The study of coping with stress has been disjointed, lacking a coherent model. The present work proposes a theoretical framework for understanding coping based on approach and avoidance. Approach and avoidance are discussed in terms of the psychoanalytic concepts of defense and working through and other historical precursors as well as recent research on coping with traumatic events. Two experiments are presented. The first consists of a scale-construction study of the Cohen Roth Approach Avoidance Scale, a self- report measure of coping strategies. A revised version of this scale is proposed based on factor-analytic data from a mixed-stress sample. Experiment 2 is a study of the long-term impact of rape. Seventy-three women, who were victims of rape an average of eight years ago, were given questionnaires covering the following areas: demographics, nature of the assault, coping styles, and current level of functioning. Most of the sample was found to still be in moderate to severe distress. The relationships between outcome and demographics, situational variables, and behavior after the assault are discussed in the context of prior research in this area. Approach and avoidance strategies, measured by the revised Cohen Roth Approach Avoidance Scale, had a complex relationship with outcome. This relationship is discussed in the context of the theoretical model of coping presented in the Introduction, focusing on the difficulty women have in resolving the trauma of rape. / This thesis was digitized as part of a project begun in 2014 to increase the number of Duke psychology theses available online. The digitization project was spearheaded by Ciara Healy.

The purpose of this research was to determine if a brief and focused training experience, based upon a multiple systems incest treatment model, would reduce attribution of incest blame. As increasing numbers of persons seek treatment for incestuous experiences, trained professionals will be needed who understand the complexities of incest and the impact of attributing blame.The present study utilized extensively Systemic Treatment of Incest: A Therapeutic Handbook by Trepper and Barrett (1989) as a basis for training. Seventy five female and forty male upper level undergraduates enrolled in two Fundamentals of Counseling and two Techniques of Psychological Intervention courses served as subjects. A randomly assigned, two group post-test only design was employed. Participation in a three hour training experience served as the independent variable. The Attribution of Incest Blame Scale (AIBS) offender, mother, victim, societal, and situational blame subscales were dependent variables. It was hypothesized training would reduce levels of blame attribution and that male subjects would blame incest victims more than female subjects. Demographic variables and hypotheses were tested by MANOVA and ANOVA statistical procedures (alpha levels = <.05).Results indicated training had a significant effect in reducing offender and mother blame while increasing situational blame, Males blamed incest victims more than did females, replicating previous findings. Post-training qualitative evaluations suggested the "vulnerability to incest" paradigm, central to systemic treatment of incest, contributed to the findings. / Department of Counseling Psychology and Guidance Services

M.A. (Clinical Psychology) / Despite similarities, shame is expressed differently among individuals. The aim of this study is to explore the lived experience of shame in two female victims of acquaintance rape. Using the tenets of Interpretative Phenomenological Analysis (IPA), a case study approach was adopted. The findings revealed how the female victims' relationship with the known assailants influenced the experience of shame. Moreover, encountering acquaintance rape twice had implications for how shame was experienced. For instance, intense self-blame and the belief in being inherently flawed was evident. Of equal importance, in both women, anger manifested primarily as indignation. Furthermore, shame manifested primarily as feeling dirty and having elements of moral impurity. However, shame did not affect the self-identity of one of the participants; instead she displayed resistance to the notion of shame affecting her global self. Thus, the study concluded that despite similarities in some features, the manifestation of shame in the context of acquaintance rape is different from in other contexts. These findings have implications for future research and clinical practice. Ultimately, this study adds to the discourse on shame in women in the context of acquaintance rape in South Africa. Moreover, it provides a theoretical framework that enables the therapist or healthcare worker to intervene with clients in such a context.

In reviewing the literature on adult survivors of child sexual abuse/incest, it became apparent that one area has remained in its infancy: a systematic method of symptom assessment. Symptoms, both short and long term, have become clinically well documented. An index, the Sexual Abuse Survivors Symptom Index (evaluating absence/presence, frequency, severity, and impact of symptoms upon the survivor), was developed rationally from the literature was administered. A background questionnaire, simplified from one already in use, was also administered to provide information regarding variables that could confound the research.Approximately 130 female adult clinical subjects were approached to determine whether they would participate in the study. Thirty-three subjects agreed to participate. Due to the small sample size, results of the factor analysis cannot be considered reliable. The principal component factor analysis did produce eight factors, which did not converge in the varimax rotation, however, three factors did emerge. The three factors represented an affective component (almost one half of the symptoms), a somatic/sexual component, and an acting out component.The background questionnaire provided some basic support to the variables the literature reported as affecting symptom severity or likelihood for abuse to occur. Areas endorsed as most severe or correlated strongly and moderately to individual symptoms were ones that were directly connected to the abuse(i.e., age of first inappropriate sexual experience, duration of the abuse, multiple abusers, frequency of the abuse, fear of being hurt by the abusers, and overt/contact type of abuse). The variables that influenced the likelihood for abuse to occur, (i.e., substance abuse, strictness, rigid religious traditions, and physical discipline) were endorsed by slightly less than one half of the subjects, but may have had severe impact individually upon each survivor of abuse. / Department of Counseling Psychology and Guidance Services

