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1、Contents lists available at ScienceDirectChild Abuse&Neglectjournal homepage: self”in the shadow of childhood sexual abuse:The long-termimplications of sexual abuse for male and female adult survivorsAnat Talmon,Karni GinzburgThe Bob Shapell School of Social Work,Tel Aviv University,IsraelA R T I C
2、L E I N F OKeywords:Childhood sexual abuseObjectified body consciousnessDisrupted body boundariesBody shameDiscomfort in close proximity to othersGenderA B S T R A C TChildhood sexual abuse(CSA)may have long-term negative outcomes for victims body re-presentations.In this study we examined a model i
3、n which the relation between CSA and anindividuals discomfort when in close proximity to others is mediated by disrupted bodyboundaries,and the relation between CSA and body shame is mediated by body self-objectifi-cation.Since most of these variables were conceptualized and assessed primarily among
4、 women,gender differences regarding the proposed model were examined.Study participants were 843college/university students(536 women and 307 men).Results from structural equation mod-eling analyses indicated that in both genders,disrupted body boundaries mediated the relationsbetween CSA and an ind
5、ividuals discomfort when in close proximity to others,as well as be-tween CSA and body shame.Body self-objectification was not associated with history of CSA.Finally,we discuss the role these findings may play in the detrimental long-term effects of CSA onboth male and female survivors,and refer to
6、their common underlying mechanism.1.IntroductionAlthough childhood sexual abuse(CSA)is more common among girls than boys,a considerable number of boys are also CSAvictims(Walker,Carey,Mohr,Stein,&Seedat,2004).A meta-analysis of studies conducted among non-clinical populations con-cluded that approxi
7、mately 18%of the women and 7.6%of the men reported experiences of CSA(Stoltenborgh,van IJzendoorn,Euser,&Bakermans-Kranenburg,2011).Similar rates were evident among samples of college and university students(e.g.,Pereda,Guilera,Forns,&Gmez-Benito,2009).Experiencing CSA may have long-term implication
8、s for victims body and self representations.The survivors body,which often“remembers”the abusive acts,may function as a living memorial of the traumatic event(Rothschild,2000).As such,it may carry thememories of being used,threatened,invaded,and/or attacked.Indeed,some studies have pointed to the as
9、sociation betweenchildhood sexual abuse and adult obesity,as the latter has been experienced as a form of protection from abuse-related sexual fears(Felitti,1993).Since the abusive acts may shake the survivors sense of safety and influence their assumptions towards themselvesand others(Janoff-Bulman
10、,1992),these memories may be manifested in their perceptions of their own bodies,as well as in theirsense of safety and comfort in the presence of others.Shame is an emotional reaction in which the individual perceives his/her own“self”as deficient and faulty(Nathanson&Lewis,1987).This sense of sham
11、e may be directed toward various characteristics of the“self,”including ones body.Body shame,in specific,may encompass negative evaluations of both ones appearance and body functioning(Andrews,Qian,&Valentine,2002;Gilbert&Miles,2014).Studies have pointed to the association between CSA and a general
12、sense of shame,among both female and malehttps:/doi.org/10.1016/j.chiabu.2017.12.004Received 29 March 2017;Received in revised form 3 December 2017;Accepted 4 December 2017Corresponding author at:School of Social Work,Tel Aviv University,Tel Aviv 69978,Israel.E-mail addresses:anattalmonmail.tau.ac.i
13、l,(A.Talmon).Child Abuse&Neglect 76(2018)416425Available online 11 December 20170145-2134/2017 Elsevier Ltd.All rights reserved.Tsurvivors(e.g.,Feiring&Taska,2005).The few studies that have examined body shame among adult survivors of CSA were con-ducted among female survivors only,yet indicated the
14、 association between childhood abuse and body shame and body dissatisfaction(e.g.,Andrews,1997).An individuals level of comfort when in close proximity to others reflects his/her sense of safety and calm in the presence ofothers.Studies have demonstrated that people generally need between 40 and 70
