Social Support of Adolescent Survivors of Child Sexual Abuse and Sexual Revictimization in Turkey

Journal of Child Sexual Abuse
ISSN: 1053-8712 (Print) 1547-0679 (Online) Journal homepage: http://www.tandfonline.com/loi/wcsa20
Social Support of Adolescent Survivors of Child

Sexual Abuse and Sexual Revictimization in Turkey
Nilüfer Koçtürk & Filiz Bilge
To cite this article: Nilüfer Koçtürk & Filiz Bilge (2017): Social Support of Adolescent Survivors
of Child Sexual Abuse and Sexual Revictimization in Turkey, Journal of Child Sexual Abuse, DOI:
10.1080/10538712.2017.1354348
To link to this article: http://dx.doi.org/10.1080/10538712.2017.1354348
Published online: 02 Aug 2017.
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Download by: [University of Warwick] Date: 03 August 2017, At: 11:55

JOURNAL OF CHILD SEXUAL ABUSE
https://doi.org/10.1080/10538712.2017.1354348
Social Support of Adolescent Survivors of Child Sexual

Abuse and Sexual Revictimization in Turkey
a
Nilüfer Koçtürk and Filiz Bilgeb
a
Ankara Child Advocacy Center, Yenimahalle Education and Research Hospital, Ankara, Turkey;
b
Psychological Counseling and Guidance Department, Hacettepe University, Ankara, Turkey
ABSTRACT ARTICLE HISTORY

Sexual revictimization refers to having a history of child sexual Received 13 January 2017
abuse and an experience of being assaulted again in adoles- Revised 4 June 2017
Accepted 6 June 2017
Downloaded by [University of Warwick] at 11:55 03 August 2017
cence or adulthood. This descriptive study examined perceived

social support of nonvictim adolescents and adolescents who KEYWORDS
had survived single sexual abuse and sexual revictimization. adolescent; child; familial
Participants were 210 adolescent girls, all aged between 15 support; family;
and 18, selected by a convenience sampling method; 70 had revictimization; revictimized
survived sexual revictimization, 70 had survived single sexual adolescent; sexual abuse;
abuse, and 70 were nonvictims. The Perceived Social Support social support
Scale was administered, and a one-way ANOVA was conducted
for data analysis. Perceived social support from the community
was lower in the sexual revictimization group than in the single
sexual abuse and comparison groups. Family social support did
not differ between the sexual revictimization and single sexual
abuse groups but was lower in both than in the comparison
group. These results indicate that victims of sexual revictimiza-
tion need social support, and both sexual revictimization and
single sexual abuse victims need familial support.
Introduction
Child sexual abuse (CSA) is an important social problem, defined by the
World Health Organization (WHO, 2003) as a child being exposed to sexual
behavior that is not socially or legally appropriate because the child cannot
fully comprehend what it means to consent or is not developmentally pre-
pared. Due to a number of factors, including variations in definition, mea-
surement, samples, and reporting methods, the incidence and prevalence of
CSA are not precisely known (Paolucci, Genuis, & Violato, 2001). In a meta-
analysis, the worldwide prevalence of child and adolescent sexual abuse
between 1980 and 2008 was determined to be 11.8% (Stoltenborgh, Van
Ijzendoorn, Euser, & Bakermans-Kranenburg, 2011). In Turkey, however,
due to the lack of a national database and studies on this subject, the
frequency of CSA cannot be determined. Results differ among studies with
regard to the characteristics of the sample group. For example, one study
CONTACT Nilüfer Koçtürk, PhD nilkeser@hacettepe.edu.tr Gözüm Park Yaşam Merkezi, 3297. Sok, 5/12,
Yaşamkent, Ankara, Turkey.
© 2017 Taylor & Francis
2 N. KOÇTÜRK AND F. BILGE
with a sample drawn from the general population found that 13.4% of 1955
female high school students were survivors of CSA (Alikasifoglu et al., 2006),
and a second found a prevalence of 32.5% in 1,799 children in government
custody (Akkus, 2014).
CSA is associated with an increase in risk for subsequent sexual victimiza-
tion and this phenomenon has been termed “revictimization” (Pittenger,
Huit, & Hansen, 2016). Though sexual revictimization (SR) is defined in
various ways in the literature (e.g., Messman & Long, 1996), it refers to
having a history of CSA and an experience of being assaulted again in
adolescence or adulthood by different offenders (Hill, Vernig, Lee, Brown,
& Orsillo, 2011; Pittenger et al., 2016). On the other hand, there is no
consensus in the literature in regard to the age cutoffs for childhood,
adolescence, and adulthood (Walker, Freud, Ellis, Fraine, & Wilson, 2017).
When studies on the prevalence of SR were examined, one study revealed

