Intergenerational continuity of child sexual abuse: A mixed methods study of risk and protective factors

Child sexual abuse (CSA) is a prevalent traumatic experience worldwide. The negative effects of CSA can put children on a trajectory where they are likely to experience later abuse (revictimization) and to have children who may also experience sexual abuse (intergenerational continuity). Both theoretical and empirical research on CSA continuity is lacking. There are limited theoretical frameworks that have been developed to conceptualize intergenerational maltreatment, and more specifically to understand the reasons for intergenerational continuity of CSA. Additionally, there are few empirical studies that have specifically examined intergenerational cycles of CSA to identify distinguishing factors that can be targeted to reduce the risk of continuity. Qualitative research documenting individuals’ lived experiences of CSA and continuity is also clearly lacking in the literature, as well as mixed method designs. To address the limitations in the literature and enrich our understanding as to how CSA may continue within families, three studies were developed. A systematic review was developed for Study 1 to identify and synthesize the literature on theoretical and/or conceptual frameworks that have been used to explain victim-to-victim cycles of abuse, the most prevalent type of continuity for CSA whereas a parent and a child are victims of CSA, but the abused parent is not the perpetrator of their child’s abuse. Searches were executed in PsychINFO, Medline and Scopus; 15 papers were included in the final sample. There were only four papers identified on the continuity of CSA specifically, highlighting a lack of focus on the theoretical explanations of this issue. As a result of this systematic review, a unified model of maltreatment continuity, more specifically victim-to-victim cycles, was proposed, which has the benefit of guiding future investigations of CSA continuity and provides key intervention targets for clinicians. Study 2 was developed to document the role of individual (e.g., mental health, child maltreatment history), relational (e.g., attachment), and socioenvironmental factors (e.g., socioeconomic characteristics) in intergenerational cycles of CSA. Specifically, Study 2 aimed to compare cycle maintainers, cycle breakers, cycle initiators, and a control group within a sample of mother-emerging adult dyads (N = 186). The sample was recruited across Canada to participate in an online study. The results support prior research in showing that there is a higher risk of CSA in dyads where the mother experienced CSA (OR =1.38). Compared to cycle initiators, maintainers reported greater psychological distress (M = 27.23 vs. 35.18), and lower mother-rated parent-child attachment (M = 115.83 vs. 111.43). Maintainers reported more post-traumatic stress symptoms only in comparison to the control group (M = 24.82 vs. 10.13). Mothers in cycle maintaining dyads were exposed to more acts of domestic violence in childhood than those in cycle breaking dyads (OR = 2.43). To further understand these quantitative results, Study 3 involved conducting individual qualitative interviews with 23 mothers who experienced CSA (12 continuity, 11 discontinuity). A qualitative description of themes showed that mothers described a variety of experiences related to parent-child and romantic relationships and parenting behaviours (e.g., difficulties with expression emotions and affection, boundary setting, lack of confidence as a parent). A mixed method integration was completed which helped to clarify and expand upon quantitative findings. Several promising directions for research, prevention, and intervention for parents with histories of CSA were identified

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