Sigurdardottir, Sigrun; Halldorsdottir, Sigridur
Stressful early life experiences cause immune dysregulation across the lifespan. Despite the fact that studies have identified childhood sexual abuse (CSA) survivors as a particularly vulnerable group, only a few attempts have been made to study their lived-experience of the physical health consequences of CSA. The aim of this study was to explore a female CSA survivor’s lived-experience of the physical health consequences of CSA and how she experienced the reactions of healthcare providers. Seven interviews were conducted with this 40-year-old woman, Anne, using a phenomenological research approach. Anne was still a young child (two to three years old) when her father started to rape her. Since her childhood, she has experienced complex and widespread physical health consequences such as repeated vaginal and abdominal infections, widespread and chronic pain, sleeping problems, digestive problems, chronic back problems, fibromyalgia, musculoskeletal problems, repeated urinary tract infections, cervical dysplasia, inflammation of the Fallopian tubes, menorrhagia, endometrial hyperplasia, chlamydia, ovarian cysts, ectopic pregnancies, uterus problems, severe adhesions, and ovarian cancer. Anne disclosed her CSA experience to several healthcare providers but they were silent and failed to provide trauma-informed care. Anne’s situation, albeit unique, might reflect similar problems in other female CSA survivors. PMID:29316709
Estévez, Ana; Ozerinjauregi, Nagore; Herrero-Fernández, David; Jauregui, Paula
Child abuse is a traumatic experience that may have psychological consequences such as dysfunctional beliefs. The aim of this study was to analyze the impulsive behaviors (alcohol abuse, gambling, drug abuse, eating disorders, Internet abuse, videogame abuse, shopping and sex addiction) in sexual abuse survivors and to study the mediating role of early maladaptive schemas in the appearance of impulsive behaviors in adult female victims. The sample consisted of 182 adult women who had suffered childhood sexual abuse (CSA), mostly referred by associations for the treatment of childhood abuse and maltreatment. Sexual abuse was found to be positively related to the domains of Disconnection/Rejection and Impaired Autonomy. Moreover, these domains were significantly related to impulsivity and impulsive behaviors. Finally, the Disconnection/Rejection domain was found to mediate between CSA and eating disorders and alcohol abuse. These results may provide important guidance for clinical intervention. © The Author(s) 2016.
Chouliara, Zoe; Karatzias, Thanos; Scott-Brien, Georgia; Macdonald, Anne; MacArthur, Juliet; Frazer, Norman
This study aimed to elicit perceptions and experiences of talking therapy services for CSA survivors and professionals utilizing qualitative interviews and analyzing transcripts using Interpretative Phenomenological Analysis. Participants included 13 adult survivors and 31 professionals in statutory and voluntary services in Scotland. Main themes…
Ginzburg, Karni; Arnow, Bruce; Hart, Stacey; Gardner, William; Koopman, Cheryl; Classen, Catherine C.; Giese-Davis, Janine; Spiegel, David
Objective: To evaluate the psychometric properties of a new measure, the Abuse-Related Beliefs Questionnaire (ARBQ), designed to assess abuse-related beliefs among adult survivors of childhood sexual abuse (CSA). Study 1 examined the structure of the scale, and Study 2 evaluated its reliability and validity. Method: One hundred and seventy female…
Cavanaugh, Courtenay E.; Harper, Bianca; Classen, Catherine C.; Palesh, Oxana; Koopman, Cheryl; Spiegel, David
Child sexual abuse (CSA) has been associated with a number of problems affecting women over their lifespan, including difficulties with parenting. However, there is a modest number of qualitative studies examining the impact of CSA on survivors who are mothers. There is a particular need for qualitative investigations that ask survivors who are mothers general questions about the impact of CSA on their lives rather than those that specifically ask about the impact of CSA on parenting. The former approach would allow survivors to describe effects that may impact parenting, but which survivors do not consciously link to affecting their parenting. Such information may inform interventions to assist this population of survivors. This secondary data analysis examined themes revealed in interviews with 44 survivors of CSA who were mothers. Participants were seeking treatment for their CSA and completed an in-person interview where they were asked open-ended questions about the sexual abuse they experienced as a child and how their abuse affects them now as adults. The interviews were recorded, transcribed, and coded using thematic analysis. The following six themes emerged from the narratives: 1) being a parent, 2) family of origin dysfunction, 3) the impact of abuse, 4) the abuse history and response to abuse, 5) coping, and 6) hopes and desires for the future. This study highlights several ways in which CSA impacts survivors who are mothers, areas for further study, and the need for interventions to assist this population in meeting the challenges they face as mothers. PMID:26301437
Ullman, S.E.; Filipas, H.H.
