Childhood sexual abuse and recovery trajectories among Jewish women survivors: A longitudinal comparison of trauma characteristics and clinical outcomes across the religious spectrum.

BACKGROUND: Despite comparable Childhood sexual abuse (CSA) rates in Orthodox and ultra-Orthodox Jewish communities relative to the general population, data on abuse characteristics, mental health outcomes, and longitudinal treatment results in these groups remain scarce. OBJECTIVE: To examine CSA characteristics, trauma-related psychopathology, and one-year treatment outcomes across religiosity levels among Jewish women CSA survivors. PARTICIPANTS AND SETTING: Jewish women CSA survivors (N = 122) across the religious spectrum (secular, traditional, Orthodox, and ultra-Orthodox) receiving phase-oriented psychotherapy at specialized public trauma centers in Israel. METHODS: Participants self-reported at treatment initiation and after 12 months on levels of religiosity (childhood and adulthood), childhood maltreatment (CM), posttraumatic stress disorder (PTSD) symptoms, dissociation, borderline personality (BPD) traits, and perceived spiritual support. CSA characteristics and psychiatric history were assessed at baseline via semi-structured clinical interviews. RESULTS: No significant baseline differences were found between religiosity groups in CSA characteristics, CM, PTSD, dissociation, or psychiatric history, except for higher psychiatric medication use among secular and traditional women. While most participants reported continuity in their childhood religiosity into adulthood, a substantial minority reported change, predominantly toward lower religiosity (35.0% less religious vs. 9.2% reporting increased religiosity). Linear mixed-effects models revealed significant main effects of time on PTSD symptoms and dissociation. Within-group analyses indicated significant reduction in PTSD symptoms among secular and Orthodox women, and in dissociation among secular and traditional women. BPD traits and spiritual support remained stable over time. CONCLUSIONS: Despite similar abuse profiles across Jewish religious affiliations, clinical trajectories differed across the religious spectrum, highlighting the importance of incorporating religiosity into trauma treatment.