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RUNNING HEAD: AN EXPLORATION OF THE BROADER ECOLOGICAL EFFECTS
OF CHILD SEXUAL ABUSE 1
An Exploration of the Broader Ecological Effects of Child Sexual Abuse
Hayley Armstrong
University of Massachusetts, Lowell
Spring, 2012
An Exploration of the Broader Ecological Effects of Child Sexual Abuse 2
Abstract
This review uses an ecological model to examine the impact of child sexual abuse on
people adjacent to the direct victim. Multiple psychological sequelae of child sexual abuse are
covered, including especially Post-traumatic Stress Disorder, emotion regulation, and
interpersonal functioning. Information processing theories are touched upon to describe the
cognitive and emotional changes that victims endure and how these influence their social
interactions. A new perspective of ecological modeling is presented for consideration.
An Exploration of the Broader Ecological Effects of Child Sexual Abuse 3
Introduction
Child sexual abuse (CSA) is an unfortunately prevalent occurrence in the United States.
Accurately recording the prevalence rate is nearly impossible due to various reasons, including
the effect of social stigma on reporting behaviors and how researchers define sexual abuse in
their studies (Lalor & McElvaney, 2010). However, estimates show an alarming rate of CSA
incidence in American society (this discussion does not include research on males). One meta-
analysis suggested that between 30% and 40% of girls are sexually abused as children (Douglas
& Finkelhor, 2005). Myers (2011) stated that a 1983 study of women found a total prevalence
rate of 47%; 16% of the study’s population were abused by family members, while 31% were
abused by nonrelatives. Other studies report an overall rate of 19.2% in women, and Ullman &
Filipas (2005) provide a rate of 15-33%. Finkelhor’s 1994 review of adult surveys (as cited in
Myers, 2011) discovered that 20-25% of women experience CSA. Such a broad range of
estimates makes identifying the scope of the problem difficult. Although a precise report is
unavailable, the current estimates nonetheless encompass a significant portion of the population.
According to most figures at least one in six American women has a history of CSA, all differing
in duration, severity, and frequency.
Most of the effects on victims, both long- and short-term, are well known to researchers
and some are outlined here. An important factor in determining the societal impact of CSA is the
understanding of the social and emotional problems faced by survivors of CSA. Are they more
likely than the general population to have serious relationship problems and poor emotion
regulation? To begin answering this question, research has shown that survivors of CSA have a
higher risk of major depression, PTSD, and substance abuse (Myers, 2011); each of these factors
An Exploration of the Broader Ecological Effects of Child Sexual Abuse 4
influences a survivor’s relationships with others. Among other sequelae, PTSD and depression
can have particularly strong effects on the health of female survivors of CSA and are often found
in this population. The present paper focuses on the interpersonal interactions between survivors
and their ecological systems as well as the impact their histories of abuse have on the people
around them.
Post-traumatic Stress Disorder
A common outcome of CSA is PTSD (Lalor & McElvaney, 2010). Of women with a
history of sexual assault, between 17% and 65% develop PTSD (Campbell, Dworkin, & Cabral,
2009). Ullman & Filipas (2006) explain that traumatic experiences typically have a
compounding effect, so that the more trauma a person experiences, the greater their PTSD
symptomology. Such symptoms include numbed social withdrawal, bad memories, nightmares,
insomnia, anxiety (Myers, 2007), feeling reluctant to enter intimate relationships, avoiding
situations or people that remind them of the abuse, and a loss of trust in others (Harvard Mental
Health Letter, 2006). The severity of these symptoms is predictive of a woman’s functional
impairment (Cloitre, Miranda, Stovall-McClough, & Han, 2005). The stronger the PTSD, the
less capable a woman is at learning and maintaining life skills, including those needed to have
successful relationships. While CSA is not the only cause of PTSD by any means, it is a
common enough occurrence in victims of CSA that it has been identified as a significant risk
factor. Of particular importance to relationship dynamics are the symptoms of numbed social
withdrawal, avoidance, and loss of trust. Self isolation is hardly conducive to encouraging the
growth of peer relationships, and may adversely influence victims when they must come into
contact with others.
Depression
An Exploration of the Broader Ecological Effects of Child Sexual Abuse 5
In general, child maltreatment is the most common predictor of adult major depression
barring recent stress and heredity (Harvard Mental Health Letter, 2006). CSA victims are no
exception to this; female victims of CSA have higher rates of depression than the general
population (Yampolsky, Lev-Wiesel, Ben-Zion, 2010). For women who are sexually assaulted or
raped in adult life, their history of CSA predicts persistent depressive symptoms (Cheasty, Clare,
& Collins, 2002). Symptoms include lethargy and apathy, or anxiety, sleep deprivation, and
agitation (Harvard Mental Health Letter, 2006). Depression is a likely outcome when rape
victims blame themselves and have low expectations of their own ability to recover or to prevent
future trauma (Resick & Schnicke, 1996, p. 13). Like PTSD, depression is not a beneficent factor
in social relationships; its symptoms reduce certain behaviors and feelings that are required for
valuable outside relationships.
Lalor and McElvaney (2010) cite Briere & Elliott’s (2003) list of unhealthy
psychological sequelae due to CSA:
“…low self-esteem, anxiety, depression, anger and aggression, posttraumatic
stress, dissociation, substance abuse, sexual difficulties, …self-injurious or self-
destructive behavior, and most of the various symptoms and behaviors seen in
those diagnosed with borderline personality disorder” (p. 163).
In addition, survivors of CSA often have emotion regulation problems (Cloitre et al., 2005),
engage in high risk sexual behaviors (DiLilo & Damashek, 2003), have a higher risk during
pregnancy (Yampolsky, Lev-Wiesel, & Ben-Zion, 2010), pregnancies at earlier ages (DeLillo &
Damashek, 2003), somatization (Briere & Jordan, 2009), higher rates of delinquency (McGrath,
Nilson, & Kerley, 2011), more attempts at suicide (Lalor & McElvaney, 2010), lower GPAs and
rates of finishing college (Schilling et al., 2007), higher chances of revictimization (Classen et
An Exploration of the Broader Ecological Effects of Child Sexual Abuse 6
al., 2001; Grauerholz, 2000; Cukor & McGinn, 2006; Miller, Markman, & Handley, 2007), and
greater chances of being in a violent intimate partner relationship (DeLillo & Damashek, 2003).
Child abuse and CSA in particular are contributing factors to problematic drug use, especially
including alcoholism in women (Butt, Chou, & Browne, 2011).
Information Processing and Victimization
A woman with a history of CSA must somehow process her abuse psychologically,
whether it is through avoidance, assimilation, or accommodation. The adoption of such an
approach affects her life significantly, so it is sensible for researchers to understand the processes
that create her world-views in these situations. An added benefit of understanding the
psychological approach taken by CSA survivors is the recognition that their views influence their
interactions with other people in their lives. Knowing a survivor’s world view and how she
created it is an important step to understanding how she views and relates to others.