Objective: This research examines the understudied issue of gender differences in disclosure, social reactions, post-abuse coping, and PTSD of adult survivors of child sexual abuse (CSA). Method: Data were collected on a cross-sectional convenience sample of 733 college students completing a confidential survey about their demographic…
Griffing, Sascha; Lewis, Carla S; Jospitre, Tania; Chu, Melissa; Sage, Robert; Primm, Beny J; Madry, Lorraine
Research suggests that the use of disengaged or avoidant strategies to cope with interpersonal violence contributes to the development of depressive symptoms and other psychological difficulties. Survivors of childhood sexual abuse (CSA) who are exposed to subsequent episodes of abuse may be more likely to rely on disengaged coping strategies, placing them at elevated risk of psychological symptomatology. In this study, we explored the interrelationships between coping, depression, and self-esteem in an ethnically diverse sample of domestic violence survivors (N = 219) with and without a history of CSA. As predicted, CSA survivors (n = 86) reported significantly greater use of disengaged coping strategies (wishful thinking, self-criticism, and social withdrawal) than non-CSA survivors (n = 133). As hypothesized, both a CSA history and the use of disengaged coping significantly predicted higher levels of depression and lower self- esteem. Clinical implications of the findings are discussed.
Edmond, Tonya; Rubin, Allen
This 18-month follow-up study builds on the findings of a randomized experimental evaluation that found qualified support for the short-term effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) in reducing trauma symptoms among adult female survivors of childhood sexual abuse (CSA). The current study provides preliminary evidence…
Griffing, Sascha; Lewis, Carla S.; Chu, Melissa; Sage, Robert; Jospitre, Tania; Madry, Lorraine; Primm, Beny J.
Research suggests that the use of disengaged or avoidant strategies to cope with interpersonal violence contributes to the development of depressive symptoms and other psychological difficulties. Survivors of childhood sexual abuse (CSA) who are exposed to subsequent episodes of abuse may be more likely to rely on disengaged coping strategies,…
Lev-Wiesel, Rachel; First, Maya
The aim of the study was to examine the role of gender in willingness to disclose childhood sexual abuse (CSA) compared to other forms of abuse (physical, emotional and neglect) in young adolescents. Willingness was examined through two terms: reluctance- the level of unwillingness or disinclination to disclose, and urge-the need to share in order to get rid of unbearable feelings. The sample consisted of 3,156 boys (n = 1,544) and girls (n = 1,612) between the ages of 11-16 who reported having been abused at least once during their life. Participants were divided into three groups: experiencing other than CSA, sexual abuse with no physical contact, and sexual abuse with physical contact. Regarding measures, a self-report questionnaire incorporating the following instruments was administered: Demographics, the Juvenile Victimization Questionnaire (JVQ), and the Disclosure of Trauma Questionnaire (DTQ). Study results indicated that CSA victims were more reluctant to disclose than victims of other than CSA forms of abuse. The more severe the CSA (physical contact) the lower was the willingness to disclose. Boys were more reluctant than girls to disclose sexual abuse whether or not it involved physical contact. Reluctance to disclose was positively associated with emotional reactions to disclosure while urge to talk was negatively correlated with emotional reactions to disclosure. Copyright © 2018. Published by Elsevier Ltd.
