and validity of the Arabic Child Sexual Abuse Questionnaire (CSAQ) in a sample of Egyptian children. The original CSAQ-English was translated into Arabic based on the established guidelines. Then, a cross-sectional study was carried out on a group of 150 male and female Egyptian children aging 8–14 years to test the translated questionnaire for validity and reliability. The Statistical analysis was performed to internal consistency, Item-Total correlation, as well as Inter-Item correlation. Cronbach's Alpha coefficient to assess internal consistency was found to be satisfactory, 0.88 and 0.89 for CSA without physical contact items and CSA with physical contact items, respectively. The item-total correlations were found to be within r =.234; P =.004 to r =.927; P = <0.001, while Inter-item correlations ranged from 0.125 to 0.928. The CSAQ-Arabic version is a reliable and valid tool that can be used by researchers in clinical practice to measure sexual victimization experiences in Arabic-speaking children based on the content and face validation together with a good internal reliability. [ABSTRACT FROM AUTHOR]

The Catholic Church has faced a large number of complaints against its representatives for sexual crimes that involved children and adolescents as victims. The objective of this study was to characterize the dynamics of this type of event, its characteristics, and its effects in terms of mental health and social consequences, as well as the spiritual damage generated. The sample comprised 182 victims from Spain and Chile, divided into three mutually exclusive groups (n = 40 committed by a representative of the Catholic Church; n = 85 by a family member; n = 57 by a perpetrator outside the family and the Church). The results show that victims of child sexual abuse (CSA) by a representative of the Catholic Church and other perpetrators are similar in many respects (e.g., religiosity, characteristics of the abuse, and mental health and social problems), but that the effects on religiosity are more serious for victims of the clergy, affecting their belief in God. Finally, the extreme decline in belief in God, due to CSA, is an important predictor for most mental health and social problems. Our results show the need to include the Catholic identity, faith and spirituality in the therapeutic context. [ABSTRACT FROM AUTHOR]

In this study, we explored survivors' experience with sextortion (threats to expose sexual images to coerce victims to provide additional pictures, sex, or other favors). We conducted in-depth telephone interviews with 48 adults aged 18 to 25 who had been targets of sextortion. Nearly half of participants were minors at the time of the sextortion incident. Data were analyzed using thematic analysis, which resulted in four major dimensions. The dimensions identified were the emotional connections between victims and perpetrators, the nature of the threats, societal responses, and integrating the sextortion into their life stories. The findings emphasized the multidimensional nature of this phenomenon. There was a wide range of emotional connections, from brief connections to close intimate relationships or strong friendships. Some threats remained unfulfilled, while other were carried out. Some threats were one-time and some lasted for years. Societal responses were central in participants' narratives, with most participants actually turning to their peers and parents for support. Many expressed thankfulness for the opportunity to tell their story during the interviews. For the majority of participants sextortion was perceived as a central event in their lives, one that changed them forever. Listening to the voices of survivors helps professionals understand these harmful situations. [ABSTRACT FROM AUTHOR]

