The experience of childhood sexual abuse: An exploratory description of psychological and adaptive functioning in Canadian men.

BACKGROUND: Childhood sexual abuse (CSA) affects a number of men yet knowledge gaps remain around comprehensively describing psychological and adaptive outcomes for this population. OBJECTIVE: Examine how a Canadian sample of men with and without CSA histories compares on broader areas of psychological and adaptive functioning. PARTICIPANTS AND SETTING: This exploratory study included 109 adult men aged 25-60 years who were grouped according to whether they experienced CSA (n = 69) or not (n = 40). Participants were recruited from Ottawa, Ontario, Canada. METHOD: Using a multi-method approach, we conducted an exploratory and comprehensive examination of how CSA contributes to various areas of psychological (e.g., depression, anxiety, stress, dissociation, anger, PTSD) and adaptive functioning (e.g., friendship quality, employment) using self-report and clinician-administered measures. RESULTS: CSA men were an average of 8.5 years old at abuse onset. Most (62.3 %) had disclosed their CSA experience, waiting an average of 13.6 years before disclosure. After controlling for covariates (i.e., other types of maltreatment, non-maltreatment adversities, education, income), results indicated a significant association between CSA and men's psychological functioning, but not their adaptive functioning. CONCLUSIONS: Findings highlight the importance of broadening our understanding of how the experience of CSA, controlling for important covariates, can contribute to the well-being of men in order to better respond to their psychological needs.

The brain at rest: Exploratory Neurophysiological Findings Among Men With Histories of Childhood Sexual Abuse.

Purpose: There is a lack of research on childhood sexual abuse (CSA) experienced by men, with even less research examining long term neurophysiological repercussions. This study explored the neurophysiology of the brain at rest to examine the influence of CSA on resting state functional connectivity (RSFC) into adulthood. Methods: RSFC was examined with functional magnetic resonance imaging (fMRI) within the default mode, salience and limbic networks in men with CSA histories, with and without post-traumatic stress disorder (PTSD; CSA + PTSD n = 7, CSA-PTSD n = 9), and men without a CSA history nor PTSD (n = 13). Results: CSA + PTSD participants had increased functional connectivity (FC) in the medial prefrontal cortex (mPFC) from the default mode network seed compared to participants with CSA-PTSD. Both CSA groups showed significantly less FC in the striatal-thalamic circuits of the salience network than the control group. Similarly, the robust FC between the bilateral amygdalae and the mPFC that was notable in control participants, was not exhibited in participants who experienced CSA with or without PTSD histories. Conclusions: These findings demonstrate that intrinsic neurophysiological differences in limbic, salience and default mode network connectivity are apparent even during a resting state between the groups of participants. This is preliminary evidence of long-term neurophysiological effects of CSA in men with PTSD, and even in those without. Importantly, these findings can validate the lived experiences of males with CSA histories and guide researchers and clinicians to potential avenues to support their well-being.

Traumatic Autobiographical Memories: Preliminary fMRI Findings Among Men With Histories of Childhood Sexual Abuse.

Childhood sexual abuse (CSA) is associated with autobiographical memory (AM) disturbances. AM is important for future thinking, sense of self, and coping with negative emotions. CSA is under-researched among men, with research examining long-term neural correlates limited even further. This study explored the neural correlates of re-experiencing traumatic/negative memories to examine the influence of CSA on AM into adulthood. Fifteen males who experienced CSA, with and without posttraumatic stress disorder (PTSD; CSA+PTSD, n = 6; CSA-PTSD, n = 9) and control males without CSA histories nor PTSD (n = 11) completed a script-driven imagery paradigm during functional magnetic resonance imaging (fMRI). Males with CSA histories, with and without PTSD, processed their negative autobiographical memories with less activation compared to control males. The CSA+PTSD group of males had less activation in the left superior occipital, left superior parietal and left parahippocampal gyri compared to control participants. The CSA-PTSD group had reduced activation in the same regions to a lesser extent. This study provides preliminary empirical evidence to suggest CSA impacts AM for traumatic experiences, and the impact is notable even for men who experienced CSA but do not have PTSD. This study highlights the need for more research with men who have experienced CSA, so that, we can fully understand the neural correlates of emotional memories, and better support the mental health and continued wellness of men who experienced CSA.