that of 1,790 girls between the ages of 18 and 22, 11.3% had survived SA only
in childhood, 39.8% had survived SA in adolescence, and 18.5% had survived
SA in both childhood and adolescence (Young, Deardorff, Ozer, & Lahiff,
2011). Another study in the United States with 714 college-aged girls showed
that 20.9% had experienced SA only in childhood, 33.1% had experienced SA
only in adolescence, and 23.2% had experienced SR in multiple developmen-
tal stages, including adulthood (Walsh, DiLillo, & Messman-Moore, 2012).
SR frequency in Turkey, however, is not known due to a lack of research on
this subject.
A strong correlation between CSA and SR has been shown in the literature
(Krahé, Scheinberger-Olwig, Waizenhöfer, & Kolpin, 1999; Testa, Hoffman,
& Livingston, 2010). Affective disorders, posttraumatic stress disorder symp-
toms, anxiety disorders, dissociation, alcohol and drug abuse, risky sexual
behaviors, and a dysfunctional family environment are factors known to
increase the risk of SR (Classen, Palesh, & Aggarwal, 2005; Messman-
Moore & Long, 2003). Although their role has not been demonstrated
experimentally, based on the ecological model proposed to explain SR, the
level of perceived support from family and society are important variables in
the context of ontogenetic development, microsystems, exosystem, and
macrosystem (Grauerholz, 2000). In this model, SR is predicted flexibly by
many variables, including past history of the victim (e.g., CSA involving
violence, low levels of self-esteem, running away from home, isolation), the
relationship environment when SR is experienced (e.g., history of past abuse
is known to the abuser), social structures (e.g., low socioeconomic status,
having a single parent, having a low level of family support), and cultural
factors (e.g., blaming the victim, rigid gender roles; Grauerholz, 2000).
According to this model, suffering a lack of family and social support is
seen as one of the factors that may lead to SR. Mason, Ullman, Long, Long,
and Starzynski (2009) also identified that adult SR victims are more often
JOURNAL OF CHILD SEXUAL ABUSE 3
blamed in comparison with victims of single sexual abuse (SSA) and sug-
gested that negative social reaction may be a factor that increases the risk
of SR.
In addition, it has been reported in prior studies that parental social
support after reporting the abuse is important for the child’s psychosocial
adjustment (Elliott & Carnes, 2001), low levels of trauma symptoms (Aydin,
Akbas, Turla, & Dundar, 2016; Bick, Zajac, Ralston, & Smith, 2014), and
resiliency after the abuse (Spaccarelli & Kim, 1995). Social support is defined
as “one’s perceptions of general support or specific supportive behaviors
(available or enacted upon) from people in their social network, which
enhances their functioning and/or may buffer them from adverse outcomes”
(Malecki & Demaray, 2002). Based on the model proposed by Cohen and
Wills (1985) for social support, one of the most important functions of social
support is to reduce the damage caused by stressful life events and to act as a
buffer. According to the buffering model as well as the main- or direct-effect
model, a lack of social support can lead to deterioration in an individual’s
well-being. Despite the importance of social support for well-being, accord-
ing to a qualitative study, only 50% of survivors reported receiving support
from their families (Schönbucher, Maier, Mohler-Kuo, Schnyder, & Landolt,
2014). Leifer, Kilbane, and Grossman (2001) found that 61.6% of mothers
supported their children after SA incidents, whereas 38.2% did not. One
study on the perceived social support of victims can be found in the estab-
lished literature on SR. According to the findings of Mason and colleagues
(2009), adult survivors of SR receive less support from their social circles in
comparison to adults who have not experienced SR. These results indicate
that, as with adult SR victims, adolescent victims of SR and adolescents
exposed to SSA may differ in perceived social support. We suggested that
this is an issue that should be investigated.
Although many studies have examined the literature on social support of
SA victims (Leifer et al., 2001; Schönbucher et al., 2014; Simsek, 2010), it can
be seen that most of the research suffers from limited sample sizes. In
addition, perceived social support from the family and from the community
is not addressed together (e.g., Simsek, 2010). Furthermore, because levels of
social support can differ across cultures, this issue should be investigated
cross-culturally, including in Turkey. There is no study on social support
comparing SSA and SR survivors in Turkey. Although some studies have
investigated social support levels of SA survivors, SR survivors are not
involved in these studies, and they have produced contradictory results
(Aydin et al., 2016; Simsek, 2010). In their review, Uslu and Kapci (2014)
demonstrated that there is a need for studies on the social support levels of
SA survivors in Turkey.
For all the reasons mentioned, there is a need to determine the social
support levels of SSA and SR victims. Moreover, in order to provide the
necessary psychological counseling and guidance services to SA survivors, the