Child sexual abuse is a problem with both a national and worldwide prevalence. In this review, the authors note that while empirical research has clearly shown the negative impact of child sexual abuse on social, psychological, and sexual functioning later in life, it has also been reported that some individuals remain asymptomatic despite a history of experiencing child sexual abuse. This implies that negative outcomes later in life are not inevitable and illustrates the critical need to elucidate how resilience may moderate the negative impacts of child sexual abuse. In addition to emphasising the role of resilience, this review also underscores the important role that cultural context plays in understanding child sexual abuse, as there are known risk factors and protective factors specific to different cultures. Similarly, one’s culture may also influence whether abuse is reported and addressed, and the topic is given special attention in this paper because it is not widely discussed within the existing literature. The impact of child sexual abuse on mental health, sexual health, and social functioning is also discussed. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to investigate sociodemographic variables, features of sexual abuse (SA), and first psychiatric evaluation results of abused children, and to analyze the relation of the psychiatric evaluation results to the children’s age and gender, type and duration of abuse, abuser-child relationship, and marital status of the children’s parents, at one of the most experienced Child Advocacy Centers (CACs) in Turkey. All data were obtained from reports prepared by child and adolescent psychiatrists. The sample of this study consists of 436 child sexual abuse (CSA) cases who admitted İzmir CAC between April 2014 and November 2015. The statistical analyses yielded significant relations between psychiatric symptoms and chronic abuse, the gender of the children, and type of abuse. Suicidal ideation and behaviors due to sexual abuse (SA) were also examined. According to our results, it is fair to say that children exposed to SA benefit from immediate psychiatric help because of their vulnerability for psychiatric disorders due to abuse. In this context, CACs are very important multidisciplinary establishments to determine children’s multiple needs to ease their trauma with collaborative teamwork. Psychiatric evaluation should be part of this multidisciplinary context. [ABSTRACT FROM AUTHOR]

Hypo-sexuality, self-reported hypoactive sexual desire and/or sexual aversion, is a common symptom experienced by women who were victims of childhood sexual abuse. This symptom may be distressing to the patient herself, and may place strain on her romantic relationships in adulthood. Unfortunately, this problem often remains undiscussed between patient and provider, in part due to the provider’s lack of comfort or knowledge regarding how best to address this issue. In this article, we explore several strategies that providers may employ in a group setting in order to help women realize their sexuality while minimizing untoward side effects such as feelings of guilt or shame, or flashbacks. We highlight the merits of each technique, and provide insights from clinical experience to guide practitioners to help their patients facing this difficult issue. [ABSTRACT FROM AUTHOR]

Child sexual abuse can have long-term negative impacts across psychological, physical, and interpersonal domains. Some of the common issues for survivors of sexual abuse include shame and self-blame, attachment-based difficulties, avoidant coping strategies, and reduced capacity for self-compassion. Compassion-focused therapy is a transdiagnostic intervention that specifically responds to these concerns. Compassion-focused therapy was originally developed for clients who experience high levels of shame and self-criticism and aims to strengthen the soothing and affiliative system through the cultivation of compassion. This article will highlight the theoretical alignment between some of the common issues and impacts associated with experiences of sexual abuse, with the core underlying principles of compassion-focused therapy. This includes (a) the capacity of the therapy’s evolutionary framework to reduce perceptions of self-blame, (b) the cultivation of compassion to respond to feelings of shame, (c) acknowledgment of the role of early attachment experiences and facilitation of corrective affiliative experiences, (d) regulation of the threat-based system following trauma, and (e) provision of an alternative to avoidant-based coping by responding to distress with compassion. It is proposed that the theoretical framework and core focus and aims of compassion-focused therapy are highly applicable for survivors of sexual abuse and therefore holds significant promise as a treatment option for this client group. [ABSTRACT FROM AUTHOR]

Sexual revictimization refers to having a history of child sexual abuse and an experience of being assaulted again in adolescence or adulthood. This descriptive study examined perceived social support of nonvictim adolescents and adolescents who had survived single sexual abuse and sexual revictimization. Participants were 210 adolescent girls, all aged between 15 and 18, selected by a convenience sampling method; 70 had survived sexual revictimization, 70 had survived single sexual abuse, and 70 were nonvictims. The Perceived Social Support Scale was administered, and a one-way ANOVA was conducted for data analysis. Perceived social support from the community was lower in the sexual revictimization group than in the single sexual abuse and comparison groups. Family social support did not differ between the sexual revictimization and single sexual abuse groups but was lower in both than in the comparison group. These results indicate that victims of sexual revictimization need social support, and both sexual revictimization and single sexual abuse victims need familial support. [ABSTRACT FROM AUTHOR]

