Health care providers must develop interventions for women child abuse survivors, encountered in a variety of health settings. Girls are more often maltreated than boys, and usually suffer multiple types of abuse. Adulthood aftereffects include depression, substance abuse, PTSD, and isolation. Some women survivors thrive, that is, they are successful in work and relationships, in despite of challenges to their mental health. It is imperative to develop interventions for adult survivors and determine how and when abused children can best be helped. In this critical narrative retrospective and prospective study, 50 multi-ethnic community-dwelling women survivors of child abuse will be screened for categorization into 2 groups of 25, struggling and thriving, to compare how they achieve and maintain well being. To capture past and current thriving a series of 4 semi-structured interviews spaced over 7 months will elicit focused life stories. The long-term goal is to promote health, improve services, and cut costs of psychiatric morbidity and lost productivity of women survivors.
The specific aims are to: (1) Discover patterns of past and recent aftereffects of child abuse as described by women survivors that are currently thriving versus those still struggling. (after effects) (2) Identify self-protective, health-promoting strategies and resources that constitute strengths for thriving in developmental, transitional and everyday situations. (Strengths) (3) Explore thriving and struggling survivors' perceptions and evaluations of interactions with others, especially health care providers, as they affect abuse aftereffects and strengths. (Interactions) (4) As certain cultural structural and environmental dimensions of work and relationships with others that women survivors view as effective or not effective in helping them thrive (context). Interview transcripts will be examined for thematic commonalities and differences using narrative analytic techniques. Data will then be examined for social, cultural and political dynamics using discourse analysis. The results will inform practice and policy changes, and to add to the growing body of theory about thriving after childhood abuse.

National Institute of Health (NIH)
National Institute of Nursing Research (NINR)
Research Project (R01)
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Special Emphasis Panel (ZRG1-NURS (02))
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Bryan, Yvonne E
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University of Tennessee Knoxville
Schools of Nursing
United States
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Thomas, Sandra P; Bannister, Sarah C; Hall, Joanne M (2012) Anger in the trajectory of healing from childhood maltreatment. Arch Psychiatr Nurs 26:169-80
Hall, Joanne M; Roman, Marian W; Thomas, Sandra P et al. (2009) Thriving as becoming resolute in narratives of women surviving childhood maltreatment. Am J Orthopsychiatry 79:375-86
Thomas, Sandra P; Hall, Joanne M (2008) Life trajectories of female child abuse survivors thriving in adulthood. Qual Health Res 18:149-66