Gesink, Dionne; Nattel, Lilian
The childhood sexual abuse (CSA) survivor population is substantial and survivors have been identified as part of the population who were under-screened or never-screened for breast, cervical and colon cancer. Our objective was to learn CSA survivor perspectives on, and experiences with, breast, cervical and colon cancer screening with the intention of generating recommendations to help healthcare providers improve cancer screening participation. A pragmatic constructivist qualitative study involving individual, semistructured, in-depth interviews was conducted in January 2014. Thematic analysis was used to describe CSA survivor perspectives on cancer screening and identify potential facilitators for screening. A diverse purposive sample of adult female CSA survivors was recruited. The inclusion criteria were: being a CSA survivor, being in a stable living situation, where stable meant able to meet one's financial needs independently, able to maintain supportive relationships, having participated in therapy to recover from past abuse, and living in a safe environment. 12 survivors were interviewed whose ages ranged from the early 40s to mid-70s. Descriptive saturation was reached after 10 interviews. Interviews were conducted over the phone or Internet. CSA survivors were primarily from urban and rural Ontario, but some resided elsewhere in Canada and the USA. The core concept that emerged was that compassionate care at every level of the healthcare experience could improve cancer screening participation. Main themes included: desire for holistic care; unique needs of patients with dissociative identity disorder; the patient-healthcare provider relationship; appointment interactions; the cancer screening environment; and provider assumptions about patients. Compassionate care can be delivered by: building a relationship; practising respect; focusing attention on the patient; not rushing the appointment; keeping the environment positive and comfortable; maintaining
Jacob, Christine M. Anderson; Veach, Patricia McCarthy
Intrapersonal and familial effects of childhood sexual abuse (CSA) were investigated by interviewing 10 female partners of male survivors. Consensual qualitative research analysis (C. Hill, B. Thompson, & E. Nutt Williams, 1997) yielded 13 domains describing male partner, female partner, couple, and family functioning. Findings concerning…
Wilson, Jane E; Wilson, Keith M
Although sexual dysfunction of childhood sexual abuse survivors has received considerable attention, other sexual difficulties experienced by survivors of CSA, such as sexual fantasies to cues of sexual abuse, have received less attention. In this A-B design case study, a young adult female survivor of childhood sexual abuse presented for treatment at a Midwest rape crisis center. After successful treatment of post-traumatic stress disorder, she complained of unwanted sexual fantasies to sexual abuse cues and concomitant guilt and shame. Following baseline data collection, treatment consisted of self-applied aversion therapy to unwanted sexual arousal to sexual abuse cues. Decrease in sexual arousal to these cues was concurrent with the introduction of treatment. A concomitant decrease in guilt and shame occurred while self-ratings of control increased.
Bonanno, George A; Colak, Deniz M; Keltner, Dacher; Shiota, Michelle N; Papa, Anthony; Noll, Jennie G; Putnam, Frank W; Trickett, Penelope K
Positive emotions promote adjustment to aversive life events. However, evolutionary theory and empirical research on trauma disclosure suggest that in the context of stigmatized events, expressing positive emotions might incur social costs. To test this thesis, the authors coded genuine (Duchenne) smiling and laughter and also non-Duchenne smiling from videotapes of late-adolescent and young adult women, approximately half with documented histories of childhood sexual abuse (CSA), as they described the most distressing event of their lives. Consistent with previous studies, genuine positive emotional expression was generally associated with better social adjustment two years later. However, as anticipated, CSA survivors who expressed positive emotion in the context of describing a past CSA experience had poorer long-term social adjustment, whereas CSA survivors who expressed positive emotion while describing a nonabuse experience had improved social adjustment. These findings suggest that the benefits of positive emotional expression may often be context specific.