Shattered World View
Social psychology explains that humans have a tendency to believe in the just-world
hypothesis that states bad things happen to bad people and good things happen to good people
(Myers, 2007). While this belief is usually incorrect, it is still widely held as a likely defense
from a sense of vulnerability. If someone believes that she is a good person, she will also believe
that nothing bad will happen to her. It provides a sense of control, one that can be shaken to its
core in the event of trauma (Resick & Schnicke, 1996). Information processing theory asserts
that in the event of new information humans will process it in terms of their schemata (Resick &
Schnicke, 1996). If the information creates cognitive dissonance then the person will either
assimilate that new bit into their existing beliefs or they will accommodate their beliefs to fit the
new information. When new information (such as a sexual assault) is not consistent with the
An Exploration of the Broader Ecological Effects of Child Sexual Abuse 7
schema (sexual assault only happens to bad people), what is called a shattered world view can
occur. A person’s beliefs about the world and themselves are altered so that a just-world
subscriber will believe that either they are a bad person (blaming themselves for the sexual
assault, assimilation) or that the world is no longer just (accommodation).
Emotional Processing Theory (Foa & Rothbaum, 1998) posits that a person could start
with a negative outlook, inclining a victim’s thoughts to be reinforced by her negative
experience. Cognitive Processing Theory (Resick & Schnicke, 1992) explains that the traumatic
event is new information that must be incorporated into the schemas held by the victim.
Cognitive Processing Theory holds that a traumatic event leads to errors in assimilation and
overaccommodation (a view that increases fear and inhibits intimacy and trust, found in almost
all rape victims) (Resick & Schnicke, 1996). Overaccommodation will change a victim’s beliefs
to be extreme; after an assault they may feel that they are never safe, must always be in control,
and cannot trust anyone. Considering the previously stated fact that 60% of survivors of CSA are
sexually assaulted after the age of 14 (as compared to 35% of non-victims) (Classen et al., 2001),
overaccomodation does not seem to be uncommon in victims of CSA.
After a traumatic event, a child must reconcile the events with her cognitions and
emotions, either interpreting the facts to fit her beliefs or changing her beliefs to fit the facts. In
either case, there is a serious risk that the outcome will be maladaptive. Early childhood is a time
when humans formulate their habits for interpersonal relationships and emotion regulation, and
child abuse impacts these two areas so that it can harm a person’s role performance in the future
(Cloitre et al., 2005). This is consistent with Cloitre et al.’s (2005) statement that women with
adult-onset sexual victimization are not typically found to have emotion regulation and
interpersonal problems. Child sexual assault is a precursor to seemingly endless deleterious
An Exploration of the Broader Ecological Effects of Child Sexual Abuse 8
possibilities. Emotion regulation problems, while seemingly small in comparison to major
depression and PTSD, are quite significant. Child abuse can create psychological and emotional
barriers that prevent successful peer to peer relationships in adults, with emotion dysregulation
being one of the most significant of these barriers (Crooks et al., 2011). Resick & Schnicke
(1996) suggest that the social functions impaired by emotion dysregulation are trust, intimacy,
power, safety, and esteem (p. 13). Overaccomodation certainly explains a few of these
functional impairments. Intimacy troubles are clearly present in most survivors of CSA based on
research findings, which, like the just-world hypothesis, seem to be a way of avoiding
vulnerability.
The successful processing of information is extremely important for avoiding negative
outcomes, such as nightmares, intrusive memories, and flashbacks. These outcomes can create
very strong emotional reactions that lead to avoidant behavior. Avoiding thinking about the
traumatic event(s) can prevent the extinction of the intense feelings associated with the memories
(Resick & Schnicke, 1996). For a survivor of CSA, avoidant behavior may mean staying away
from men, refusing sexual intimacy, avoiding certain activities like getting ice cream (if the
perpetrator took the victim out on “dates”, for instance), and otherwise not confronting the event
psychologically. It also means the perpetuation of uncontrolled, strong affective responses that
are painful in nature. Such intrusions are an interruption of daily life and are a constant reminder
of the event(s). While this information is representative of some difficulties that survivors face, it
is also prudent to recognize the effects that these events and their subsequent psychological
damage have on those involved in the victim’s life.
Interpersonal Outcomes
An Exploration of the Broader Ecological Effects of Child Sexual Abuse 9
An important step to determining the influence that CSA has on adult relationships is to
identify its effects as the victims grow into adults. Most research in this area seems to focus on
the victim in particular, with some concerns regarding the process of transmission from one
victim to another. By examining the long-term outcomes that influence the lives of survivors, the
exploration of their interpersonal relationships (including the transmission of CSA) becomes
more important; the knowledge of how these multiple adverse outcomes affects third parties may
lead to better services for victims and larger efforts at prevention. First, it is necessary to
understand the problems that victims have with their relationships and consider methods for
learning more about how a victim’s troubles may harm others.
Intimate partnerships for survivors of CSA have been found by multiple studies to have
more discord, higher chance of separation, higher chance of divorce, less relationship
satisfaction, and higher risk of intimate partner violence (DiLillo & Damashek, 2003). As for
interpersonal relationships in general, strong indicators that a woman was sexually abused as a
child are her difficulties in emotion regulation and poor interpersonal skills. Women with adult-
onset victimization are rarely found to have these issues (Cloitre et al., 2005). It appears that the
quality of a woman’s adult interpersonal relationships is negatively affected by her abusive
experiences in childhood (Gamble, Smith, Poleshuck, He, & Talbot, 2010). Abuse also affects
her patterns of attachment (Gamble et al., 2010).
Attachment
In terms of Attachment Theory, survivors of CSA usually have insecure (anxious or
avoidant) attachment styles; these are characterized by feelings of mistrust and discomfort
regarding support from attachment relationships. This is because their assaults were evidence of
a serious lack of safety provision by their caregivers (Smith et al., 2012). In a study of university
An Exploration of the Broader Ecological Effects of Child Sexual Abuse 10
women, Schilling, Aseltine Jr., and Gore (2007) found that those who were sexually abused had
more anxious and avoidant attachment styles in their intimate partnerships than other women.
These women also showed a history of lower relationship quality and more fears of intimacy.
Analyzing attachment styles can help explain the problematic interpersonal relationships that
survivors of CSA often have. An anxious attachment style can lead a survivor to place too much
value on a relationship, so that in order to maintain that relationship she will exhibit unhealthy
behaviors, such as sacrificing her integrity to fit in, or ignoring her own needs for the needs of
others. In contrast, those survivors with avoidant attachment styles place too little value on social
relationships so as to reduce their chances of enduring pain or disappointment in them (Smith et
al., 2012). In adult women with a history of CSA, this may lead to social isolation and rebuffing
attempts by others to become emotionally close.
