Have a theological question?

Research has consistently indicated that coping strategies mediated the long-term psychological sequelae of childhood sexual abuse, and that active coping strategies are associated with good adaptation to stress (Coffey, Leitenberg, Henning, Turner, & Bennett; 1996; Himelen & McElrath, 1996; Spaccarelli, 1995).

Cognitive Avoidant Strategies

Leitenberg, Greenwald and Cado’s (1992) retrospective study of long-term methods of female survivors’ coping, found that denial and emotional suppression were used most commonly, and this highly correlated with poorer adult psychological adjustment. But when used for a shorter term, according to Steel, Sanna, Hammond, Whipple, & Cross (2004), it can be adaptive.

Leitenberg et al. (1992) also found that behavioural avoidance (e.g., trying to avoid the perpetrator), which is common as a childhood strategy, was associated with greater symptomatology in adulthood. However, a more extreme form of behavioural avoidance used by some victims is to run away from home (McCormack, Janus, & Burgess, 1986).

Powers, Evkenrode, & Jaklitsch (1990) found that runaways are not common among general CSA victims, but incest victims were over-represented among them (92% of their sample), as were victims whose mothers either participated in the abuse, or were the only perpetrator (63%).

Disengagement strategies, where the survivor disengaged from transactions with others and the environment, in Coffey et al’s (1996) study, invariably also resulted in greater psychological distress in the victims, and this form of disengagement was more frequently used for the stress associated with sexual abuse than for other stressors.

Avoidant coping appears to be widely used by survivors, both male and female (Chaffin, Wherry, & Dykman, 1997; Sigmon, Greene, Rohan, & Nichols, 1996), and especially by sexually abused adolescents (Bal, Van Oost, Bourdeaudhuij, & Crombez, 2003). Poor cognitive mechanisms, in terms of higher self-isolation, self-blaming, and wishful thinking, used by women were surfaced by Futa, Nash, Hansen, & Garbin (2003), which supported Spaccarelli’s (1994) and Johnson and Kenkel’s (1991) studies.

The latter also found that coping through detachment-distancing was associated with more serious sexual exposure (i.e., intercourse and more different kinds of abuse) and with coercion (threats of physical harm).

Morrow and Smith (1995) broadly categorized into two groups the variety of strategies women used in coping with CSA. First, they keep themselves from being overwhelmed by threatening and dangerous feelings, by reducing intensity of feelings, avoiding or escaping feelings, dividing feelings into manageable parts.

Second, they manage their helplessness, powerlessness, and lack of control by reframing abuse to give an illusion of control, attempting to master trauma, controlling other areas of life, and by rejecting power. Perrott, Morris, Martin, & Romans (1998) also concluded that reframing by women survivors of the abuse event(s) was more likely to have favourable mental health outcomes.

Rew, Esparza, and Sands’ (1991) research of 271 college students discovered that sexually abused men were more likely than women to use coping strategies that keep stress under control without attempting to address the problem directly (i.e., hoping for improvement, resigning himself to a fateful situation, withdrawing, or letting someone else solve the problem).

Rew, Esparza, and Sands’ (1991) research of 271 college students discovered that sexually abused men were more likely than women to use coping strategies that keep stress under control without attempting to address the problem directly (i.e., hoping for improvement, resigning himself to a fateful situation, withdrawing, or letting someone else solve the problem).

Disclosure and Support Seeking

Wyatt and Newcomb (1990) examined women’s retrospective reports of CSA in order to identify circumstances and coping strategies that served as internal and external mediators of the immediate and long-term effects of abuse. Their results suggested that maladaptive coping responses (e.g. self-blame, nondisclosure) can contribute to poorer outcomes in the long-term, but purposeful disclosure of the abuse may be initially stressful and anxiety provoking, but adaptive in the long run.

Pennebaker and colleagues’ (Pennebaker & Beall, 1986; Pennebaker, Kiecolt-Glaser, & Glaser, 1988) studies, relevant to disclosure as a form of coping, found that asking subjects to discuss some traumatic life experiences tended to have positive effects on their health over an extended period of time.