Posttraumatic growth, defined as positive psychological changes in the aftermath of adversity and suffering, is a relatively recent focus in psychological research. The addition of this concept to the literature has provided a new, more resiliency-based framework through which to view survivors of various forms of trauma. Despite estimates that over half of all sexual assaults are not reported to the authorities, current crime statistics indicate that 1 in 4 women are sexually assaulted in their lifetime (Campbell & Wasco, 2005). Given the large percentage of the population that is impacted by sexual assault, it is essential that professionals better understand the factors that influence the successful healing and growth that can occur post-trauma. The purpose of this study was to further expand the literature on posttraumatic growth in sexual assault survivors by considering this phenomenon through the lens of attachment theory. Specifically, this study tested a proposed model of the inter-relationships among subjective and objective perceptions of threat during the sexual assault, adult romantic attachment, and posttraumatic growth. It was hypothesized that adult romantic attachment and parent-child attachment would mediate the relationship between subjective, or perceived threat, defined as the victim's perception of life threat, and objective threat, defined as the severity of the sexually aggressive act perpetrated on the victim, and posttraumatic growth. Finally, it was hypothesized that subjective threat appraisal would better predict posttraumatic growth than objective threat appraisal. Contrary to hypotheses, results of the study indicated that adult romantic attachment and parent-child attachment did not mediate the relationship between subjective and objective threat appraisal and posttraumatic growth. Thus, both path analytic models were not viable. However, exploratory analysis indicated that both subjective and objective threat appraisal were directly related to posttraumatic growth, with subjective perceived threat appraisal accounting for more of the variance.

We have conducted a phenomenological research with four women victims of rape in order to discover the impact of the elements which give meaning to their lives, on their recovery. The results of our research demonstrate that overall the elements of the meaning of life have been beneficial for women's recovery. The elements that were identified are the importance of children, the philosophy of life, the goals to achieve, the significant relationships, the financial autonomy and helping others. Those elements have been identified in two previous researches. However two new elements appeared which are the attachment to their job and the development of their skills analysis. Our theoretical framework appeals to social work, sociology, psychology, psychiatry and philosophy. Our vision is feminist.

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In a survey of parents, professionals, and college students in Northern Virginia, 123 adults indicated they had experienced child sexual abuse. Their responses were examined in an effort to identify characteristics of child sexual abuse which might be related to long term negative effects. The variables examined include (a) incestuous verses non-family abuse, (b) victim's reported feelings of responsibility about the sexual abuse, (c) victim's reported feelings of guilt about the sexual abuse, (d) the duration of the sexual abuse, (e) the age of the victim at time of the sexual abuse, and (f) whether or not the sexual abuse was kept secret. Only one of the six variables was found to be significantly related to long term negative effects. The research found evidence that keeping the child sexual abuse experience/s secret may be positively related to long term negative effects of child sexual abuse. Of the 83 participants who reported that the sexual abuse had remained a secret, 58 also reported long term negative effects. The importance of creating a safe and secure atmosphere in which children are able to disclose incidents of child sexual abuse is emphasized by the findings of this research. / Master of Science

This research focuses on the personal stories surrounding men who were sexually abused in childhood. The aim of this study is to shed light on the experiences of these men, and attempt to lift the veil of secrecy and stigma attached to male childhood sexual abuse. Three participants were selected for this qualitative study using the selection procedure of purposive sampling. Each participant was introduced with the use of a semi-structured interview format, and the information that was obtained from each participant was explored using a hermeneutic analysis approach. The results suggest that society’s naivety and ignorance of issues pertaining to sexually abused men are prominent. Both differences and similarities, in relation to the experiences of these men, are evident. With particular reference to the three participants whom partook in this study, the differing experiences that appear significant are suicidal ideation; low self-esteem; flashbacks; fear of men in general; and mind-body separation. The similar experiences that are evident within the participants’ stories are their desire for secrecy; fear of what society may think of them; desperate attempts to cope and subsequently escape the memories of their pasts; long-lasting effects, such as a lack of trust and an absence of intimacy; and determination to move forward and prevail. / Psychology / M.A. (Clinical Psychology)

Although researchers and clinicians have been aware of male victims of childhood sexual abuse, the literature still lacks sufficient data on the long-term effects for adult males sexually abused during childhood. The current study examined the long-term psychological impacts of childhood sexual abuse for adult males. A standardized measurement, SCL-90-R, was used to assess current psychological functioning such as somatization, obsessivecompulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. A questionnaire consisting of demographic data and childhood experiences was also administered to collect background information. Seventy-four undergraduate male students enrolled in counseling psychology courses were recruited. The abused group consisted of twelve subjects who reported histories of child sexual abuse. The rest of the sample (62) consisted of the nonabused group. Due to the small sample size, the results must be interpreted with extreme caution. Results of multiple t-tests suggested that there is no significant difference between the abused and nonabused group on subscales of the SCL-90-R. / Department of Counseling Psychology and Guidance Services