Emotional support and adjustment over a year’s time following sexual abuse discovery☆
Introduction
Children and adolescents who have been sexually abused are at increased risk for the development of a number of psychosocial problems including depressive symptoms, post-traumatic stress disorder (PTSD), poor self-esteem, inappropriate sexual behavior, and substance abuse (e.g., Ackerman, Newton, McPherson, Jones, & Dykman, 1998; Boney-McCoy & Finkelhor, 1995; Kendall-Tackett, Williams, & Finkelhor, 1993; Silverman, Reinherz, & Giaconia, 1996; Widom, 1999). Although most victims of sexual abuse experience some acute psychosocial problems, not all display long-term psychological distress (Ackerman et al., 1998; Feiring et al., 1998, Feiring et al., 2002; Finkelhor, 1990, Kendall-Tackett et al., 1993). Some children appear resilient to the chronic negative effects of abuse and are able to develop healthy concepts of self and social relationships. Resilience is conceptualized as a process whereby individuals who experience traumatic events cope or adjust in ways that are better than expected (Luthar, Cicchetti, & Becker, 2000).
Most studies examining effects of child sexual abuse (CSA) employ cross-sectional or retrospective designs. Moreover, adjustment is not typically examined across more than one domain (e.g., emotional vs. school functioning). In order to understand the heterogeneity in adaptation after traumatic events, it is necessary to examine a range of factors that might contribute to resilience as well as multiple domains of functioning (Luthar et al., 2000). This paper examines how characteristics of the social support network help explain variations in children’s and adolescents’ adjustment. It examines persistence over a year’s time in patterns of support in a sample first seen at the time of abuse discovery (Feiring et al., 1998). Of interest were the ways in which social support from caregivers and peers promotes resilience under the adverse conditions of having been the victim of sexual abuse. This study examines adjustment in terms of stigmatization, symptoms of psychological and behavioral disorders, self-esteem, and school functioning. Four major questions are addressed: (1) Are there age differences in children’s perceptions of emotional support over time? (2) Are there gender differences in perceptions of emotional support over time? (3) Does the relation between support and adjustment vary as a function of the source of support? (4) Does more emotional support at the time of discovery promote resilience by decreasing negative and increasing positive adjustment over time?
A developmental perspective must be adopted to understand the impact of victimization on children as well as the operation of protective factors (Finkelhor, 1995). It is reasonable to expect children and adolescents to differ in how they process and respond to victimization, yet most of the literature on CSA has not examined age differences in patterns of support provision and adjustment (Kendall-Tackett et al., 1993). Similarly, there is limited knowledge about how developmental period is related to the response of victims’ support network and there is almost no research concerning patterns of support over time. From a normative perspective children would be expected to rely more on their parents for emotional support than on same-sex or other-sex friends (Furman & Buhrmester, 1992). In contrast adolescents are striving for greater autonomy from parents and thus may experience greater conflict concerning relying on parents for emotional support and protection (Steinberg, 1990). We expected victims of CSA to show the normative pattern, with children compared to adolescents reporting relatively more support from parents than friends. Such a pattern was expected to place adolescents at a disadvantage for seeking the kind of support needed during times of extreme stress (Salt, Myer, Coleman, & Sauzier, 1990). Adolescents compared to children may also receive less support from caregivers because they are seen as more responsible for their victimization (Collings & Payne, 1991, Elliot & Carnes, 2001, Salt et al., 1990).
Some studies suggest that gender plays a role in the kind of abuse experienced and the outcomes of abuse. Research indicates girls may experience more severe CSA and higher levels of PTSD and depression (Feiring et al., 2002; Wolfe, Sas, & Wekerle, 1994). It also is reasonable to consider the impact of gender on the relations among the CSA experience, social support, and adjustment. Some studies find that mothers are more protective of sons than daughters whereas others show no differences by gender in this type of maternal support (Heriot, 1996, Pintello & Zuravin, 2001, Salt et al., 1990). Although existing literature examining the relation between victim’s gender and the response of the victim’s support network is inconsistent, the developmental literature suggests that girls and boys networks differ (Feiring & Lewis, 1991, Youniss & Smollar, 1985). Girls may be better at seeking support from others when they feel stressed (Belle, 1989, Cross & Madson, 1997). Based on the literature with normative samples we expected that girls would be more effective than boys at seeking support as reflected in higher satisfaction.
Whereas the provision of emotional support is related to more optimal adjustment, it remains unclear whether the identity of the support provider also plays a role. Different providers of supportive relationships (e.g., parents vs. friends) might differentially impact adjustment following sexual abuse. For the most part, only caregiver support has been examined in the CSA literature (Elliot & Carnes, 2001). In the study of perceived social support, the provider model stipulates that specific sources of support, that is specific support relationships, are the central determinant of the effects of support (Scholte, Lieshout, & van Aken, 2001). Parental support is associated with fewer symptoms of psychological distress and a greater level of social competence in the short-term and is thought to be vital for later adjustment (e.g., Elliot & Carnes, 2001; Everson, Hunter, Runyon, Edelsohn, & Coulter, 1989; Feiring et al., 1998; Hazzard et al., 1995, Leifer et al., 1993; Spaccarelli & Kim, 1995). In contrast, results from this study at the time of abuse discovery showed emotional support from friends was associated with more negative self-esteem and more PTSD symptoms (Feiring et al., 1998). This report examines whether the positive relation of caregiver support and the negative relation of peer support to adjustment persisted over a year’s time from abuse discovery. Given the major stress surrounding abuse discovery and its aftermath, reliance on and availability of caregiver compared to friends support was expected to be more important and positively predictive of better adjustment in both children and adolescents (Spaccarelli & Fuchs, 1997). We expected that support from parents may be particularly important to help victims feel safer and less stigmatized, making them less likely to develop symptoms.
