Peritraumatic Pain in Child Sexual Abuse: Children’s Descriptions of Pain as Conveyed in Their Testimonies Following Child Sexual Abuse

Abstract

The literature on child sexual abuse (CSA) has contributed significantly to the understanding of its characteristics, epidemiology, and consequences. Considerably less attention has been dedicated, however, to the subjective experiences of the abused children, and more specifically to their experiences of pain. The current study explored the way children perceive and describe pain during and shortly following incidents of sexual abuse. The sample was comprised of 35 transcripts of forensic interviews following alleged CSA. Thematic analysis of the children’s narratives identified three themes: (a) pain during the abusive incidents, described using words indicating its intensity and quality; (b) pain shortly after the abusive incidents, including weeks later, and (c) pain as embedded within the complex dynamic with perpetrator. The children struggled to localize the pain, mainly using words such as “inside” and “deep.” Moreover, they testified that in the course of the abusive incidents, they were often silenced when trying to communicate their pain to the perpetrators. The children’s narratives provided us with a unique opportunity to learn about the pain not only during the abusive incidents but also following it. Additionally, children described suffering from pain in areas that were not directly injured during the CSA incidents, mainly referring to the head, abdomen and legs. The discussion addresses the potential intervening factors in peritraumatic CSA pain, as well as its potential links with chronic post-traumatic physical and mental morbidity. This study illuminates the necessity to address the complicated links between short- and long-term physical, emotional, cognitive, and interpersonal manifestations of CSA.

The memory and identity theory of ICD-11 complex posttraumatic stress disorder.

“…This kind of flashback is common in populations exposed to extreme interpersonal trauma (Macdonald et al, 2018). However, a study of sexually abused children has revealed that abuse-related pain experiences may be numerous and difficult to localize and may present after the abuse itself (Tsur et al, 2022). This suggests that mechanisms are needed that do not just encode traumatic moments.…”

Peritraumatic Pain in Child Maltreatment: A Systematic Literature Review

“…Of these samples, six (75%) were children who were maltreated by a parent or caregiver (Katz & Tener, 2021a, 2021bKatz et al, 2020;Lev-Wiesel et al, 2014;Simon et al, 2018;Tsur et al, 2021Tsur et al, , 2022 and two (25%) were of children evaluated due to allegations or concerns of abuse by parents, caregivers, family members, or family friends (Drouineau et al, 2017;Taylor & Higginbotham, 2020). Three (37.5%) of the eight children's samples studied sexual abuse (Katz et al, 2020;Taylor & Higginbotham, 2020;Tsur et al, 2022), three (37.5%) studied physical abuse (Katz & Tener, 2021a, 2021bSimon et al, 2018;Tsur et al, 2021), one (12.5%) did not specify the type of the maltreatment (Drouineau et al, 2017), and one studied multiple types of abuse (physical, sexual, emotional, neglect, and witnessing domestic violence; Lev-Wiesel et al, 2014). The remaining three (27.27%) samples were of adults who retrospectively reported childhood sexual abuse (Carballo-Diéguez & Dolezal, 1995;Dolezal & Carballo-Diéguez, 2002;Sigurdardottir & Halldorsdottir, 2013).…”

Trauma Chronicity and the Long-Term Needs of Childhood Sexual Trauma Survivors

“…CST is a complex trauma involving physical, emotional, and sexual components [12,17,18]. It may include sexual behaviors which are painful and fear-arousing, such that the sexual experience itself encompasses both physical and psychological trauma [12,17,[19][20][21][22].…”