15、centimeters of personal space around them,in orderto feel undisturbed;yet,personal space is a malleable entity that is responsive to situational demands and individual differences(Hayduk,1983).Studies have indicated that CSA survivors have greater difficulty in regulating the physical distance betwe
16、enthemselves and others,and tend to feel discomfort when physically close to others,as compared to individuals who have not beensexually abused(Geanellos,2003;Sakson-Obada,2014).Since body shame represents the individuals body identity,it may also be associated with individuals discomfort when they
17、arein close proximity to others.When individuals perceive their bodies as inadequate,as in cases of body shame,they tend to prefergreater interpersonal distance between themselves and others(Frede,Gautney,&Baxter,1968;Sakson-Obada,2014).The currentstudy examines a model in which the relations of CSA
18、 to body shame,and discomfort in close proximity to others among adult maleand female CSA survivors are explained by two mediators:body self-objectification and disrupted body boundaries.1.1.The mediating role of body self-objectificationBody objectification is a process,often occurring during an in
19、terpersonal interaction,in which an individuals body is no longerperceived by others as a subject;rather,it has been transformed into an object for the others use,satisfaction and enjoyment(Fredrickson&Roberts,1997;Nussbaum,1995).Then,through internalization,objectified individuals may undergo a pro
20、cess ofbody self-objectification,a phenomenon in which they themselves view their bodies as instruments to satisfy the needs and desires ofothers(Dworkin,1985;Fredrickson&Roberts,1997;Nussbaum,1995).Self-objectification has mainly been discussed in the context of gender power relations;that is,certa
21、in social structures that havebeen internalized by women may lead them to believe that men are entitled to treat them in a sexual manner(Fredrickson&Roberts,1997;Nussbaum,1995).It is not surprising,then,that although there has been an increase in the empirical attention given to self-objectification
22、 among men(e.g.,Calogero,2009;Steer&Tiggemann,2008),studies have indicated that it is higher among womenthan among men(e.g.,Frederick,Forbes,Grigorian,&Jarcho,2007;Roberts&Gettman,2004).Although most of the writing on body self-objectification refers to the phenomenon in light of social-cultural pro
23、cesses,CSA canalso be viewed as a potentially objectifying experience.Abusive acts often contain aggressive elements,expressed in the perpetratorsuse of the victims body.These acts negate the autonomy and humanity of the victim;while they are happening,the victims body isessentially rendered a passi
24、ve object(Dworkin,2009;Gervais&Davidson,2013).Indeed,a significant association was found betweenchildhood maltreatment(as examined with a general score that included CSA)and self-objectification(Talmon&Ginzburg,2017a).In addition,severity of trauma symptoms among survivors of sexual trauma has been
25、shown to be associated with body self-ob-jectification(Miles-McLean et al.,2015).Body self-objectification may be linked to a sense of body shame.When individuals are consistently exposed to external andinternal comments related to their bodies,their body satisfaction tends to decrease,and the seeds
26、 of shame are thus planted(Gilbert&Miles,2014).Studies have documented the relation between self-objectification and body shame(Fredrickson,Roberts,Noll,Quinn,&Twenge,1998;Steer&Tiggemann,2008;Szymanski and Henning,2007),but this link was evident mainly among females.Furthermore,the few studies that
27、 have examined body self-objectification and body shame among men have reported controversialfindings.Some studies demonstrated a positive relation between body self-objectification and body shame(e.g.,Daniel&Bridges,2010).Others,however,did not find this association(Fredrickson et al.,1998;Roberts&
28、Gettman,2004).More surprising arefindings that have shown that self-objectification was associated with decreased levels of shame among men(Calogero,2009;Tiggemann&Kuring,2004).1.2.The mediating role of disrupted body boundariesBody boundaries demarcate the self;they separate the self from its surro
29、undings(Kochan-Wjcik,2011;Sakson-Obada,2014)anddraw a clear line between the“self”and the“not self”(Anzieu&Turner,1989).These boundaries provide individuals with afundamental sense of their sustainability and existence(James,2001),in which their bodies are felt to be an integral part of theirselves.
