A Preliminary Quantitative Analysis of Men’s Brief Childhood Sexual Abuse Narratives and Emotion Regulation

Abstract

There remains a need to better understand childhood sexual abuse (CSA) among men, given its prevalence and harmful impacts. This preliminary study examined the information in men’s brief, 30-s CSA narratives, which were constructed for a neuroimaging component of a larger project comparing psychological outcomes for men with and without CSA histories. We also explored men’s emotion regulation following construction of the CSA narrative and its links with information in the narrative. Twenty-one cis-gender men with CSA histories were recruited from the community. Their average age was 40.9 years (range 25–59), and the majority were White, employed, partnered, and without biological children. Men provided a brief CSA account that was audio-recorded and transcribed. Following the narrative construction, men also completed the State Difficulties in Emotion Regulation Scale. The transcripts were quantitatively coded for the presence of sexual abuse descriptors, CSA-related emotions, and content around responsibility. Men provided rich information, with most including details about perpetrator gender, sexual acts, abuse location, and feelings about the abuse. There was little to no mention of CSA duration, disclosure, feelings toward the perpetrator, and responsibility (although some mentioned the perpetrator’s responsibility). Greater information in the narratives was associated with greater self-reported emotional awareness and better emotion regulation. While preliminary and largely descriptive, the findings point to the importance of creating emotionally safe and gender-sensitive opportunities for men to share their CSA experiences, with a focus on supporting difficult topics related to disclosure, responsibility, and the harms associated with masculinity norms (especially regarding emotional expression).

Childhood sexual abuse (CSA) is broadly defined as sexual activity with a child below the age of consent, which is 16 years in Canada (Department of Justice Canada, 2023). The prevalence of CSA worldwide is high, and there is increasing recognition that boys often experience sexual harm while growing up that can result in multiple adverse outcomes that include mood, anxiety, and somatic difficulties, posttraumatic stress, substance use difficulties, risk of sexual exploitation, aggressive/antisocial behaviors, suicidality, and impairments in interpersonal and sexual functioning (Dube et al., 2005; Easton & Kong, 2017; Gauthier-Duchesne et al., 2023a; Maniglio, 2009; Moss et al., 2023; Moorman & Romano, 2023; O’Gorman et al., 2023; Spataro et al., 2004). Findings from qualitative research also speak to the negative outcomes associated with male childhood sexual victimization. For example, O’Leary et al. (2017) conducted interviews with 20 Australian men seeking counselling services for their CSA experiences. Four general themes emerged around the impacts of CSA, namely 1) difficulties around sexuality (e.g., identity and functioning); 2) impaired self-concept; 3) psychological and emotional well-being difficulties (e.g., distress, silencing, substance use); and 4) difficulties in social functioning (e.g., interpersonal relationships, violent behavior). In a recent Canadian study with 26 men who had experienced sexual harm during childhood and were seeking counselling services (Gauthier-Duchesne et al., 2023b), interviews around CSA impacts on externalizing behaviors revealed three themes, specifically 1) using aggression to express feelings of anger and protect one’s physical/psychological integrity; 2) engaging in rule-breaking behavior to protect against feelings of injustice and betrayal stemming from the CSA experience; and 3) consuming alcohol and drugs as a way to avoid CSA-related feelings of distress and suffering.

Turning to prevalence, Stoltenborgh et al.’s (2011) meta-analysis of 217 publications from over 10 countries found the rate of male CSA to be 7.6%. Another meta-analysis (Barth et al., 2013), which included 55 studies across 24 countries, yielded a similar prevalence of 8% for male CSA, with rates of 17% for non-contact experiences, 6% for contact experiences, and 3% for the specific contact experience of penetration. In 2018, the Canadian Survey of Safety in Public and Private Spaces (SSPPS) gathered retrospective data from individuals older than 15 years of age on experiences of physical and sexual abuse prior to age 15 (Statistics Canada, 2022). Nationally representative CSA estimates for men indicated that 3.7% reported having been sexually touched against their will or forced into unwanted sexual activity prior to age 15. It is also important to recognize the common co-occurrence of other forms of harm. Data from the SSPPS showed that nationally, 2.4% of men in Canada reported both childhood sexual and physical abuse, and most of these men also indicated having experienced harsh parenting/neglect or having witnessed violence within their home prior to 15 years of age (Statistics Canada, 2022). While these numbers are alarming, CSA prevalence rates based on child reports tend to be even higher, with findings for boys from North American studies ranging from 5.1 to 17.3% (International Society for Traumatic Stress Studies, Sexual Violence Briefing Paper Work Group, 2018). Of course, the rates across all prevalence studies, regardless of methodology, are significant underestimates as many experiences of childhood sexual harm are not reported to the appropriate authorities or are not disclosed at the time of victimization. For example, in a study of 253 adult men in North America (Romano et al., 2019), the majority (77.5%) indicated that their CSA experience had not been reported to child protection or law enforcement. Moreover, men who disclosed their experiences waited an average of 15.4 years from the time of CSA onset.

