Among the many researched outcomes of childhood sexual abuse (‘CSA’), relational difficulties have been well documented. However, male CSA survivors may experience several outcomes that are unique to their gendered experience and yet remain largely under-represented in the literature. A gap was identified in the research around the experience of the male survivor in therapy for childhood sexual abuse, particularly where it relates to relationship building. Therefore the research aimed to explore this from the perspective of the survivors, with a focus on trust within the therapeutic relationship. To achieve this, the researcher interviewed 6 male survivors of sexual abuse, all of whom had greater than one years’ experience in a therapy that focused on their abuse. The researcher adopted a semi-structured interview format which facilitates partial guidance by the new data introduced by the participant. Transcripts of the interviews were analysed using interpretative phenomenal analysis with a consistent curiosity stance that allowed the researcher to partially bracket their prior knowledge. The analysis resulted in four master themes emerging; i) Finding and Connecting; ii) Negotiating Masculine identity, iii) Accepting and Committing to the process; and iv) Trust. Findings highlighted the necessity of reducing epistemic vigilance in the early relationship and the importance of negotiating power dynamics with support for challenge by the client in order to facilitate trust. The experience of masculine social expectations in a male CSA survivor is explored with regards to the trust relationship and an unexpected finding was made in the importance of group work. These findings were linked to previous research in the area of male CSA, recommendations are made for future research and implications for practitioners were explored.

Background: Childhood sexual abuse (CSA) has the potential to compromise the socioemotional development of the victim resulting in an increased vulnerability to difficulties regulating emotions and one’s sense of self. Emotion is thought to play a key part in a number of psychological disorders which CSA survivors are at increased risk of developing. A better understanding of the basic emotions experienced in this population and emotion regulation will inform current treatment. Aims: This research aimed to develop a better understanding of the emotions experienced by survivors of CSA and the relationship between “implicit” and explicit emotions and psychopathology. Method: Two empirical studies were conducted. Study 1 employed a cross-sectional consecutive case series design involving 109 survivors of CSA. Participants completed a set of measures relating to basic emotions, emotion regulation and symptoms. Exploratory factor analyses were conducted on the Basic Emotions scale (BES). Regression analyses were used to explore the relationship between emotions experienced, emotion regulation strategies and psychological symptoms. Study 2 examined basic emotions, “implicit disgust self-concept” and psychopathology in a population of CSA survivors (n=26) and a group of individuals currently receiving psychological therapy who reported that they had not experienced childhood trauma (n=25). Participants completed self-report measures pertaining to emotion, emotion regulation, symptoms and cognitive fusion. Participants also completed an implicit association test. Results: Exploratory factor analyses supported the structure of three versions of the BESWeekly, General, and Coping in a sample of survivors of childhood sexual abuse. In all three versions of the scale, disgust explained the largest proportion of variance. The basic emotions of sadness, fear and disgust as well as external dysfunctional coping strategies appear to predict PTSD symptomatology in this sample. The results of Study 2 also support the finding that self-reported disgust is prominent in the emotion profile of CSA survivors. Implicit disgust self-concept was not significantly correlated with other emotions or psychopathology. However, implicit disgust self-concept was found to be significantly associated with cognitive fusion. Discussion: Psychotherapeutic approaches for survivors of childhood sexual abuse should address the emotional experience of this population. In particular, these findings suggest that sadness and disgust should be targeted in therapy.

The incidence of both childhood sexual abuse and eating disorders is rising. A study of 422 undergraduate college females was undertaken using self report format to determine the incidence of childhood sexual abuse and eating disorders in a college population, and to determine the relationship between the two. In all, 57% of the women surveyed reported experiencing some form of sexual contact before the age of 14. Using the EDI-2 to assess risk of eating disorder development, 42% of these formerly abused women were found to be at risk for the development of an eating disorder. This was not found to be statistically different from the risk of eating disorder development experienced by the nonabused females in this population. However, there were differences found on the dimensions of Interpersonal Distrust, Interoceptive Awareness and Ineffectiveness, indicating that two of the major issues in eating disorder development for the abused women are trust both of themselves and of others, and self-esteem.