30、Thus,body boundaries are experienced as a barrier that protects individuals from their surroundings(Krzewska&Doliska-Zygmunt,2013).Individuals differ in their sense of body boundaries:Well-defined body boundaries enable individuals to be attentive to their bodysensations,to be sensitive to them,and
31、to interpret them in a meaningful way(Sakson-Obada,2014).By contrast,individuals with asense of disrupted body boundaries may find it difficult to identify their body sensations.This difficulty may be expressed as eitherapathy towards their bodies(Streeck-Fischer&Kolk,2000),or alternatively,as an ex
32、aggerated sensitivity to body signals,which mayevoke a sense of threat(Schmidt,Lerew,&Trakowski,1997).Since a disruption in body boundaries may reflect peoples alienationtowards their bodies,it may be related to body self-objectification.As abusive sexual acts,by nature,involve an invasion in which
33、the victims may lose control over their bodies,these experiencesmay impair the survivors recognition of their body boundaries.Indeed,a link between childhood maltreatment(as examined with ageneral score that included CSA)and disrupted body boundaries was observed among female students(Talmon&Ginzbur
34、g,2017a).Other studies have provided further indirect evidence supporting this association.For instance,women with dysphoric body disorderA.Talmon,K.GinzburgChild Abuse&Neglect 76(2018)416425417reported high levels of child abuse and neglect when compared to norms for a health maintenance organizati
35、on(HMO)sample ofwomen(Didie et al.,2006).In addition,experiences of early interpersonal trauma have been shown to be associated with a disruptionin sense of body identity as well as with negative attitudes toward the body,among both male and female survivors(Sakson-Obada,2014).Although the associati
36、on between disrupted body boundaries and an individuals discomfort when in close proximity to others hasnot yet been studied,there is indirect evidence supporting the rationale behind this association.Studies have shown that individualswith well-defined body identities are able to regulate their phy
37、sical distance from others in a way that allows them to feel safe andcomfortable,both physically and emotionally,whereas individuals with undefined body identities tend to avoid social interactionsand/or report feeling intimidated during such interactions(Sakson-Obada,2010,2014).1.3.The current stud
38、yThe current study examines a model which elucidates the mechanism underlying the association between CSA,body shame,andan individuals discomfort when in close proximity to others,among university college/students.As most of the studies addressingthese phenomena have referred to women,we aimed to ex
39、amine this model among both male and female students.It is hypothesizedthat:1.CSA will be positively associated with body shame and an individuals discomfort when in close proximity to others.2.The association between CSA and body shame will be mediated by body self-objectification.More specifically
40、,CSA will bepositively associated with body self-objectification,which will be positively associated with body shame.3.The association between CSA and an individuals discomfort when in close proximity to others will be mediated by disrupted bodyboundaries.More specifically,CSA will be positively ass
41、ociated with disrupted body boundaries,which will be positively asso-ciated with an individuals discomfort when in close proximity to others.4.A positive association will be found between body self-objectification and disrupted body boundaries.5.A positive association will be found between body sham
42、e and an individuals discomfort when in close proximity to others.2.Method2.1.Participants and procedureA convenience sample of 843 university students participated in the study.The participants were recruited through the internet inone of three ways:first,through student Facebook groups whose membe
43、rs attended a variety of universities/colleges,studied in anumber of different fields,and were at differing levels of their education(i.e.,BA,MA,and PhD students);second,through onlinestudent forums;and third,through a post published on the researchers“wall”that was virally distributed in a snowball
44、 technique.Potential participants were invited to participate in a study,being conducted among university students in Israel,on the long-termeffects of negative childhood experiences.The inclusion criteria were being a university student,being 18 years of age or older,andbeing able to read and write
45、 in Hebrew.Of the sample,536(63.6%)were females,and 307(36.4%)were males.The average age of the participants was 25.15 years(SD=4.45;range 1856).No difference was found between the genders with regard to age,t(841)=.71,p=.08.Gender dif-ferences were found in education status,2(1)=4.28,p=.04,as more
46、male participants were undergraduate students(n=261,85.3%)than female participants(n=424,79.5%).Most of the participants(n=581;68.9%)were single.No gender differenceswere found in relationship status 2(1)=2.59,p=.11.Data were collected after the study received approval from the universitys Instituti
47、onal Review Board(IRB)and informed consentfrom the participants was obtained.As compensation,each participant was given the opportunity to take part in a lottery,the prizefor which was gift vouchers,in the amount of$27.Participants used Qualtrics Research Software to fill in the questionnaires,andco
48、mpletion took about 20 min.2.2.Measures2.2.1.Background variablesParticipants completed a brief demographic questionnaire that assessed age,education,and relational status.Childhood sexual abuse was assessed by the sexual abuse subscale of the Childhood Trauma Questionnaire(CTQ;Bernstein et al.,2003
49、),which consists of five items reflecting sexual abuse(e.g.,“Was touched sexually,”“Was hurt if didnt perform a sexual act thatwas requested”).The items were rated on a five-point Likert-type scale with response options ranging from 1(never true)to 5(veryoften true).Sum scores were used,with higher
50、scores representing greater levels of sexual abuse.The validity of the CTQ scores wassupported by positive correlations between CTQ scores as reported by adolescents who were admitted to inpatient psychiatric clinics,and as per their therapists ratings(Bernstein et al.,2003).Reported internal consis