Emotion Regulation
Walsh, DeLillo, and Scalora (2011) explained emotion regulation as the ability to label,
express, and clearly identify emotions, to exhibit goal-oriented behaviors in the face of emotional
duress, to access and employ skills for the control of emotional reactions, and to feel acceptance
for those reactions. An inability to express one’s emotions can certainly detract from intimacy
with others as communication remains an important part of healthy relationships. Difficulties
with communication in intimate partnerships can lead to the dissolution of the relationship
(Bradley, Friend, & Gottman, 2011). Emotion dysregulation may lead a survivor to misread her
emotions and react to others in inappropriate ways. Crooks, Scott, Ellis, & Wolfe (2011) stated
that many CSA survivors experience difficulties in interpersonal functioning that hinder their
ability to establish healthy relationships with peers. Peculiarly significant to a woman’s history
of CSA (Cloitre et al., 2005), problems in emotion regulation are connected to her interpersonal
An Exploration of the Broader Ecological Effects of Child Sexual Abuse 11
relationships in a manner that most other people may not experience. Emotion dysregulation
seems to disrupt communication with others through the victim’s misidentification of her
emotional states and her general inability to recognize appropriate situations for her emotional
expressions. Problems in emotion regulation may lead to overreactions to benign situations in the
workplace, at home, or in stressful environments. Inconsistent reactions to stimuli may become
even more problematic; her behavior may confuse or hurt other people if she responds to similar,
yet separate, events in unpredictable ways.
Intergenerational Transmission
CSA may affect a child’s attachment style to caregivers, leading that child to have
dysfunctional attachments as she gets older, including with her own children. Mothers with
histories of CSA are found to have children with greater internalizing (e.g. depression, anxiety)
and externalizing (e.g. delinquency) symptoms than other children (DiLillo & Damashek, 2003);
this may be due to a higher likelihood of maternal to child attachment dysfunction in such
families. A parent’s own childhood experience of physical abuse can lead the victim to become a
perpetrator, while CSA victims are more likely to have children who become victims of sexual
abuse (Kim, Noll, Putnam, & Trickett, 2007). CSA studies report that there is an association
between a mother’s history of CSA and her daughter’s subsequent child sexual victimization
(Kim et al., 2007). Mothers of victims have significantly higher chances of having been
victimized as children (Leifer, Kilbane, & Kalick, 2004). The same study noted that women who
were sexually abused as children and had a child who was sexually abused had “more disturbed
functioning”, described as psychological difficulties and ineffective parenting strategies, than
control group mothers. It could be that the disturbed functioning exists early on and aids in the
abuse of the child, the child’s abuse history is psychologically damaging to the mother, or both;
An Exploration of the Broader Ecological Effects of Child Sexual Abuse 12
the direction of causality is undetermined. A caring and supportive adult is an essential factor in
producing healthy outcomes for a child (DiLillo & Damashek, 2003). Unfortunately, families in
which sexual abuse occurs typically have high levels of dysfunction (DiLillo & Damashek,
2003) decreasing the likelihood that a child will have access to a supportive adult. Leifer,
Kilbane, & Kalick (2004) noted that there are many female survivors of CSA who leave their
children vulnerable to being molested by a romantic partner; this secondary transmission of
sexual abuse occurs in 24- 42% of cases.
Adult Sexual Revictimization
Female survivors of CSA are more likely to be raped or otherwise sexually assaulted as
adults than females without a history of CSA (Classen, Field, Koopman, Nevill-Manning, &
Spiegel, 2001). Such a history effectively doubles the rate of adult sexual victimization in
women (Ullman & Filipas, 2006), and one study found that near 60% of female CSA victims
experienced another sexual victimization after the age of 14. In contrast, approximately 35% of
women without sexual abuse histories were found to have been sexually assaulted after this age
(Classen et al., 2001). Revictimization affects the compounded nature of multiple traumas on
PTSD symptomology effectively exacerbating its symptoms; stronger PTSD symptoms further
reduce a survivor’s ability to form and maintain healthy relationships.
Lutz-Zois, Phelps, & Reichle (2011) discovered some of the first empirical evidence for a
social-cognitive mechanism of sexual revictimization. They determined that, paradoxically,
mistrust was a mediating variable in the revictimization of survivors of CSA. It is curious that
mistrust should lead to revictimization among CSA victims. Similar to the PTSD symptom of
avoidance, mistrust can reduce a woman’s ability to identify if her feelings of fear are
appropriate. This makes it difficult to recognize who can be trusted. Without the ability to
An Exploration of the Broader Ecological Effects of Child Sexual Abuse 13
distinguish between the trustworthy and the dangerous, trust loses its usefulness as a mechanism
for knowing when she is safe with others. The strength and reliability of her social network is
therefore unfortunately compromised; such relationships are an essential part of her healthy
interpersonal functioning.
Impact on Others
To examine the full impact that CSA has on society it is necessary to understand its
influence on the lives of its victims and on the lives of those with whom victims interact. It has
been found that children who are sexually abused are more likely to have a mother who was also
sexually abused (Leifer, Kilbane, & Kalick, 2004). What other effects does a person’s history of
CSA have on those around them? This question is difficult to answer and is the driving force
behind the impending discussion of an ecological model of social interactions. Discovering the
factors involved in healthy social interaction and comparing those to how survivors of CSA
relate to others could help to enumerate the skills deficits of those survivors with functional
impairments. Until then, however, an examination of the social and emotional impact on others
as mediated by survivors of CSA is a necessary beginning.
All of the behaviors previously listed are possible outcomes of CSA, and all of these
behaviors can have deleterious effects for the friends, family, and other social systems of
survivors. But how deeply can these behaviors affect others, and in what ways? Drug use and
suicide can shatter families; unhealthy sexual behaviors can spread disease, increase the risk of
pregnancy, and emotionally damage intimate partners; delinquency can do damage to
communities and financially drain taxpayers; emotion dysregulation may cause co-workers
undue stress and decrease productivity in the work place; PTSD and other psychological
disorders may prevent survivors of CSA from working at all; and there seems to be a mechanism
An Exploration of the Broader Ecological Effects of Child Sexual Abuse 14
that leads many mothers who were sexually abused as children to have their children become
sexually abused, and many times the mothers are in a violent intimate partnership. The range of
pathways there are for CSA to cause damage in a person’s life is wide. This damage may be
spread to others via social interaction, and emotional attachments with a survivor may not be
necessary for their abuse outcomes to cause problems for others.
There can be great depth to the destructive effects that survivors of CSA have on others;
suicide can mean the loss of a family member, a friend, or an intimate partner. In contrast,
placing a delinquent survivor in jail might cost an unrelated citizen a few tax dollars, with that
citizen in total ignorance of where that money is spent. Yet that money is still spent, and over
time these costs add up to significant amounts of time, energy, and money invested in reducing
the social liabilities presented by survivors of CSA. The sexual abuse of children is not the only
social ill that deserves such attention, but it provides an excellent starting point for creating an
ecological model of the transmission of unhealthy psychological sequelae and behaviors.
A New Ecological Model
Urie Bronfenbrenner’s (1979) paper was initially created to explore the contexts in which
behaviors occur throughout human development. Out of his work came a model for evaluating
the behaviors of an individual in relation to the context in which they occur, as well as the
interconnectedness of those settings for explaining human development. Campbell, Dworkin,
and Cabral (2009) examine the effects of sexual assault on women’s mental health using
Bronfenbrenner’s ecological model; however, this view is limited. The following discussion
takes a different direction; what is the effect that an individual experiencing negative
psychological sequelae has on his or her society? For that matter, what is the overall effect of
multitudes of such individuals interacting with the world? What is the cost to society? The broad
An Exploration of the Broader Ecological Effects of Child Sexual Abuse 15
range and strong likelihood of harmful psychological sequelae produced by CSA is a great
candidate for providing an example of a different approach to ecological models.