Cantón-Cortés, David; Cantón, José; Cortés, María Rosario
The Emotional Security Theory (EST) was originally developed to investigate the association between high levels of interparental conflict and child maladaptative outcome. The objective of the present study was to analyze the effects of emotional security in the family system on psychological distress among a sample of young female adult survivors of child sexual abuse (CSA). The role of emotional security was investigated through the interactive effects of a number of factors including the type of abuse, the continuity of abuse, the relationship with the perpetrator and the existence of disclosure for the abuse. Participants were 167 female survivors of CSA. Information about the abuse was obtained from a self-reported questionnaire. Emotional security was assessed with the Security in the Family System (SIFS) Scale, and the Symptom Checklist-90-Revised (SCL-90-R) was used to assess psychological distress. In the total sample, insecurity (preoccupation and disengagement) was correlated with high psychological distress scores, whereas no relationship was found between security and psychological distress. The relationship between emotional insecurity and psychological distress was stronger in cases of continued abuse and non-disclosure, while the relationship between emotional security and distress was stronger in cases of extrafamilial abuse and especially isolated or several incidents and when a disclosure had been made. No interactive effect was found between any of the three emotional variables and the type of abuse committed. The results of the current study suggest that characteristics of CSA such as relationship with the perpetrator and, especially, continuity of abuse and whether or not disclosure had been made, can affect the impact of emotional security on psychological distress of CSA survivors. Copyright © 2015 Elsevier Ltd. All rights reserved.
Wark, Joe; Vis, Jo-Ann
Research shows that child sexual abuse (CSA) can have detrimental effects on adult functioning. While much research regarding the effects of CSA on parenting of mothers is available, there is a dearth of information on how CSA impacts fatherhood. This literature review finds that the parenting experiences of male survivors are characterized by self-perceptions as adequate parents, deficient parenting as measured by standardized instruments, conceptualization of parenting as an intergenerational legacy and potential healing experience, fear of becoming an abuser, and physical and emotional distance from their children. These themes are strongly related to social discourses on intergenerational cycle of violence theories. Fatherhood is not exclusively problematic for male survivors and can be a healing experience and a source of strength for some survivors. Based on literature concerning male survivors who are parents, narrative therapy is recommended as a therapeutic model to explore how fathers who are survivors challenge dominant discourses around legacies of family violence, intergenerational parenting deficiencies, and victimization. Restorying fatherhood as a healing opportunity is essential when working with fathers who are male survivors and their families. © The Author(s) 2016.
Musliner, Katherine L; Singer, Jonathan B
The goals of this study were to evaluate the effects of emotional support from friends and parents at two time points (adolescence and adulthood) on adult depression in a nationally representative sample of survivors of childhood sexual abuse (CSA), and examine whether the associations were moderated by the identity of the perpetrator (parent/caregiver vs. not). Data were taken from Waves I and IV of the National Longitudinal Study of Adolescent Health (Add Health). The study sample included 1,238 Add Health participants with a history of CSA and an equivalently sized comparison group of individuals with no history of CSA. Parental support was measured using four items from each wave that assessed the warmth of participants' relationships with their parents and their satisfaction with those relationships. Friend support in adolescence was measured using participants' perceptions of how much their friends cared about them and in adulthood using participants' self-reported number of close friends. Depression was measured using a 10-item subscale of the CES-D. Logistic regressions showed that support from friends and parents in adulthood were significantly associated with lower odds of adult depression in CSA survivors who reported non-parent/caregiver abuse. Among survivors of parent/caregiver abuse, emotional support was not significantly associated with adult depression regardless of when or by whom it was provided. In conclusion, emotional support in adulthood from friends and parents is associated with reduced odds of adult depression in CSA survivors, but only in cases where the abuse was perpetrated by someone other than a parent or caregiver. Copyright © 2014 Elsevier Ltd. All rights reserved.
Niehaus, Ashley F; Jackson, Joan; Davies, Stephanie
Childhood sexual trauma has been demonstrated to increase survivors' risk for engaging in unrestricted sexual behaviors and experiencing adolescent sexual assault. The current study used the sexual self-schema construct to examine cognitive representations of sexuality that might drive these behavioral patterns. In Study 1 (N = 774), we attempted to improve the content validity of the Sexual Self Schema Scale for child sexual abuse (CSA) survivors, introducing a fourth sexual self-schema factor titled the "immoral/irresponsible" factor. In Study 2 (N = 1150), the potential differences in sexual self-views, as assessed by the four sexual self-schema factors, between CSA survivors and non-victims were explored. In addition, Study 2 evaluated how these sexual self-schema differences may contribute to participation in unrestricted sexual behaviors and risk for sexual assault in adolescence. Results indicated that a history of CSA impacted the way women viewed themselves as a sexual person on each of the four factors. CSA survivors were found to view themselves as more open and possessing more immoral/irresponsible cognitions about sexuality as compared to women who did not have a CSA history. In addition, the CSA survivors endorsed less embarrassment and passionate/romantic views of their sexual selves. The interaction of CSA severity and the sexual self-schemas explained variance in adolescent sexual assault experiences above and beyond the severity of CSA history and participation in risky sexual behaviors. The findings suggest that sexual self-views may serve to moderate the relationship between CSA and adolescent sexual assault. Implications of these findings and directions for future research are discussed.
