Women with Histories of Childhood Sexual Abuse and Substance Abuse: A Comparative Case Study of Their Subjective Experiences
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Authors
Denman, Sarah Stauffacher
Issue Date
2002
Type
Dissertation
Language
en
Keywords
Alternative Title
Abstract
A comparative case study was performed exploring how the effects of childhood sexual abuse led to substance abuse and how these effects impacted substance abuse treatment. Three participants underwent in-depth interviews. Previous researchers in the quantitative tradition have developed some theories as to why women with a history of childhood sexual abuse become substance abusers. This study provides a deepening understanding of the subjective, contextual experiences of a few of these women. The researcher interviewed three women between 40 and 50 in the San Francisco Bay Area. The literature review was divided into three domains: (1) the effects of childhood sexual abuse, (2) substance abuse and treatment, and (3) the relationship between childhood sexual abuse and substance abuse. Interview questions were constructed based on the literature in the three domain areas. The interview results are presented, highlighting the themes that emerged from the three domain areas. To assist·in developing themes, the qualitative research software Qualitative Solutions and Research Non-numerical Unstructured Data Indexing Searching and Theorizing or QSR NUD-IST was used. The themes under the first domain, the effects of childhood sexual abuse, were revictimization, fear, anger, guilt, low self-esteem, relationship difficulties, disclosing the abuse, suicide attempts, psychiatric admissions, and eating disorders. The themes under the second domain, substance abuse, were: first use, drug of choice, alcohol abuse of parents, positive effects of using, negative effects of using, self-initiated abstinence, treatment modalities attempted, pros and cons of treatment programs, relapses, and whether childhood sexual abuse was addressed in substance abuse treatment. Domain three, participants' understanding of the relationship between childhood sexual abuse and substance abuse, did not lend itself to being subdivided into separate themes. The information was presented in the results as the participants described their experiences. From the themes presented above, an analysis was performed looking for links between childhood sexual abuse and substance abuse. The data for this analysis was the participants' subjective experience of the lasting impact on their functioning. The results of the study showed that there were four significant issues for these women. These issues were (1) emotional reactions from childhood sexual abuse, (2) difficulties with relationships, (3) issues around telling about the abuse, and (4) how the effects of childhood sexual abuse influenced substance abuse and treatment issues. A discussion is included, which addresses these issues for the three women in the study in terms of how childhood sexual abuse led to substance abuse and how the abuse affected their substance abuse treatment. This study highlights how three women were left with long-lasting effects from their childhood sexual abuse and how those effects played a role in their struggle with substance abuse. This study also recommends needed changes in substance abuse treatment.