social support needs of these survivors should be examined. The emphasis in
the literature on social support and the family in the development of repeated
victimization (Grauerholz, 2000), the indication of victims that familial sup-
port is a necessary type of social support for victims (Schönbucher et al.,
2014), and the fact that negative social reactions after disclosure and the
concomitant decrease in levels of social support are associated with beha-
vioral problems in victims (Sigurvinsdottir & Ullman, 2015; Stappenbeck,
Hassija, Zimmerman, & Kaysen, 2015) show that perceived support from the
family and society are more important than any other source of social
support. Therefore, this study aimed to determine whether adolescents who
are exposed to SR, who are exposed to SSA, and who are not exposed to SA
show significant differences in levels of perceived social support from family
and community. Consistent with this purpose, the following hypotheses were
formulated:
Hypothesis 1: There is a significant difference in the mean levels of perceived

community support for SR survivors, SSA survivors, and nonvictims.
Hypothesis 2: There is a significant difference in the mean levels of perceived

family support for SR survivors, SSA survivors, and nonvictims.
Method
As this study seeks to understand whether there are significant differences in
the social support levels of SR survivors, SSA survivors, and nonvictims, its
model can be classified as a comparative relational screening model. This is a
research model that aims to determine the extent of shared variation and
degree of variation between two or more variables (Karasar, 2010).
Participants
Participants were 210 female adolescents selected by a convenience sampling
method aged 15–18. Of these, 33.3% were survivors of SR (n = 70), 33.3%
were survivors of SSA (n = 70), and 33.3% were nonvictims (n = 70). In total,
140 participants were victims who had been referred to the Ankara Child
Advocacy Center for forensic interview by judicial authorities; 70 participants
who were admitted to the Ministry of Health Yenimahalle State Hospital
Pediatric Polyclinic, which is in the same neighborhood as the Ankara Child
Advocacy Center, were recruited as the comparison group.
The average ages of participants were 16 years (SD = .83) in the compar-
ison group, 15.96 years (SD = .82) in SSA survivors, and 15.93 years
(SD = .97) in SR survivors. None of the differences between the mean ages of
the three groups were significant (F2;207 = .14; p > .05).
In the study, the 70 adolescents exposed to SSA had one abuser and the SA
event occurred only once. It was determined that the 70 victims of SR were
each exposed to SA by between 2 and 30 abusers, and information was
obtained on 177 abuse incidents in total. With regard to closeness between
the sexual abuser and the victim, 42.9% (n = 30) of the 70 SSA group
adolescents were exposed to SA by acquaintances (relatives, neighbors,
etc.), 24.3% by boyfriends or fiancés (n = 17), 20% by strangers (n = 14),
and 12.9% by family members (n = 9). In addition, 46.3% (n = 82) of the SR
group adolescents were exposed to SA by boyfriends or fiancés, 30.5% by
acquaintances (n = 54), 19.2% strangers (n = 34), and 4% by family mem-
bers (n = 7).
Preliminary analyses were conducted for the SSA and SR groups. These
indicated that few differences were found between the two groups in terms of
sociodemographic variables, except for intrafamilial SA, which was signifi-
cantly more severe in the SSA group (12.9% versus 4%, χ2(1) = 6.56, p < .05),
and type of abuse, for which the SR group were more likely to be raped
(73.4% versus 45.7%, χ2(1) = 17.09, p < .05; see Table 1). The two victim
groups did not differ on physical abuse by the mother (24.3% versus 20%, χ2
(1) = .37, p > .05), or having double parents (61.4% versus 50%, χ2(1) = 1.85,
p > .05; see Table 1).
Procedure
This study was conducted at the Ankara Child Advocacy Center of the
Ministry of Health, where forensic interviews are conducted with child
abuse survivors. Victims who come to this center are those who have
reported to judicial authorities that they were subjected to SA; they are
directed to the center by the prosecution to be interviewed by forensic