Samson, Alana; And Others
This booklet offers information about sources of help for First Nations adult survivors of childhood sexual abuse, particularly in Canada. It explains the definition of sexual abuse and describes the specifics of the law regarding such abuse. Descriptions of common aspects of childhood sexual abuse include quotes from adult survivors. Long-term…
Wolf, Molly R; Nochajski, Thomas H
Although the issue of dissociative amnesia in adult survivors of child sexual abuse has been contentious, many research studies have shown that there is a subset of child sexual abuse survivors who have forgotten their abuse and later remembered it. Child sexual abuse survivors with dissociative amnesia histories have different formative and therapeutic issues than survivors of child sexual abuse who have had continuous memory of their abuse. This article first discusses those differences in terms of the moderating risk factors for developing dissociative amnesia (e.g., age, ethnicity, gender, etc.) and then mediating risk factors (e.g., social support, trait dissociativity, etc.). The differences between the two types of survivors are then explored in terms of treatment issues.
Carr, Alan; Dooley, Barbara; Fitzpatrick, Mark; Flanagan, Edel; Flanagan-Howard, Roisin; Tierney, Kevin; White, Megan; Daly, Margaret; Egan, Jonathan
Objective: To document the adult adjustment of survivors of childhood institutional abuse. Method: Two hundred and forty-seven adult survivors of institutional abuse with a mean age of 60 were interviewed with a protocol that included the Childhood Trauma Questionnaire, modules from the Structured Clinical Interview for Axis I Disorders of DSM IV…
Harding, Hilary G.; Zinzow, Heidi M.; Burns, Erin E.; Jackson, Joan L.
Previous research suggests that similarity to a victim may influence attributions of responsibility in hypothetical child sexual abuse scenarios. One aspect of similarity receiving mixed support in the literature is respondent child sexual abuse history. Using a sample of 1,345 college women, the present study examined child sexual abuse history,…
Postmus, Judy L; Plummer, Sara-Beth; McMahon, Sarah; Murshid, N Shaanta; Kim, Mi Sung
Intimate partner violence (IPV) often includes economic abuse as one tactic commonly used by an abuser; unfortunately, there is a lack of empirical understanding of economic abuse. Additionally, research is limited on the predictors of economic self-sufficiency in the lives of women experiencing IPV. This paper furthers our knowledge about economic abuse and its relationship with economic self-sufficiency by presenting the results from an exploratory study with IPV survivors participating in a financial literacy program. Of the 120 individuals who participated in the first wave, 94% experienced some form of economic abuse, which also correlated highly with other forms of IPV. Seventy-nine percent experienced some form of economic control, 79% experienced economic exploitative behaviors, and 78% experienced employment sabotage. MANOVA results also indicated that economic control differed significantly based on education with those with a high school education experiencing higher rates than those with less than high school education or those with some college. Finally, results from the OLS regressions indicated that experiencing any form of economic abuse as well as economic control significantly predicted a decrease in economic self sufficiency. Implications suggest that advocates should assess for economic abuse when working with survivors and should be prepared to offer financial tools to increase survivors' economic self-sufficiency. Policymakers should understand the ramifications of economic abuse and create policies that support survivors and prohibit economic abuse. Finally, more research is needed to fully understand economic abuse and its impact on survivors and their economic self-sufficiency.