Childhood sexual abuse (CSA) is associated with negative outcomes in adulthood, including difficulty in relationships. Research has posited CSA may lead to insecure attachment in survivors, which may be the vehicle by which dysfunctional parent-child relationships develop. The purpose of the proposed study was to examine differences in parenting outcomes between CSA and non-CSA mothers utilizing both observational and self-report methods and to examine the unique impact of CSA on parenting attitudes. Abuse status was determined by scores on the Sexual Abuse subscale of the Childhood Trauma Questionnaire (CTQ), with the CSA group comprised of mothers scoring in the moderate to severe range. Mothers self-reported parenting attitudes on the Parent-Parental Acceptance Rejection Questionnaire/Control (P-PARQ/Control) and the Adult Adolescent Parenting Inventory-2 (AAPI-2), while parental depression was assessed with the revised Beck Depression Inventory (BDI-2). Parenting behaviors were observed by coding the Parent-Child Interaction Assessment (PCIA). Hypotheses were not supported until child gender was considered as a third variable. Results of MANCOVA analyses indicated CSA mothers, but not comparison mothers, exhibited significantly poorer limit-setting skills (h² = .21) with male children compared to female children, but did not self-report these differences. Although not statistically significant, small but potentially meaningful effect sizes were found when the self-reports of CSA mothers were compared to their observed behaviors. Specifically, CSA mothers displayed increased levels of physical nurturance (h² = .11) and role reversal (h² = .08) with male children compared to female children, but again, did not self-report these differences. Finally, CSA mothers, but not comparison mothers tended to self-report greater beliefs in corporal punishment with male children compared to females (h² = .08). Secondary findings revealed parental depression was the only unique predictor of parental nurturance, attitude toward corporal punishment, and role reversal. Findings confirm the importance of third variables, including child gender and parental depression. Theoretical and clinical implications are discussed, as well as limitations and future research directions.

The serotonin transporter (SLC6A4) has been a prominent choice in studying multiple neuropsychiatric illnesses. However, underlying molecular mechanisms of the regulatory control of this gene leading to these illnesses remain incomplete. Since this locus is the target of virtually every antidepressant, understanding the molecular mechanisms would benefit the development of effective therapeutic agents. In an attempt to better understand the regulatory control of the human serotonin transporter, a series of investigations were conducted on the 5HTTLPR genotype, DNA methylation and SLC6A4 mRNA expression with respect to childhood sexual abuse and depression. Moreover, since vast majority of studies have only concentrated on the Long (L) and Short (S) polymorphisms, the characteristics of the Extra-Long (XL) allele with respect to transcriptional efficiency was investigated. Finally, due to the increase in gene expression studies, the normalization of gene expression with respect to multiple housekeeping genes was explored. Through this study, we demonstrate significant gene-environmental interaction effects at this locus. The extra-long variant was associated with increased gene transcriptional efficiency. Also, although the best gene expression normalization was achieved with one housekeeping gene, we present a strong explanation on the importance of utilizing more than one housekeeping gene. These results could certainly aid in understanding and treating disorders related to the human serotonin transporter.

Although previous research has established a correlation between childhood sexual abuse and internalized shame in adult survivors, very little research has been done to examine how disclosure affects that correlation. An adult female sample of survivors of childhood sexual abuse (N=467) were surveyed to determine a possible moderating effect of disclosure on internalized shame. It was predicted that 1) severity of abuse would be a significant predictor of internalized shame; 2) disclosure would be a significant predictor of internalized shame; and 3) disclosure would moderate the relationship between severity of abuse and internalized shame. Through structural equation modeling using AMOS, results indicated a statistically significant positive relationship between severity and internalized shame as well as a statistically significant negative relationship between disclosure and internalized shame. However, when examining the possible moderating effect of disclosure on the relationship between severity and internalized shame, disclosure was found to have had no effect. Possible explanations for these results are given, and future research is discussed. Implications for clinical practice are included.