There are a number of barriers to men sharing their experiences of childhood sexual victimization, such as global societal norms about masculinity (e.g., power, control, self-reliance) and the incongruence with male victimization, as well as fears around the reaction to disclosure and the meaning for men’s sexual identity in cases of victimization by a male perpetrator (Alaggia, 2005; Chynoweth et al., 2020; Easton, 2013, 2014; Nodzenski & Davis, 2023; O’Gorman et al., 2023). The dominant norms “encourage boys and men to think and act in accordance with rigid social expectations of masculinity, including self-reliance, maintaining control, high sex drive, demonstrating strength, toughness, and exercising power over others” (O’Gorman et al., 2023, p. 2). Within the context of childhood sexual victimization, one can understand how men might struggle with disclosure and emotions (e.g., self-blame, shame), because they were unable as youth to have prevented or ended their victimization and, as such, were vulnerable, weak, and powerless based on conventional norms of masculinity (Easton, 2014; Gauthier-Duchesne et al., 2023b; Nodzenski & Davis, 2023).

Masculinity norms do not give men the opportunity to heal from the negative impacts associated with their CSA experiences by making it difficult to disclose and seek help. Kaiser et al.’s (2020) meta-analysis of 11 studies on masculinity and posttraumatic stress showed a small but statistically significant relationship between greater endorsement of masculinity norms and increased posttraumatic stress (r = .22). Masculinity norms were assessed using standardized instruments and were grouped into one of three classes: performance of masculine gender role norms (e.g., emotional control, self-reliance, violence, power over women, disdain for homosexuality, success dedication); agreement with gender role norms (e.g., anti-femininity, toughness, restrictive emotionality, self-reliance, importance of sex); and stress from the inability to conform to gender role norms (e.g., performance failure, subordination to women, fear of physical inadequacy, emotional expressiveness). Although the causal mechanisms underlying this association remain unclear, it was suggested that masculinity norms around restrictive emotionality (avoidance of emotions, emotion dysregulation) may be important in terms of impacting the well-being of men who have experienced traumatic events. It should be noted that the studies included in the meta-analysis had an almost exclusive focus on military trauma among veterans so it remains unknown whether similar findings would appear for men who have experienced sexual harm during childhood.

In light of the many barriers that exist to men’s CSA disclosures, we were interested in understanding what men share with others, as research findings do suggest that such communications often occur at some point in the individual’s life in the context of disclosures to family, friends, partners, and/or professionals (Easton, 2013; Moorman & Romano, 2023; Romano et al., 2019). In a number of treatment frameworks (Herman, 1997) and interventions (Cohen et al., 2006) focused on CSA (and traumatic events more generally), there is a retelling and processing of the sexual harm that was experienced once foundational conditions have been met (e.g., trusting therapeutic relationship, safety and stability in the individual’s life and in the therapeutic setting, readiness on the part of the individual to undertake this work). This retelling and processing of CSA to promote understanding and healing can be in the form of a trauma narrative that is developed and examined therapeutically over the course of a treatment intervention.