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

Child abuse affects people’s ways of thinking, feeling, and observing the world, resulting in dysfunctional beliefs and maladaptive schemas. Thus, consequences of child abuse may persist during adulthood. Therefore, the aim of this study was to analyze the psychological consequences (anxiety, phobic anxiety, depression, and hopelessness) of different types of maltreatment (physical, sexual, and emotional abuse and physical and emotional neglect) and to study the role of early maladaptive schemas in the onset of symptomatology in adult female victims of child abuse. The sample consisted of 75 women referred by associations for treatment of abuse and maltreatment in childhood. Sexual abuse was the type of maltreatment that was most strongly related to most dysfunctional symptomatology, followed by emotional abuse and physical abuse, whereas physical neglect was the least related. Also, early maladaptive schemas were found to correlate with child abuse and dysfunctional symptomatology. Finally, early maladaptive schemas mediated the relationship between sexual abuse and dysfunctional symptomatology when the effect of other types of abuse was controlled. These results may provide important guidance for clinical intervention. [ABSTRACT FROM PUBLISHER]

A systematic meta-review of reviews and meta-analyses on problems reported by survivors of Child Sexual Abuse (CSA) was conducted. The aim was to comprise a comprehensive overview of 1) problems reported by survivors of CSA, and 2) variables moderating these relations. Two raters independently conducted a search through PubMed, PsychINFO, Campbell Library, Cochrane Library and Web of Science. Twenty-five reviews and meta-analyses reporting on 53 problems related to CSA were analyzed. All fell into five domains: medical, psychological, sexual, repeated (self-)harm, and a final category of other problems. Thirty-six of all problems (68%) were consistently and significantly more commonly reported by CSA survivors as compared to individuals without a history of CSA. Most moderator analyses did not significantly influence these relationships. In conclusion, CSA is associated with various problems across different domains and overall, these problems are prevalent independent of specific characteristics of and circumstances surrounding the abuse. [ABSTRACT FROM AUTHOR]

The significant gap between the prevalence of child sexual abuse and disclosure underscores the need for new, innovative, and creative screening tools to identify victims to end the abuse and provide these victims with appropriate treatment. This article presents the cumulative efforts of a series of innovative studies dealing with sexually abused survivors and offenders that concentrates on preventing, assessing, screening, and treating Child Sexual Abuse (CSA). We start by describing the need and rationale for using the arts for purposes of identification and treatment. We discuss how these arts help bypass censorship and dissociation mechanisms involving the body as a critical factor during the assessment and the treatment. Each of the articles is then presented. The introduction is organized to show how non-verbal techniques for the prevention, screening, assessment and treatment of sexual abuse in chidren can move beyond verbal techniques that are known to be limited in their effectiveness. [ABSTRACT FROM AUTHOR]

In a 2015–2016 UK survey of 35, 248 adults, 7% reported experiencing sexual abuse as children. This review considers the value of Art Therapy (AT) in recognizing individual needs and experiences and supporting victims to manage the lasting impact of abuse. Three main bodies of research were identified: the use of AT in childhood sexual abuse (CSA) investigations; the use of art therapy in the treatment of the psychological sequelae of CSA victims in childhood and adulthood; and an assessment of how art therapy compares to other therapeutic approaches for CSA victims. The review highlights that AT particularly benefits rapport building between victim and therapist/investigator, and alleviates some psychological consequences of sexual abuse – particularly anxiety, post-traumatic stress, and dissociation. By engaging the limbic system, AT may also provide a communicative form, building a narrative where verbal communication is hindered. However, the analysis brings attention to several weaknesses in the current AT research: available studies tend to have small sample sizes and few quantitative findings. This review concludes by identifying the need for research which considers the clinical implications of AT in CSA cases for the future. [ABSTRACT FROM AUTHOR]

Qualitative analysis of boys’ narratives about child sexual abuse revealed several themes, including memories of the abuse, the disclosure and subsequent events, the healing journey, and a meta-theme titled “fear and safety.” In this article, boys’ (N = 19) experiences related to fear and safety and the healing journey are explored. The narratives provided a unique look at boys’ road to recovery, perceptions of counseling, and hopes for their futures. Recommendations for counseling boy victims are discussed. [ABSTRACT FROM AUTHOR]

