Therapists will be more effective practitioners when they understand the factors that contribute to sexual boundary violations. The authors' interviews with former female victims indicated that offending therapists were mostly reputable psychologists working alone, and that boundary violations developed gradually. The clients were often victims of child sexual abuse. Many reported pleasurable feelings during the affair but saw the experience as hurtful or exploitative in retrospect. The authors' findings imply that practitioners should minimize seemingly innocuous physical consolation or self-disclosure, especially with survivors of child abuse. They are encouraged to select offices with other professionals and to participate in peer-supervision activities. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Conducted life-history interviews to determine the thoughts, feelings, and misgivings of 3 men (aged 27–32 yrs) who were sexually abused as children and who tried to come to terms with their sexual identity. Ss' accounts illustrate 3 types of sexual orientation among such victims of sexual abuse: homosexual, heterosexual, and unsure but possibly bisexual. Although the sexual orientation of 2 Ss was not affected by the abuse, the process of coming to terms with their sexual identity involved years of silent suffering. The sexual abuse appeared to have interrupted heterosexual development and to have introduced lifelong sexual-identity confusion in the remaining S. Coming to terms with sexual orientation was complicated by internalized homophobia and having to deal with a homophobic culture. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This qualitative study explored the effects of childhood sexual abuse on adult male survivors. Qualitative methodology was used to analyse in-depth interviews with ten males who had been sexually abused as children. The ten men participated in the research, largely motivated by their experience that society does not acknowledge the sexual abuse of males. They described the abuse as having significantly affected their sexual identity, as well as their emotional and sexual relationships as adults. The implications of these issues for therapists who treat male survivors are documented along with a discussion of interventions to assist the treatment process.
At a community-based domestic violence program, 218 men with a history of partner abuse were randomly assigned to either feminist-cognitive-behavioral or process-psychodynamic group treatments. The treatments were not hypothesized to differ in outcome. However, men with particular characteristics were expected to have lower recidivism rates depending on the type of treatment received. Treatment integrity was verified through audio-taped codings of each session. The partners of 79% of the 136 treatment completers gave reports of the men's behavior an average of 2 years post-treatment. These reports were supplemented with arrest records and self-reports. Rates of violence did not differ significantly between the two types of treatment nor did reports from the women of their fear level, general changes perceived in the men, and conflict resolution methods. However, interaction effects were found between some offender traits and the two treatments. As predicted, men with dependent personalities had better outcomes in the process-psychodynamic groups and those with antisocial traits had better outcomes in the cognitive-behavioral groups. The results suggest that more effective treatment may occur if it is tailored to specific characteristics of offenders.
There are no epidemiological data in Europe on associations between sexual molestation in males and psychological disturbance.
To investigate whether sexual molestation in males is a significant predictor of psychological disturbance.
We recruited men attending general practice and genitourinary medicine services. Participants took part in a computerised interview about sexual molestation as children or adults. We ranked reported sexual experiences into three categories of decreasing severity. Each category was treated as an independent predictor in a multivariate analysis predicting different types of psychological disturbance.
Men who reported child sexual abuse were more likely to report any type of psychological disturbance. Men who reported sexual molestation in adulthood were 1.7 (1.0-2.8) times more likely to have experienced a psychological disorder, but self-harm was the single most likely problem to occur (odds ratio=2.6, range=1.3-5.2). Men reporting 'consenting' sexual experiences when aged under 16 years also were more likely to report acts of self-harm (odds ratio=1.7, range=0-2.8).
Sexual abuse as a child or adult is associated with later psychological problems. All forms of sexual molestation were predictive of deliberate self-harming behaviour in men.
This meta-analytic review examines the findings of 22 studies evaluating treatment efficacy for domestically violent males. The outcome literature of controlled quasi-experimental and experimental studies was reviewed to test the relative impact of Duluth model, cognitive-behavioral therapy (CBT), and other types of treatment on subsequent recidivism of violence. Study design and type of treatment were tested as moderators. Treatment design tended to have a small influence on effect size. There were no differences in effect sizes in comparing Duluth model vs. CBT-type interventions. Overall, effects due to treatment were in the small range, meaning that the current interventions have a minimal impact on reducing recidivism beyond the effect of being arrested. Analogies to treatment for other populations are presented for comparison. Implications for policy decisions and future research are discussed.
The focus of the present paper is the main problems found in the study of male child sexual abuse. Aspects of child sexual abuse of males reviewed here include (a) definitions, (b) prevalence rates and under-reporting, (c) effects, (d) possible mechanisms of how sexual abuse affects male victims, (e) gender related risks, (f) types of abuse, (g) perpetrators of abuse, and (h) the victim/perpetrator cycle. We conclude that while much research is urgently required in this area, some tentative conclusions are warranted and some important trends are beginning to emerge for future research directions.
