This study aims to contribute to our knowledge about the under researched area of sexual grooming, first of all, by reviewing the available literature to establish a baseline of understanding and secondly by considering three different perspectives, which expanded our understanding further. In depth interviews, lasting between one hour and a total time of approximately four hours, were conducted with five adult survivors of child sexual abuse, six child sex offenders and six police officers with child protection experience. Interpretative Phenomenological Analysis was used to analyse the interview data, which identified four main themes: vulnerability, offenders’ self grooming, entrapment and grooming shadow. These themes highlighted an ecological view, which acknowledged the multiple factors influencing an individual’s experience of childhood sexual abuse, and recognised the dynamic nature of sexual grooming, including its apparent link between childhood experience of this phenomenon and adulthood. Attribution and perceived power were the most significant influences within the sexual grooming process. The analysis was used to develop a new definition and two models of sexual grooming, which capture the complexity of this phenomenon. These models provide a framework within which to understand sexual grooming and furthermore to communicate this understanding to a non-academic audience. The Grooming ‘Cycle’ is of particular value with regard to raising public awareness, which is an important aspect as the research has revealed that child protection can only be effective if everybody takes responsibility for it.

The aim of this study was to examine how trauma may affect the development of psychosis. Previous research in the field of Personal Construct Theory has found that people who have a diagnosis of schizophrenia have a poorly elaborated self-concept. This study investigated whether there may be a relationship between trauma and self-elaboration in people who have experienced psychosis. It was hypothesised that more severe trauma in childhood would lead to lower self-elaboration, greater conflict in the self concept and lower elaboration of self when experiencing a traumatic life event in childhood. It was also hypothesised that people would see themselves as less like other people if they had experienced more severe trauma. A sample of 21 people who had experienced psychosis completed repertory grids. The grids included elements of self at different times in one’s life, self in different life events and other people. When childhood sexual abuse was the main grouping variable, the high trauma group had lower self-elaboration, saw themselves as more different to other people and had greater conflict in their self-concept. The findings of the study were discussed in relation to childhood abuse and its impact on self-construction. Limitations of the study were also discussed and related to future research on the relationships between self-concept, trauma and psychosis.

Hearing disclosures of childhood sexual abuse (CSA) is a clinical reality for many therapists. Psychologists within mental health services are working increasingly with clients who have traumatic histories, including the presence of CSA. Recently there has been a drive towards improving services for adult survivors of CSA, with an emphasis on asking health and social care service-users about abuse. Recent research has demonstrated that the experience of talking about CSA in psychological therapy can be a complex experience for client and clinician with varied consequences for both parties. The research into psychologists‟ experiences of CSA disclosure has been limited to surveys of psychologists‟ practice and knowledge and has lacked a scientific approach. This study aimed to expand on the scientific research into CSA disclosure with a Constructivist Grounded Theory approach (CGT). CGT was used to explore psychologists‟ experiences of CSA disclosure from clients in Adult Mental Health. Eight psychologists took part in the current study and were recruited from a large Clinical Psychology service in Scotland. Data was collected through semi-structured interviews. Core categories constructed in this study contributed to a model of psychologists‟ experiences of disclosure in AMH clinical practice. Core categories referred to “Negotiating the Dance of Disclosure” and “Nurturing the Pre-conditions to Disclosure”, which occur in parallel to the therapeutic relationship; whereas “Growing Personally and Professionally” and “Carrying the Weight of the Work” refer to the impact of hearing disclosures and talking about CSA with clients. Research findings are discussed and the implications of this model in relation to theory and areas of development for research and clinical practice are considered.

Childhood sexual abuse (CSA) has been linked to a number of adult psychological maladies. The MMPI-2 has shown specific patterns such as an inverted V in the validity scales, a floating profile, and a 4-5-6 configuration to be present more often in adults who have experienced childhood trauma. Both children and adults who have experienced trauma have shown a number of neurophysiological differences when compared to non-traumatized individuals. However, little research has looked at differences in quantitative electroencephalography (QEEG) patterns in these individuals. The purpose of this study is to determine differences seen in the MMPI-2 and the QEEG when comparing adults who report CSA to adults who deny any history of childhood abuse. Differences between the two groups in MMPI-2 basic scales and supplementary scales PK and PS were determined. This study also examined the ability to correctly classify individuals into the two groups using three patterns seen in the MMPI-2 basic scale profiles (inverted V, floating profile, and 4-5-6 configuration). In addition, this research included exploratory analyses to develop predictor models for CSA group membership. Predictors in the models were derived from MMPI-2 scales, alpha relative power at each of the 19 sites in the International 10/20 electrode placement system, as well as alpha/delta, alpha/theta, and alpha/beta ratios at each of the 19 sites. A total of 46 participants were included in this study, 24 from archived files and 22 newly recruited individuals. Each participant received a MMPI-2 and a QEEG. Significant differences were found between the MMPI-2 scores of the two groups, but MMPI-2 patterns were unable to correctly classify individuals. Models were found which were clinically relevant and statistically significant. The models were based on depression and social maladjustment. The depression models included scales F and 2 of the MMPI-2 and alpha relative power at left frontal sites. The social maladjustment models included scales 4 and 8 of the MMPI-2 and alpha relative power at temporal sites. These findings support previous research showing higher levels of pathology in MMPI-2 profiles and evidence for temporal and left-frontal differences in adults who report CSA.