experts in order to avoid secondary trauma. Forensic interviews of victims
Table 1. Descriptive Statistics for the Sample.

CG SSAG SRG All
(n = 70) (n = 70) (n = 70) (N = 210)
Type of SA — 9 (12.9%) 7 (4%) 16 (6.5%)
Intrafamilial — 61 (87.1%) 170 (96%) 231 (93.5%)
Extrafamilial — 32 (45.7%) 130 (73.4%) 162 (65.6%)
Penetration 10 (14.3%) 17 (24.3%) 14 (20%) 41 (19.5%)
Mother’s physical abuse 55 (78.6%) 43 (61.4%) 35 (50%) 133 (63.3%)
Double parents
Note. SA = sexual abuse; CG = comparison group; SSAG = single sexual abused group; SRG = sexual
revictimized group. The comparison group is nonvictims of SA.
are conducted in a room with mirrors and cameras, accompanied by prose-

cutors and experts, and video recordings of interviews are sent to the court.
After the study was approved by the institutional review board, partici-
pants were included in this study on a voluntary basis and informed consent
forms were administered. Between September 2013 and June 2014, victims
who indicated exposure to SA with forensic interviews based on the The
Cornerhouse forensic interview (RATAC) protocol (Anderson et al., 2010),
regardless of the evidence, were asked for their consent to participate in the
research following their forensic interviews. The same researcher performed
all interviews based on the RATAC protocol because the researcher has the
training and experience to interview SA victims. One hundred percent of the
invited victims agreed to participate in the research. The inclusion criterion
for victims exposed to SA was sexual touching without the victim’s consent
(e.g., touching the genitals or rape). Victims who reported types of SA that
did not involve touch, like verbal abuse or exhibitionism, were not included
in the study. In the recruitment of the comparison group, inclusion criteria
were absence of any medical or psychiatric illness and SA history. After an
initial interview conducted by the first author, adolescents who agreed to
participate in the research and who met the relevant criteria were included in
the study. During their forensic interviews, adolescents who were exposed to
SA both in childhood and in adolescence were assigned to the SR group, and
adolescents who were exposed to SA only in adolescence were assigned to the
SSA group. In addition, after individual interviews based on the RATAC
protocol, informed consent forms were collected from 70 adolescents who
were not exposed to SA, and the perceived social support scale was adminis-
tered to these adolescents. As the number of SR victims admitted to the
center was 70 during the data collection period, and since there were no
major quantitative differences among the groups within the planned analysis,
recruitment of 70 participants for each group was deemed appropriate. Data
collection ended in June 2014.
Measures
Sexual abuse
In accordance with the literature, SR was defined in this study as having
been sexually abused in childhood (before age 13) and exposed to abuse
again during adolescence. Participants were allocated to the SA groups
according to the time and number of SA events given by victims indicating
their exposure to SA during forensic interviews based on the RATAC
protocol (Anderson et al., 2010). Regarding to the RATAC protocol, the
interviews with the victims were conducted with questions such as “Has
someone touched at your private body parts? Could you tell me everything
about it?” to learn about the SA incidents and details of what the victims
experienced. The information related to the abuse type and abuser that
was gathered via the interviews was recorded in the information forms at
the end of each interview. The same questions were asked to the compar-
ison group with regard to the RATAC protocol to learn whether they had
been to exposed to SA or not. Group allocation was thus based on victims’
statements; the presence of evidence was not evaluated. During their
forensic interviews, adolescents who were exposed to SA both in childhood
and in adolescence were assigned to the SR group, adolescents who were
exposed to SA only in adolescence were assigned to the SSA group. SR
survivors were coded as “2,” SSA survivors were coded as “1,” and non-
victims were coded as “0.”
Perceived social support