Describes a curative factor framework and offers it as a model for conceptualizing group phenomena. 11 curative factors (interpersonal learning, identification, instillation of hope, imparting information, socializing techniques, universality, catharsis, existentialism, family reenactment, cohesion, and altruism) are organized on a triangle of continua that integrates the concerns, developmental dynamics, theoretical perspectives, and leader behaviors that characterize group counseling. It is suggested that counselors can use the framework to assess groups and to choose interventions that potentially facilitate curative factors congruent with the groups' goals. Investigators can use the framework to identify directions and methods for studies on group counseling. The framework is based primarily on theory; additional counseling experience and empirical research are recommended to establish its validity and utility. (31 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Discusses the challenges faced by clinicians working with male victims of child sexual abuse by distinguishing between male and female ways of resolving issues of attachment and separation, which have been identified by contemporary feminist writers. It is suggested that males, more than females, tend to respond to anxiety with aggression, disruptive activity, and counterphobic responses to vulnerability. This disruptive activity is a necessary move away from pain and depression and is an effort to reclaim vitality and creativity. Therapists should (1) prepare clients for the emergence of this behavior in therapy, (2) recognize, validate, and contain it by providing a supportive milieu, and (3) resolve it by helping the client to achieve a balance between intimacy and independence. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This study explored the impact of sexual abuse on male sexual identity, utilizing qualitative methodology in interviews with 10 sexually abused men. The findings suggest that male survivors struggle with the disparity between sexual victimization and societal stereotypes of masculinity. The greatest difficulty was with social sex role identity; however, male abuse survivors also question their gender identity. While participants had no sexual orientation identity problems, they tended to find sexual contact threatening. Implications for clinical practice are suggested.
In previous research, adults who reported childhood sexual abuse have been more suicidal than nonabused adults, but no research has examined their cognitive deterrents to suicide. Strict definitions of sexual abuse in these studies have excluded (a) unwanted sexual experiences with peers, and (b) exploitive experiences not involving genital contact (i.e., unwanted sexual invitations or suggestions, unwanted exposure to others' genitals via exhibitionism, unwanted kissing or hugging in a sexual way). The present study compared suicidal behavior and cognitive deterrents to suicide in 266 college students using both a strict and a liberal definition of sexual abuse. Both women and men abused by adults or peers were more suicidal as adult college students than were women and men with no such history. Women reported similar degrees of suicidality as men, but greater survival and coping beliefs and more fear of suicide. Those whose sexual abuse involved touching were more suicidal, and felt less able to cope, and less responsibility for their families, than nonabused adults. Implications are that adults who experienced childhood sexual abuse that involved touching are more suicidal and have less cognitive deterrents to suicide than adults who have not, regardless of whether they are men or women or whether they were abused by adults or by peers.
This study examined associations between family of origin violence, self-reports of psychopathology on the MCMI-II, and current spouse abuse among partner assaultive men. Compared to nonviolent men in discordant (n = 24) and well-adjusted (n = 24) relationships, partner assaultive men (n = 24) were significantly more likely to report childhood histories of physical abuse and physical abuse of the mother in the family of origin. The partner assaultive men also reported significantly higher scores on a variety of MCMI-II personality disorder and Axis I disorder scales. When negative affectivity was controlled, however, batterers differed from contrast groups only on scales assessing antisocial and aggressive characteristics. Within the partner assaultive group, a history of severe childhood abuse was associated with higher scores on a variety of MCMI-II personality disorder and Axis I disorder scales, and higher levels of psychological and physical aggression directed toward the current relationship partner. Abuse of the mother in the family of origin among batterers was associated with higher levels of psychological and physical aggression toward the current partner, but not with self-reported psychopathology. The results support prior descriptions of a batterer subgroup with significant trauma histories, more psychological difficulties, and higher abuse levels than other batterers, suggesting continuities in social and emotional development from childhood maltreatment to adult relationship violence.
The authors argue that shame is a core issue for many men who assault their partners. Shame must therefore be addressed in treatment groups. This article outlines how one intervention, "the confession," elicits shame and how that shame is negotiated through the various stages of group development.
This article presents a model for a long-term process group for treating adult survivors of childhood sexual abuse. The reasons for the preference of an ongoing group are presented in light of their relevance to the early traumas of survivors. The rationale and philosophy guiding these groups with their emphasis on strengths rather than pathology, on individuation, and on educational and therapeutic components are highlighted. The developmental life of the group and corresponding behavior of members at each stage are viewed within the overarching concept of closeness, a key issue for survivors to experience and work through during their recovery.
This literature review explores the reasons why comparatively few adult males with a history of childhood sexual abuse are seen by professionals for help with difficulties relating to that abuse. Two potential explanations are discounted as myths-that relatively few males are sexually abused, and that abuse has little effect on males. However, it is suggested that society (including professionals and the victims themselves) has given credence to these myths. Male victims are relatively unlikely to disclose their experience of childhood abuse, and (as a coping strategy) they deny the impact of sexual abuse on their lives. Professionals fail to hypothesise that their male clients may have been abused, and do not create the conditions that would enable males to talk about the abuse. Blumer's (1971) model of the social construction of problems is applied to account for these beliefs and behaviours on the part of victims and clinicians. It is argued that the childhood sexual abuse of males has not yet acquired legitimacy as a problem recognised by society, thus lagging behind the abuse of females. In short, the "evil' of childhood sexual abuse in the male population is not being seen or heard by clinicians, and is not being recognised or talked about by victims. Clinical implications are considered.