There is little to no research, to our knowledge, on the trauma disclosures and narratives of men with CSA histories in terms of their content. For boys, Foster (2017a, 2017b) conducted two related studies in the United States with 19 3–17-year-olds who had experienced sexual abuse and had participated in counselling that included the creation of a trauma narrative. Qualitative analyses indicated that “fear and safety” was a meta-theme that cut across the narratives when boys spoke about their abuse, perpetrators, disclosure, subsequent investigation, and treatment. The narratives included past fears related to CSA memories, disclosure, and the start of intervention services, as well as present fears around symptoms (e.g., nightmares), addressing the trauma in treatment, and being in the presence of strangers for fear of harm. The narratives also included future-oriented safety fears that focused on potential re-victimization, concern that other children might experience sexual abuse by the same perpetrator, and more general worries that loved ones (e.g., family, friends) might be harmed by a CSA experience (Foster, 2017a). In terms of the content in the narratives, there were 1) descriptors of the sexual abuse (e.g., duration, acts) and perpetrators (e.g., relationship, use of coercion); 2) thoughts about themselves, their perpetrators, and the abuse; and 3) feelings that often included anger, fear, and sadness (Foster, 2017b). For the aftermath, narratives tended to include feelings related to the end of the relationship with the perpetrator and to the reactions of others upon disclosure, as well as changes in friendships following the abuse that included having greater or fewer friends and having experienced changes because of associated school transitions or moves to a different neighbourhood (Foster, 2017a). There also was information about the length of time before disclosure, reasons for disclosing or waiting, and to whom the abuse was disclosed as well as information about the boys’ experiences with the investigation process and, in some instances, with the judicial system (Foster, 2017b).

Study Objectives

Better understanding the information that men share about their CSA experiences is important in terms of being better prepared to support men’s stories and promote healing, whether in a personal or professional capacity. This study was an initial attempt to 1) examine, by way of a quantitative approach, the content of brief CSA narratives among 21 Canadian men with histories of childhood sexual harm and 2) explore emotion regulation strategies related to the creation of these narratives (and the link between emotion regulation and trauma narrative content). This study was of a preliminary and largely descriptive nature so there were no specific hypotheses about the way in which men would manage their CSA narrative-related emotions. However, we anticipated that there would be a tendency to rely on more unhelpful strategies (e.g., limited awareness and/or acceptance of feelings).

Methods

Participants and Procedures

The ethical aspects of this study were approved by our university’s office of research ethics and integrity. We relied on a subset of data previously collected as part of a larger project on the psychological and adaptive functioning of men with and without CSA histories. For the larger project, which also received university ethics approval, participants were recruited through study posters around the university, posts on the websites of community-based organizations that work with men, and social media. Men who expressed an interest in learning more about the project contacted the principal investigator (JM) who ensured that inclusionary criteria were met. Specifically, men were required to be between the ages of 25–59 years, fluent in English, and residing in relative proximity to the in-person data collection site. Men also completed a brief screening to determine whether they had experienced sexual harm during childhood, using the definition in the Criminal Code of Canada as sexual exploitation or contact/non-contact sexual acts before the age of 16 years with an individual in a position of authority, trust, or dependency (Department of Justice Canada, 2023). These recruitment and screening procedures resulted in a sample of 109 men who completed the larger project, with 69 men who reported having experienced CSA and 40 men who did not report a CSA history.

The participants in the larger project provided written consent to complete several data collection components over the course of 2–3 in-person meetings, including a clinical and diagnostic interview as well as clinician-administered (JM) and self-report questionnaires (Moorman & Romano, 2023). Participants were informed that they had the option to end their involvement in the project at any point or to skip any data collection component if they chose to do so. The larger project also included a neuroimaging component that examined, by way of functional magnetic resonance imaging (fMRI), emotional processing and working memory associations, resting state functioning, and traumatic autobiographical memory. For the latter, men who provided consent constructed a brief (30 s) CSA narrative that was audio-recorded, transcribed, and then audio-recorded again by the same male research assistant for all participants. The recorded narrative was played three times to participants while in the fMRI scanner to examine which and how parts of the brain were activated during this autobiographical memory task. Additional information about this neuroimaging script-driven imagery task may be found in Chiasson et al. (2022).

At the time that men constructed their CSA narrative, they also completed several questionnaires, one of which included the State Difficulties in Emotion Regulation Scale (S-DERS; Lavender et al., 2017) following the trauma construction. A meeting at a local research hospital was then scheduled so that men could listen to the recording of their CSA narrative while in an MRI scanner for purposes of examining various patterns of brain activity. Because the narratives were constructed for the neuroimaging data collection component, they were required to be brief and 30 s in duration. Careful attention was paid to participants’ well-being throughout the study. Breaks, refreshments, and check-ins were provided, and participants were provided with a list of resources (e.g., distress help lines) as well as monetary compensation in appreciation of their research involvement. In addition, participants were contacted by the primary investigator (JM) following the in-person data collection meetings to assess how they were feeling and to provide additional mental health resources, if requested. For additional information about the larger project’s sample and procedures, please see Moorman and Romano (2023).