The primary study aim was to evaluate the latent biological effect of childhood sexual abuse (CSA) on adults by quantifying acquired cytogenetic changes and cortisol levels in identical twins who were discordant (N=22) or concordant (N=2) for a history of CSA. Although the difference scores for cortisol values between discordant identical co-twins were not significantly different from zero, a trend was observed for the twins exposed to intercourse, the most severe form of CSA, to have a blunted cortisol awakening response. Acquired cytogenetic changes were assessed by scoring telomere lengths and somatic cell abnormality frequencies via a cytokinesis-block micronucleus (MN) assay. No significant difference in overall telomere intensity values was observed between co-twins, but chromosome-specific telomere differences were observed in the individuals exposed to intercourse compared to their unabused co-twins ([χ2(45)= 62.88; p= 0.040 and χ2(45)= 73.72; p= 0.004). Specifically, shortened telomeres were observed on the short arms of chromosomes 3, 5, & 6, and long arms of chromosomes 11 & 13. A significant increase in MN frequencies was observed in the abused twins compared to unabused twins (t=2.65; df=16; p=0.009). A significant interaction between micronuclei frequencies and age was also observed, suggesting that the biological effects of stress are cumulative (coefficient [SE] = 0.030 [0.009]; p=0.0006). However, the pattern of chromatin present in MN, which was assessed using spectral karyotyping methodologies, was not limited to the subset of chromosomes with telomeric attrition. In summary, this is the first assessment of acquired chromosomal abnormalities, chromosome-specific telomere lengths and cortisol levels in identical adult twins discordant for exposure to CSA. Given that a portion of biological changes were most pronounced in the intercourse discordant twins, these findings support a possible dose-response relationship with CSA severity. Our data also suggest that the MN assay is a superior tool in assessing the latent effects of stress compared to either cortisol profiling or the measurement of telomere lengths. Collectively, application of the information gained from these studies may allow for novel screening techniques to identify individuals who are most at risk for developing stress-associated disease states.

Doctor of Philosophy / Department of Family Studies and Human Services / Karen S. Myers-Bowman / The current study was conducted with women survivors of childhood sexual abuse (CSA) about their experiences of resilience in the context of interpersonal and sexually intimate relationships. Six women between the ages of 18 and 55, who self-identified as resilient on the pre-screening form, were invited to participate in the study. Qualitative methods with a phenomenological lens were employed. One-on-one interviews were conducted with participants. The results revealed the perspective and focus the survivors have regarding resilience and sexuality in interpersonal relationships. The participants had very similar thought patterns, which supports the idea that women survivors who self-identify as resilient have very similar experiences when it comes to resilience, relationship functioning and the view of themselves as sexual beings. Some of the main themes that emerged included but were not limited to bouncing back, moving forward, determination, confidence, use of voice, safe, loving relationships, empowered, church, God, religion, etc. Although each woman’s experience is not exactly the same, their views regarding their mental, emotional, and physical experiences as survivors of CSA were very similar.

Thesis advisor: Danny G. Willis / Abstract Childhood sexual abuse (CSA) survivors are at risk of suffering from myriad physical, emotional, relational, spiritual, and energetic aftereffects. Scant research has addressed healing of spiritual and energetic aftereffects, especially sense of fragmentation/soul loss. No published research has addressed shamanic healing for CSA survivors. Thus, the purpose of this qualitative descriptive research was to describe the use of shamanic healing as a complementary health approach for adult CSA survivors from the perspectives of shamanic healers. A qualitative descriptive design was used in this research. In-depth semi-structured individual interviews were conducted with a purposive sample of 15 shamanic practitioners. Interviews focused on the shamanic practitioners’ perspectives of CSA healing from western and shamanic viewpoints, shamanic methods of assessment, intervention, evaluation of outcomes, and benefits for adult CSA survivors. Interview data were analyzed using conventional qualitative content analysis, including coding, sorting, and categorizing. Shamanic practitioners described the Western viewpoint on CSA healing as limited in scope by not adequately addressing energetic and spiritual aftereffects, with the potential to leave the survivor stuck in victim mode. In contrast, the shamanic perspective was described as an expanded paradigm for CSA healing, extending beyond the individual to multigenerational healing. CSA was framed as an event in the survivor’s life that served as a teacher of life lessons, inviting the survivor to live up to one’s full potential and not be defined by CSA. The findings indicated that shamanic healing has the potential to facilitate transformative integrative healing of the adult CSA survivor by addressing the relational, spiritual, energetic, and multigenerational impact of CSA. Shamanic healing involved integrating the survivor’s perceived lost soul parts (vital energy) back into consciousness, clearing toxic energy, and restoring energy flow. The findings have implications for nursing education, theory, practice, research, and policy. The findings can serve as a foundation for designing future research on shamanic healing to address the full spectrum of healing needs of adult CSA survivors. / Thesis (PhD) — Boston College, 2016. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