Bronfenbrenner’s model identified a systematic way of viewing an individual in society. What
can it say about a society influenced by individuals? After Campbell, Dworkin, and Cabral’s
(2009) work, an ecological model is described here in terms of the individual, microsystem,
exosystem, macrosystem, and chronosystem.
Individual
Individuals are influenced by those around them, and the reverse is also true. The sexual
abuse of a child affects her cognitions, emotions, and physiological responses to certain stimuli.
Campbell, Dworkin, & Cabral (2009) explain that a sexual assault victim’s characteristics and
coping methods influence her recovery. Her reactions to the abuse may change her view of
herself and of her microystem, those immediately around her such as family and peers.
Microsystem
This is the family, peers, and group relations (e.g. school and church) sphere. It is at this
system level that CSA might have the second most direct impact. How far through the layers the
effects of a victim’s history of CSA travel is not well studied at this point. There are multiple
difficulties with studying the people around a survivor, but primarily this is due to the risk of
identifying the survivor as a victim to those whom she does not want that information disclosed.
If this were not a problem, conceivably a research endeavor could interview the microsystem of a
survivor and gather perceptions, reflections, thoughts, and histories that the interviewees have of
the survivor. The purpose of gaining this knowledge would be to examine the impact that non-
resilient victims of CSA have on the people they interact with. Perhaps sexually abusing a child
is like a striking a sour note that ripples through the ecosystem and decreases in effect as it
An Exploration of the Broader Ecological Effects of Child Sexual Abuse 16
encounters resistance; a survivor of CSA has the strongest negative effect on those closest to her
and the risk of harm decreases as it travels through her ecological systems. The effects may be
covert, like the as yet unknown reason that many mothers of CSA victims were also victimized
as children. Time could also be a factor, with its passage leading to less outward symptoms; or
conversely the compound effect of multiple victimizations may worsen symptoms over time.
Because of the lack of evidence regarding the effect of CSA on a survivor’s microsystem, it is
unknown whether it holds significant consequences for her friends, family, and peers.
Exosystem
The exosystem is made of one’s community and societal systems, such as the medical
and legal systems (Campbell, Dworkin, & Cabral, 2009). Sexually abused children often spend
time interacting with these two systems in particular. In this case, an individual incident of CSA
may be a blip on the radar of those systems because of their size. Numbers indicating prevalence
are required to fully understand this level, numbers which are variable due to difficulties in
measuring on a larger scale. Some estimates say that as many as 12-40% of women are survivors
(Yampolsky, Lev-Wiesel, & Ben-Zion, 2010), and that 1 in 12 children annually are victimized
(McGrath, Nilsen, & Kerley, 2011). The prevalence of CSA in the United States is a difficult
number to nail down. However, more accurate survey methods and a field-wide consensus as to
how to measure CSA prevalence could produce a workable percentage. An accurate report of the
prevalence of CSA would assist in creating programs to reduce its influence on the community.
Influences on an individual from the exosystem include those by media, school systems,
area industry, and local politics. This paper seeks to examine the opposite direction of study;
how do individuals influence the exosystem? Is it necessary to be in a position of power to have
an impact or can a system be changed by the sheer number of people who are victims of CSA?
An Exploration of the Broader Ecological Effects of Child Sexual Abuse 17
This is not a clear-cut case of the victim having an influence on a large system. An amalgamation
of individuals who have experienced trauma may have a compounded effect on the exosystem
that helps to shape culture, community, and society. However, systems have been created to
address the problem of sexual violence against children, and in so doing may have decreased the
harmful overall effects of the pandemic of sexual abuse. A current difficulty in knowing the truth
of this is that the existence of a decrease is not measureable because the scope of the problem is
not fully measurable. More research is needed to determine how victims of CSA truly influence
their ecological systems.
Macrosystem
The macrosystem can be seen as a more national or global level of influence. Typically,
the individual is seen to be influenced by this system but the reverse is not thought of as true.
Perhaps a few individuals have a measurable influence on global systems. It is not expected that
a single victim of CSA will have a strong effect in this system, yet with enough people who
experience similar symptoms from similar events (e.g. trauma related PTSD from a history of
CSA) there may be an effect (e.g. higher suicide rates). This is probably the most difficult level
to measure, and instead of being from survivors of CSA the influence may be from a
conglomeration of systematic violence against women.
Chronosystem
Bronfenbrenner also included what he called the chronosystem; a change over time in the
strength and effects of influences passing between the ecological system levels. For the up to
60% of CSA victims who are sexually revictimized as adults (Classen et al., 2001), adulthood
does not give them enough time to heal. Instead, traumatic events like sexual revictimization
tend have a compounding effect to increase symptomology, especially that of PTSD. The effect
An Exploration of the Broader Ecological Effects of Child Sexual Abuse 18
of the chronosystem is such that there is a difference over time, even within one person, in how
life stressors are overcome. The chronosystem signifies the accumulation of life events and their
influences on a person as time progresses.
The incidence of CSA has existed for an unknown amount of time. It could be that, while
taboo, CSA has become normalized through its consistent presence in humanity. Society’s
silence on the matter has allowed this behavior to pass through generations, spreading quietly
from parent to child, from victim to victim. It is possible that pedophiles (while not the only
perpetrators of CSA) are genetically predisposed to a sexual attraction for children because that
trait was allowed to proliferate through human ignorance. This is simple speculation, however,
yet working to understand CSA’s effect on the chronosystem may provide us with better tools
with which to undermine its influence.
A New Perspective
The purpose of this report is to explore the broader impact of CSA. Well-known are the
variables involved in the struggles and recovery of survivors. Researchers are now in a position
to take a more expansive view of social ills; with more inquiry, the literature may be able to
definitively say whether the sexual abuse of children is a primary cause of poor interpersonal
functioning, the fear of intimacy, or whether CSA is a primary cause of itself through social and
intergenerational transmission. It seems as though a new perspective on ecological models is
needed. While more than useful in defining the influences on one person’s life, they hold in store
another function, one that determines the outcomes of those influences through their effects on
other people. As noted above, one person can strongly impact the lives of family, friends, and
strangers. Of particular importance is the danger that lies in unidentified victims of CSA raising
children because of the transmission of psychological difficulties and sexual abuse. CSA leads to
An Exploration of the Broader Ecological Effects of Child Sexual Abuse 19
many serious personal and social problems for victims, but if it could be concluded that these
adverse outcomes for the victim are also harmful to others, then CSA may be considered as a
larger threat by those with the resources to combat it. Based on the current state of research, a
conclusion such as this would not be unexpected.
The extant literature is does not yet have a complete picture of the effects of CSA. In
order to paint it, researchers would need to analyze every one of its outcomes. Currently, the
focus is on the harm to victims. A notion to consider when it comes to CSA is that it tends to
cycle from victim to victim, meaning that victims either allow it to happen to others around them
or they become perpetrators. Therefore, one incident of the sexual abuse of a child cannot be
viewed as isolated. There are repercussions that last through the lives of victims and change how
they view the world. CSA causes damage, and the purpose of a new ecological perspective is to
examine the true extent of that damage and to learn how it can be diminished.