For the current study, we relied on data from the transcribed narratives constructed by men who experienced CSA. Although there originally were 69 participants with CSA histories in the larger project, several declined participation in this component. There were 21 men with CSA experiences who constructed a trauma narrative, and a smaller subset (n = 15) met eligibility criteria for the neuroimaging component, which included such circumstances as few substance use difficulties, no recent head injury, no diagnosed attention-deficit/hyperactivity disorder, and certain height/weight parameters (Chiasson et al., 2022). The 21 men identified as cis-gender and had an average age of 40.6 years (SD = 10.4, range from 25–59). The men were primarily White (71.4%) and did not have children of their own (76.2%). Most men (57.1%) were in an intimate relationship, while 28.6% had never married, and 14.3% were separated or divorced. Around 4 in 10 men had high school as their highest completed level of education (42.8%), followed by community college/undergraduate studies (28.5%) and graduate school (19%). The majority of men (76.2%) were employed outside the home on a part- or full-time basis, and almost half (47.6%) reported a total household gross income of less than $29,000 in Canadian dollars.

Measures

CSA Narratives  

Men were instructed to provide a brief (approximately 30 s) account of their CSA experience (or choose the one that they felt was most difficult for them if there were multiple experiences). The narrative was audio-recorded and transcribed. The following script, which was formulated based on Frewen and Lanius’ (2010) script-driven imagery method, was read to each participant: “I’m going to ask you to tell me about your experience during a traumatic event. Can you think of any particular event related to childhood sexual abuse? Please be sure to tell me about things that you actually remember rather than things that other people may have told you or that you may have heard through the media. I want you to provide as much detail as you are comfortable revealing about the event. Our interest is not so much in what part of the event you choose to talk about, but rather in how you describe the event. So do not feel pressured to pick any particular event. In a few sentences, tell me about your most traumatic childhood sexual abuse experience.”

Emotion Regulation

The State Difficulties in Emotion Regulation Scale (S-DERS; Lavender et al., 2017) is a 21-item self-report measure of emotion regulation for a specific event or time frame (rather than a dispositional tendency). Individuals are asked to indicate the extent to which each item applies to their emotions right now, with response options ranging along a 5-point scale from 1 (not at all) to 5 (completely). The S-DERS includes four subscales: Non-acceptance of current emotions (7 items; I feel guilty for feeling this way; I feel like I’m a weak person for feeling this way.); Difficulties modulating emotional and behavioral responses in the present moment (7 items; My emotions feel overwhelming; I believe that I will continue feeling this way for a long time.); Lack of clarity about the current emotional state (2 items; I am confused about how I feel; I have no idea how I am feeling); and Limited awareness of emotional states (5 items; I am acknowledging my emotions; I believe that my feelings are valid and important). Note that the items for the awareness subscale were reversed scored so that higher scores indicated greater lack of awareness. In the current study, the S-DERS was administered following the construction of the CSA narrative. For the sample of 21 participants, the internal consistency for the total score was good (α = 0.84), while subscale internal consistencies were acceptable for modulation difficulties (α = 0.79) and limited awareness (α = 0.77), good for lack of clarity (α = 0.86), and excellent for non-acceptance (α = 0.92).

The subscales of the S-DERS seemed appropriate for examining the way men cope with talking about their childhood sexual victimization as they tap into the acceptance, modulation, clarity, and awareness of emotions. Past research has shown that men often avoid dealing with CSA-related feelings and may attempt to regulate difficult feelings with such harmful strategies as substance use and anger/aggression (e.g., Gauthier-Duchesne et al., 2023b; O’Leary et al. (2017). Moreover, dominant masculinity norms run counter to men developing skills around emotional awareness, acceptance, and regulation (e.g., sharing feelings with others) and often serve to silence men and contribute to mental health impairments, especially in instances where men have experienced sexual victimization (Easton, 2014; Gauthier-Duchesne et al., 2023b; Kaiser et al., 2020; Nodzenski & Davis, 2023).