The abused-abuser hypothesis posits that a history of sexual victimization may increase the risk of engaging in sexually abusive behavior for some victims. Although many researchers have discovered a higher prevalence of childhood sexual abuse (CSA) in sex offenders in comparison with non-sex offenders, less research has considered how specific characteristics of prior sexual abuse may contribute to how these individuals sexually abuse others. For the present study, archival data were collected from 243 youths receiving residential treatment for sexually abusive behavior and self-reported data were collected from university students with no known history of sexual offending. The present study confirms disproportionally high rates of CSA in the sample of sexually abusive youth, compared to non-sexual abusers. Further, among the sample of sexually abusive youth, we examined the effects of sexual perpetrator characteristics and age of sexual victimization on victim choice, age at first sexual offense, and number of sexual offenses, number of arrests, and sexual victims. Results revealed associations between perpetrator characteristics and victim choice. Additionally, being sexually victimized by a male or a relative was significantly associated with a younger age of onset of sexually abusive behavior and a younger age of sexual victimization suggested a greater number of sexual victims. Implications and future directions will be explored.

Research has shown childhood sexual abuse (CSA) to be related to many negative outcomes in adulthood including psychopathology. Findings in this area, however, are very inconsistent, with the relationship between CSA and adult outcomes varying greatly across studies. This relationship is further complicated by the co-occurrence with CSA of other risk factors in childhood. The present study examines the prediction of adult psychopathology, measured by the Brief Symptom Inventory (BSI; Derogatis, 1982), made by CSA, measured by the Early Sexual Experiences Survey (ESE; Bartoi & Kinder, 1998), childhood SES (Hollingshead, 1975), parental bonding, as measured by the Parental Bonding Instrument (PBI; Parker, Tupling, & Brown, 1979), and parental separation/divorce. It was hypothesized that CSA, SES, PBI, and parental separation/divorce would significantly predict BSI scores. It was also hypothesized that CSA would significantly predict BSI scores beyond the variance accounted for by the other variables. Results indicated that all predictor variables were significantly related to BSI score in the hypothesized direction, except for childhood SES which was found to be unrelated to BSI score in adulthood. A regression model including parental care, overprotection, and divorce/separation significantly predicted BSI score. When objective and subjective CSA severity scores were added to the equation, the amount of variance in BSI score accounted for significantly increased. Amounts of shared variance were quite high, but results indicated that CSA severity accounts for variance in adult psychological functioning beyond that accounted for by parental care, overprotection, and divorce.

Childhood abuse can impact the survivors' life in many ways. Children learn various skills from their caregivers, such as the tools needed to develop and maintain healthy relationships. When a child is abused by their caregiver, there can be a drastic impact on how the child perceives the world, and the therapeutic relationship is important in the healing process. This interpretative phenomenological analysis (IPA) study explored the lived experiences of therapists who work with adult women who are survivors of childhood sexual abuse to better understand the effects that childhood sexual abuse has on the therapeutic relationship. The theoretical base for the study was attachment theory that was conceptualized within a traumatic framework. Participants were recruited through online media forums and with the use of flyers posted at local counseling offices in the metro area of Albuquerque, New Mexico. Eight therapists who self-identified as meeting the criteria for this study were recruited and interviewed in-person; the data was analyzed by hand. Five themes emerged during the analysis: the enhancing effects of disclosure, seeking to empower clients, the client's emotional distress, negative feelings and loss of self, and ability to maintain boundaries. This study contributes to provide avenues for social change by developing awareness and education resources for therapists to increase their effectiveness of treatment and develop ways in which support can be employed to serve the affected population through education and rapport building. This in turn has the potential of increasing successful treatment outcomes, which allows clients to build better external positive, healthy relationships.