Coyle, Eimear; Karatzias, Thanos; Summers, Andy; Power, Mick
Childhood sexual abuse (CSA) has the potential to compromise socio-emotional development of the survivor resulting in increased vulnerability to difficulties regulating emotions. In turn, emotion regulation is thought to play a key part in a number of psychological disorders which CSA survivors are at increased risk of developing. A better understanding of the basic emotions experienced in this population and emotion regulation strategies will inform current treatment. This paper examines the relationships between type of emotions experienced, emotion regulation strategies, and psychological trauma symptoms in a sample of survivors of CSA. A consecutive case series of CSA survivors (n=109) completed the Basic Emotions Scale (BES)-Weekly, General, and Coping versions; the Regulation of Emotions Questionnaire; the Post-traumatic Stress Checklist-Civilian Version (PCL-C); and the Clinical Outcomes in Routine Evaluation Outcome Measure. Significantly higher levels of disgust than other levels of emotions were reported on the weekly version of the BES. In addition, significantly higher levels of disgust and lower levels of happiness were reported on the BES-General subscale. Regression analyses revealed that sadness, fear, disgust, and external dysfunctional coping strategies predicted global post-traumatic stress disorder and re-experiencing symptomatology measured by the PCL-C. Global distress, as measured by CORE, was predicted by the emotions of sadness, disgust, and low happiness, as well as dysfunctional regulatory strategies. In addition, preliminary exploratory factor analyses supported the structure of all three versions of the BES, with disgust explaining the largest percentage of variance, followed by happiness. The findings highlight the utility of profiling basic emotions in understanding the strong associations between emotional phenomena, particularly the emotion of disgust and psychopathology in CSA survivors.
Postmus, Judy L; Plummer, Sara-Beth; Stylianou, Amanda M
Recent attention has been given by researchers to understanding how abusers use economic abuse strategies. Unfortunately, limited measures are available to accurately understand the prevalence of economic abuse in the lives of survivors. Recently, researchers created the 28-item Scale of Economic Abuse (SEA) but further validation is needed. This article describes the psychometric evaluation of the SEA through confirmatory and exploratory factor analyses using data collected with 120 survivors of abuse. The findings provide evidence for the reliability and validity of the SEA-12 as a shorter instrument to measure economic abuse as a distinct form of abuse. © The Author(s) 2015.
McPherson, Paul; Scribano, Philip; Stevens, Jack
Child sexual abuse (CSA) often requires psychological treatment to address the symptoms of victim trauma. Barriers to entry and completion of counseling services can compromise long-term well-being. An integrated medical and mental health evaluation and treatment model of a child advocacy center (CAC) has the potential to reduce barriers to mental…
Viviani, Anna Michele
Childhood sexual abuse is a prevalent but taboo topic in society. Conservatively 80,000 new cases are reported each year with many more either unreported or unsubstantiated within the legal system. Survivors of childhood sexual abuse often times seek counseling assistance to manage the variety of short-and long-term emotional issues that may arise…
Wolf, Molly R.; Nochajski, Thomas H.
Although the issue of dissociative amnesia in adult survivors of child sexual abuse has been contentious, many research studies have shown that there is a subset of child sexual abuse survivors who have forgotten their abuse and later remembered it. Child sexual abuse survivors with dissociative amnesia histories have different formative and…
Nelson, Briana S.; Wampler, Karen S.
Study compared female childhood sexual abuse (CSA) survivors and their male partners with a group of couples reporting no CSA. Both female CSA survivors and their partners reported higher symptoms of stress, suggesting support for the theory of secondary traumatic stress. Relationship impairment results did not support the hypothesis that CSA…
Jarvis, T J; Copeland, J; Walton, L
This study investigated whether child abuse (CSA) was associated with earlier substance use and greater severity of substance dependence and what aspects of CSA might predict substance abuse. The study compared (a) drug and alcohol treatment clients with and without a history of CSA and (b) CSA survivors outside drug and alcohol treatment who did or did not have current substance abuse. Semi-structured interviews took place at participants' homes, treatment agencies or the research centre. Volunteer participants included 100 women recruited from drug and alcohol treatment programmes and 80 CSA survivors recruited through CSA counseling services and medial advertising. The results focus on data from the Opiate Treatment Index, Severity of Alcohol Dependence Questionnaire, Substance Dependence Scale, Self-Esteem Inventory and self-reported histories of CSA. There were no differences between CSA survivors and other drug and alcohol treatment clients in their severity of dependence. Women with a history of CSA more frequently identified stimulants as their main problem drug and reported an earlier age of first intoxication and earlier use of inhalants. Among abused CSA survivors outside drug and alcohol treatment, women with current substance abuse had typically been abused during adolescence by someone outside the family, whereas those without current substance abuse were typically abused by family members before adolescence. The results suggest that adolescence is a crucial time for the influence of CSA experiences on substance abuse.