Data Analyses

To address the first study objective, two research assistants used a quantitative approach to independently code the transcripts for the presence of information on 16 variables, namely 11 CSA characteristics (e.g., descriptors of the sexual acts, age, duration, perpetrator, disclosure) and 5 variables related to feelings and responsibility (e.g., feelings toward self, perpetrator, and abuse; responsibility of self or others). These variables of interest were determined by two study authors (ER, JM) based on their CSA research experience and involvement in the development of the larger project’s data collection measures and procedures. Note too that review of the transcripts showed that all CSA-related content was captured through this coding scheme. Disagreements in the coding of the data were resolved through discussion with a third reviewer (ER). The two research assistants (one of whom is co-author SD) who carried out the coding underwent training that consisted of reviewing the definition of each variable (and examples of what the variable did and did not include) and completing several transcripts that were then discussed with the authors who developed the coding to ensure understanding. Once the dichotomous coding of data was completed (i.e., presence or absence of each variable in the narrative), percentages were calculated as well as descriptions of the various categories.

To address the second study objective, we first calculated descriptive statistics (mean, standard deviation) for the S-DERS sub-scale scores. We then examined any links between the variables contained in the CSA narratives (dichotomous) and the S-DERS subscales (ordinal) using rank biserial correlations. We also examined any links between the amount of information contained in the CSA narratives (continuous variable that represented the total number of variables included in the narrative out of a possible 16) and the S-DERS subscales (ordinal) using kendall tau – which is well suited for examining correlations between continuous and ordinal variables. All analyses were conducted using SPSS version 28.

Results

CSA Narratives

CSA Characteristics

As a whole, the narratives of the 21 men captured much information on the characteristics of their childhood sexual victimization. Figure 1 indicates that all men made reference to the gender of the perpetrator, with the majority of perpetrators identified as male (16 of 21), followed by female (4 of 21), and both male and female (1 of 21). The majority (n = 18, 85.7%) indicated the types of sexual acts which were experienced, with most references to touching of private parts (12 of 18 men) followed by oral-genital contact (5 of 18 men). The majority of men (n = 18, 85.7%) also mentioned the location in which the sexual victimization occurred, with references to their childhood home (7 of 18), the perpetrator’s home (6 of 18), or another location, such as camp or a relative’s home (5 of 18). The majority (n = 15, 71.4%) also mentioned their age at the time of the event, with half of the men (8 of 15) indicating being preschool-aged (three to six years) and half (7 of 15) indicating being school-aged (seven to ten years). The majority of men (n = 15, 71.4%) also mentioned the age of the perpetrator in their narratives, with most (10 of 15) indicating that the perpetrator was an adult over 18 years of age, and 5 indicating that the perpetrator was under the age of 18. Finally, the majority of men (n = 15, 71.4%) detailed their relationship with the perpetrator, with most (7 of 15) indicating a stranger or acquaintance (e.g., babysitter, family friend), followed by a parental Fig. (4 of 15) or a sibling/extended family member (4 of 15).

Fig. 1.

Number of men (out of 21) who mentioned CSA characteristics in their trauma narratives

Other CSA characteristics appeared in the narratives, but to a much lesser degree. A little over one-third of the men (n = 8, 38.1%) spoke about the use of coercion around the sexual abuse, with half of the references (4 of 8) to threats of harm to family members if the abuse were disclosed, two references to physical restraint, one reference to threats of “getting into trouble”, and one reference to manipulation/bribery. A little over one-third (n = 8, 38.1%) spoke about the frequency of sexual victimization in either direct terms (e.g., perpetrator engaged in sexual abuse multiple times) or indirectly (e.g., perpetrator engaged in sexual abuse when a parent was absent). Finally, 6 of the 21 men (28.6%) indicated the involvement of other individuals in the CSA, either as additional perpetrators (4 of 6) or as other victims/witnesses (2 of 6). Finally, there were several CSA characteristics that were rarely mentioned in the men’s trauma narratives, namely disclosure and duration of the CSA.