Recent studies indicate that men experience unique barriers to disclosure of child sexual abuse. Blind spots held by mental health providers and social service agencies may inadvertently help produce and sustain these barriers. However, therapists who specialize in treating this population may also hold important insights into the barriers clients face. Because delayed and nondisclosure of child sexual abuse have been associated with negative mental health outcomes for adult survivors, understanding these barriers is critical to improve clinical practice and facilitate help-seeking. Using conventional content analysis, this study examined the perceptions of nine therapists who specialize in the treatment of men who were sexually abused in childhood, many of whom are considered pioneers in the field. Analyses identified nine types of barriers, which were organized into three categories: intrapersonal experience (difficult feelings, lack of language, and self-engagement), social milieu (internalized social stigma, negative responses, social loss or judgment, and masculine identity dissonance), and health care environment (structural barriers, relational challenges with therapists, and unhelpful therapeutic strategies). Implications for future research, clinical training, and clinical practice are discussed. [ABSTRACT FROM AUTHOR]

Commercial sexual exploitation of children has emerged as a critical issue within child welfare, but little is currently known about this population or effective treatment approaches to address their unique needs. Children in foster care and runaways are reported to be vulnerable to exploitation because they frequently have unmet needs for family relationships, and they have had inadequate supervision and histories of trauma of which traffickers take advantage. The current article presents data on the demographic characteristics, trauma history, mental and behavioral health needs, physical health needs, and strengths collected on a sample of 87 commercially sexually exploited youth. These youth were served in a specialized treatment program in Miami-Dade County, Florida, for exploited youth involved with the child welfare system. Findings revealed that the youth in this study have high rates of previous sexual abuse (86% of the youth) and other traumatic experiences prior to their exploitation. Youth also exhibited considerable mental and behavioral health needs. Given that few programs emphasize the unique needs of children who have been sexually exploited, recommendations are offered for providing a continuum of specialized housing and treatment services to meet the needs of sexually exploited youth, based on the authors’ experiences working with this population. [ABSTRACT FROM AUTHOR]

Due to reliability problems, use of retrospective measurement to assess child sexual abuse has long concerned researchers. Possible psychosocial causes of these reliability issues—including problem avoidance—have not been thoroughly studied. We tested the reliability of retrospective child sexual abuse measurement in a nationally representative sample of 12,438 adults over two periods (2001–2002, 2007–2008), assessed sex differences in reliability, and examined whether reliability depends on problem avoidance tendencies. Nearly three-fourths of child sexual abuse cases in the former wave were not again reported, and two-thirds of child sexual abuse cases in the latter wave were not previously reported. Females were more likely to report CSA later if reported previously (OR = 5.11). Participants who reported child sexual abuse in the former wave but not the latter were more avoidant than consistent reporters (3.13 versus 2.77). Our findings suggest that females may report child sexual abuse more consistently. Furthermore, inconsistent reporting may indicate problem avoidance. Suggestions for researchers and practitioners are discussed. [ABSTRACT FROM AUTHOR]

Child sexual abuse is associated with factors that enhance the vulnerability of the child, raising physical and mental health complications in adulthood. Three hundred and fifty students participated in this cross-sectional study. Important determinants of sexual abuse were parents not living together, not living with parents, family type, and current parents’ marital status (p < 0.05). Respondents living with both parents were two times less likely to experience sexual abuse (OR = 0.5, CI: 0.3, 0.9) than respondents living with their guardians. Respondents whose parents were living together were about two times less likely to experience sexual abuse (OR = 0.6, CI: 0.3–0.9) than respondents whose parents were not living together. Respondents whose parents were either divorced or separated were about six times more likely to experience sexual abuse (OR = 5.6, CI: 1.1–27.2) than respondents with widowed parents. The study showed that parental togetherness protected against child vulnerability and risk of being sexually abused. [ABSTRACT FROM PUBLISHER]

