Hope and Fulfillment After Complex Trauma: Using Mixed Methods to Understand Healing

Abstract

Research has shown that the experience of Childhood Sexual Abuse (CSA) can increase the rates of physical and emotional sequela, including depression, anxiety, PTSD, and physical pain. However, little is known about the healing journeys for those women who, after surviving CSA, also experience unwanted sexual experiences (USE) as a young adult. The goal of this mixed method study is to compare identity, distress, and positive health outcomes for survivors of CSA and USE with those of women who have survived USE alone. First, 206 women completed a survey that evaluated mental health distress, trauma centrality, and health indicators, and these women were invited to take part in an additional interview. A subsample of 24 women agreed to be interviewed with a narrative interview that examined trauma recovery from a holistic perspective. Thematic analysis of the interview data revealed contextual and internal barriers and facilitators of healing. Eight qualitative dimensions were derived from code frequencies of the emerging 50 qualitative codes, including Normalization, Denial, Negative Impact, Positive Coping, Rumination, Identity Healing, Hope, and Fulfillment Healing, and Engagement Healing. We then used t-tests to compare the mean code frequencies of these code complexes for survivors of CSA/USE and USE alone, and the significant findings revealed hypotheses to be tested in the larger quantitative sample. H1: Survivors of CSA will have less denial than USE alone; H2: Survivors of CSA will have higher Negative Impact scores than USE alone, and H3: Survivors of CSA will have more Hope and Fulfillment than USE alone. H1 was supported; survivors of both CSA and USE had a significantly higher mean Centrality Scores than Survivors of USE alone. H2 was supported, and all negative impact scores were significantly higher for the survivors of both CSA and USE than survivors of USE alone. H3 was partially supported. Survivors of both CSA and USE had significantly higher mean Post-Traumatic growth scores. However, survivors of USE alone had significantly higher means for Sense of Coherence and Self-Compassion scores. Implications for practice are discussed.

Women's Contexts and Circumstances of Posttraumatic Growth After Sexual Victimization: A Systematic Review

“…The sample sizes of studies ranged from 2 to 39,703 with 19 (48.8%) studies having used qualitative, 19 (46.3%) quantitative, and 3 (7.3%) mixed-methods. The vast majority (63.4%) of studies were conducted in the USA (Cole and Lynn, 2010;Singh et al, 2010;Drauker et al, 2011;Warner Stidham et al, 2012;Williams and Nelson-Gardell, 2012;Wilson et al, 2012;Arias and Johnson, 2013;Davidson et al, 2013;McClain and Frederick Amar, 2013;Foster and Hagedorn, 2014;Ullman, 2014;Bryant-Davis et al, 2015;Kelley and Gidycz, 2015;Simon et al, 2015;Crews et al, 2016;Hartley et al, 2016;Hitter et al, 2017;Kerlin and Sosin, 2017;Smigelsky et al, 2017;Barnett and Maciel, 2019;Catabay et al, 2019;Kirkner and Ullman, 2019;Lahav et al, 2019;Nelson et al, 2019;Saint Arnault and Sinko, 2019;Strauss Swanson and Szymanski, 2020) followed by European studies with 9.8% (Phanichrat and Townshend, 2010;Whitelock et al, 2013;Perez-Gonzalez et al, 2017;Anderson et al, 2019), and two in South Africa (Phasha, 2010;Walker-Williams et al, 2012). One study each was from Australia (Vilencia et al, 2013), Bangladesh (Kaiser and Sinanan, 2020), Brazil (Pessoa et al, 2017), India (George and Bance, 2019), Israel (Kaye-Tzadok and Davidson-Ard, 2016),...…”

‘‘Now, I know my life is not over!’: Introduction and Adaptation of the RESPECT HIV Intervention, OraQuick, and Trauma-Informed Care for Female Victims of Non-Partner Sexual Violence in Haiti

“…The World Health Organization (WHO) currently aims to reduce new HIV infections in girls and women to less than 100,000, [56][57] engaging PLHIV in counseling and care to reduce the virus to a non-detectable load and reduce its transmission and increase self-testing in highly impacted nations and communities. [56] In the present study, we sought additional data regarding the characteristics of NPSV found in previous studies and assessed the acceptability and feasibility of implementing a Haitian Kreyòl version of the RESPECT EBI together with OraQuick, an oral-fluid HIV antibody screen, using TIC as an approach.…”

“…The World Health Organization (WHO) currently aims to reduce new HIV infections in girls and women to less than 100,000, [56-57] engaging PLHIV in counseling and care to reduce the virus to a non-detectable load and reduce its transmission and increase self-testing in highly impacted nations and communities. [56]…”

“…Moreover, they are further victimized by an inadequate and unempathetic healthcare system—healthcare workers who fail to adequately care for them physically and emotionally once under their jurisdiction, by not protecting the confidentiality of their HIV status after testing, and by blaming them for inviting these salacious atrocities. The “sociocultural milieu that tolerates, excuses, and normalizes sexual assault makes clear labeling a challenge for survivors” [56, p. 7] . Further, “failure to acknowledge the reality of trauma and abuse in the lives of children and the long-term impact this can have on the lives of adults, is one of the most significant clinical and moral deficits of current mental health approaches”.…”

Hope in Low‐Income Families—A Study of Family Hardiness in Singapore

“…In addition, we found that family hardiness displayed complementary mediation of the aforementioned relationship, indicating that other mediators could be present. Some possible additional mediators are the social relationships within the family, social support outside the family (Patterson, 2002), presence of traumatic life experiences (Saint Arnault & Sinko, 2019), health status (Gallagher & Lopez, 2017), and mothers' educational level (Jackson et al, 2017).…”