Posttraumatic distress, hope, and growth in survivors of commercial sexual exploitation in Nepal.

Abstract

Commercial sexual exploitation affects between 5,000 and 7,000 girls and women in Nepal each year and can have devastating physical and psychological consequences. Much research has documented these effects; however, there is no published research that focuses on whether healing and growth outcomes are possible for survivors of commercial sexual exploitation. The narratives of 26 girls and women (13-18 years) were taken at two time points during participation in a 6-week group psychoeducation and art therapy program, which was delivered across three nongovernmental organizations in Kathmandu, Nepal. Thematic analysis of the data was undertaken. Themes emerging from Time Point 1 were psychological distress in the form of anxiety and grief over loss of family, psychosomatic symptoms, empathy and compassion, and posttraumatic growth (PTG; new possibilities, relating to others, and personal strength). The themes emerging from Time Point 2, were empathy and compassion and PTG (cognitive restructuring, new possibilities, relating to others, and personal strength). These outcomes were seen alongside ongoing distress. Future research would advance knowledge by further examining the process of PTG in this population, if the changes observed were lasting, and, if so, ways in which PTG can be facilitated or promoted.

‘Using Q-methodology to Explore What is Valued from Child Sexual Exploitation Services: The Importance of Safety’

“…In one study the sample size was too large for the qualitative approach selected as it did not seem to allow for the depth and richness of participants' experiences to be explored fully (Hoot et al, 2006). Some of the studies were not clear about their recruitment processes or their rationale for certain participant eligibility criteria (Shaw et al, 2017;Sprang & Cole, 2018;Volgin et al, 2018). Typical areas that lacked detail included how participants were selected to take part and explanations for the sample size, and whether this had been pre-determined or arrived at naturally.…”

“…A significant limitation of six of the quantitative and one of the qualitative studies was the lack of reporting of the informed consent of the participants, and it is unclear whether they were aware of their data being used for research purposes (Cole et al 2014;Frey et al, 2018;O'Brien et al, 2017;Landers et al, 2017;Sprang & Cole, 2018;Shaw et al 2017;Volgin et al, 2018). Several of the studies outlined their processes for signposting after participation in order to reduce the risk of harm.…”

“…When comparing children who have experienced CSE with control groups, several studies found that children who scored higher on PTSD scales, were more likely to experience avoidance, re-experiencing of their trauma and hyperarousal, higher levels of dissociation, more behavioural problems, a higher incidence of mood difficulties, more complex mental health difficulties, more likely to be withdrawn and depressed, and more likely to rate their own mental health as worse (Cole et al, 2014;O'Brien et al, 2017;Shaw et al, 2017;Svensson et al, 2012;Svedin & Priebe, 2006). Volgin et al (2018) shared similar results in their qualitative project with survivors of sexual exploitation in Nepal, observing significant levels of anxiety and distress in their participants. This study was the only study to report participants' experiences of medically unexplained physical symptoms being related to their distress, which was a significant theme within their findings.…”

Virtues as Correlates and Predictors of Posttraumatic Stress and Growth

“…College is considered a time of personal growth even without trauma exposure, but college students who have experienced trauma have also reported experiences of PTG (Grad & Zeligman, 2017; Hooper et al, 2009; Mohr & Rosén, 2017). Although the relationship between PTS and PTG is not fully understood (Jayawickreme & Blackie, 2014; Zoellner & Maercker, 2006), researchers agree that positive psychological changes have been evident during and following cognitive and emotional processing of painful experiences (Vieselmeyer et al, 2017; Volgin et al, 2019). The relationship between PTG and sociodemographic characteristics remains largely inconclusive (Sherr et al, 2011), with some researchers suggesting women and people of color have a higher tendency toward PTG (Jin et al, 2014) and others finding no differences by race, religion, or gender (Milam, 2004; Zeligman et al, 2016).…”

“…Through the experience of a traumatic event, hope has been identified as a component linked to adjustment, health, well‐being, and growth (Liu et al, 2017; Subandi et al, 2014; Zhou et al, 2018). It increases a person's ability to make sense of their suffering and to find positives following trauma, which might reflect PTG (Subandi et al, 2014; Volgin et al, 2019; Zhou et al, 2018).…”