Emotions and Responsibility

Figure 2 indicates that the majority of men (n = 15, 71.4%) spoke about feelings related to their childhood sexual victimization. The more commonly mentioned emotions included fear (4 of 15 men), disgust (4 of 15 men), and “difficult” (4 of 15 men). In four narratives, words such as “exciting”, “exploratory”, or “nice” were used, but the context was within a more complicated relationship with a perpetrator that had some positive aspects (e.g., someone with whom to talk) coupled with harm and fear. Other less commonly mentioned emotions included confusion and indifference. It should be noted that these numbers exceeded 21 because more than one emotion may have been reported in a narrative. One-third of the men (n = 7, 33.3%) expressed feelings about themselves as a victim. Of these men, most (4 of 7) spoke of shame/guilt while several mentioned feeling embarrassed of themselves. Feelings about the perpetrator were rarely expressed in the narratives of men in this study (n = 2, 13.3%), with several references to feeling anger and feeling disrespected.

Fig. 2.

Number of men (out of 21) who mentioned feelings and responsibility in their trauma narratives

In terms of issues of responsibility, there were four men (19.0%) who indicated the responsibility of others in their narratives. Specifically, they spoke about how the perpetrators used typical caregiving circumstances (e.g., bathing a child) to conceal the CSA as well as manipulation, bribes, and threats of harm to a loved one to prevent disclosure of the CSA. None of the narratives mentioned the extent to which men blamed or did not blame themselves for the sexual harm that they experienced.

Summary

Overall findings showed that, despite the brief nature of the task, men provided rich information on the CSA characteristics as well as on their feelings and issues of responsibility. For CSA characteristics, most narratives (71.4—100%) contained information about perpetrator gender, age, and relationship, about the types of sexual acts that were experienced and where they occurred, and about child age at the time of the sexual victimization. Other information included in the narratives involved CSA frequency, the use of coercion, and the involvement of other individuals, although these variables were only mentioned in 28.6 – 38.1% of the men’s narratives. Finally, there was little to mention in the narratives of CSA duration or disclosure issues. For emotions and responsibility, most narratives (71.4%) contained information about men’s CSA-related emotions (e.g., fear, disgust), but emotions toward the perpetrator or toward themselves as a victim were rarely to moderately mentioned. Similarly, the narratives rarely contained information around responsibility, although several men spoke about the fact that perpetrators rightly bore the responsibility of the CSA.

Emotion Regulation

Emotions Following Trauma Narrative Construction

Following the construction of their brief CSA narrative, men completed a state-based emotion regulation measure. Scores for the subscales were as follows: non-acceptance (M = 13.0, SD = 6.7, potential range from 7–35); modulation difficulties (M = 11.6, SD = 4.6, potential range from 7–35); limited awareness (M = 12.4, SD = 4.3, potential range from 5–25); and lack of clarity (M = 3.6, SD = 2.2, potential range from 2–10). The mean scores for non-acceptance, modulation difficulties, and lack of clarity fell closer to the lower end of possible scores, indicating that men did not report many narrative-related emotion regulation difficulties. For limited awareness, the mean score was closer to the middle range of possible scores, suggesting that there was an average level of awareness of feelings following the construction of the trauma narrative.

Link Between Emotion Regulation and CSA Narrative Characteristics  

We explored the correlations between specific variables contained in the CSA narratives and emotion regulation following construction of the trauma narrative (using the S-DERS subscales). Although there were several associations that almost reached statistical significance, findings indicated one statistically significant association between lack of clarity and CSA feelings (Spearman r = −0.48, p = 0.03). This suggests that men who had narratives that included information about their CSA-related feelings had lower scores on lack of clarity (i.e., had a clearer sense of their feelings).

We were also interested in examining whether the amount of information contained in the CSA narrative had any relationship with emotion regulation following its construction. Results showed that greater amount of information contained in the trauma narratives (i.e., number of variables out of a total of 16 that were coded) was associated with fewer narrative-related difficulties around awareness of feelings (Kendall’s tau = −0.35, p = 0.04). Focusing specifically on CSA characteristics, greater inclusion of this information in the narratives was associated with fewer narrative-related emotion modulation difficulties (Kendall’s tau = −0.36, p. = 0.04). Focusing specifically on feelings and issues of responsibility, greater inclusion of this information in the CSA narratives was associated with fewer narrative-related difficulties around awareness of feelings (Kendall’s tau = −0.43, p = 0.02).