The Perceived Social Support Scale (PSSS), which was developed by Yildirim
(1997) in order to determine perceived social support levels of high school
students, was employed in this study. Items are rated on a 3-point scale with
responses ranging from 1 (does not apply to me) to 3 (completely applies to
me). Example items from the PSSS are “I always feel their support behind
me” and “They do not understand me.” Participants answer each item
separately for family and community subscales. Fourteen items are positive
and 11 items are reversed statements. Total scores for each subscale range
from 26 to 78. A higher score indicates a higher level of perceived social
support (Yildirim, 1997).
The PSSS can measure the level of perceived social support from family,
relatives, friends, teachers, and the community (Yildirim, 1997). Because the
scale’s 26 items are responded to separately for each source of social support,
one or more of the subscales may be used depending on the topic of research.
As the aim of this study was to determine the perceived level of social
support from society and family in SA victims, only the community and
family subscales were used in this study. Participants were asked to answer
each item on the scale individually, thinking about their families and the
community.
In previous research, internal consistency estimates for each subscale were
.79 for the family subscale and .80 for the community subscale (Yildirim,
1997). In the current study, Cronbach’s α was .95 for the family subscale and
.90 for the community subscale.
Analysis
SPSS 21.0 was used for statistical analysis. An initial check was performed to
see whether the collected data met the assumptions for parametric analyses.
A one-way ANOVA was employed to test for differences in perceived social
support from family and the community between SR survivors, SSA
survivors, and nonvictims. A homogeneity of variance analysis was carried