Emotion Regulation and Mental Health among Men with Childhood Sexual Abuse Histories.

Childhood sexual abuse (CSA) is a form of child maltreatment which has been increasingly recognized as a common experience among men. Research on male CSA remains under-developed but suggests many negative mental health impacts. The current study examined the link between mental health outcomes and different emotion regulation strategies among 69 adult men. Men completed measures on their current mental well-being, and participated in a clinical interview about emotion regulation strategies used to manage memories about their sexual victimization. Results indicated that the most frequently used emotion regulation strategies were expressive suppression, rumination, and cognitive avoidance. For perceived effectiveness, men identified cognitive avoidance, self-medication, and behavioral avoidance as being most helpful in managing their CSA-related distress. Finally, greater use of deliberate self-harm, rumination, and behavioral avoidance was associated with more internalizing difficulties, while greater use of deliberate self-harm and self-medication was linked with more externalizing difficulties. Greater perceived efficacy of positive reappraisal was associated with fewer externalizing behaviors. Although these findings require replication through larger mixed-methods studies, they suggest the importance of incorporating emotion regulation strategies into interventions aimed at improving mental well-being among men with CSA histories.

The influence of emotion on working memory: Exploratory fMRI findings among men with histories of childhood sexual abuse.

BACKGROUND: 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. OBJECTIVE: To provide preliminary insight into the neural basis of the impact of CSA during two working memory tasks. PARTICIPANTS AND SETTING: Men with CSA histories, with and without post-traumatic stress disorder (PTSD; CSA + PTSD n = 7, mean age = 45; CSA-PTSD; n = 9, mean age = 41), and men without a CSA history nor PTSD (n = 13, mean age = 36) participated in the study at a local hospital. METHODS: Participants completed a letter n-back task and an emotional picture n-back task during fMRI to measure working memory and the influence of emotion on working memory. They also completed self-report measures to assess mental health and childhood abuse histories. RESULTS: In the letter n-back task, men with CSA + PTSD had less activation in the cerebellum and left fusiform gyrus compared to CSA-PTSD men. During the working memory task with negative emotional pictures the control group had greater frontal activation, while the CSA-PTSD group had greater limbic activation. Analyses were performed with independent-samples t-tests. CONCLUSIONS: This study provides preliminary empirical evidence of the impact CSA can have on men regarding working memory when negative stimuli are involved. It highlights that CSA, even without a diagnosis of PTSD, can have a significant neurophysiological impact. It also provides clinicians with information to support well-being and help with potential day to day challenges.

Men with childhood sexual abuse histories: Disclosure experiences and links with mental health.

BACKGROUND: There is limited research on the disclosure experiences of men who have experienced childhood sexual abuse and on how such experiences might impact mental health outcomes. OBJECTIVE: The current study described men's disclosure experiences and examined the role of disclosure characteristics on mental well-being (internalizing and externalizing behaviors, substance use, resilience). PARTICIPANTS AND SETTING: Men (N = 253) from across Canada and the U.S. were recruited through websites for males with sexual abuse histories. Men aged 18-59 years anonymously completed an online study on their sexual abuse, disclosure experiences, and mental health outcomes. RESULTS: Findings indicated that 77.9% of men disclosed their sexual abuse, although they waited an average of 15.4 years before sharing their experience. Once disclosed, 64.4% of the men reported a positive response (e.g., support), while 35.6% reported a negative response (e.g., blame). Regression analyses indicated that a greater delay in disclosure predicted greater externalizing behaviors (B = .49, p < .05), although this was a small effect (Cohen's f2 = 0.02). Additional disclosure variables were associated with components of externalizing (aggressive and rule-breaking behaviors) and internalizing (somatic complaints) behaviors. CONCLUSIONS: These results require replication in future studies. However, they do suggest that efforts need to be undertaken to address the barriers that hinder men from disclosing their sexual abuse and to ensure that men are supported once they disclose.