Discussion

This descriptive study was intended to provide preliminary data about the way men who experienced sexual harm while growing up talk about their trauma as adults. We adopted a quantitative approach to capture the types of information contained in men’s brief CSA narratives and to explore men’s emotion regulation strategies immediately following construction of the narrative. As previously mentioned, the current study was part of a larger project. The sample in the current study was small primarily because the CSA narrative was part of a neuroimaging data collection component that had exclusionary criteria which eliminated the potential participation of a number of men. As such, our interpretation of findings from this exploratory study, coupled with the fact that the narratives were brief, is preliminary in nature. However, there were several interesting findings that can form the basis for additional research on male CSA, which continues to be an issue of significant concern that requires on-going research and discussion in public forums to minimize the stigma that often silences victims.

For the first objective around examining the content of the trauma narratives, men provided details about the CSA (e.g., perpetrator information, types of sexual abuse experienced, age at the time of victimization), their feelings (e.g., fear, disgust), and in only a few instances, statements about the perpetrator’s responsibility for the abuse. It is difficult to map these findings onto existing ones because of limited past research. However, the information that we examined quantitatively in men’s CSA narratives seems aligned with Foster’s (2017b) qualitative analysis of boys’ trauma narratives that included descriptors of the sexual acts and information about the perpetrators. Moreover, fear as the most-frequently identified emotion in men’s trauma narratives is aligned with Foster’s (2017a) findings for boys’ CSA narratives where “fear and safety” was a predominant theme. Unlike the findings from Foster (2017a, 2017b), men in the current study rarely mentioned the issue of disclosure or the impacts of the CSA on their well-being and functioning. The narratives in Foster’s (2017b) study were in a treatment context and would have allowed boys the opportunity for elaboration – unlike the more circumscribed current study where men constructed 30-s narratives for purposes of a neuroimaging component of a larger research project. As such, it is difficult to know if the greater detail in the boys’ narratives was a function of the context, the sample (boys whose CSA was recent versus men in the current study who ranged in age from 29–59 years and whose CSA was a more distal experience), and/or the way in which participants approached the task.

It is worth noting that men in the current study often provided rich information about CSA characteristics but almost never mentioned disclosure. It is possible that this information may have been communicated with a lengthier task or with some prompting on the part of the researcher. It is also possible that the experience in the narrative was not disclosed and so, men did not see the relevance of mentioning an event that did not occur. Finally, it may be that the disclosure experiences were difficult and so, men chose not to talk about an emotional event as part of their brief trauma narrative. It is important to again emphasize that disclosure of childhood sexual victimization is often extremely difficult for all victims. Past research has found that men who choose to disclose often wait many years and even decades before confiding in a trusted individual (Easton, 2013; Romano et al., 2019).

For the second objective of exploring men’s emotion regulation strategies immediately following construction of their CSA narrative, the mean scores from the four subscales of the S-DERS indicated few difficulties around the acceptance, modulation, and clarity of feelings. The mean score for awareness of feelings was in the average range. These findings were not aligned with our expectations. Given the length of time since the childhood sexual victimization, it may be that men in the current study had past opportunities to process their CSA-related emotions. It is also possible that men who consented to the research project were more comfortable sharing their past sexual victimization experiences and associated feelings. It is also possible that men were hesitant to indicate the extent of their difficulties with emotion regulation so that there may have been a bias in responding (which is always a possibility with self-report measures). This latter possibility is worth noting given that neuro-imaging findings from a subset of our participants indicated autobiographical memory impacts (i.e., less activation in associated brain regions) for their CSA experiences, and autobiographical memory is associated with such processes as emotion regulation (Chiasson et al., 2022).

Turning to the links between variables contained in the CSA narratives and emotion regulation strategies, there was only one statistically significant correlation. Specifically, men who included information about their CSA-related emotions also reported greater clarity about their emotions, which makes intuitive sense. Given the correlational nature of the findings, it is also possible that men who have greater clarity about their emotions include more emotion-related information in their trauma narratives. For the other subscales in the emotion regulation measure (non-acceptance, modulation difficulties, limited awareness), several approached statistical significance so it is possible that a larger sample size would have provided the statistical power needed to observe significant relationships.

Several interesting findings appeared when examining the link between the totality of information contained in the CSA narratives and related emotion regulation. When the narratives included more information about CSA characteristics, there were fewer self-reported difficulties with the modulation of narrative-related emotions. In addition, when the narratives included more information around emotions and issues of responsibility, there was a greater self-reported awareness of emotions. Although there is no past research with which to compare the current study findings, it seems likely that talking about the trauma helped with regulating emotions that arose from the narrative and gaining awareness of the emotions experienced after the narrative. Given the correlational nature of findings, however, it is also possible that greater emotional awareness and a greater ability to modulate emotions helped men create CSA narratives that were richer in the amount of detail that was communicated.