out using Levene’s F-test. If the assumption was met, Tukey’s test was used,
and if it was not, Dunnett’s C was used (Buyukozturk, 2011).
Results
The level of perceived social support from the community was examined first
for each group in the study. Table 2 shows that perceived social support from
the community differs among the three groups. The highest mean score
belongs to the comparison group and lowest mean score belongs to the SR
group. The ANOVA results in Table 2 indicate that the mean scores for
perceived support from the community differed between groups
(F2;207 = 4.87; p = .009). This result supports the first hypothesis of the
study. As Levene’s value (F2;207 = 1.09; p = .34) showed homogeneity of the
group variances, Tukey’s paired comparison test was used to determine
which group means were significantly different. The results of this test are
shown in Table 3, which indicates that perceived community support scores
were lower for those who had survived SR than they were for the comparison
and SSA groups, showing a small effect (η2 = .05).
Table 2. Means and Standard Deviations of Perceived Social Support Scale for Sexual Abuse
Exposure.
CG SSAG SRG All
(n = 70) (n = 70) (n = 70) (N = 210)
F
Variable M (SD) M (SD) M (SD) M (SD) (2, 207) Levene η2
Social support 55.44 (9.38) 55.34 (10.13) 50.70 (11.21) 53.83 (10.46) 4.87** 1.09 0.05
community
Family 68.13 (8.95) 63.33 (13.25) 59.76 (12.97) 63.74 (12.32) 8.74*** 6.55** 0.08
Note. Possible range of PSSS subscales scores range is 26–78. CG = comparison group; SSAG = single sexual
abused group; SRG = sexual revictimized group.
**p < .01. ***p < .001.
Table 3. Post Hoc Contrasts for Perceived Social Support by Sexual Abuse Exposure.
95% CI
Std.
Variable Comparison Mean difference error Lower bound Upper bound
Social support CG versus SSAG .10000 1.74 −3.99 4.20
community
CG versus SRG 4.74286* 1.74 0.64 8.84
SSAG versus SRG 4.64286* 1.74 0.54 8.74
Family CG versus SSAG 4.80000* 1.91 0.22 9.38
CG versus SRG 8.37143*** 1.88 3.86 12.88
SSAG versus SRG 3.57143 2.21 −1.74 8.88
Note. CG = comparison group; SSAG = single sexual abused group; SRG = sexual revictimized group.
CI = confidence interval; LB = lower bound; UB = upper bound.
*p < .05. ***p < .001.
Second, perceived family support among the groups was investigated.

Table 2 shows that perceived family support differed by group. Specifically,
the comparison group had the highest score and adolescents who had
survived SR had the lowest score.
The ANOVA results in Table 2 show that the perceived family support
scores of adolescents differed significantly by group (F2;207 = 8.74; p = .000).
This result supports the second hypothesis. Levene’s test (F2;207 = 6.55;
p = .002) showed that the homogeneity of variance assumption was violated,
and accordingly, Dunnett’s C paired comparison test was used to determine
which group means were significantly different (see Table 3). Table 3 shows
that adolescents who survived SSA and SR reported lower perceived family
support than did the comparison group. However, perceived family support
did not differ between the SSA and SR groups. We also investigated effect
size; there was a medium-sized effect, at η2 = .08.
Discussion
In this study, perceived social support from the family and from the com-
munity in adolescents who had survived SSA and SR, compared to nonvic-
tims, was examined. It was found that SR survivors’ perceived community
support level was lower than that of both the SSA and comparison groups,
while perceived family support level in the SR group was lower than in the
comparison group but not the SSA group. Although no other study compar-
ing these three groups in terms of family and community support was found
in the literature, these findings are similar to several studies on this subject
(Mason et al., 2009; Schönbucher et al., 2014). Mason and colleagues (2009)
showed that survivors of SR received less support from their social environ-
ment, while Schönbucher and colleagues (2014), in a qualitative study on
survivors of SA aged 15–18, found that only 50% of survivors (n = 13)
received support from their families.
Another study on 36 SA survivors aged 6–17 showed somewhat different
results (Simsek, 2010). This study showed that social support scores of SA
survivors were similar to those in a comparison group. However, as SA
survivors’ age increased, perceived social support from families and teachers
decreased. As the age and number of survivors differed from our study, the
lack of correspondence in results might be best explained by sampling and
measurement differences. Furthermore, researchers have employed different
definitions of parental support and measurement tools, and these differences
can lead to variation in findings (Bolen & Gergely, 2014; Bolen & Lamb,
2007).
Lower perceived social support from the family and the community in the
SR group in this study is consistent with the arguments of the ecological
model. According to the ecological model, individual behavior can only be
understood by taking into account individual, interpersonal, and sociocul-

