5 - (SYM 130) Analysis of Impact Statements Among Those with Childhood Sexual Abuse: A Novel Application of Cognitive Processing Therapy with Gay, Bisexual, and Other MSM

Cognitive processing therapy (CPT) is an evidence-based treatment for post-traumatic stress disorder (PTSD) and symptoms that may develop after a trauma (e.g., childhood sexual abuse; CSA). CPT is designed to facilitate emotional processing and help individuals challenge and modify unhelpful thoughts related to their trauma. Impact statements are a key component of CPT; they are written descriptions of the personal meaning of the trauma and how it has affected an individual’s view of themselves, other people, and the world. Treatment for CSA has been typically influenced by the voices of female survivors; however, the voices of male survivors also need to be included as they may have different treatment needs. The purpose of the current study was to analyze impact statements completed by MSM with CSA histories as part of a multisite randomized clinical trial (RCT). This qualitative analysis provided insight into the lived experiences of these men in order to extend the current knowledge base and further inform treatment needs. 

The RCT was conducted to examine the effects of cognitive-behavioural therapy for trauma and self-care on symptoms of post-traumatic stress among HIV-uninfected MSM (N = 190) with a history of CSA and HIV risk. From this sample, participants (n = 95) were randomized into the treatment condition and completed impact statements as part of the treatment. Thirty-nine audio recorded impact statements (M_age = 38.3, SD = 11.7) were selected for the current study based on the participants’ ability to articulate a detailed and diverse account of how the experience of CSA impacted their view of themselves, other people, and the world. Reflexive thematic analysis was used to analyze and interpret themes and patterns across the impact statements.

Four themes emerged related to the experience of CSA by MSM: (1) trauma-related changes in cognition, (2) trauma-related changes in affect, (3) trauma-related changes in behaviour, and (4) trauma-related resilience building. The first three themes were consistent with well-established findings on negative mental health outcomes and health risk behaviors associated with CSA among MSM. The fourth theme was consistent with the growing literature exploring correlates of resilience among MSM. These themes may provide a richer understanding into the lived experiences of MSM with CSA histories when compared to quantitative research that is often conducted with this population and may inform treatment goals when using CPT among MSM with CSA.