No description available.

No description available.

In Canada, the lifetime prevalence of the sexual abuse of boys is estimated at one in six (Dorais, 2009; Dube, Anda, Whitfield, Brown, Felitti, Dong, & Giles, 2005; Hopper, 2010; Briere & Elliot, 2003). Despite growing awareness of male victims of childhood sexual abuse, it is estimated that police reports are made in only 4.4% of cases (Priebe & Svedin, 2008). There continues to be little understanding as to why the reporting rate is so low. A sample of 155 male survivors of childhood sexual abuse was obtained through a community agency that provides support to this population. Data were gathered from participants’ intake forms on four variables that were expected to influence police reporting: 1) the survivors' age at the time of the first incident 2) the duration of the abuse; 3) the relationship between the survivor and the perpetrator; and 4) the sex of the perpetrator. It was predicted that the perpetrator's sex would be the most powerful predictor of a male's decision to report sexual abuse because of the ‘feminization of victimization’ phenomenon. This is the culturally based assumption that victims are female and perpetrators are male that leads male victims’ to question their own experiences and to a tendency by others to not take their victimization seriously. The findings revealed that perpetrator sex was not a significant predictor of police reporting. Only abuse duration was associated with whether a police report had been made. Other important findings were: 1) the mean age of this sample seeking support for childhood abuse was 50 years; 2) in almost 30% of cases, abuse began before the participant was six years old; 3) 49% of participants had been abused by family members; 4) 20% of participants had been abused by female perpetrators; and 5) in 75% of cases, a police report had not been made. Further research is needed to identify the factors influencing whether sexual abuse of boys is reported to police in order to enhance support services and police response. / May 2016

This study was motivated by encounters with persons with repeated suicidality in clinical psychiatry. Their suicide attempts are frequently regarded as manipulative, and the patients are often labelled a “borderline personality disorder”. They cause frustration and are sometimes met with repellent attitudes among clinicians, but clinical experience as well as research shows that their personal history regularly includes severe childhood trauma and often childhood sexual abuse. The first part of the study was undertaken to investigate the frequency of borderline personality disorder among consecutive persons admitted to hospital after a suicide attempt, the experience of adverse life events among them and the motives for the act. The concept and definition of parasuicide was used as inclusion criterion. During the 10 months of the study 81% of all parasuicide inpatients gave their consent to partake, altogether 64 patients, 41 women and 23 men. Standardized instruments were used for assessment of personality disorders, and self-report questionnaires were used to investigate motives and adverse life events. Seven years later, follow-up interviews were conducted with 51 of these persons, 32 women and 19 men. This second part of the study used qualitative methods in the form of thematic open-ended interviews to allow for the patients’ own descriptions of their suicidality and mental health in the years following the suicide attempt. The role of psychiatry in this process was one of the themes in the interview. Use of psychiatric treatment and support during the follow-up period was investigated through a review of the medical charts recorded at the psychiatric clinic. The quantitative part of the study showed that among the parasuicide patients there was a considerable overrepresentation of borderline personality disorder, and that the frequency of adverse life events was much higher in this subgroup. The motives for the parasuicide did not differ between those with borderline personality disorder and the others. Childhood sexual abuse could be identified as the most important factor influencing suicidality and extent of psychiatric treatment after the index parasuicide. The patients’ own descriptions in the follow-up interview were related to the theoretical perspectives of symbolic interactionism, therapeutic alliance, perception of difference, empowerment and the concept of modernity. In the narratives a picture emerges of a psychiatric health care that carries the potential to offer therapeutic relationships, but often fails in its aims. In therapeutic alliances built on personal relationships, characterized by close and frequent encounters and a focus not only the weaknesses but also the strengths of the patient, there was room for personal development. A reliance on therapeutic method instead of a therapeutic alliance with the patient and a lack of a collaborative perspective in therapeutic work set definite hindrances for the therapeutic process, according to the views of the patients. Regardless of the severity of the life experiences and personality dimensions that had lead to the parasuicide, the core prerequisite for subsequent stabilisation was an orientation towards significant others that saw and supported the potential for change and helped redefine the situation. These significant others were sometimes found in the psychiatric health care services, but were mainly found outside of psychiatry. The conclusions of the study are that there is a close correlation between repeated suicidality, borderline personality disorder, female gender and adverse events such as childhood sexual abuse, and that the repeated suicidality is better explained by adverse events such as childhood sexual abuse than by personality disorder. This background seriously challenges repellent attitudes towards these patients. The narratives of the patients pose definite challenges for the therapeutic community to embrace new ways to find working therapeutic alliances after a parasuicide, possibly based around perspectives of empowerment and mutuality. Identifying the processes that helps the person find “the difference that makes a difference” should be in focus of future psychiatric research and at the heart of psychiatric support and treatment after parasuicide, to enable the patients to find their own strengths and resources and in this way be able to leave it all behind.

Objective: To date there have been few if any qualitative studies of adults who have experienced childhood sexual abuse (CSA) followed by psychotic experiences later in life. This study aimed to explore how a sample of four women make sense of their childhood experiences of sexual abuse and their psychotic experiences later in life. Methodology: Data was gathered through semi-structured interviews with four women. The data were analysed using Interpretative Phenomenological Analysis (IPA) in order to develop a detailed understanding of the women’s search for meaning in their own lives. Results: Four major themes emerged from the analysis of the women’s accounts: ‘Interpersonal difficulties,’ ‘Striving to Get Better’ and ‘A Relationship with Shame’ and ‘Links Between CSA, Mental health & Psychosis’. These are explored in detail. Conclusions: The women’s accounts highlight the ongoing difficulty of living with psychosis and CSA, in particular, the role of psychosis in exacerbating isolation, shame and negative self perceptions. Attention is also drawn to the development of competence for therapists in this area of work. Clinical Implications: Supporting and validating existing healthy coping strategies as well as exploration of the interaction of psychosis and CSA through psychological mechanisms of shame as well as family / society discourses. Therapist/ researcher selfawareness is crucial in supporting clients with such traumatic histories.