tural factors (Grauerholz, 2000; Pittenger et al., 2016). The emergence of
lower levels of familial and social support of victims in the SR group supports
the view that victims are not supported by society and by their families in
maintaining their physical and mental health; they are often blamed merci-
lessly, and their families are often repulsed by and rejecting toward them.
Victims’ families do not support them in achieving success, help them to
develop in all aspects of life, or encourage them to share their troubles readily
with society and their families. The obtained findings show that, as stated in
the ecological model, victims in the SR group experienced problems at the
level of microsystem, exosystem, and macrosystem. According to this, per-
ceived social support from family is one of the factors of the microsystem
while perceived support from community is one of the exosystem factors. In
addition, in the SR group, due to the multiple SA events, blaming of the

victim, and negative reactions by the family and the community may result
from cultural norms that are one of the factors of the macrosystem. As an
example of the common cultural norms, the act of girls losing their virginity
before marriage is not accepted in the Turkish community (Ugurlu & Akbas,
2013). An adolescent victim who suffers SA involving penetration could be
alienated from the community due to this social norm. Due to lack of social
support from the family and community, in the form of a vicious cycle, such
victims might become more vulnerable to SR. That is, lack of social support
from the family and community could lead the victim to feel alone and
worthless, and the victim could go experience psychiatric symptoms or the
aggravation of such symptoms. These can further lead the victim to exhibit
risky behaviors and acquire a negative network of friends, lead the victim to
increased contact with the potential abusers, and /or lead the abuser to
perceive the victim as an easy target; as a result, this can lead to SR.
In accordance with this view, Grauerholz (2000) stated that a lack of social
support can seriously reduce victim’s social resources and power (e.g., shap-
ing her relationship with potential abusers) and may have a direct impact on
adolescents’ vulnerability to SA. On the other hand, another reason the SR
group perceived less social support as compared to the SSA group might be
that they had a clearer evaluation of the reaction of the community because
of their past SA experiences. That is, the SR group had had time to evaluate
the reaction of the community after the first SA experience and experience
the legal processes, whereas the SSA group had not yet gone through the legal
processes, and they might not have disclosed what they had suffered to their
community. It is known that victims may encounter negative attitudes in the
judicial system, such as skepticism, blame, or judgment (Greeson, Campbell,
& Fehler-Cabral, 2016). Considering Turkey’s inadequate juvenile justice
system for SA victims and the need for special measures (Erzurumluoglu,
2013), the effects of negativity in the judicial process may form part of the
low level of support the SR group perceives from the community. The source
of low levels of social support may also be examined in future studies.
In addition, we suggest that the SR group’s perceived social support level
being lower than that of the SSA group indicates that, following SA, social
support might be a protective factor against SR. In other words, while
absence of both familial and social support can increase susceptibility for
SA victims, despite the lack of familial support, being supported by another
social structure helps avoid alienation from society. This can be considered a
source of power and therefore a factor that increases victims’ resilience. In
future studies, the effects of alienation from society and perceived social
support from the community on strength can be examined.
Lower levels of perceived family support in both the SR and SSA groups
compared to the comparison group might indicate that victims were the
targets of negative attitudes from their families, such as disbelief, blame, and/
or stigmatization after disclosure. This lack of support from families could be
the result of rigid social gender roles, families’ own need for psychological
support after the incident, parents’ low level of education, and/or their need
for counseling or education on how to approach the victim. A study in which
SA scenarios were given to 153 parents showed that parents handle SA
inadequately and that they need professional support (Walker-Descartes,
Sealy, Laraque, & Rojas, 2011). Moreover, personality traits, psychiatric
problems, attachment to and economic dependency on the perpetrator, living
with the perpetrator, inadequacy of the family support system, and presence
of domestic violence are reported as reasons why parents cannot provide
adequate social support for their victimized children (Cyr, McDuff, &
Hébert, 2013; Elliott & Carnes, 2001; Leifer et al., 2001). In addition,
Schönbucher and colleagues (2014) showed that factors including domestic
abuse, younger age victimization, adult abusers, and violent abuse are inver-
sely proportional to perceived support. In this study, the possible factors that
may affect familial support for SA groups might include the SSA group being
exposed to more intrafamilial abuse, the SR group being exposed to SA more
than once and at a younger age, the SR group having experienced mostly
penetration and having the abuser be most frequently a lover or fiancé. These
factors matter because, in patriarchal societies such as that of Turkey, in
which parents do not approve of romantic relationships for female children,
it is thought that if the abuser is a lover or fiancé, the female victim is blamed
for the SA; this can also be a factor leading to a lack of support from the
family and society. However, causal and longitudinal studies are necessary to
draw strong conclusions.
In conclusion, further studies are necessary to improve family and social
support for children who are exposed to SA. For this purpose, training
programs for the community as well as guidance for families should be
provided. Issues such as the emotional and behavioral problems the victims
go through, how to approach victims, secondary trauma, and stigmatization