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Childhood maltreatment can have detrimental consequences on individual well-being and cognitive functioning. One type of childhood maltreatment that remains stigmatized and under-researched among men is child sexual abuse (CSA). Research examining the neurophysiological consequences of CSA in males is limited even further. This dissertation presents three original research articles which provide preliminary evidence of the lasting neurophysiological impact of CSA in men. We recruited all male participants, of those who experienced CSA, some had PTSD (CSA+PTSD) others did not have PTSD (CSA-PTSD) allowing for the examination of differences in males with histories of CSA (but no PTSD) versus those who have CSA histories and PTSD. We also recruited control males with no CSA histories nor PTSD. Three functional MRI tasks and one resting state functional scan were obtained. The letter n-back, and an emotional picture n-back task were used in the first study as a measure of working memory and emotional processing. The first study highlights the lasting impact CSA can have on men, regarding brain activity during working memory, and working memory when negative emotional stimuli are involved. The second study examined how negative/traumatic memories are re-experienced. Results from the second study demonstrate that CSA impacts the neurophysiology of autobiographical memory for traumatic experiences. In the final study, resting state functional connectivity was examined within the default mode, salience and limbic networks, and differences in functional connectivity within the networks were observed. Together, these findings highlight the long-term neural impact of CSA and can validate the experience of men who have lived through CSA. They can also guide researchers and clinicians to potential avenues of support for the well-being of these men. These studies highlight the need for more research with men who have experienced CSA so we can fully understand their altered neurophysiological responses, and how this knowledge can be used to support their mental health and continued wellness throughout their lives.

Childhood sexual abuse (CSA) is a stressful life experience with lasting/far-reaching health and psychopathological consequences. Our laboratory recently identified a significantly increased frequency of acquired chromosomal anomalies (assessed using the cytokinesis-blocked micronucleus assay) in adult female twins exposed to CSA when compared to their unexposed co-twin. The primary aim of this study was to evaluate potential mechanism(s) underlying the observed increases in levels of micronuclei in an expanded group of 90 female identical twins (61 CSA+ females and 29 CSA- females [including a total of 27 MZ co-twin pairs]) using fluorescence in situ hybridization (FISH) methodologies, with PNA probes specific for the centromeric and telomeric regions of all chromosomes coupled with the standard CBMN assay, we were able to characterize the chromosomal contents of MN and, thus, gain insight into the mechanisms underlying MN formation. By scoring 100 MN per study participant for the number of centromeric signal(s) and/or telomeric signal(s) present, we categorized the MN as harboring either: (1) terminal fragments (only a telomeric signal); (2) acentric interstitial fragments (no telomeric or centromeric signal); (3) centric interstitial fragments (only a centromeric signal); or (4) an intact chromosome(s) or chromatid(s). We identified elevated frequencies of intact chromosome-derived MN in CSA+ women as compared to CSA- women (P=0.014), implicating chromosome loss as a mechanism potentially underlying the increased frequencies of MN identified in adult females with a history of CSA. MN containing fragmented chromosomes were also observed in all of the study participants evaluated; however MN containing terminal fragments and MN containing acentric interstitial fragments were seen less frequently in CSA+ women compared to CSA- women. This study represents the first time that the chromosomal contents of MN have been evaluated in individuals in the context of a psychosocial factor. As chromosomal loss and breakage contributes to the development of age-related health problems, these observations provide important insight into the biological mechanisms that may underlie the latent morbidity and psychopathology associated with childhood adversity. Future studies aimed at understanding the biological impact of early-life trauma could determine if the observed increase in acquired chromosomal abnormalities results in detectable somatic clonal mosaicism. This knowledge could ultimately be used to develop screening tools to identify individuals “at risk” for negative health outcomes in adulthood.

The goal of this thesis is to explore the mechanisms underlying the association between women's experiences of child sexual abuse (CSA) and substance use in adulthood. Specifically, I evaluated the role of CSA, adult sexual victimization (ASA), and psychological distress including symptoms of depression, perceived stress, and PTSD on substance use. Research has shown that individuals who experience CSA are more likely to experience ASA, which results in psychological distress. Individuals may engage in substance use to cope with psychological distress from CSA and ASA, consistent with the self-medication hypothesis. Women (N = 225) were recruited from Mechanical Turk (MTurk) and completed an online survey. Results indicate positive correlations between CSA, ASA, psychological distress, problem drinking, and drug use. Further, there was an indirect effect of CSA on substance use through ASA, but not psychological distress. Results highlight the importance of trauma informed care for women's psychological distress and problem substance use.