Differential Profiles of Sexually Abused Adolescent Boys.

Victims of child sexual abuse (CSA) are a heterogeneous population. Several characteristics may influence the outcomes associated with this adverse childhood experience, including personal (e.g. age) and CSA characteristics (e.g. relationship to the perpetrator). This study relied on a person-centered approach to account for this heterogeneity and focused on adolescent boys, an understudied population. Data were drawn from a representative sample of high school students aged 14 to 18 years old in Quebec, Canada. A total of 3.9% (n = 138) of boys reported CSA. Various CSA characteristics (severity, relationship to the perpetrator, and number of events) were used as indicators to derive classes. A four-class solution emerged from the latent class analysis: CSA in a sports context (6%), intrafamilial CSA (8%), extrafamilial CSA (52%) and multiple CSA (34%). The multiple CSA profile included boys who were sexually abused in multiple situations by different perpetrators and who were victims of acts involving penetration. The exploration of correlates associated with class membership revealed that adolescent boys included in the multiple CSA profile were distinguished by higher rates of delinquent behaviors and alcohol and drug use. They were more likely than members of other latent classes to belong to sexual minorities. This exploratory study sheds light on sexually victimized adolescent boys and the deleterious consequences that may affect them, particularly boys who have experienced multiple CSA events. We conclude that prevention efforts should focus on the demystification of sexual trauma among boys and on using trauma-informed care approaches for adolescent externalizing behaviors.

Child Sexual Abuse, Self-esteem, and Delinquent Behaviors During Adolescence: The Moderating Role of Gender.

To reflect the complex phenomena of child sexual abuse (CSA), studies should examine possible gender specificities and explore potentially explanatory mechanisms. The current study aimed to test the moderating effect of gender in the mediated relationship between CSA, self-esteem, and delinquency during adolescence. A moderated mediation model was tested among a representative sample of 8,194 high school students (57.8% girls and 42.2% boys) age 14 to 18 in the province of Quebec in Canada. Results showed that self-esteem has an indirect effect on the relationship between CSA and delinquency. Gender (being a boy) was associated with a higher level of self-esteem and an increased risk of delinquent behaviors. Among victims of CSA, boys reported lower levels of self-esteem than girls, which was associated with an increased risk of displaying delinquent behaviors. Self-esteem may be an important target of intervention for sexually abused youth, especially for boys. Focusing on promoting positive self-esteem may also reduce the risk for male adolescents struggling with the deleterious consequences of delinquency.

Experiences of Disclosure and Reactions of Close Ones from the Perspective of Child Sexual Abuse Survivors: A Qualitative Analysis of Gender Specificities.

The disclosure of child sexual abuse (CSA) is a complex process that remains partially understood, despite its crucial role in survivors' recovery. Gender specific experiences of disclosure have been little investigated while this information is crucial to better tailor interventions for survivors. This qualitative study aims to 1) explore survivors' experiences in disclosing to close ones, and 2) contrast experiences of male and female survivors. Fifty-one CSA survivors (25 women and 26 men) aged 18 years or older were recruited via community services for survivors. Two main categories emerged from thematic content analysis: 1) experiences of disclosure hindering CSA recovery or 2) ones fostering CSA recovery. Men felt ignored when their close ones were focused on their own emotions of indifference, helplessness and guilt toward CSA. Men felt guilty when confronted with reactions of blame for their own inaction or disempowered when pressured to remain silent or to forgive. Women felt ignored when their close ones showed anger toward their perpetrator. Women felt guilty when they were held accountable for CSA events or disempowered when pressured to take legal actions. Women, but not men, reported feeling considered through caring and heart-to-heart discussions. Recommendations for awareness messages and practitioners are discussed.

Child Sexual Abuse among a Representative Sample of Quebec High School Students: Prevalence and Association with Mental Health Problems and Health-Risk Behaviors.

OBJECTIVE: The objective of this study was to estimate the prevalence of child sexual abuse in a representative sample of Quebec high school youths and document its associations with mental health problems and health-risk behaviors. METHOD: Data were drawn from the Quebec Youths' Romantic Relationships Survey, which involved a one-stage stratified cluster sampling of 34 Quebec high schools from Grades 10 to 12. A total of 8,194 youths (mean age = 15.35) were recruited. The survey assessed child sexual abuse, mental health problems (psychological distress, post-traumatic stress symptoms, suicidality), health services utilization, and health-risk behaviors (alcohol, drug, and cannabis use). Gender-stratified multivariate analyses were used to assess associations between child sexual abuse and mental health problems and health-risk behaviors while controlling for confounding demographic variables and other forms of child maltreatment experienced in childhood. RESULTS: A total of 14.9% of girls and 3.9% of boys reported having experienced child sexual abuse. Child sexual abuse was independently associated with an increased risk of psychological distress, greater health services utilization, and increased health-risk behaviors, after controlling for other forms of childhood maltreatment experienced. CONCLUSIONS: Child sexual abuse is prevalent among youths in Quebec and is associated with an increased risk of a host of negative consequences. Continued efforts in the development of early detection strategies as well as prevention and intervention programs are warranted.

