University of Iowa Iowa Research Online Theses and Dissertations Spring 2011 Men who were sexually abused during childhood: an examination of factors that influence long-term mental health Scott Douglas Easton University of Iowa Copyright 2011 Scott Douglas Easton This dissertation is available at Iowa Research Online: https://ir.uiowa.edu/etd/957 Recommended Citation Easton, Scott Douglas. "Men who were sexually abused during childhood: an examination of factors that influence long-term mental health." PhD (Doctor of Philosophy) thesis, University of Iowa, 2011. https://doi.org/10.17077/etd.8hfiop4v Follow this and additional works at:https://ir.uiowa.edu/etd Part of theClinical and Medical Social Work Commons MEN WHO WERE SEXUALLY ABUSED DURING CHILDHOOD: AN EXAMINATION OF FACTORS THAT INFLUENCE LONG-TERM MENTAL HEALTH by Scott Douglas Easton An Abstract Of a thesis submitted in partial fulfillment of the requirements for the Doctor of Philosophy degree in Social Work in the Graduate College of The University of Iowa May 2011 Thesis Supervisor: Professor Carol A. Coohey 1 ABSTRACT Men who were sexually abused during childhood (MSAC) represent a highly stigmatized, marginalized population at risk for a variety of psychological problems across the lifespan. Little research has been conducted to understand why some MSAC incur mental health problems and others do not. The purpose of this study was to identify which factors are related to mental distress among MSAC using a psychosocial trauma processing model: account-making. Using a cross-sectional design, the researcher collected data on 487 MSAC through an anonymous, online survey. Multivariate analyses for the final direct effects model revealed that high conformity to masculine norms, account-making stage, and two disclosure variables (told after one year, overall response to disclosure) were related to higher levels of mental distress. Three control variables were also related to mental distress: older age, childhood stressors, and current stressors. Posttraumatic growth moderated the relationship between abuse severity (force, penetration) and mental distress. The results of this study strengthened the knowledge base of MSAC, further developed account-making theory, and provided useful recommendations for clinical practice with this population. Future areas of research were identified. Abstract Approved: __________________________________ Thesis Supervisor __________________________________ Title and Department __________________________________ Date MEN WHO WERE SEXUALLY ABUSED DURING CHILDHOOD: AN EXAMINATION OF FACTORS THAT INFLUENCE LONG-TERM MENTAL HEALTH by Scott Douglas Easton A thesis submitted in partial fulfillment of the requirements for the Doctor of Philosophy degree in Social Work in the Graduate College of The University of Iowa May 2011 Thesis Supervisor: Professor Carol A. Coohey Graduate College The University of Iowa Iowa City, Iowa CERTIFICATE OF APPROVAL ___________________________ PH.D. THESIS ______________ This is to certify that the Ph.D. thesis of Scott Douglas Easton has been approved by the Examining Committee for the thesis requirement for the Doctor of Philosophy degree in Social Work at the May 2011 graduation. Thesis Committee: __________________________________ Carol A. Coohey, Thesis Supervisor __________________________________ Mercedes Bern-Klug __________________________________ Sara Sanders __________________________________ John Harvey __________________________________ William Liu __________________________________ Robert D. Baller To the health and well-being of those affected by child sexual abuse and to those who are working to alleviate suffering and distress caused by it ii …to live is to suffer, to survive is to find meaning in the suffering. If there is a purpose in life at all, there must be a purpose in suffering and in dying. But no man can tell another what this purpose is. Each must find out for himself, and must accept the responsibility that his answer prescribes. Gordon W. Allport, preface to V. Frankl, Man’s Search for Meaning, 1984 …loss is the fundamental human experience that underlies many emotions, both negative and positive. Loss is also the key meaning that people associate with trauma. Dealing with loss can lead to growth experiences such as the development of the ability to reach out to help others and the courage to endure pain with hope. John H. Harvey, Perspectives on Loss and Trauma: Assaults on the Self, 2002 iii ACKNOWLEDGMENTS I want to thank my dissertation chair, adviser, and mentor—Dr. Carol Coohey— for the innumerable hours she invested in me over the past five years. She is a brilliant scholar who strives for excellence in any project she undertakes. Her belief in me and my research topic strengthened my resolve to complete this degree and become a professor. Her persistence in challenging me to refine my ideas—over and over— improved my analytical thinking and writing skills. Through her dedication to my development, she modeled many of the traits of an ideal mentor. It is one of my career goals that one day