Psychological Distress and Revictimization Risk in Youth Victims of Sexual Abuse

Psychological distress, including depression and anxiety, has been associated with increased risk for sexual revictimization in youth who have experienced child sexual abuse. The present study utilized assessment information from treatment seeking youth with histories of sexual abuse to explore specific risk indicators for revictimization—risk taking, social problems, maladaptive cognitions, and posttraumatic stress—that may be indicated by self-reported distress. The relationship between initial levels of distress and change in symptoms over a 12-week course of treatment was also explored. Participants were 101 youth referred to a child-focused therapeutic group for victims of sexual abuse, 65 youth referred to an adolescent-focused group, and their non-offending caregivers. Results revealed that when combined into a distress score, depression and anxiety were associated with delinquent behaviors, interpersonal difficulties, maladaptive cognitions, and posttraumatic stress symptoms for child and adolescent group participants at presentation to treatment. Children exhibited improvement on measures of interpersonal difficulties, maladaptive cognitions, and self-reported posttraumatic stress disorder (PTSD) symptoms. Adolescents exhibited less change over time, with significant improvement on self-reported social problems and PTSD only. Higher psychological distress was associated with less improvement in regard to negative expectations of abuse impact for child group participants. The findings suggest that distress indicates the presence of specific revictimization risk indicators, helping to identify targetable symptoms for intervention. Therefore, screening for psychological distress after discovery of sexual abuse may help detect youth at higher risk for revictimization and guide treatment

Psychological Distress and Revictimization Risk in Youth Victims of Sexual Abuse

Psychological distress, including depression and anxiety, has been associated with increased risk for sexual revictimization in youth who have experienced child sexual abuse. The present study utilized assessment information from treatment seeking youth with histories of sexual abuse to explore specific risk indicators for revictimization—risk taking, social problems, maladaptive cognitions, and posttraumatic stress—that may be indicated by self-reported distress. The relationship between initial levels of distress and change in symptoms over a 12-week course of treatment was also explored. Participants were 101 youth referred to a child-focused therapeutic group for victims of sexual abuse, 65 youth referred to an adolescent-focused group, and their non-offending caregivers. Results revealed that when combined into a distress score, depression and anxiety were associated with delinquent behaviors, interpersonal difficulties, maladaptive cognitions, and posttraumatic stress symptoms for child and adolescent group participants at presentation to treatment. Children exhibited improvement on measures of interpersonal difficulties, maladaptive cognitions, and self-reported posttraumatic stress disorder (PTSD) symptoms. Adolescents exhibited less change over time, with significant improvement on self-reported social problems and PTSD only. Higher psychological distress was associated with less improvement in regard to negative expectations of abuse impact for child group participants. The findings suggest that distress indicates the presence of specific revictimization risk indicators, helping to identify targetable symptoms for intervention. Therefore, screening for psychological distress after discovery of sexual abuse may help detect youth at higher risk for revictimization and guide treatment

Identifying and addressing barriers to treatment for child sexual abuse survivors and their non-offending caregivers

Mental health treatment is a critical part of an effective and compassionate response to the disclosure of child sexual abuse (CSA). Given the vast negative consequences for children and families following CSA, engagement in treatment can benefit youth and their non-offending caregivers. Yet, these families face unique barriers to treatment initiation, adherence, and effectiveness. The identification of these barriers allows clinicians, researchers, and policy makers to increase treatment utilization, engagement, and value. The current review and its recommendations derive from the existing literature combined with knowledge gained from a clinical research team with more than 20 years of experience offering a treatment program for CSA survivors and their non-offending family members. The review organizes barriers around factors related to individual characteristics of children and caregivers, perceptions and beliefs commonly held following CSA, and challenging family interactions in the context of individual and group treatment for CSA. Finally, barriers related to systemic and societal factors are examined given the importance of understanding the legal and cultural context in which families seek and engage in treatment. Recommendations for further research, suggestions for clinicians, and considerations for policy change to decrease the identified treatment barriers for families impacted by CSA are provided

Increasing Students’ and New Professionals’ Knowledge of Child Sexual Abuse Outcomes: An Evaluation of an Online Intervention

Following disclosure, support from professionals (e.g., mental health clinicians, social workers, health care providers, teachers) can help increase resiliency in youth who experience child sexual abuse (CSA). Particularly, those who respond compassionately and competently, believe and report the abuse, do not blame the victim, and increase the family’s protective factors are best suited to decrease negative outcomes. Yet, research shows that many professionals are not adequately prepared to support families due to insufficient knowledge and misinformed beliefs (Pelisoli, Herman, & Dell’Aglio, 2015). Moreover, few assessments measure knowledge specific to the aftermath of CSA and few interventions aim to increase professional knowledge on outcomes with the goal of increasing child resiliency. Therefore, the purpose of this project was to (a) develop and evaluate a measure to assess knowledge and beliefs about the consequences of CSA and (b) develop and evaluate an online intervention that provides students and developing professionals with information about CSA outcomes, corrects misperceptions, and empowers adults to increase child resiliency. Two studies were completed to meet these aims. Findings from Study 1 confirmed that a sample of 143 university students and developing professionals lacked sufficient knowledge about CSA outcomes. The instrument created was determined to be suitable at measuring CSA knowledge and beliefs. The 408 participants in Study 2 first completed the pre-treatment measure of CSA knowledge, were randomly assigned to the online CSA intervention or the attention control group (training on youth development), then completed the post-treatment measure. A subset of the sample completed the CSA assessment again two weeks after initial participation to measure retention. Findings showed that the CSA webinar significantly increased participants’ knowledge of CSA outcomes and changed unsupportive beliefs. The control group demonstrated a nominal, yet significant, increase from pre- to post-test. Those who received the CSA training held more knowledge and supportive beliefs than those in the control group and this knowledge was broadly retained two weeks after completion of the training. Participants reported the CSA intervention was valuable and increased their motivation to support survivors. While several CSA-related interventions exist for adults, this intervention addressed gaps in current training efforts. Advisor: David J. Hanse