The current study examined the association between childhood sexual victimization and adult psychiatric disorders among male inmates. It further assessed the association between the perception of an event (as sexual abuse or not) and psychiatric diagnoses.
A sample of 211 randomly-selected male inmates were interviewed. The Diagnostic Interview Schedule (Version III-R) was used to assess psychiatric diagnoses. An additional questionnaire assessing childhood sexual abuse and perception of childhood sexual abuse was also administered.
Forty percent of the inmates met standard criteria for childhood sexual abuse, which far exceeded rates found in the general population. Significant differences were found between inmates who had a history of childhood sexual abuse and those who did not for a variety of psychiatric diagnoses. Forty-one percent of those who met criteria for childhood sexual abuse did not consider themselves to have been abused. Those who did not consider themselves to have been abused had higher rates of alcohol abuse/dependence, while those who considered themselves to have been abused had higher rates of posttraumatic stress and obsessive-compulsive disorder.
This study emphasizes the importance of perception or "cognitive appraisal" of the sexual experience (as abusive or not) and the need for further study regarding the potential mediating role of cognitive appraisal. Other implications of these findings include the need for primary prevention programs designed to reduce childhood sexual abuse, and inmate rehabilitation programs with an emphasis on the connection between victimization and criminality.
To characterize the nature, frequency, and treatment of male sexual assault encountered by physicians in an ED. A minor objective compared the lengths of time the victim knew the assailant between males and females to determine whether there were differences between male and female victims.
Retrospective review over four years of all male patients with a diagnosis of sexual assault presenting to an urban academic ED in New York City. Demographics, types of injury, assailant/victim information, and treatment of the assault were obtained.
Twenty-seven male sexual assaults (approximately 12% of all sexual assaults) were documented during this time period. Forcible rectal, oral, or both rectal and oral intercourse occurred 14, 4, and 9 times, respectively. Documented physical trauma occurred in nine of 27 visits, with two admissions for head trauma. Five additional patients complained of rectal pain with no independent objective evidence of trauma. Prophylactic treatment with antibiotics for the prevention of Neisseria gonorrhoeae and Chlamydia trachomatis was offered in 26 of 27 episodes and prophylactic HIV protection was given to only two of 21 eligible patients. Documentation of HIV status and HIV counseling occurred only in ten and five visits, respectively. The male-to-female odds ratios for whether the assailant was unknown, known less than 24 hours, or known more than 24 hours were 0.43 (95% CI = 0.15 to 1.26), 2.48 (95% CI = 0.94 to 6.53), and 0.92 (95% CI = 0.31 to 2.71), respectively.
The percentage of total sexual assaults occurring in males who present to an ED is now more than 10% of all sexual assaults seen in this urban ED. These assaults are associated with a high proportion of patients with documented trauma. Although the treatment of traditional sexually transmitted diseases appears to be covered well, the need for HIV documentation, counseling, and possible HIV prophylaxis should be addressed more aggressively. In comparing the lengths of the relationships between the victim and the assailant, it appears twice as likely that the female victim will not know her assailant compared with the male, and twice as likely that the male victim will know his assailant less than 24 hours compared with the female.
Men's childhood physical abuse experiences are understudied.
To obtain descriptions about men's personal childhood physical abuse histories and estimate their association with adult outcomes.
Population-based telephone survey.
Urban areas with high frequency of domestic violence against girls and women.
298 men recruited through random-digit dialing.
6 Conflict Tactics Scale items and psychiatric, sexual, and legal history questions.
One hundred of 197 (51%) participants had a history of childhood physical abuse. Most (73%) participants were abused by a parent. Childhood physical abuse history was associated with depression symptoms (P = 0.003), post-traumatic stress disorder symptoms (P < 0.001), number of lifetime sexual partners (P = 0.035), legal troubles (P = 0.002), and incarceration (P = 0.007) in unadjusted analyses and with depression symptoms (P = 0.015) and post-traumatic stress disorder symptoms (P = 0.003) in adjusted analyses.
There may have been inaccurate recall of past events. Lack of exposure time data disallowed direct comparison of abuse perpetration by mothers versus fathers. Other unmeasured variables related to childhood physical abuse might better explain poor adult outcomes.
The high frequency of childhood physical abuse histories in this population-based male sample, coupled with the high proportion of parent perpetrators and the association between childhood physical abuse and adult outcomes that are often associated with perpetration of violence, argues for more study of and clinical attentiveness to potential adult outcomes of men's own childhood physical abuse histories.