But those who were chronic low-level thinkers in their samples, exhibited poorer psychological adjustment. The sexual abuse of females is significantly more likely to be disclosed and reported, while on the contrary, the sexual abuse of males is significantly more likely to remain concealed and, consequently, underreported (Boney-McCoy & Finkelhor, 1995; Feiring, Taska, & Lewis, 1999).

Research outcomes associated with seeking social support were conflicting. Conte and Schuerman (1987) established that child victims who reported an available supportive relationship with an adult or a sibling were rated as less symptomatic. However, Johnson and Kenkel (1991) contradicted Conte and Schuerman (1987), where incest victims’ use of support seeking strategy actually produced a higher symptomatology as rated by the subjects’ therapists, where they were viewed as more dependent, helpless, and depressive.

Contrary to predictions, Merrill, Thomsen, Sinclair, Gold, & Milner (2001) found that childhood parental support had little direct or indirect impact on adult adjustment in a sample of 5,226 female navy recruits. However, males with histories of CSA tend to keep the abuse concealed and not seek for social support for decades with 27 as the mean number of years since the abuse began when it was disclosed to anyone (Sigmon, Greene, Rohan, & Nichols, 1996), whereas the mean age at disclosure tends to be younger and the mean delay in years tends to be less for females (Lamb & Edgar-Smith, 1994).

Emotional Release

The efficacy of cathartic emotional release as a coping strategy has been widely accepted by practitioners. Many clinicians have stated the benefits of direct and indirect expression of anger, for example, by writing unsent letters to perpetrators, or appearing with other victims in a treatment setting to ventilate angry feelings in front of a sex offender group (Draucker, 2000; Gartner, 1999; Hunter, 1995), but no substantive studies have been done to assess the value of this type of coping.

Rew, Esparza, and Sands’ (1991) found that both men and women were more likely to cope with their problems using affective responses (e.g., worrying, getting angry, and taking the tension out on others) compared to their non-abused counterparts.

Cognitive Restructuring

Restructuring is a coping strategy that seeks to change the understanding of a stressful event and its implications. This form of intervention was the most efficacious because survivors’ misperceptions associated with CSA was the most significant feature of psychological distress, as sex is often equated with loss of control, powerlessness, anger, rage, shame, secrecy, betrayal, and denial of personal reality (Hunter, 1995).

Cognitive restructuring techniques have been effective in treating aspects of CSA among both women and men (Ross, 1997; Spiegel, 2003; Walker, 1994). Roth and Newman (1993) and Lebowitz, Harvey, and Herman (1993) encouraged assisting victims in understanding feelings that surrounded their traumatic experience(s), while believing that they have control over those memories and feelings as trauma themes are incorporated into the personality.

This process, they claimed, will help the victim build new meanings and associations toward recovery. Draucker (1989) found that when perceptions of making sense of the abuse is disregarded, women who continue to search for meaning tended to suffer from more symptoms, had more social impairment, and lower self-esteem.

However, the restructuring process may be painful for children as well as adults, as evidenced from Leifer, Shapiro, Martone, and Kassem’s research (1991). They conducted a Rorschah test on a sample of school-aged victims to examine cognitive coping, and they found that higher levels of cognitive coping activity were positively correlated to psychological distress.

Exceptions to the efficaciousness of the use of positive coping strategies are the studies of Tremblay, Hebert, and Piche (1999), and Shapiro and Levendosky (1999). In their investigations of the mediating role of coping strategies in children and adolescents, they found no support for the mediating influence of coping between sexual abuse and psychological distress.

Instead, Tremblay and colleagues (1999) stated that a direct relationship existed between the perpetrator identity and behaviour problems, and between avoidance and the occurrence of behavioural difficulties in sexually abused children, while Shapiro and Levendosky (1999) attributed the variance in psychological distress to attachment issues instead of coping.

This is synopsis of a segment of my postgraduate thesis. Relevant material will be summarized in this blog over the coming weeks.

About Coram Deo

Coram Deo — before the face of God. This blog reflects on Scripture, world events, science, music, psychology, and the human mind — always through the lens of Christian faith. All of life is lived before the face of God.