This is a multicentric, descriptive, cross-sectional study of child and adolescent sexual abuse in women over 18 years in 24 primary care sexual and reproductive health centers in Catalonia. A total of 1,013 women were recruited; 345 (37.6%, 95% CI: 34.6–40.9) reported exposure to child sexual abuse: 32.4% disclosed being touched in a sexual way, and 9.6% reported completed sexual intercourse. Abuse occured before the age of 13 in 63.4% of respondents. The perpetrator was a relative or an acquaintance in almost 80% of cases. The risk was higher among women of Central or South American origin (OR: 2.86; 95% CI: 1.33–6.12). Only 31.9% of women disclosed the abuse and 17.3% were blamed. Abuse that involved attempted or completed sexual intercourse was significantly associated with recurrence, physical violence, and revictimization in adulthood. [ABSTRACT FROM PUBLISHER]

A risk for commercial sexual exploitation is childhood maltreatment. It’s unknown whether juveniles in commercial sexual exploitation experience more childhood maltreatment than adults or how involved child protective services is in investigating maltreatment, a focus of this study. Women (N = 96) who sold sex commercially completed a cross-sectional questionnaire. Descriptive statistics,ttests, chi-squares, and odds ratios were used to examine differences in background, childhood maltreatment, and child protective services involvement by juvenile or adult entry. Although 93% of participants experienced child maltreatment, juveniles had increased odds of parent/caregiver sexual abuse, being left alone, being kicked out, and running away from a parent/caregiver. There were no differences in cumulative childhood maltreatment resulting in an investigation or removal, indicating that juveniles not investigated or removed by child protective services had as much childhood maltreatment as juveniles who were investigated or removed by child protective services. Results highlight the need for child welfare staff to recognize childhood maltreatment as risks for commercial sexual exploitation. [ABSTRACT FROM PUBLISHER]

Child sexual abuse has the potential to cause distress for the victim across the lifespan. Romantic relationships may be particularly difficult for victims of child sexual abuse. This retrospective study examined differences in adult romantic attachment, sexually compulsive behaviors, and emotion regulation by history of child sexual abuse in a large, nonclinical sample. Those with a history of child sexual abuse reported more attachment anxiety in romantic relationships and engaged in more sexually compulsive behaviors. Overall, males displayed more sexually compulsive behaviors than females regardless of history of sexual abuse. Males with a history of sexual abuse displayed the greatest number of sexually compulsive behaviors. Surprisingly, no differences were observed in emotion regulation or attachment avoidant behaviors by history of child sexual abuse. Future research should seek to replicate current findings and examine emotion regulation difficulties experienced as a result of trauma. [ABSTRACT FROM PUBLISHER]

Trauma from female incestuous child sexual abuse may result in negative psychological consequences affecting adult relationships. This study explored relational consequences of incestuous child sexual abuse, focusing on conflict resolution styles, relationship satisfaction, and relationship stability. Using the RELATionship Evaluation dataset, 457 heterosexual couples in which female partners experienced incestuous child sexual abuse were compared to a group of 1,827 couples with no sexual abuse history. Analyses tested differences in the frequencies of reported conflict resolution styles for incestuous child sexual abuse and non–incestuous child sexual abuse groups, the mediating effects of conflict resolution styles on the relationship between incestuous child sexual abuse, and self- and partner-reported relationship satisfaction and stability. Significant differences in the reports of types of conflict resolution styles were found for incestuous child sexual abuse versus non–incestuous child sexual abuse groups. Incestuous child sexual abuse and conflict resolution styles were negatively related to relationship satisfaction and stability and there was a significant indirect effect between female incestuous child sexual abuse, female volatility, and relationship instability. Clinical applications for couple relationships are discussed. [ABSTRACT FROM PUBLISHER]