DISCUSIÓN DE RESULTADOS

It is no longer controversial to suggest that sexual abuse represents a developmental challenge to children. However, child sexual abuse is not a unitary phenomenon, it can vary along a number of dimensions of severity such as duration, age of onset, nature of abuse, and relationship to perpetrator. Research has tended to focus on how these variables increase symptomatology in abused children, yet a number of methodological issues undermine progress in this area. To date, little is known about which o f these factors mediate the harmful effects of child sexual abuse, particularly for boys who are commonly described as responding to such abuse with aggressive and sexualised behaviour. The literature on adults who were sexually abused as children, centred around adult women abused in childhood, seems to suggest that being believed and supported is an essential component of recovery, presumably because of the impact on self-esteem and subsequent coping strategies.

Studies of child sexual abuse have previously focused on mothers roles in the onset of child sexual abuse. The potential role of mothers in a child's recovery from child sexual abuse is a relatively new perspective, as discussed in Chapter Two.

Developmental psychopathology theories have tended to conceptualise pathways, or trajectories of risk following adverse environmental experiences. The sexual abuse literature has focussed on the behavioural responses o f mothers to their children, primarily using cross-sectional designs. For example, researchers have asked whether mothers acted in such a way as to indicate that they believed and supported their child, or did they contribute in some way to their child's abuse by being depressed, or

Intuitively, these appear to be important areas to study. A recent shift has been seen from the study o f parental attitudes and behaviours to that o f parental cognitions as important markers of the parent-child relationship (Dix, 1991; Bugental, 1992).

How might maternal attributions afiect the child's risk trajectory as depicted in the simplified model below?

Reduction of risk 1 1 ...> Recovery Adaptation Resolution Child Sexual Abuse 1 Maternal attributions 1 1 ^ I Potentiation of risk ...> Low self-esteem Depression Sexual perpetration

Figure 5.i: Proposed model of pathways following child sexual abuse

Attributing negative events, such as abuse, to Unstable or transitory causes (such as 'it only happened once or twice'; or '1 told him not to go round to his house that day'), may indicate minimisation of abuse which is likely to impact on a number of important

factors. Low self-esteem is commonly reported in victims of child sexual abuse and may be exacerbated in children whose abuse is minimised, which in turn is a risk-factor for further psychopathology. Assuming that attributions do represent markers of parent-child interaction, minimising the effects of abuse may also influence protective action which might alter the boy's exposure to further risk o f revictimisation. This demonstrates one way in which maternal attributions in non-abusive parents might lead to increased vulnerability to poor outcome for the sexually abused child.

Another example would be if negative events such as sexual abuse were attributed to causes which were Internal and Controllable to the boy.

For example is 'he is so friendly to strangers, I'm not really surprised this

happened'). This may reflect a pattern of blaming the child inappropriately. Even blaming the child for his own victimisation which is traditionally seen as an inherently uncontrollable experience, this in turn may be communicated to the child. The effects o f blaming and minimisation of child sexual abuse could be seen to exacerbate the

child's response to abuse via the hypothesized traumagenic effects o f traumatic sexualisation, betrayal, powerlessness and stigmatisation.

Obversely, a proposed positive function of maternal attributions may interrupt the negative chain o f events that is described for male victims of sexual abuse. We know that not all boys who are sexually abused will be traumatically sexualised or develop into perpetrators of abuse. It is conceivable that the promotion of self-esteem and self- efficacy which are to a large extent, dependent on the availability of supportive

personal relationships, is in turn influenced by the way in which mothers interpret negative events in their child's life.

It is important to recognise that establishing a definitive link between parental

cognitions and parental behaviour is beyond the scope of this, and other cross-sectional studies, and remains an ongoing dilemma in the fields of social and developmental psychology. Similarly, although the model outlined above (5.i) indicates the role of attributions in a causal sequence of events, one important limitation o f this study is that the direction of influence cannot be determined.

This study was designed to improve our knowledge of maternal attributions, and their potential role in the negotiation of the 'risk situation' by the male victim of child sexual abuse. It has been shown that certain types of maternal attributions act as markers of 'distress' in the parent-child relationship. It is known that parental beliefs about child antisocial behaviour can lead to and maintain patterns of family interactions involving progressively more aggressive and antisocial behaviour.

Attributions may also have an important role to play in the development and maintenance o f antisocial or other maladaptive outcomes for male victims of child sexual abuse.

Mechanisms by which maternal attributions might influence sons' response to child sexual abuse likely to be complex. A number of different theoretical perspectives are drawn on in this thesis to help establish the proposition that maternal attributions are likely to have an enduring and important role in mothers affective and behavioural responses to their child.

It is important to recognise that the model above (5.i) is over-simplified and that a number of intervening variables have not been included. Factors such as abuse

variables, and individual characteristics are likely to affect the child's response to abuse. However, as already noted, the specific contribution of these variables remains vague and are therefore limited in their application to the development of intervention programmes with children who have been sexually abused.

One factor which has repeatedly been found to characterise mothers of both victims and young perpetrators of child sexual abuse is their own history of sexual and physical abuse. This has rarely been addressed systematically and is one aim of this current study. The potential influence of mother's own abuse has been shown to be of relevance in parenting failures, such as child abuse. Early experiences o f childhood abuse have also been shown to influence subsequent mental health and cognitive processes such as memory. The influence of childhood experiences on maternal attributions about negative events has recently begun to be addressed and may provide an important link to current attributions.

It is proposed that a study of maternal attributions in this clinical group of boys provides an original contribution to the study of attributions and distressed families.

A methodological approach was sought to overcome difficulties with previous research in this area. As discussed in the previous chapter, attribution research has been

hampered by the use of questionnaires, analogue methods and laboratory-based observations, which has left the question of how parents explain actual events in their own and their children's lives unanswered.

The study o f parental attributions, that is, the way parents interpret their own and their child's behaviour has been shown to affect emotional reactions and in turn, their

responses to their child. The study of parental attributions has been extended to the study of mothers of physically abused and neglected children, however this model of parental cognitions has yet to be applied to the complex field of childhood sexual abuse.

There has been little in the way of sensitive and reliable methods with which to systematically identify and rate causal attributions spoken in natural discourse. The previous chapter addressed attribution theory and introduced an innovative and ecologically valid coding system to rate causal attributions in the study of adjustment in victims of disasters, families with schizophrenic patients, and to both distressed and non-distressed mother-child relationships.

This thesis seeks to address the apparent gap in the literature, in the study of child sexual abuse and parental attributions, which has failed to directly explore attributions in families where child sexual abuse has taken place. Given the central role o f mothers as primary caregivers, the trend towards mother-only households and the possibility of confounding the design of the study by including fathers who were perpetrators, this study focused exclusively on attributions made by mothers.