Doctor of Philosophy / School of Family Studies and Human Services / Rick Scheidt / This exploratory collective case study utilized structured interviews to investigate retrospective reports of potential losses in resources resulting from childhood sexual abuse (CSA) and whether Selection, Optimization, and Compensation (SOC) “Solutions” were used by six adult male survivors to help offset these losses. Within- and between-case analyses of thematic reports are offered. Specifically, a description of each case is presented with an overview of the analysis of both unique and shared SOC Solution responses. SOC is presented in developmental research literature as a model of self-regulation across the life span. Retrospective reports of the participants suggest they did not engage in self-regulation in response to this childhood trauma. Rather, their reports evidenced the use of reactive “holding strategies” as opposed to deliberate use of selection strategies. This suggestive discovery supports previous research indicating that child survivors of trauma may have reduced self-regulation capacities. Childhood self-regulation may occur through the support of an adult (“dyadic regulation”). Findings further illustrate that the abuse may increase isolation in childhood. However, isolation, as an immediate childhood response to the abuse, may have reduced their potential for dyadic regulation as they dealt with the abuse on their own. Participants reports indicated the use” holding strategies” in childhood that were typically maladaptive. This may have led to the use of maladaptive optimization solutions in childhood that supported these holding strategies. Participants’ reports indicate that they were unable to deliberately access and implement adaptive compensation solutions until they reached adulthood, where these solutions seemed to contribute to more effective loss-directed responses. Baseline reserve capacity and developmental reserve capacity related to adaptive responding in the SOC model are discussed in the present context of trauma. The contributions of this case study to theory building in both the SOC developmental literature and clinical practice with male survivors of CSA are cautiously offered. Results may inform the theoretical reach of the SOC model, showing the limits of the self-regulation model when applied to childhood trauma. The study may inform clinical practice with this population by highlighting the importance of helping children self-regulate through dyadic regulation. Through this process, children may be guided by supportive adults to intentionally select adaptive goals to focus on following sexual abuse. Resources that male survivors may access and/or develop to adjust to the losses caused by childhood sexual abuse are offered.

This study attempted to determine whether perceptions of reactions to disclosure are related to psychological and physical outcomes among individuals with a history of youth sexual abuse (YSA). It was expected that receiving more hurtful responses overall would be related to higher levels of internalizing, somatic, and PTSD symptoms. It was also predicted that perceptions of response to disclosure would predict psychological and physical outcomes beyond the influence of relevant abuse characteristics. Eighty-six female undergraduates recruited from a large Midwestern university completed a series of questionnaires assessing YSA, non-sexual trauma, depression, anxiety, PTSD, somatic symptoms, disclosure, and social reactions to disclosure. Results indicated that those who reported experiencing YSA had higher levels of psychological and physical symptoms than those who reported a non-sexual traumatic event. Also, those who reported receiving more hurtful responses to disclosure overall had higher levels of PTSD and internalizing and physical symptoms. However, this relationship was only true for survivors of YSA. In addition, response to disclosure predicted internalizing and physical symptoms beyond the influence of the duration of abuse, accounting for 23 percent of the variance. These findings suggest that many survivors of YSA may need psychological services, and that an important focus of treatment may be assessing and strengthening social support.

Research has shown that 1 in 9 women in prenatal care have a history of childhood sexual abuse. Pregnant women with a history of childhood sexual abuse are at increased risk of depression, somatization, preterm contractions, posttraumatic stress symptomology, and re-traumatization. The purpose of this study was to bridge the gap in literature between research and practice. Data was collected from practitioners regarding the care and treatment of pregnant women with a childhood sexual abuse history. It was hypothesized that screening practices and modification to care and treatment based on practitioner knowledge of prior sex abuse history will vary by provider type and provider title. A quantitative, online-based survey design was used to gather data from prenatal and birthing practitioners regarding their treatment of female patients who have a history of childhood sexual abuse. Data was analyzed via multiple regression analysis. The data analysis did not lead to any significant results and therefore was unable to support any findings regarding the research questions and hypotheses. The results of this study can be used to encourage practitioners to seek education regarding childhood sexual abuse and its effects on the health and wellbeing of pregnant women. Further, this study brings awareness to the importance of screening for childhood sexual abuse and modifying care during pregnancy and childbirth.

No description available.

Although existing literature is rich with descriptions of the process of coming out for lesbian women, the present study is distinctive in its systematic examination of coming out from the perspective of lesbian women who were sexually abused as children. Through the hermeneutic-phenomenological analysis of interviews with selected participants who identified as lesbian women, the objective of this study was to identify and describe participants' perspectives of childhood sexual abuse, coming out experiences, and their perception of how these experiences might interrelate. Within the complex layers that were common to all the participants, the researcher attempted to interpret and make sense of phenomena across all cases, while respecting and recognizing the meanings that each participant brought to the interview. The results of this study were consonant with findings from previous studies that suggested maintaining a lesbian identity is an ongoing task, continually informed by events and relationships that typically occur during the lifespan of an individual. However, in the course of this investigation, the findings pointed to a new understanding—the coming out process becomes more complicated when histories of childhood sexual abuse need to be considered. While family and social factors had powerful influences on coming out for all the participants, the emotional and behavioral strategies that each woman adapted in order to cope with long-term sequelae of CSA, also appeared to have considerable impact on the coming out process as well. / Ph. D.