An Exploration of the Broader Ecological Effects of Child Sexual Abuse 20
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Ecological Effects of CSA

  • 1. RUNNING HEAD: AN EXPLORATION OF THE BROADER ECOLOGICAL EFFECTS OF CHILD SEXUAL ABUSE 1 An Exploration of the Broader Ecological Effects of Child Sexual Abuse Hayley Armstrong University of Massachusetts, Lowell Spring, 2012
  • 2. An Exploration of the Broader Ecological Effects of Child Sexual Abuse 2 Abstract This review uses an ecological model to examine the impact of child sexual abuse on people adjacent to the direct victim. Multiple psychological sequelae of child sexual abuse are covered, including especially Post-traumatic Stress Disorder, emotion regulation, and interpersonal functioning. Information processing theories are touched upon to describe the cognitive and emotional changes that victims endure and how these influence their social interactions. A new perspective of ecological modeling is presented for consideration.
  • 3. An Exploration of the Broader Ecological Effects of Child Sexual Abuse 3 Introduction Child sexual abuse (CSA) is an unfortunately prevalent occurrence in the United States. Accurately recording the prevalence rate is nearly impossible due to various reasons, including the effect of social stigma on reporting behaviors and how researchers define sexual abuse in their studies (Lalor & McElvaney, 2010). However, estimates show an alarming rate of CSA incidence in American society (this discussion does not include research on males). One meta- analysis suggested that between 30% and 40% of girls are sexually abused as children (Douglas & Finkelhor, 2005). Myers (2011) stated that a 1983 study of women found a total prevalence rate of 47%; 16% of the study’s population were abused by family members, while 31% were abused by nonrelatives. Other studies report an overall rate of 19.2% in women, and Ullman & Filipas (2005) provide a rate of 15-33%. Finkelhor’s 1994 review of adult surveys (as cited in Myers, 2011) discovered that 20-25% of women experience CSA. Such a broad range of estimates makes identifying the scope of the problem difficult. Although a precise report is unavailable, the current estimates nonetheless encompass a significant portion of the population. According to most figures at least one in six American women has a history of CSA, all differing in duration, severity, and frequency. Most of the effects on victims, both long- and short-term, are well known to researchers and some are outlined here. An important factor in determining the societal impact of CSA is the understanding of the social and emotional problems faced by survivors of CSA. Are they more likely than the general population to have serious relationship problems and poor emotion regulation? To begin answering this question, research has shown that survivors of CSA have a higher risk of major depression, PTSD, and substance abuse (Myers, 2011); each of these factors
  • 4. An Exploration of the Broader Ecological Effects of Child Sexual Abuse 4 influences a survivor’s relationships with others. Among other sequelae, PTSD and depression can have particularly strong effects on the health of female survivors of CSA and are often found in this population. The present paper focuses on the interpersonal interactions between survivors and their ecological systems as well as the impact their histories of abuse have on the people around them. Post-traumatic Stress Disorder A common outcome of CSA is PTSD (Lalor & McElvaney, 2010). Of women with a history of sexual assault, between 17% and 65% develop PTSD (Campbell, Dworkin, & Cabral, 2009). Ullman & Filipas (2006) explain that traumatic experiences typically have a compounding effect, so that the more trauma a person experiences, the greater their PTSD symptomology. Such symptoms include numbed social withdrawal, bad memories, nightmares, insomnia, anxiety (Myers, 2007), feeling reluctant to enter intimate relationships, avoiding situations or people that remind them of the abuse, and a loss of trust in others (Harvard Mental Health Letter, 2006). The severity of these symptoms is predictive of a woman’s functional impairment (Cloitre, Miranda, Stovall-McClough, & Han, 2005). The stronger the PTSD, the less capable a woman is at learning and maintaining life skills, including those needed to have successful relationships. While CSA is not the only cause of PTSD by any means, it is a common enough occurrence in victims of CSA that it has been identified as a significant risk factor. Of particular importance to relationship dynamics are the symptoms of numbed social withdrawal, avoidance, and loss of trust. Self isolation is hardly conducive to encouraging the growth of peer relationships, and may adversely influence victims when they must come into contact with others. Depression
  • 5. An Exploration of the Broader Ecological Effects of Child Sexual Abuse 5 In general, child maltreatment is the most common predictor of adult major depression barring recent stress and heredity (Harvard Mental Health Letter, 2006). CSA victims are no exception to this; female victims of CSA have higher rates of depression than the general population (Yampolsky, Lev-Wiesel, Ben-Zion, 2010). For women who are sexually assaulted or raped in adult life, their history of CSA predicts persistent depressive symptoms (Cheasty, Clare, & Collins, 2002). Symptoms include lethargy and apathy, or anxiety, sleep deprivation, and agitation (Harvard Mental Health Letter, 2006). Depression is a likely outcome when rape victims blame themselves and have low expectations of their own ability to recover or to prevent future trauma (Resick & Schnicke, 1996, p. 13). Like PTSD, depression is not a beneficent factor in social relationships; its symptoms reduce certain behaviors and feelings that are required for valuable outside relationships. Lalor and McElvaney (2010) cite Briere & Elliott’s (2003) list of unhealthy psychological sequelae due to CSA: “…low self-esteem, anxiety, depression, anger and aggression, posttraumatic stress, dissociation, substance abuse, sexual difficulties, …self-injurious or self- destructive behavior, and most of the various symptoms and behaviors seen in those diagnosed with borderline personality disorder” (p. 163). In addition, survivors of CSA often have emotion regulation problems (Cloitre et al., 2005), engage in high risk sexual behaviors (DiLilo & Damashek, 2003), have a higher risk during pregnancy (Yampolsky, Lev-Wiesel, & Ben-Zion, 2010), pregnancies at earlier ages (DeLillo & Damashek, 2003), somatization (Briere & Jordan, 2009), higher rates of delinquency (McGrath, Nilson, & Kerley, 2011), more attempts at suicide (Lalor & McElvaney, 2010), lower GPAs and rates of finishing college (Schilling et al., 2007), higher chances of revictimization (Classen et
  • 6. An Exploration of the Broader Ecological Effects of Child Sexual Abuse 6 al., 2001; Grauerholz, 2000; Cukor & McGinn, 2006; Miller, Markman, & Handley, 2007), and greater chances of being in a violent intimate partner relationship (DeLillo & Damashek, 2003). Child abuse and CSA in particular are contributing factors to problematic drug use, especially including alcoholism in women (Butt, Chou, & Browne, 2011). Information Processing and Victimization A woman with a history of CSA must somehow process her abuse psychologically, whether it is through avoidance, assimilation, or accommodation. The adoption of such an approach affects her life significantly, so it is sensible for researchers to understand the processes that create her world-views in these situations. An added benefit of understanding the psychological approach taken by CSA survivors is the recognition that their views influence their interactions with other people in their lives. Knowing a survivor’s world view and how she created it is an important step to understanding how she views and relates to others. Shattered World View Social psychology explains that humans have a tendency to believe in the just-world hypothesis that states bad things happen to bad people and good things happen to good people (Myers, 2007). While this belief is usually incorrect, it is still widely held as a likely defense from a sense of vulnerability. If someone believes that she is a good person, she will also believe that nothing bad will happen to her. It provides a sense of control, one that can be shaken to its core in the event of trauma (Resick & Schnicke, 1996). Information processing theory asserts that in the event of new information humans will process it in terms of their schemata (Resick & Schnicke, 1996). If the information creates cognitive dissonance then the person will either assimilate that new bit into their existing beliefs or they will accommodate their beliefs to fit the new information. When new information (such as a sexual assault) is not consistent with the