I will be able to positively impact students in the way that Carol helped me. I also want to thank Dr. Rob Baller, the methodologist on my dissertation committee. From the first time I met Rob, I was struck by his unique combination of brilliance, humility, integrity, and patience. Over the past two years (especially in the summer of 2010), he dedicated dozens of hours assisting me with data analysis. Sitting side-by-side in front of the dataset, I learned a tremendous amount on topics such as developing multivariate models, writing syntax, dealing with missing data, and others. The acquisition of this new knowledge increased my confidence in my scholarly potential, and, ultimately, influenced my decision to start my career at a research- intensive institution. Other members of my committee provided exceptional support during my doctoral program. Dr. Sara Sanders and Dr. Mercedes Bern-Klug provided encouragement and critical feedback at several key points in the past five years. Because they are exemplary teachers, I learned a great deal about how to reach students both inside and outside of the classroom. I am also grateful for their help in connecting me to the field of gerontology. Through his course titled Loss and Trauma and his trauma processing model (account-making), Dr. John Harvey greatly influenced my scholarly and personal iv development. I wish him well in his retirement. Also, I benefited from the advice and expertise of Dr. William Liu, especially in the area of culturally competent research and practice with male clients. I’ll never forget his motto that scholars have the best job in the world; they are paid to think, write, and teach. Several other individuals were very important in my professional development including Dr. Patrick O’Leary (University of Southampton); Dr. James Hall (University of Alabama); Dr. Miriam Landsman, Lisa D’Aunno, J.D., and the friends at the National Resource Center for Family Centered Practice; Mr. Anthony Rodriguez, LISW (The Men’s Center); Dr. William Knabe; Mr. Lary Belman, LISW; Ms. Allethina Harker, LISW (Horizons Agency); my colleagues in the doctoral program; and the students in my classroom. I also want to acknowledge Ms. Agnes DeRaad for her excellent editorial assistance on this dissertation. I am extremely thankful for the assistance of three national survivor organizations that are dedicated to improving the lives of men who were sexually abused during childhood: the Survivors’ Network of those Abused by Priests, MaleSurvivor, and 1in6.org. Several individuals were instrumental during the planning phases of data collection: Mr. David Clohessy, Ms. Barbara Dorris, Mr. Steve Theisen, Mr. Ken Followell, Dr. Karen Terry, Mr. John Carson, Mr. Steve LePore, and Dr. Jim Hopper. Thank you, kindly! I am deeply indebted to the 487 men who participated in this study. For many of them it took courage, time, and emotional resources just to complete the survey. Although I did not offer compensation, I hope each of them knows how incredibly grateful I am for their willingness to share their stories. It is my highest aspiration that this study accurately represents their voices, increases our understanding of the sexual abuse of boys and men, and contributes to real-world, practical interventions to alleviate pain and suffering caused by child sexual abuse. I wish each of them health and well- being. v I am very thankful for the support from the John A. Hartford Foundation. I benefited greatly from both the Pre-Dissertation Program and the Hartford Doctoral Fellowship. In particular, I want to thank Dr. Jim Lubben (Boston College) and Dr. Ruth Dunkle (University of Michigan) for their wisdom, guidance, and support. I am also grateful for financial support from three other sources: the Peter and Elli Malta Paleologos Foundation, the Graduate College (University of Iowa), and the School of Social Work (University of Iowa). I would like to thank my family and friends for their practical and emotional support which sustained me during this five year journey: Mom, Dad, Bob, Greg and Michelle (and their families), the Estefan family, and Fred. From house projects (e.g., painting the kitchen) to musical cards (We Will Rock You!) to stockpiles of Arabic food to small loans for slaying the P.M.I. dragon, you’ve helped me in many, many ways. Thank you and I love you. Finally, I want to thank my greatest and strongest supporter: my wife, Ikram Estefan Easton. Her first name in Arabic means “generous”. Through her words and actions, she proved 1000 times over that she deserves that name. She is an amazing teacher who is passionate about education, learning, and knowledge development. Her love inspires me, buoys my spirit, and encourages me to keep focused on what matters in our lives: faith in God, dedication to our family, and a commitment to good health. She also brought us two sources of pure joy—Yvette and Andrew—who show us on a daily basis the beauty of life. As we embark on the next phase of our lives, it seems fitting to exclaim one thing: “Noshkar Allah!” Yallah, habibtee, let’s move to Boston! vi