Panken criticizes Louise DeSalvo's book, Virginia Woolf: The Impact of Childhood Sexual Abuse on Her Life and Work. Panken disputes DeSalvo's major contention that "sexual violence" by Woolf's half-brothers, Gerald and George Duckworth, is a central theme in her writing and had a serious impact on her psychopathology. This sexual exploitation was "neither annihilating nor instrumental in leading to her early suicide attempt or to her suicide." The author states that the important factors in Woolf's suicide were her cyclothymic predisposition, characterological depression, decreased self-esteem, fear of losing her writing ability, and a loss of closeness in her intimate relationships.