Consequences of sexual abuse
Today, I address two studies related to effects of sexual abuse. First, So, LaVoy, Harmouch & Alfano (2023) published “Objective and Subjective Sleep Patterns and Biomarkers of Stress among Women with a History of Sexual Abuse in Childhood” in Psychological Trauma: Theory, Research, Practice, and Policy. Here are the edited abstract and impact statements:
Childhood sexual abuse (CSA) is associated with posttraumatic stress symptoms (PTSSs) and sleep disturbance into adulthood. The latter is thought to emerge from dysregulation in biobehavioral systems, including nighttime hyperarousal; however, studies investigating specific mechanisms to explain these long-term sleep problems are limited. The present study examined presleep arousal, fear of sleep, and the cortisol awakening response (CAR) as putative mediators between PTSS and sleep disturbance in women with a history of CSA. N = 64 cis-gendered women with a self-reported history of CSA completed a baseline diagnostic interview, self-reported mental health and sleep measures, 7 days of actigraphy monitoring with concurrent sleep diary, and 2 days of saliva sampling. PTSSs were not significantly associated with actigraphy-estimated sleep variables but were positively associated with self-reported sleep onset latency (SOL) and negatively associated with self-reported sleep quality. Similarly, PTSSs were not significantly associated with CAR but were associated with higher presleep arousal and fear of sleep ratings. Mediational models identified greater presleep cognitive arousal to partially explain the PTSS–SOL relationship. Specific features of CSA (i.e., age at time of abuse, location of abuse, relationship to the perpetrator) did not moderate this association. Findings suggest that targeting maladaptive cognitions (e.g., worries, rumination) that occur during the presleep period may be a potential intervention target in mitigating sleep disturbance and PTSSs in this population.
Childhood sexual abuse is associated with chronic adverse health outcomes, including posttraumatic stress symptoms (PTSSs) and sleep problems; however, mechanisms maintaining these associations have yet to be empirically investigated. The present study identified presleep cognitive arousal to partially mediate the association between PTSSs and prolonged sleep onset latency and therefore may be an important target for intervention in mitigating symptoms.
As a chronic insomniac, I tend to select studies related to sleep because the effects of poor sleep are so extensive. Here, it’s helpful to see that one of the consequences of child sexual abuse is an adverse effect on sleep quality, especially in delaying sleep onset. The next study looks specifically at memory. Dixon (2024) published “The Brain Under Sexual Attack: A brief report on neurobiological disturbances in trauma memory” in Psychological Trauma: Theory, Research, Practice, and Policy. Here are the edited abstract and impact statements:
The pathway from experiencing sexual assault to successful prosecution of sexual assault cases is plagued by complicated and myriad factors, resulting in suboptimal outcomes for both survivors and judicial systems. In particular, disturbance of posttraumatic memory recall under stressful circumstances can negatively impact the veracity of survivor testimony. This brief report integrates empirical findings from studies of trauma memory disturbance, and more specifically the impacts of glucocorticoid activation in sexual assault memory, contextualizing through the lens of implications for sexual assault litigation. Studies have begun to demonstrate the neurobiological underpinnings of such memory disturbance, indicating that trauma memory recall under duress activates the hypothalamic–pituitary–adrenal axis and glucocorticoids, and subsequently inhibits retrieval mechanisms in the hippocampus. However, research in this realm is somewhat nascent, requiring further study to sufficiently build evidence for the adjustment of judicial proceedings to be increasingly trauma-informed. A review of current empirical research indicates that survivors of sexual assault are vulnerable to trauma memory disturbance during litigation proceedings.
This brief report provides suggestions and future directions to aid in the adjustment of witness testimony procedures for survivors of sexual assault in order to optimize survivor psychological outcomes via reduction of stress. Findings synthesized are also important in providing a roadmap for conditions under which the veracity and justness of judicial outcomes may be enhanced by increasing the propensity for accurate testimony and concordant ability for perpetrator prosecution.
While poor sleep is bad, failed prosecution of sexual abuse perpetrators is horrific. I thought this was an important study in reminding professionals of the neurophysiological impacts of sexual abuse that can actually interfere with accurate memory when a victim is asked to testify.