Child Sexual Abuse: Stigmatization of Victims and Suggestions for Clinicians

CHILD SEXUAL ABUSE (CSA) occurs frequently, with one recent review suggesting that approximately 1 in 10 children will experience sexual abuse before age 18 (Townsend&Rheingold, 2013). Victims of CSA are at risk for developing a range of psychological and behavioral problems, including depression, anxiety, posttraumatic stress disorder (PTSD), suicidal thoughts and behavior, substance abuse, high-risk and inappropriate sexual behavior, and other conduct problems (Maniglio, 2009; Tyler, 2002). However, not all children experience these short- and long-term effects and many factors influence the heterogeneity of response to CSA (Kendall-Tackett, Williams, & Finkelhor, 1993; Putnam, 2003). Stigma, defined as “a mark of disgrace associated with a particular circumstance, quality, or person” (Oxford English Dictionary, 2017), can play an important role in victims’ recovery (Coffey, Leitenberg, Henning, Turner, & Bennett, 1996).As such, the purpose of this paper is to critically review the literature on how survivors of CSA are currently stigmatized, identify the consequences of such stigma, and make suggestions for clinicians working with CSA victims and their families

Attributions of Blame in a Hypothetical Child Sexual Abuse Case: Roles of Behavior Problems and Frequency of Abuse

Youth who are blamed for their sexual abuse may experience increased negative outcomes, such as amplified self-blame. Similarly, blaming nonoffending parents can impede their ability to support their child following disclosure. Understanding the factors that influence how people perceive victim, caregiver, and perpetrator responsibility is imperative for the protection and treatment of families who have experienced sexual abuse. Little research has explored victim and abuse characteristics that influence the perception of sexual abuse. As such, the purpose of this study was to examine the roles of behavior problems and frequency of abuse in the attribution of blame in a hypothetical sexual abuse case. In addition, the relationship between several respondent characteristics and assignment of responsibility were explored as secondary aims. The study used a two (behavior problems: three suspensions in one school semester vs. no mention of behavior problems) by two (one abuse occurrence vs. five abuse occurrences) between-subjects design. Seven hundred forty-two participants read one of the four child sexual abuse (CSA) vignettes and completed measures related to responsibility. ANOVAs revealed those who read a vignette where the youth experienced multiple abuse incidents rated the victim as more responsible regardless of whether or not the youth was described as having behavior problems. Results indicate that respondents may have attributed more blame to the victim due to the belief that she could have done something to stop the abuse after the first incident. The abuse frequency manipulation when combined with the behavior manipulation appeared to relate to how respondents perceived the victim’s parents. Males and younger respondents attributed more blame to the victim; however, sexual abuse or assault history did not associate with victim responsibility ratings. Clinical and research implications were discussed

Attributions of Blame in a Hypothetical Child Sexual Abuse Case: Roles of Behavior Problems and Frequency of Abuse

Youth who are blamed for their sexual abuse may experience increased negative outcomes, such as amplified self-blame. Similarly, blaming nonoffending parents can impede their ability to support their child following disclosure. Understanding the factors that influence how people perceive victim, caregiver, and perpetrator responsibility is imperative for the protection and treatment of families who have experienced sexual abuse. Little research has explored victim and abuse characteristics that influence the perception of sexual abuse. As such, the purpose of this study was to examine the roles of behavior problems and frequency of abuse in the attribution of blame in a hypothetical sexual abuse case. In addition, the relationship between several respondent characteristics and assignment of responsibility were explored as secondary aims. The study used a two (behavior problems: three suspensions in one school semester vs. no mention of behavior problems) by two (one abuse occurrence vs. five abuse occurrences) between-subjects design. Seven hundred forty-two participants read one of the four child sexual abuse (CSA) vignettes and completed measures related to responsibility. ANOVAs revealed those who read a vignette where the youth experienced multiple abuse incidents rated the victim as more responsible regardless of whether or not the youth was described as having behavior problems. Results indicate that respondents may have attributed more blame to the victim due to the belief that she could have done something to stop the abuse after the first incident. The abuse frequency manipulation when combined with the behavior manipulation appeared to relate to how respondents perceived the victim’s parents. Males and younger respondents attributed more blame to the victim; however, sexual abuse or assault history did not associate with victim responsibility ratings. Clinical and research implications were discussed