The protective value of support might vary based on when it is offered both in relation to the abuse experience and to the developmental stage of the victim. Most studies finding beneficial effects of emotional support are focused on the time directly following disclosure of CSA. However, it is not known whether effects of early support endure over time or whether current functioning engenders biased recollections of past support (e.g., Mannarino & Cohen, 1996). The literature is limited by retrospective data, concurrent or short-term studies and small samples (Mannarino & Cohen, 1996, Spaccarelli & Kim, 1995). For this study, we expected that emotional support at the time of abuse discovery from the primary adult caregiver (typically the mother), would be particularly important for promoting resilience over time.
Section snippets
Sample selection and characteristics
Participants were recruited from urban and suburban populations in the eastern United States. They were confirmed cases of sexual abuse by at least one of the following criteria: specific medical findings, confession by the offender, abuse validated by an expert such as child protective services (CPS), or conviction of the offender in family or criminal court. About half of the sample came directly from CPS and the remainder came from other referral sources (e.g., medical clinics) and were not
Results
The majority of the sample came from single parent families (71%) and were poor (70% with an income of $25,000 or less). The ethnicity of the sample was self described as: African-American (40%), White (34%), Hispanic (18%), and other (8%, including Asian and Native Americans). Based on the most serious form of contact abuse reported by this sample, 67% experienced genital penetration. Thirty-four percent of perpetrators were parents or parent-figures. Almost half of the sample (43%) lived with
Discussion
It is generally assumed that emotional support promotes resilience and protects against the development of psychosocial problems in children and adolescents who were sexually abused. However, knowledge is limited about individual differences in emotional support or the impact of support on resilience among victims of CSA. In this study, resilience was defined in terms of positive functioning after childhood sexual abuse; less depression, PTSD and behavior problems as well as better self-esteem.
Acknowledgements
We gratefully acknowledge the efforts of Patricia Lynch and Patricia Myers in data collection and the children, adolescents, and families for their participation.
References (55)
- et al.
Prevalence of post traumatic stress disorder and other psychiatric diagnoses in three groups of abused children (sexual, physical, and both)
Child Abuse & Neglect
(1998) - et al.
Prior victimization: A risk factor for sexual abuse and for PTSD-related symptomatology among sexually abused youth
Child Abuse & Neglect
(1995) - et al.
Attribution of causal and moral responsibility to victims of father-daughter incest: An exploratory examination of five factors
Child Abuse & Neglect
(1991) - et al.
Predicting symptomatology and self-blame among child sexual abuse victims
Child Abuse & Neglect
(1995) - et al.
The impact of maternal history and behavior upon foster placement and adjustment in sexually abused girls
Child Abuse & Neglect
(1993) - et al.
Adolescent friendships mediating childhood adversity and adult outcome
Journal of Adolescence
(1997) - et al.
The long-term sequelae of child and adolescent abuse: A longitudinal community study
Child Abuse & Neglect
(1996) - et al.
Resilience criteria and factors associated with resilience in sexually abused girls
Child Abuse & Neglect
(1995) - et al.
Factors associated with the development of posttraumatic stress disorder among child victims of sexual abuse
Child Abuse & Neglect
(1994) - Achenbach, T. M. (1991). Integrative guide for the 1991 CBCL/4–18, YSR, and TRF Profiles. Burlington, VT: University of...
The abuse dimensions inventory. Initial data on a research measure of abuse severity
Journal of Interpersonal Violence
Interventions for sexually abused children: Initial treatment outcome findings
Child Maltreatment
Models of the self: Self construals and gender
Psychological Bulletin
Sexually abused children suffering posttraumatic stress symptoms: Initial treatment outcome findings
Child Maltreatment
Comparative efficacies of supportive and cognitive behavioral group therapies for young children who have been sexually abused and their nonoffending mothers
Child Maltreatment: Journal of the American Professional Society on the Abuse of Children
Reactions of nonoffending parents to the sexual abuse of their child: A review of the literature
Child Maltreatment
Maternal support following disclosure of incest
Journal of Orthopsychiatry
The transition from middle childhood to early adolescence: Sex differences in the social network and perceived self-competence
Sex Roles
Stigmatization and the development of friendship and romantic relationships in adolescent victims of sexual abuse
Child Maltreatment
Social support and children’s and adolescents’ adaptation to sexual abuse
Journal of Interpersonal Violence
Adjustment following sexual abuse discovery: The role of shame and attributional style
Developmental Psychology
Early and long-term effects of child sexual abuse: An update
Professional Psychology: Research and Practice
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The preparation of this paper was made possible by a grant from the National Institute of Mental Health—MH49885.
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Present address: The College of New Jersey, Center for Youth Relationship Development, PO Box 7718, 2000 Pennington Rd., Ewing, New Jersey 08628-0718, USA.