Young, T. Lorraine; Riggs, Matt; Robinson, Jill L.
To address the lack of empirically grounded measures of childhood sexual abuse severity, a survey of self-report items was developed following a thorough review of the childhood sexual abuse literature. An exploratory factor analysis was conducted using data collected from a convenience sample of college students that included 275 females and…
Scribano, Philip V; Hornor, Gail; Rhoda, Dale; Curran, Sherry; Stevens, Jack
Given the commonly held belief that physical examinations for child sexual abuse (CSA) are very distressing, our primary objective was to evaluate anxiety during these assessments using the Multidimensional Anxiety Score for Children (MASC-10). A second objective was to compare self-reported anxiety to parental report using the MASC-10 and to medical provider's rating of emotional distress using the Genital Examination Distress Scale (GEDS). Child/parent dyads completed the MASC-10 prior to the evaluation and were retested at the completion of the medical exam. GEDS assessment occurred during the medical exam. One hundred seventy-five subject dyads were enrolled and were predominantly female (77%), Caucasian (66%), accompanied by mother (90%), and receiving Medicaid (57%). A significant subgroup of children reported clinically significant levels of anxiety at the pre-examination assessment (17.1%) and post-examination assessment (15.4%). However, most subjects reported low anxiety at both pre- and post-examination assessments. Both child and parent report demonstrated less anxiety, on average, post-examination compared to pre-examination scores. Reduced anxiety was measured with a mean pre-T-score=55.8 versus mean post-T-score=53.1 (p<.001). Correlation coefficients for pre-T-scores and post-T-scores of child/parent dyad were 0.3257 (p<.0001) and 0.3403 (p<.0001). A small correlation was noted between child reported anxiety and medical provider observation using the GEDS for pre-exam (0.1904, p=.01), and post-exam (0.2090, p=.02). Our research indicates that the majority of children are not severely anxious during medical evaluations for CSA. In addition, the MASC-10 shows promise as an instrument to assess anxiety from the ano-genital examination in CSA because it could be quickly completed by most patients and their parents, indicated a wide range of anxiety levels, and demonstrated some sensitivity to change. While parent report may identify some child anxiety
Zafar, Sadia; Ross, Erin C.
The Childhood Sexual Abuse Stereotypes Scale was developed to assess stereotypes of adult survivors of childhood sexual abuse. Scale items were derived from two studies that elicited cultural and personal beliefs about, and emotions experienced towards adult childhood sexual abuse survivors among university undergraduates. Two scales, Emotions and…
McGregor, Kim; Julich, Shirley; Glover, Marewa; Gautam, Jeny
This study reports on a postal questionnaire, conducted in 2004, with female survivors of historic child sexual abuse. The questionnaire explored their experiences of health professionals' responsiveness to disclosure of child sexual abuse history. Of 61 participants, aged between 22 and 65, 69% had disclosed to health professionals. Those who had…
Maree, Jacobus G.; Venter, Cobus J.
This study examined whether life design counselling can enhance the career resilience of a sexual abuse survivor. One participant was selected through purposive sampling. Five life design sessions occurred over a period of three months. Various (postmodern) qualitative and quantitative techniques were used to gather data while data analysis was…
Norris, Thomas L.
This paper describes a four-phase therapeutic approach that has proven useful to adult female and male survivors of child sexual abuse. The methods described are primarily used in individual therapy, although the context is within the family therapy realm and relies heavily upon Structural Family Systems Theory. The four phases which a victim…
Gilewski, Michael J.
