Impact of Sexual Abuse on

Victims
Anna C. Salter, Ph.D.
 Emotional Visibility
Emotional Invisibility

Where Does Safety Lie?

Sequelae of Child Sexual Abuse

• PTSD
• Depression
• Anxiety Disorders
• Dissociation
• Sexual Problems
• Re-Victimization
• Intimacy Issues
• Somatization
• Health Problems
 Affective Sequelae

 Affective Flashbacks

 Secondary to Cognitions

 Secondary to Current Realities

 PTSD
General Population

Men
5%

Women
10%
Childhood Abuse and Interpersonal
Violence

26% - 52%
Post-Traumatic Stress Disorder
 Intrusive Symptoms

 Avoidant Symptoms

 Arousal Symptoms
Intrusive Symptoms

 Intrusive Memories

 Affective Flashbacks

 Physical Responses to Triggers

 Nightmares
 Triggers
• Smell of aftershave

• Footsteps on the stair

• Alone in the room with a male

• Bathroom

• Dental appointments
Avoidant Symptoms

 Refusal to talk or think about abuse

 Avoidance of reminders

 Numbing

 Post-traumatic decline
 Arousal Symptoms
 Hyper-startle

 Lack of concentration

 Irritability

 Difficulty sleeping
Why Some, Not All, Affected?
Correlates of PTSD in Rape Victims

Life Threat

Physical Injury

Completed Rape

8.5 x
(Kilpatrick et al., 1989)
Characteristics of Assault
%
 Rape Alone 29

 Rape/Physical Injury 58

 Rape/Life Threat 69

 Rape/Injury/Life Threat 79

(Kilpatrick et al., 1989)

 Worse Outcome
Intrusiveness

Injury

Physical Violence

(E.g., Banyard et al., 2004; Collings, 1995;

O’Leary, 2010)
Contact with Offender
 Court appearances
 Supervised visitation

 Apology sessions

 Unsupervised visitation

 Reunification
 Affective Sequelae

 Affective Flashbacks

 Secondary to Cognitions

 Secondary to Current Realities

Impact of Trauma on World View
 Non-Traumatized Beliefs

 Above average
 Things will work out
 Underestimate chances of negative
events
 Overestimate chances of positive events
 Overestimate personal efficacy
 Rated Selves More Positively
than Peer of Same Sex and Age

87%

(Taylor, Lerner et al., Submitted for

Publication)
 One’s Strengths Important
Rare

 One’s Failings Unimportant

Common
(Campbell, 1986; Marks, 1984)
Time is on Our Side
Poor Performance

Remember as Better

20 Minutes Later

(Greenwald, 1980)
 Not Recent Phenomena
One month

Rated mood each day compared to Own

typical mood

Almost everybody

Typically happier than they typically are

(Johnson, 1938)
 Lifetime Probabilities
of Experiencing Trauma
Type %
 Fire 10
 Car wreck w/ injury 23
 Robbery 25
 Loved one die from homicide,
suicide or accident 30
 Some sort 69
(Norris, 1992)
Trauma-Based World View
Shattered Assumptions

Belief in Personal Invulnerability

Belief the World is Meaningful
Belief in Personal Efficacy
(Janoff-Bulman, 1992)
 Fall-Out from Chowchilla Kidnapping

“Massive interferences with Optimism & Trust”

(Terr, 1985)
 Fall-Out from Chowchilla Kidnapping

 Age 9 Russians ruining ozone layer

Everybody killed

 Age 10 World end in 2000

Live in Mountains: Towns
Not Safe
Fall-Out from Chowchilla Kidnapping

23 of 25 Afraid of the Future

 World View and Sexual Abuse
“When you get old, you die. I have
grandparents who are sixty or sixty-nine
and I don’t think they are ready to die.
But I sometimes think I am going to die
sooner than other people – I don’t know
why I think this. I think bad people will
hurt me. I may be killed instead of
dying.”
(Terr, 1990 p. 31)
Implicit Versus Explicit Denial
Why do they shoot spies?
Worse Outcome
Parent

(Kendall-Tackett, 1993)
 Silence
39% of children

Never told anyone as children

(O’Leary et al., 2010)

 Type of Abuse
More severe

More frequent and longer lasting

Worse outcome

(Banyard et al., 2004; Boudewyn & Liem, 1995)

 Characteristics of Abuse
Multiple abusers

Worse outcome

(Briere & Runtz, 1988; O’Leary et al., 2010)

 Disclosure
Adolescents and children who disclosed

Greater psychological distress

Than those who didn’t

(Feiring et al., 2002; O’Leary et al., 2010)

 Impact of Disclosure
Adolescents who disclosed

Felt less supported

Perceived others’ reactions as negative

Blamed selves for abuse

(Feiring et al., 2002)
 Type of Disclosure
Children who disclosed to someone other
than mother

Poorer mental health

(Ruggiero et al., 2000)

 Response of Listener
If person disclosed to then tells someone
else without permission

Children have more mental health problems

(Gold, 1986; O’Leary, 2010)
 Response of Mother
Mothers who believed and supported

Children had fewer mental health problems

(Browne & Finkelhor, 1986; Luster & Small,

1997; Merrill et al., 2001)
Discussion of Abuse
Those who discussed abuse

Not just disclosed

Within one year of abuse

Better mental health

(O’Leary et al., 2010)