The Development of a Sexual Abuse Severity Score

Abstract

Childhood sexual abuse (CSA) is common and is associated with both mental and physical health problems in adulthood. Using data from an age and sex-stratified population survey of Olmsted County, MN residents (n=610), we developed a sexual abuse severity score (SASS). The abuse characteristics of 156 CSA respondents were associated with self-reported trauma, somatization, and alcohol use. Characteristics included: age of first sexual abuse, more than one perpetrator, degree of coercion, severity of abuse (i.e. attempted intercourse is more severe than fondling), and the number of occurrences. This is one of the few reports to develop a risk summary that quantifies the severity of childhood sexual abuse.

Complexity of Childhood Sexual Abuse: Predictors of Current Post-Traumatic Stress Disorder, Mood Disorders, Substance Use, and Sexual Risk Behavior Among Adult Men Who Have Sex with Men

“…There is currently no gold standard for the measurement of CSA complexity, although researchers agree that frequency and intensity of abuse, current functioning, and context of CSA matters when attempting to characterize post-abuse adjustment (Casey & Nurius, 2005; Kaysen, Rosen, Bowman, & Resick, 2010; Loeb, Gaines, Wyatt, Zhang, & Liu, 2011; Zink, Klesges, Stevens, & Decker, 2009). Given the evidence demonstrated in the literature, we believe that the CSA complexity is significantly influential in risk for impaired mental health, substance use, and sexual risk taking.…”

Perception vs. Circumstances of the Child Sexual Abuse Event in Relation to Depression and Post-traumatic Stress Symptomatology

“…For example, Bornstein, Kaplan, and Perry (2007) reported that sexual abuse (mild or severe) was rated as being more traumatic and severe if perpetrated by a parent than by a babysitter. While Zink, Klesges, Stevens, and Decker (2009) found that the factors that contribute to the severity of CSA are the age at first sexual abuse experience, more than one offender, degree of coercion, and the number of occurrences. Based on the previous review the aims of the current study were twofold: (a) to further explore the contribution of coerced, completed penetration and the identity of the offender on the severity of distress (depression and PTS) in adult female survivors of CSA and to (b) examine to what extent the objective circumstances, in terms of the identity of the offender and coerced intercourse, will determine the subjective perception of the CSA experience in terms of severity.…”

Characteristics of childhood sexual abuse in lesbians and heterosexual women

“…Indicators of CSA severity, drawn from previous research, included (1) genital CSA (Kendler et al, 2000; Zink et al, 2009); (2) vaginal or anal intercourse (Dube et al, 2005; Molnar et al, 2001); (3) younger age of first CSA (Casey & Nurius, 2005; Zink et al, 2009); (4) larger number of perpetrators (Briere & Runtz, 1988; Casey & Nurius, 2005); (5) greater number of CSA occurrences (Jasinki et al, 2000; Zink et al, 2009); (6) longer duration of CSA (Briere & Runtz, 1988; Lange et al, 1999); and (7) physical force or coercion (Dube et al, 2005). …”

“…Hughes, Johnson, and Wilsnack (2001) found that lesbians reported more different types of CSA experiences than heterosexual women. Understanding CSA severity is important because the few studies that assessed CSA severity found a “dose-response” relationship between severity (e.g., genital CSA, physical coercion) and adverse outcomes (Bulik, Prescott, & Kendler, 2001; Zink, Klesges, Stevens, & Decker, 2009). …”

“…Some studies have found more negative long-term outcomes following abuse by a father figure (Casey & Nurius, 2005; Ketring & Feinauer, 1999) or by perpetrators who are strangers or authority figures, caretakers, or parents’ friends (Zink et al, 2009). Tomeo and colleagues (2001) found that lesbians were more likely than heterosexual women to be abused by a female perpetrator (cf.…”