Understanding Shame, Guilt, and Blame Reactions to Child Abuse: Overview of the Literature and Contrast of Adolescent Victims by Sex and Sexual Orientation

Childhood sexual and physical abuse are known to have devastating impacts on victims, leading to later struggles with mental health and substance-related problems, among other challenges. Victims who experience pervasive abuse-related thoughts and emotions, such as shame, guilt, and blame, are at increased risk of poor outcomes, including difficulties with emotional regulation, relationships, and social functioning. Scholars and clinicians have argued that working through these cognitive-emotional reactions should be treatment objectives in therapy with impacted individuals. Importantly, sex and sexual orientation groups demonstrate differences in post-traumatic reactions to abuse, and these differences are thought to be revealing of how familial and societal forces can support or impede post-traumatic growth and healing. For example, it is suggested that sexual minority abuse victims face compounding stressors, including words and actions that have the effect of invalidating their sexual identity, which can complicate their processing of abuse-related trauma. We conducted a review of the literature and two series of analyses, using secondary data on adolescent victims of physical and sexual abuse to analyze group differences in levels of abuse-related shame, guilt, blame toward abusers, and blame toward others. The first series examined differences by sex; the second examined differences by sexual orientation. Adolescents who identified their sex as female and/or their sexual orientation as lesbian, gay, or bisexual (LGB) reported (1) higher levels of abuse-related shame, guilt, and blame, (2) stronger correlations between shame/guilt/blame and abuse severity, and (3) stronger correlations between guilt and blame, in comparison to male and heterosexual respondents. These trends were noted for victims of sexual and physical abuse. The findings converge with prior scholarship suggesting that female and sexual minority abuse victims are at heightened risk for intensified and concomitant abuse-related shame, guilt, and blame; and that abuse-related thoughts and emotions cluster differently across sex and sexual minority groups. We highlight the need for trauma frameworks that incorporate identity, context, and meaning making; and clinical strategies that address compounding stress, shame, guilt, stigma, and invalidation when serving sexual minority abuse victims.