Silence is golden – or is it not?

Many people who experienced childhood sexual abuse never tell anyone, or wait many years before they do, often out of shame, guilt or fear of how others will respond. In our earlier study, we investigated whether people who disclosed their experiences differed in symptoms and social support from people who did not disclose. But does disclosure actually change how people feel, and how supported they are? Or do pre-existing differences between people who do and do not disclose explain what we found? 

To study this, we followed the adults with a history of childhood sexual abuse who had never disclosed it to friends or family members, a group that is rarely studied. We invited these participants to complete another questionnaire six months later. Forty participants completed both assessments. This allowed us to examine who disclosed for the first time during those six months, to whom they disclosed, what kind of responses they received, and whether their posttraumatic stress disorder (PTSD) symptoms changed. We also investigated how supported they felt during disclosure. 

Who do people tell, and how do confidants respond? 

By the six-month follow-up, sixty percent of the participants (24 out of 40) had disclosed their experiences for the first time. We refer to these participants as ‘disclosers’, and to those who had remained silent as ‘non-disclosers’. On average, disclosers had waited 31.5 years before telling friends or family about their experiences. Most chose to tell a friend rather than a partner, family member, or colleague.  

The responses disclosers received were generally positive. People reported being reassured that they were not to blame, being asked about what they needed, and being offered comfort. These responses were more positive than those reported in similar studies. Perhaps the long delay led people to choose their confidants carefully, or the baseline assessment may have prepared them for disclosure. 

What happened to PTSD symptoms? 

Disclosers showed a significant reduction in PTSD symptoms from baseline to follow-up, whereas non-disclosers showed no significant change. At follow-up, disclosers also reported fewer PTSD symptoms than non-disclosers. A somewhat surprising finding was that the decrease in PTSD symptoms was not associated with the perceived supportiveness of the responses to their disclosure. This may be because receiving mostly positive responses was the norm in our sample, making it difficult to detect differences between supportive and unsupportive reactions.

Speaking may be golden, at least for some 

It is important to note that we cannot conclude that disclosure itself caused the reduction in PTSD symptoms. Our sample was small and other variables that we did not measure could have influenced both the decision to disclose and the reduction in symptoms. What the findings do suggest is that breaking the silence, even many years later, may be associated with improvements in symptoms.  

For clinicians, this means that they can help clients with a traumatic (sexual) experience to consider also disclosing it to a close person in their private life. Clinicians may support them in thinking about whether, when, and to whom they want to tell, while taking into account the client’s readiness, preferences and context. Future studies should focus more on understanding the mechanisms of disclosure, to find out for whom disclosure is most helpful and for whom is not. Only then can we better support people who are unsure about speaking up. Since silence about childhood sexual abuse is seldom golden. 

The full, peer-reviewed paper “From silence to sharing: A six-month prospective study on adult disclosure of childhood sexual abuse” has been published open access in the scientific journal ‘Child Abuse & Neglect’. 

Interested to learn more about this topic? Read Kyra's previous blog post 'Behind the silence of childhood sexual abuse' here.