would be included in these training programs. In addition, studies aiming to
improve the juvenile justice system and child protection services to provide
social support for survivors during the legal process may be helpful.
Limitations
This study has some basic limitations. First, the study group only included
female adolescents. As a result, this study cannot be generalized to male
victims of SA; more research is needed to evaluate whether male victims
receive the same perceived social support from family and the community.
Second, this study is the first in Turkey on perceived social support from
family and the community among adolescent SR survivors. Further

research is needed to evaluate the generalizability of our findings. Third,
because only victims who disclosed their experiences to the forensic units
were available for participation in the study, community-based research is
also needed. Fourth, SA was determined in the collected data based on the
statements of the victims. Although this is another limitation to the study,
London, Bruck, Ceci, and Shuman (2005) reported that children rarely lie
when stating their exposure to SA. Last, as this study did not employ a
causal design, causal and longitudinal studies are needed to determine
whether a lack of family and community support after SA leads to sexual
revictimization of SA survivors.
Compliance with ethical standards

All procedures followed were in accordance with the ethical standards of the responsible
committee on human experimentation (institutional and national) and with the Helsinki
Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for
being included in the study.
Conflict of interest
All authors declare that they have no competing interests.
Author Notes
Nilüfer Koçtürk, PhD, Yenimahalle Education and Research Hospital, Ankara, Turkey.
Filiz Bilge, PhD, Psychological Counseling and Guidance Department, Hacettepe University,
Ankara, Turkey.
ORCID
Nilüfer Koçtürk http://orcid.org/0000-0001-6124-1842
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Social Support of Adolescent Survivors of Child Sexual Abuse and Sexual Revictimization in Turkey

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Journal of Child Sexual Abuse

ISSN: 1053-8712 (Print) 1547-0679 (Online) Journal homepage: http://www.tandfonline.com/loi/wcsa20

Social Support of Adolescent Survivors of Child

Nilüfer Koçtürk & Filiz Bilge

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Social Support of Adolescent Survivors of Child Sexual

ABSTRACT ARTICLE HISTORY

cence or adulthood. This descriptive study examined perceived

When studies on the prevalence of SR were examined, one study revealed

necessary psychological counseling and guidance services to SA survivors, the

Hypothesis 1: There is a significant difference in the mean levels of perceived

Hypothesis 2: There is a significant difference in the mean levels of perceived

Table 1. Descriptive Statistics for the Sample.

are conducted in a room with mirrors and cameras, accompanied by prose-

Perceived social support

survivors, and nonvictims. A homogeneity of variance analysis was carried

Second, perceived family support among the groups was investigated.

size; there was a medium-sized effect, at η2 = .08.

understood by taking into account individual, interpersonal, and sociocul-

addition, in the SR group, due to the multiple SA events, blaming of the

go through, how to approach victims, secondary trauma, and stigmatization

family and the community among adolescent SR survivors. Further

Compliance with ethical standards

Stoltenborgh, M., van Ijzendoorn, M. H., Euser, E. M., & Bakermans-Kranenburg, M. J.

sexual revictimization: A meta-analytic review. Trauma, Violence, & Abuse, 1–14.

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