  • 7. An Exploration of the Broader Ecological Effects of Child Sexual Abuse 7 schema (sexual assault only happens to bad people), what is called a shattered world view can occur. A person’s beliefs about the world and themselves are altered so that a just-world subscriber will believe that either they are a bad person (blaming themselves for the sexual assault, assimilation) or that the world is no longer just (accommodation). Emotional Processing Theory (Foa & Rothbaum, 1998) posits that a person could start with a negative outlook, inclining a victim’s thoughts to be reinforced by her negative experience. Cognitive Processing Theory (Resick & Schnicke, 1992) explains that the traumatic event is new information that must be incorporated into the schemas held by the victim. Cognitive Processing Theory holds that a traumatic event leads to errors in assimilation and overaccommodation (a view that increases fear and inhibits intimacy and trust, found in almost all rape victims) (Resick & Schnicke, 1996). Overaccommodation will change a victim’s beliefs to be extreme; after an assault they may feel that they are never safe, must always be in control, and cannot trust anyone. Considering the previously stated fact that 60% of survivors of CSA are sexually assaulted after the age of 14 (as compared to 35% of non-victims) (Classen et al., 2001), overaccomodation does not seem to be uncommon in victims of CSA. After a traumatic event, a child must reconcile the events with her cognitions and emotions, either interpreting the facts to fit her beliefs or changing her beliefs to fit the facts. In either case, there is a serious risk that the outcome will be maladaptive. Early childhood is a time when humans formulate their habits for interpersonal relationships and emotion regulation, and child abuse impacts these two areas so that it can harm a person’s role performance in the future (Cloitre et al., 2005). This is consistent with Cloitre et al.’s (2005) statement that women with adult-onset sexual victimization are not typically found to have emotion regulation and interpersonal problems. Child sexual assault is a precursor to seemingly endless deleterious
  • 8. An Exploration of the Broader Ecological Effects of Child Sexual Abuse 8 possibilities. Emotion regulation problems, while seemingly small in comparison to major depression and PTSD, are quite significant. Child abuse can create psychological and emotional barriers that prevent successful peer to peer relationships in adults, with emotion dysregulation being one of the most significant of these barriers (Crooks et al., 2011). Resick & Schnicke (1996) suggest that the social functions impaired by emotion dysregulation are trust, intimacy, power, safety, and esteem (p. 13). Overaccomodation certainly explains a few of these functional impairments. Intimacy troubles are clearly present in most survivors of CSA based on research findings, which, like the just-world hypothesis, seem to be a way of avoiding vulnerability. The successful processing of information is extremely important for avoiding negative outcomes, such as nightmares, intrusive memories, and flashbacks. These outcomes can create very strong emotional reactions that lead to avoidant behavior. Avoiding thinking about the traumatic event(s) can prevent the extinction of the intense feelings associated with the memories (Resick & Schnicke, 1996). For a survivor of CSA, avoidant behavior may mean staying away from men, refusing sexual intimacy, avoiding certain activities like getting ice cream (if the perpetrator took the victim out on “dates”, for instance), and otherwise not confronting the event psychologically. It also means the perpetuation of uncontrolled, strong affective responses that are painful in nature. Such intrusions are an interruption of daily life and are a constant reminder of the event(s). While this information is representative of some difficulties that survivors face, it is also prudent to recognize the effects that these events and their subsequent psychological damage have on those involved in the victim’s life. Interpersonal Outcomes
  • 9. An Exploration of the Broader Ecological Effects of Child Sexual Abuse 9 An important step to determining the influence that CSA has on adult relationships is to identify its effects as the victims grow into adults. Most research in this area seems to focus on the victim in particular, with some concerns regarding the process of transmission from one victim to another. By examining the long-term outcomes that influence the lives of survivors, the exploration of their interpersonal relationships (including the transmission of CSA) becomes more important; the knowledge of how these multiple adverse outcomes affects third parties may lead to better services for victims and larger efforts at prevention. First, it is necessary to understand the problems that victims have with their relationships and consider methods for learning more about how a victim’s troubles may harm others. Intimate partnerships for survivors of CSA have been found by multiple studies to have more discord, higher chance of separation, higher chance of divorce, less relationship satisfaction, and higher risk of intimate partner violence (DiLillo & Damashek, 2003). As for interpersonal relationships in general, strong indicators that a woman was sexually abused as a child are her difficulties in emotion regulation and poor interpersonal skills. Women with adult- onset victimization are rarely found to have these issues (Cloitre et al., 2005). It appears that the quality of a woman’s adult interpersonal relationships is negatively affected by her abusive experiences in childhood (Gamble, Smith, Poleshuck, He, & Talbot, 2010). Abuse also affects her patterns of attachment (Gamble et al., 2010). Attachment In terms of Attachment Theory, survivors of CSA usually have insecure (anxious or avoidant) attachment styles; these are characterized by feelings of mistrust and discomfort regarding support from attachment relationships. This is because their assaults were evidence of a serious lack of safety provision by their caregivers (Smith et al., 2012). In a study of university
  • 10. An Exploration of the Broader Ecological Effects of Child Sexual Abuse 10 women, Schilling, Aseltine Jr., and Gore (2007) found that those who were sexually abused had more anxious and avoidant attachment styles in their intimate partnerships than other women. These women also showed a history of lower relationship quality and more fears of intimacy. Analyzing attachment styles can help explain the problematic interpersonal relationships that survivors of CSA often have. An anxious attachment style can lead a survivor to place too much value on a relationship, so that in order to maintain that relationship she will exhibit unhealthy behaviors, such as sacrificing her integrity to fit in, or ignoring her own needs for the needs of others. In contrast, those survivors with avoidant attachment styles place too little value on social relationships so as to reduce their chances of enduring pain or disappointment in them (Smith et al., 2012). In adult women with a history of CSA, this may lead to social isolation and rebuffing attempts by others to become emotionally close. Emotion Regulation Walsh, DeLillo, and Scalora (2011) explained emotion regulation as the ability to label, express, and clearly identify emotions, to exhibit goal-oriented behaviors in the face of emotional duress, to access and employ skills for the control of emotional reactions, and to feel acceptance for those reactions. An inability to express one’s emotions can certainly detract from intimacy with others as communication remains an important part of healthy relationships. Difficulties with communication in intimate partnerships can lead to the dissolution of the relationship (Bradley, Friend, & Gottman, 2011). Emotion dysregulation may lead a survivor to misread her emotions and react to others in inappropriate ways. Crooks, Scott, Ellis, & Wolfe (2011) stated that many CSA survivors experience difficulties in interpersonal functioning that hinder their ability to establish healthy relationships with peers. Peculiarly significant to a woman’s history of CSA (Cloitre et al., 2005), problems in emotion regulation are connected to her interpersonal
