A scoping review of adult survivors’ experiences of shame following sexual abuse in childhood

Abstract

Shame following childhood sexual abuse (CSA) can be intensely painful and destructive to one's sense of self and place in the world. Organised around an internalised core belief of worthlessness, extreme shame presents as a major therapeutic challenge in therapy with many CSA survivors. A range of clinical and empirical literature, alongside recounts of survivors lived experience, shows that shame is an effect of CSA for many survivors. Yet research has rarely focused specifically on survivors’ qualitative or lived experiences of shame. This article reports the results of a scoping review of the empirical research investigating adult survivors’ experiences of shame following sexual abuse in their childhood. Conducted in March 2018, the search strategy involved on‐line searches of English language, peer review and select grey literature repositories for articles published up to the end of 2017. Of the 28 peer reviewed studies included in the review, only three studies specifically investigate adult survivors lived experiences of shame. The synthesised findings from the studies identify five themes demonstrating the pervasive and detrimental influence of shame following CSA: (1) Psychological effects and trauma symptoms; (2) Relationships and social connections and disconnections; (3) Disclosure; (4) Self concept; and, (5) The process of recovery. These findings resonate with conceptual literature and broader research on the influence of shame following violence and highlight areas for future research and clinical practice. This scoping review identifies three key gaps: a need for further research across specific populations and groups; research evaluating therapeutic interventions responding to shame; and research that specifically investigates adult survivors’ lived experiences of shame following CSA.

Health care consumption among adolescent girls prior to diagnoses of sexual abuse, a case–control study in the Stockholm Region

“…Delayed disclosure of sexual abuse may also explain why not all diagnoses were registered at the specialized emergency ward for raped patients at Södersjukhuset in Stockholm. Instead the first diagnosis was often (23.1%) recorded within child psychiatric care after several outdoor visits supporting earlier findings that disclosure is a process over time [ 24 , 30 ]. The high risk of re-victimization after CSA in combination with delayed disclosure, also makes it plausible that some of the cases with their first diagnosis of sexual abuse registered at Södersjukhuset in Stockholm had experiences of CSA prior to the sexual abuse that resulted in the visit to the clinic.…”

“…Previous research on adverse childhood experiences (ACEs), among which sexual abuse is the most common for girls, has proven ACEs to be a strong risk factor for mental health problems, suicide risk and re-victimization [ 5 , 16 , 18 , 32 ]. Qualitative research on disclosure of childhood sexual abuse (CSA) shows that significant delay of disclosure, often for several years, is common [ 20 , 21 , 24 , 30 ]. It also shows that disclosure is a process over time, and that it is not likely to occur spontaneously without a safe context [ 24 , 30 ].…”

“…Qualitative research on disclosure of childhood sexual abuse (CSA) shows that significant delay of disclosure, often for several years, is common [ 20 , 21 , 24 , 30 ]. It also shows that disclosure is a process over time, and that it is not likely to occur spontaneously without a safe context [ 24 , 30 ]. Another study showed that 26.0% of the female patients ( n = 298) in a study sample from the specialized emergency ward for raped patients at Södersjukhuset in Stockholm had experiences of CSA prior to the sexual abuse that resulted in the visit to the clinic [ 25 ].…”

Impact of intimate partner violence and childhood maltreatment on maternal–infant maltreatment: A longitudinal study

“…One possible reason for the phenomenon is that pregnant women with poly‐victimizations of IPV and childhood maltreatment may find it more difficult to disclose their problems and seek help; this may worsen their psychosocial health, exacerbate psychosocial problems like depression and a lack of social support (Kita, Haruna, et al, 2020; Saint Arnault, 2009), and result in maternal–infant maltreatment after childbirth. The majority of the victims of childhood maltreatment tend to suffer on disclosing their experiences and seeking help, possibly due to their insecure attachment style, low self‐esteem, and feelings of guilt, shame, and self‐blame (MacGinley, Breckenridge, & Mowll, 2019; Mwakanyamale et al, 2018; Worsley et al, 2018). In addition, women abused by their partners tend to not present help‐seeking behavior due to their fear of worsening the level of violence received by them and being criticized and discriminated against, as well as developing hopeful feelings toward themselves and other people (Bancroft & Silverman, 2004; Fanslow & Robinson, 2010; Fugate et al, 2005; Gender Equality Bureau Cabinet in Japan, 2017; Krug et al, 2002).…”

School-going transgender youths’ experiences at health care facilities: a systematic scoping review protocol

“…However, to the best of our knowledge, the last scoping review conducted on transgender youths' experiences of health and social care was conducted between 2006 and 2016 [34]. This is while many transgender youth still experience extreme human rights violations, gender-based violence and transphobia and are often refused medical care due to their gender identity [35,36]. Such adverse experiences have social, educational, health, psychological, and societal implications which not only impacts the individual but also their families, societies, and health systems globally [37].…”