A survey and in-depth interview study on female survivors of childhood sexual abuse

Abstract

Background and Objectives: Childhood sexual abuse (CSA) has been a focus of clinical research for several decades. Empirical literature revealed that survivors of CSA reported sexual dissatisfaction and were prone to engage in a variety of sexual risk taking behaviors. Previous studies also suggested that poor sexual self esteem accounted for the re-victimization among CSA survivors. However, very few studies explored survivors’ other aspects of sexual self-concept (SSC) which reflected the sexual well-being of the survivors. This study examined eight dimensions of SSC among CSA female survivors and also looked into their psychological well-being.

Method: A questionnaire survey was conducted to collect data via convenience sampling. Individual in-depth interviews were carried out to supplement findings and implications of the survey study. Informed consent was solicited before data collection. Participation was voluntary and anonymous. The questionnaire survey included eight subscales SSC (sexual esteem, sexual efficacy, sexual satisfaction, sexual anxiety, sexual depression, sexual fear, sexual motivation, and sexual consciousness) adapted from the Multidimensional Sexual Self-concept Questionnaire developed by (Snell, 1998). Psychological well-being was measured by global self-esteem and life satisfaction. Data were collected via convenience sampling from various sources, including institutes of tertiary education, social service organizations, health centers, and personal network. The individual in-depth interview was semi-structured and lasted for two to three hours. An interview guide was developed to ensure that the interviews were conducted in a proper and systematic manner. The interview explored how SSC was affected by CSA experience, without specifically looking into the details of CSA events. Interviewees (N=25) were encouraged to freely express their thinking and feelings regarding the CSA experience. To ensure trustworthiness of the interview, the narrative analytic method delineated by Fraser (2004) was followed closely. Specifically, the following steps were taken: (i) made reference with the interview guide; (ii) noted emotional changes of the survivors; (ii) recorded and prepared verbatim transcript of each interview; (iii) scanned across domains of sexual self-development experience; (iv) linked survivor’s personal accounts with social and cultural factors; and (v) sorted out common themes emerged from each transcript. At the end of the interview, debriefing was conducted to ensure that interviewee’s emotion was properly regulated and the interviewee was able to maintain a calm emotion after the interview. To maintain a calm emotion after the interview. Results: A total of 1025 respondents (60.7% were females) participated in the survey study, of which 56 female respondents reported a history CSA. Compared with females with no history of CSA, female survivors of CSA did not show any significant decrease in sexual esteem, sexual efficacy, and sexual satisfaction. However, they exhibited higher levels of sexual anxiety, sexual depression, and sexual fear. They also reported poorer self-esteem and lower life satisfaction. The findings had significant implications as empirical literature showed that negative SSC and poor psychological well-being were associated with mental ill-health, difficulty in intimate relationship, and poor quality of life. The in depth interviews revealed that sexual self were multi-faceted, which was in accord withthe multidimensionality of SSC. Undesirable family and social factors in the growth process tended to intensify the negative impacts of CSA. Negative social attitudes towards female survivors exerted greater damaging effects than did the CSA event itself. The common themes of the interviews showed that female survivors felt inferior to other women. They were distrustful of others and fearful of building intimate relationship. Their distress often manifested itself as self-blame, anxiety, depression, and even suicidal attempts. The emerged common themes were consistent with the social and psychological problems implicated by negative SSC and poor psychological well-being. The interviews further revealed that some survivors learned to let go and overcome their distress through self-healing. They construed and attached positive meanings to their experience of CSA. Religious beliefs and religious support group also played a significant role in helping survivors to overcome their ordeals. Through a process of meaning making and self-healing, some survivors were able to transform their painful experience into positive energy in their new life. Some others successfully alleviated their sufferings through psychological or pastoral counselling.

Conclusion: CSA experience was detrimental to sexual and psychological well-being, which may produce pervasive damaging effect on mental health, social relationship, and quality of life. Through self-healing process and professional counseling, female survivors of CSA were able to overcome their trauma and lead a healthy life.