  • 11. An Exploration of the Broader Ecological Effects of Child Sexual Abuse 11 relationships in a manner that most other people may not experience. Emotion dysregulation seems to disrupt communication with others through the victim’s misidentification of her emotional states and her general inability to recognize appropriate situations for her emotional expressions. Problems in emotion regulation may lead to overreactions to benign situations in the workplace, at home, or in stressful environments. Inconsistent reactions to stimuli may become even more problematic; her behavior may confuse or hurt other people if she responds to similar, yet separate, events in unpredictable ways. Intergenerational Transmission CSA may affect a child’s attachment style to caregivers, leading that child to have dysfunctional attachments as she gets older, including with her own children. Mothers with histories of CSA are found to have children with greater internalizing (e.g. depression, anxiety) and externalizing (e.g. delinquency) symptoms than other children (DiLillo & Damashek, 2003); this may be due to a higher likelihood of maternal to child attachment dysfunction in such families. A parent’s own childhood experience of physical abuse can lead the victim to become a perpetrator, while CSA victims are more likely to have children who become victims of sexual abuse (Kim, Noll, Putnam, & Trickett, 2007). CSA studies report that there is an association between a mother’s history of CSA and her daughter’s subsequent child sexual victimization (Kim et al., 2007). Mothers of victims have significantly higher chances of having been victimized as children (Leifer, Kilbane, & Kalick, 2004). The same study noted that women who were sexually abused as children and had a child who was sexually abused had “more disturbed functioning”, described as psychological difficulties and ineffective parenting strategies, than control group mothers. It could be that the disturbed functioning exists early on and aids in the abuse of the child, the child’s abuse history is psychologically damaging to the mother, or both;
  • 12. An Exploration of the Broader Ecological Effects of Child Sexual Abuse 12 the direction of causality is undetermined. A caring and supportive adult is an essential factor in producing healthy outcomes for a child (DiLillo & Damashek, 2003). Unfortunately, families in which sexual abuse occurs typically have high levels of dysfunction (DiLillo & Damashek, 2003) decreasing the likelihood that a child will have access to a supportive adult. Leifer, Kilbane, & Kalick (2004) noted that there are many female survivors of CSA who leave their children vulnerable to being molested by a romantic partner; this secondary transmission of sexual abuse occurs in 24- 42% of cases. Adult Sexual Revictimization Female survivors of CSA are more likely to be raped or otherwise sexually assaulted as adults than females without a history of CSA (Classen, Field, Koopman, Nevill-Manning, & Spiegel, 2001). Such a history effectively doubles the rate of adult sexual victimization in women (Ullman & Filipas, 2006), and one study found that near 60% of female CSA victims experienced another sexual victimization after the age of 14. In contrast, approximately 35% of women without sexual abuse histories were found to have been sexually assaulted after this age (Classen et al., 2001). Revictimization affects the compounded nature of multiple traumas on PTSD symptomology effectively exacerbating its symptoms; stronger PTSD symptoms further reduce a survivor’s ability to form and maintain healthy relationships. Lutz-Zois, Phelps, & Reichle (2011) discovered some of the first empirical evidence for a social-cognitive mechanism of sexual revictimization. They determined that, paradoxically, mistrust was a mediating variable in the revictimization of survivors of CSA. It is curious that mistrust should lead to revictimization among CSA victims. Similar to the PTSD symptom of avoidance, mistrust can reduce a woman’s ability to identify if her feelings of fear are appropriate. This makes it difficult to recognize who can be trusted. Without the ability to
  • 13. An Exploration of the Broader Ecological Effects of Child Sexual Abuse 13 distinguish between the trustworthy and the dangerous, trust loses its usefulness as a mechanism for knowing when she is safe with others. The strength and reliability of her social network is therefore unfortunately compromised; such relationships are an essential part of her healthy interpersonal functioning. Impact on Others To examine the full impact that CSA has on society it is necessary to understand its influence on the lives of its victims and on the lives of those with whom victims interact. It has been found that children who are sexually abused are more likely to have a mother who was also sexually abused (Leifer, Kilbane, & Kalick, 2004). What other effects does a person’s history of CSA have on those around them? This question is difficult to answer and is the driving force behind the impending discussion of an ecological model of social interactions. Discovering the factors involved in healthy social interaction and comparing those to how survivors of CSA relate to others could help to enumerate the skills deficits of those survivors with functional impairments. Until then, however, an examination of the social and emotional impact on others as mediated by survivors of CSA is a necessary beginning. All of the behaviors previously listed are possible outcomes of CSA, and all of these behaviors can have deleterious effects for the friends, family, and other social systems of survivors. But how deeply can these behaviors affect others, and in what ways? Drug use and suicide can shatter families; unhealthy sexual behaviors can spread disease, increase the risk of pregnancy, and emotionally damage intimate partners; delinquency can do damage to communities and financially drain taxpayers; emotion dysregulation may cause co-workers undue stress and decrease productivity in the work place; PTSD and other psychological disorders may prevent survivors of CSA from working at all; and there seems to be a mechanism
  • 14. An Exploration of the Broader Ecological Effects of Child Sexual Abuse 14 that leads many mothers who were sexually abused as children to have their children become sexually abused, and many times the mothers are in a violent intimate partnership. The range of pathways there are for CSA to cause damage in a person’s life is wide. This damage may be spread to others via social interaction, and emotional attachments with a survivor may not be necessary for their abuse outcomes to cause problems for others. There can be great depth to the destructive effects that survivors of CSA have on others; suicide can mean the loss of a family member, a friend, or an intimate partner. In contrast, placing a delinquent survivor in jail might cost an unrelated citizen a few tax dollars, with that citizen in total ignorance of where that money is spent. Yet that money is still spent, and over time these costs add up to significant amounts of time, energy, and money invested in reducing the social liabilities presented by survivors of CSA. The sexual abuse of children is not the only social ill that deserves such attention, but it provides an excellent starting point for creating an ecological model of the transmission of unhealthy psychological sequelae and behaviors. A New Ecological Model Urie Bronfenbrenner’s (1979) paper was initially created to explore the contexts in which behaviors occur throughout human development. Out of his work came a model for evaluating the behaviors of an individual in relation to the context in which they occur, as well as the interconnectedness of those settings for explaining human development. Campbell, Dworkin, and Cabral (2009) examine the effects of sexual assault on women’s mental health using Bronfenbrenner’s ecological model; however, this view is limited. The following discussion takes a different direction; what is the effect that an individual experiencing negative psychological sequelae has on his or her society? For that matter, what is the overall effect of multitudes of such individuals interacting with the world? What is the cost to society? The broad