A mediational model linking perceptions of security, alexithymia and behavior problems of sexually abused children.

BACKGROUND: Perceptions of security toward parents are related with internalized and externalized problems among victims of child sexual abuse (CSA). Alexithymia, which is difficulty in identifying and expressing feelings, is associated with the quality of parent-child relationships (Oskis et al., 2013) and behavior problems in children (Di Trani et al., 2013). OBJECTIVE: The current study tested the mediational role of alexithymia in the relationship between perceptions of security toward parents and behavior problems among CSA victims. PARTICIPANTS AND METHOD: Using a short-term multi-informant prospective design, 263 victims of CSA aged 6-12 years completed the Kerns Security Scale (Kerns, Klepac, & Cole, 1996), which evaluates perceived attachment security to mothers and fathers. Parents completed the Child Behavior Checklist (Achenbach & Rescorla, 2001) at Time 1 to provide baseline scores of behavior problems and again four months later. At Time 2, parents also assessed the children's alexithymia using the Children's Alexithymia Measure (Way et al., 2010). RESULTS: Perceptions of security were both associated with alexithymia, as well as with internalizing and externalizing problems (p < .05). A mediational model showed that perception of security toward fathers outweighed the mother-child relationship in predicting children's alexithymia. Path analysis revealed that the father-child relationship predicted decreased behavioral problems at Time 2 through a lower level of alexithymia. The model explained 46.9% of internalizing problems and 56.1% of externalizing problems (p < .05). CONCLUSIONS: The findings support the relevance of alexithymia as an intervention target for CSA victims and underscore the importance of the father-child relationship.

Gender as a predictor of posttraumatic stress symptoms and externalizing behavior problems in sexually abused children.

Despite the proliferation of studies documenting outcomes in sexually abused victims, gender differences remain understudied. The bulk of studies have relied on retrospective samples of adults with insufficient representation of male victims to explore gender specificities. This study examined differential outcomes among boy and girl victims of sexual abuse. A predictive model of outcomes including abuse characteristics and sense of guilt as mediators was proposed. Path analysis was conducted with a sample of 447 sexually abused children (319 girls and 128 boys), aged 6-12. Being a girl was a predictor of posttraumatic stress symptoms, while being a boy was a predictor of externalizing problems. Being a boy was also associated with more severe abuse, which in turn predicted posttraumatic stress symptoms. Child's gender was not related to perpetrator's relationship to the child or sense of guilt. However, sense of guilt predicted posttraumatic stress symptoms and externalizing problems while perpetrator's relationship to the child predicted externalizing problems. Gender specificities should be further studied among sexually abused children, as boys and girls appear to manifest different outcomes. Sense of guilt should be a target in intervention for sexually abused children, as results highlight its link to heightened negative outcomes.

[Sense of guilt in sexually abused children : Mediating role of avoidance coping on anxiety and self-esteem]. / Culpabilité chez les enfants victimes d'agression sexuelle : Le rôle médiateur des stratégies d'évitement sur l'anxiété et l'estime de soi.

Prior studies have suggested self-blame and sense of guilt as important elements associated with the effects of childhood sexual abuse on adult survivors (Cantón-Cortés, Cantón, Justicia & Cortés, 2011). However, few studies have explored the potential impact of the sense of guilt on outcomes in child victims. This study examines the mediating role of avoidance coping on the relationship between sense of guilt and outcomes (anxiety and self-esteem) in sexually abused children. The sample consisted of 447 sexually abused children (319 girls and 128 boys) aged 6 to 12. Path analysis indicated that children with higher feelings of guilt about the abuse showed more anxiety and lower levels of self-esteem. Indirect effects also indicated that sense of guilt predicted avoidance coping, which in turn contributed to higher anxiety and lower self-esteem. This model, which fits the data well for both girls and boys, explains 24.4 % of the variance in anxiety and 11.2 % of the variance in self-esteem. Results suggest that sense of guilt is an important target for clinical intervention with sexually abused children.