Emma Brennan Dublin City University

1. Confiding in friends: A
systematic review of the
literature
Emma Brennan
Dublin City University

2. Overview
 Peer Relationships
o Friendship qualities
o Risk and protective factors
o Child Development
o Psychopathology
 Child Sexual Abuse disclosure
 Friends and Child Sexual Abuse disclosure
 Conclusion
 Future recommendations

3. Systematic Review
 Systematic reviews, defined as:
‘A comprehensive review of literature which differs from a traditional literature
review in that it is conducted in a methodical (or systematic) manner, according to
a pre-specified protocol to minimise bias, with the aim of synthesising the retrieved
information.’ (Dempster, 2011)
 Search items: Child abuse, child sexual abuse, disclosure, peer, friend
 Time period: 2000-2015
 Databases: PubMed, PsychINFO, Web of Science
 PsychINFO:
 137: child sexual abuse and disclosure
 2: child sexual abuse disclosure and peer
 PubMed:
 15: child sexual abuse and disclosure and peers
 Web of Science:
 24 : child sexual abuse and disclosure and peers

4. Peer Relationships

5. Qualities of a friend
(Roberts-Griffin, 2011)
 Trustworthy
 Supportive
 Good listener
 Honest
 Non-Judgmental

6. Friendships:
Benefits:
 Develop moral judgment and values
 Develop a sense of identity
 Positive psychosocial adjustment
 Better self-image and better school performance
 Provide a buffer against the development of internalizing problems (Bukowski et al., 2010)
 Harry Stack Sullivan (1953) theorized that friends, or as he called them “chumships,” could
negate the effects of negative experiences
Risks:
 Psychosocial, emotional and academic difficulties (Nyarko, 2012).
 Snowballing trajectory of depressed affect: Loneliness, sadness, and depressed affect
result from peer group isolation (Bukowski et al. 2010)
 Social withdrawal risk factor for cascading increases in depressed affect (Bukowski et al.
2010)

7. Friendships and Child Development:
Bolger et al. (1998)
o Peers promote emotional security
o Encourage exploration of their environment
o Improved social skills
o Thus, peer relationships can be very beneficial for vulnerable populations
Buhrmester & Furman, (1987)
Companionship –
 Adults are frequent companions during early childhood and the elementary school years
 Instead, children tum to same-sex peers as they get older (13-16 years)
 Girls reported greater intimacy in friendships than boys on open-ended descriptions of friendships
 It appears that male-male friendships never achieve the same level of intimate disclosure as female-female
friendships
 This difference is consistent with traditional stereotypes held in society

8. Friendships and Psychopathology:
 Farineau et al. (2013)
 Adolescents in foster care
 Vulnerable youths: Peer relationships may be even more important to the positive development of
adolescents because other key relationships and attachments (such as to parents) have been
disrupted
 Sanders et al. (2014)
 “Vulnerable youth”: by virtue of involvement in 1/ 2 services
 Mean age: 15.19-15.34
 Withdrawing socially may be a positive attempt at risk reduction, but without compensatory
strategies to fill the relational void, such attempts are not sustainable, and they bring heightened
risks for poorer mental health.
 Friends provided emotional protection and substituted for the emotional resources missing from
their families for vulnerable group youths.
 Peers exacerbated exposure to risks but an absence of friends compromised psychosocial well-
being.

9. Child Sexual Abuse Disclosure

10. Difficulties with disclosing
 Alaggia (2004)
 Face-to-face interviews developing dimension of disclosure
o Accidental, purposeful, and prompted/elicited’
 Current study highlighted need for expansion:
1. Behavioral and indirect verbal attempts
2. Disclosures intentionally withheld
3. Disclosures triggered by recovered memories.
 McElvaney et al. (2013)
 22 sexually abused young people
 Reasons for not disclosing:
o Fear of not being believed
o Being asked questions about their well-being
o Feeling ashamed about what happened
o Blaming themselves for the abuse

11. Benefits/ Risks with disclosure
 Benefits of disclosing:
 Support associated with adjustment of children (Elliott & Carnes, 2001)
 Promote self-esteem, self-worth and psychological well-being
 Risks of disclosure:
 Reduced social contact
 Stigma/labelling
 PTSD

12. Friendships and CSA Disclosure

13. What is an informal disclosure?
o Telling somebody about the abuse outside of a formal interview
o Most younger children disclose first to parents, many teenagers
disclose first to peers
o Emotional pressure from both within the child and from outside
influenced disclosure over time and can lead to a verbal disclosure
(McElvaney et al. 2012)

14. Prevalence of disclosure to peers
Hershkowitz et al. (2007)
 Older children disclose more often to friends; more supportive role played by the peer group as children get older
Schonbucher et al. (2012):
 26 adolescent participants
 Qualitative and quantitative data assessed details of disclosure: content analysis
 Peers were most often the first recipients of disclosure (n = 13, 50%),
 Disclosure more likely when perpetrator was not a family member, no feeling of guilt, parents still living together
Kogan (2005):
 327 Adolescents 12-17, taken from the national survey of adolescents (78% female)
 Disclosure effects are more apparent during adolescence due to some aspect of the developmental phase, such as the volatility of
parent-child relationships or the process of identity development
 Prompt disclosure to an adult reduced likelihood of re-occurrence, further victimization and the symptomology at assessment
 Likelihood of revictimisation was 4 times higher for those that did not disclose to an adult

15. Overview to CSA disclosure
 Cossar et al. (2013)
 Online peer support site
 Interview
 Focus group
 Young people often came to the attention of services due to their behaviour and conduct
rather than through explicitly disclosing abuse.
 Young people were careful to whom they talked, fearing that friends would gossip about
them, that it might be too much responsibility for a friend to shoulder, or wanting to visit
friends to distract themselves, rather than to confide in them.
 Their friendship is a “Safe place”
 In some cases friends were an important link in a chain of telling, which went from the young
person to a friend to the friend’s parent to a professional.
 Conclusion:
 Inform practitioners about value of building secure trusting peer relationships and also
provide children with access to people they can trust in school, the community and
specialist services.

16. Friends as a mediator for psychopathology?
 The relationship between disclosing the abuse and mental health
symptoms is mediated by an inadequate response by parents and
significant others (O’Leary, 2010)
 Adams & Bukowski (2007):
 The findings from the current study suggest that relationships with friends and
parents may play an important role in understanding the links between
childhood sexual abuse and later anxiety disorders and that these relationships
may also be important sources of protection against the negative effects of
childhood sexual abuse.

17. Implications for policy
 Sanders et al. (2014)
 Peer Paradox:
 Need for effective programme design across the mental health, child welfare,
justice and education systems
 Provide viable long-term alternatives for youth that support them moving away
from antisocial peers
 Policies that encourage programmes to support vulnerable youth to build other
support networks and re-engage with mainstream social institutions are
important

18. Conclusion
Peers/Friends
Positive
Increased self-
esteem, positive
adjustment, better
psychological
well-being
Informs
practitioners
about the benefits
of including friends
in treatment
Increased
autonomy,
improved social
skills
Negative
Mental health
difficulties, PTSD,
guilt/shame,
social
withdrawal
More information
needed about
how to help
friends in need

19. Future recommendations
 Young people can be a good source of support to friends who disclose to
them
 Develop policy that encourages social support (peer support)
development for vulnerable children
 More detailed research about the specific factors that influence
adolescents to disclose to peers rather than parents

20. “Too often we underestimate the power of a touch, a smile, a kind
word, a listening ear, an honest compliment, or the smallest act of
caring, all of which have the potential to turn a life around”.
Leo Buscaglia