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LES HOMMES ET LA GUÉRISON : Théorie, recherche et pratique dans le travail auprès des victimes masculines d'abus sexuels durant l'enfance

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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.
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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.
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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.
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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.
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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.
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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.
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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.