Limitations and Future Research Considerations

The current study provided a snapshot of the information contained in men’s CSA narratives and the way they managed emotions that arose from the narrative construction. The small sample size limited our ability to draw more definitive conclusions about the research questions and about the stability of the correlations between the trauma narrative content and emotion regulation strategies. Also, the narratives were very brief because they were originally constructed for a neuroimaging component of a larger research project that did not require a lengthy narrative. While acknowledging that this brief timeframe likely limited the amount of information that men could share about their sexual victimization experiences, we were also mindful of minimizing potential distress given that the task was intended for research, and not clinical, purposes. There is information from the adult psychiatry field (Mazza et al., 2022) that 5-min speech samples can effectively capture key information related to expressed emotion from caregivers of adult patients and its relationship with patients’ mental health functioning (i.e., schizophrenia, depression). However, it is difficult to know whether this duration would be applicable in the current context as the 5-min timeframe has not been examined with individuals who have experienced childhood sexual victimization, using their own verbalizations (rather than those of family members). Given the novelty of the current study, it would seem important for future research to experiment with different time lengths for the development of trauma narratives within a research context.

Research that builds on this study would benefit from a larger sample that is more representative in nature (e.g., gender and sexual identity, race and ethnicity). It would also be important to provide men with the opportunity to elaborate on their CSA narrative, perhaps in a more conversational manner. With these suggestions, it would then be possible to conduct rigorous quantitative analyses to explore, for example, the way various trauma narrative variables predict emotion regulation strategies (controlling for such variables as victimization factors and current diagnostic functioning as well as testing interaction effects) and to conduct person-centered analyses to identify profiles of men’s CSA-related emotion regulation strategies. More elaborate CSA narratives would also provide an opportunity to conduct qualitative thematic analyses.

Conclusion

It would be best to consider this study as offering a snapshot of the way men communicate about their childhood sexual victimization experiences and of the strategies used to manage associated emotions. The findings point to the need to create safe, validating spaces for men to share details of their childhood sexual harm as well as emotions related to their experiences and themselves as victims. This is needed to de-stigmatize and heal from these painful and impactful experiences. It would seem especially important to explore issues of disclosure and notions of responsibility as these were rarely mentioned in the narratives. Disclosure (and the reactions of others) is a critical topic given past research indicating that greater delays in sharing CSA are related to greater impairments in men’s mental well-being and functioning (Easton, 2013, 2014; Romano et al., 2019). Exploring the impediments to healing caused by masculinity norms would also seem important given the negative impact of such norms on men’s emotion regulation abilities and trauma processing (Kaiser et al., 2020), alongside the relationship between effective emotion regulation and mental health outcomes among men who have experienced CSA. In addition to giving men a safe space to share their CSA, it also seems important to provide on-going opportunities for sharing as the study findings showed an association (although the direction is unclear) between more elaborate and information-rich narratives and several aspects of more helpful emotion regulation strategies (modulation, awareness). The sharing of CSA experiences is part of evidence-based treatment frameworks and interventions. We also wish to underscore O’Gorman et al.’s (2023) conclusion that CSA interventions must be gender-sensitive given the challenges associated with childhood sexual victimization in men (e.g., masculinity norms, disclosure, avoidance of emotional exploration).

Author Contributions

All authors were involved in the conception and design of the study. J. Moorman and E. Romano were involved in data collection. E. Romano and S. Dyyat were involved in data analysis and in writing the first draft of the manuscript. All authors were involved in reviewing various drafts of the manuscript as well as in reading and approving the final manuscript.

Funding

This study was partially supported by a team grant from the Canadian Institutes of Health Research (610738–190799; Principal Investigator Dr. Christine Wekerle).

Declarations

Competing Interests

The authors, E. Romano, S. Dyyat, and J. Moorman, have no competing financial or non-financial interests to declare related to this research study.

Ethics Approval

The ethical aspects of the current study were approved by our University’s Office of Research Ethics and Integrity. All individuals provided written informed consent to participate in the larger research project from which data for the current study were based.