  • 15. An Exploration of the Broader Ecological Effects of Child Sexual Abuse 15 range and strong likelihood of harmful psychological sequelae produced by CSA is a great candidate for providing an example of a different approach to ecological models. Bronfenbrenner’s model identified a systematic way of viewing an individual in society. What can it say about a society influenced by individuals? After Campbell, Dworkin, and Cabral’s (2009) work, an ecological model is described here in terms of the individual, microsystem, exosystem, macrosystem, and chronosystem. Individual Individuals are influenced by those around them, and the reverse is also true. The sexual abuse of a child affects her cognitions, emotions, and physiological responses to certain stimuli. Campbell, Dworkin, & Cabral (2009) explain that a sexual assault victim’s characteristics and coping methods influence her recovery. Her reactions to the abuse may change her view of herself and of her microystem, those immediately around her such as family and peers. Microsystem This is the family, peers, and group relations (e.g. school and church) sphere. It is at this system level that CSA might have the second most direct impact. How far through the layers the effects of a victim’s history of CSA travel is not well studied at this point. There are multiple difficulties with studying the people around a survivor, but primarily this is due to the risk of identifying the survivor as a victim to those whom she does not want that information disclosed. If this were not a problem, conceivably a research endeavor could interview the microsystem of a survivor and gather perceptions, reflections, thoughts, and histories that the interviewees have of the survivor. The purpose of gaining this knowledge would be to examine the impact that non- resilient victims of CSA have on the people they interact with. Perhaps sexually abusing a child is like a striking a sour note that ripples through the ecosystem and decreases in effect as it
  • 16. An Exploration of the Broader Ecological Effects of Child Sexual Abuse 16 encounters resistance; a survivor of CSA has the strongest negative effect on those closest to her and the risk of harm decreases as it travels through her ecological systems. The effects may be covert, like the as yet unknown reason that many mothers of CSA victims were also victimized as children. Time could also be a factor, with its passage leading to less outward symptoms; or conversely the compound effect of multiple victimizations may worsen symptoms over time. Because of the lack of evidence regarding the effect of CSA on a survivor’s microsystem, it is unknown whether it holds significant consequences for her friends, family, and peers. Exosystem The exosystem is made of one’s community and societal systems, such as the medical and legal systems (Campbell, Dworkin, & Cabral, 2009). Sexually abused children often spend time interacting with these two systems in particular. In this case, an individual incident of CSA may be a blip on the radar of those systems because of their size. Numbers indicating prevalence are required to fully understand this level, numbers which are variable due to difficulties in measuring on a larger scale. Some estimates say that as many as 12-40% of women are survivors (Yampolsky, Lev-Wiesel, & Ben-Zion, 2010), and that 1 in 12 children annually are victimized (McGrath, Nilsen, & Kerley, 2011). The prevalence of CSA in the United States is a difficult number to nail down. However, more accurate survey methods and a field-wide consensus as to how to measure CSA prevalence could produce a workable percentage. An accurate report of the prevalence of CSA would assist in creating programs to reduce its influence on the community. Influences on an individual from the exosystem include those by media, school systems, area industry, and local politics. This paper seeks to examine the opposite direction of study; how do individuals influence the exosystem? Is it necessary to be in a position of power to have an impact or can a system be changed by the sheer number of people who are victims of CSA?
  • 17. An Exploration of the Broader Ecological Effects of Child Sexual Abuse 17 This is not a clear-cut case of the victim having an influence on a large system. An amalgamation of individuals who have experienced trauma may have a compounded effect on the exosystem that helps to shape culture, community, and society. However, systems have been created to address the problem of sexual violence against children, and in so doing may have decreased the harmful overall effects of the pandemic of sexual abuse. A current difficulty in knowing the truth of this is that the existence of a decrease is not measureable because the scope of the problem is not fully measurable. More research is needed to determine how victims of CSA truly influence their ecological systems. Macrosystem The macrosystem can be seen as a more national or global level of influence. Typically, the individual is seen to be influenced by this system but the reverse is not thought of as true. Perhaps a few individuals have a measurable influence on global systems. It is not expected that a single victim of CSA will have a strong effect in this system, yet with enough people who experience similar symptoms from similar events (e.g. trauma related PTSD from a history of CSA) there may be an effect (e.g. higher suicide rates). This is probably the most difficult level to measure, and instead of being from survivors of CSA the influence may be from a conglomeration of systematic violence against women. Chronosystem Bronfenbrenner also included what he called the chronosystem; a change over time in the strength and effects of influences passing between the ecological system levels. For the up to 60% of CSA victims who are sexually revictimized as adults (Classen et al., 2001), adulthood does not give them enough time to heal. Instead, traumatic events like sexual revictimization tend have a compounding effect to increase symptomology, especially that of PTSD. The effect
  • 18. An Exploration of the Broader Ecological Effects of Child Sexual Abuse 18 of the chronosystem is such that there is a difference over time, even within one person, in how life stressors are overcome. The chronosystem signifies the accumulation of life events and their influences on a person as time progresses. The incidence of CSA has existed for an unknown amount of time. It could be that, while taboo, CSA has become normalized through its consistent presence in humanity. Society’s silence on the matter has allowed this behavior to pass through generations, spreading quietly from parent to child, from victim to victim. It is possible that pedophiles (while not the only perpetrators of CSA) are genetically predisposed to a sexual attraction for children because that trait was allowed to proliferate through human ignorance. This is simple speculation, however, yet working to understand CSA’s effect on the chronosystem may provide us with better tools with which to undermine its influence. A New Perspective The purpose of this report is to explore the broader impact of CSA. Well-known are the variables involved in the struggles and recovery of survivors. Researchers are now in a position to take a more expansive view of social ills; with more inquiry, the literature may be able to definitively say whether the sexual abuse of children is a primary cause of poor interpersonal functioning, the fear of intimacy, or whether CSA is a primary cause of itself through social and intergenerational transmission. It seems as though a new perspective on ecological models is needed. While more than useful in defining the influences on one person’s life, they hold in store another function, one that determines the outcomes of those influences through their effects on other people. As noted above, one person can strongly impact the lives of family, friends, and strangers. Of particular importance is the danger that lies in unidentified victims of CSA raising children because of the transmission of psychological difficulties and sexual abuse. CSA leads to
  • 19. An Exploration of the Broader Ecological Effects of Child Sexual Abuse 19 many serious personal and social problems for victims, but if it could be concluded that these adverse outcomes for the victim are also harmful to others, then CSA may be considered as a larger threat by those with the resources to combat it. Based on the current state of research, a conclusion such as this would not be unexpected. The extant literature is does not yet have a complete picture of the effects of CSA. In order to paint it, researchers would need to analyze every one of its outcomes. Currently, the focus is on the harm to victims. A notion to consider when it comes to CSA is that it tends to cycle from victim to victim, meaning that victims either allow it to happen to others around them or they become perpetrators. Therefore, one incident of the sexual abuse of a child cannot be viewed as isolated. There are repercussions that last through the lives of victims and change how they view the world. CSA causes damage, and the purpose of a new ecological perspective is to examine the true extent of that damage and to learn how it can be diminished.
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