Adult survivors of childhood abuse are some of the more difficult and challenging patients in psychotherapy. This paper applies a transpersonal model of empathy to therapeutic work with these individuals. The transpersonal model of empathy extends traditional humanistic models which strive towards "advanced accurate empathy" to the level…
Coyle, Eimear; Karatzias, Thanos; Summers, Andy; Power, Mick
Background Childhood sexual abuse (CSA) has the potential to compromise socio-emotional development of the survivor resulting in increased vulnerability to difficulties regulating emotions. In turn, emotion regulation is thought to play a key part in a number of psychological disorders which CSA survivors are at increased risk of developing. A better understanding of the basic emotions experienced in this population and emotion regulation strategies will inform current treatment. Objective This paper examines the relationships between type of emotions experienced, emotion regulation strategies, and psychological trauma symptoms in a sample of survivors of CSA. Method A consecutive case series of CSA survivors (n=109) completed the Basic Emotions Scale (BES)—Weekly, General, and Coping versions; the Regulation of Emotions Questionnaire; the Post-traumatic Stress Checklist—Civilian Version (PCL-C); and the Clinical Outcomes in Routine Evaluation Outcome Measure. Results Significantly higher levels of disgust than other levels of emotions were reported on the weekly version of the BES. In addition, significantly higher levels of disgust and lower levels of happiness were reported on the BES—General subscale. Regression analyses revealed that sadness, fear, disgust, and external dysfunctional coping strategies predicted global post-traumatic stress disorder and re-experiencing symptomatology measured by the PCL-C. Global distress, as measured by CORE, was predicted by the emotions of sadness, disgust, and low happiness, as well as dysfunctional regulatory strategies. In addition, preliminary exploratory factor analyses supported the structure of all three versions of the BES, with disgust explaining the largest percentage of variance, followed by happiness. Conclusions The findings highlight the utility of profiling basic emotions in understanding the strong associations between emotional phenomena, particularly the emotion of disgust and psychopathology in CSA
Wright, Margaret O'Dougherty; Fopma-Loy, Joan; Fischer, Stephanie
Objective: There has been relatively little attention given to positive adaptation following childhood sexual abuse (CSA), and typically such resilience has been explored primarily in the intrapersonal domain. This study explored questions about later resilience following CSA within a multidimensional framework by assessing resilience across…
Shapiro, Deborah L.; Levendosky, Alytia A.
A study of 80 adolescent females found that attachment style mediates the effects of child sexual abuse (CSA) and child abuse and neglect on coping and psychological distress. The indirect effects of CSA and other abuse through attachment accounted for most of the effects on coping and psychological distress. (Author/CR)
Grossman, Susan F.; Lundy, Marta; Bertrand, Cathy; Ortiz, Cynthia; Tomas-Tolentino, Grace; Ritzema, Kim; Matson, Julia
This analysis compared the characteristics and service patterns of adult survivors of childhood sexual assault/abuse and adult survivors of adult sexual assault/abuse. Utilizing data from sexual assault crisis centers serving survivors in a Midwestern state over a six year period and controlling for revictimization, we describe and compare the…
Sigurdardottir, Sigrun; Halldorsdottir, Sigridur; Bender, Soley S; Agnarsdottir, Guðrun
Childhood sexual abuse (CSA) survivors deal with complex mental, physical and relationship problems in adulthood which negatively affects their well-being and health. The aim of the present paper was to present a description of the Wellness-Program for female CSA survivors, the participating women's evaluation of the different therapies in the program as well as a qualitative study on their experience of the program's effects on their life, health and well-being. The Wellness-Program lasted for 10 weeks with organised schedule 20 hours per week. A team of health professionals used a holistic approach and provided traditional and complementary individual and group therapy focusing on both mind and body. In-depth phenomenological interviews with ten women, 22-53 years old, were conducted 1 week before and 1 week after the program as well as 15 months later. Data collection and data analysis were guided by the Vancouver School of doing phenomenology. Prior to participating in the program, the women were unable to work or attend school, were on disability allowance, were socially isolated and had complex health problems. After the Wellness-Program, all the women, except one, were back to work, school or in further rehabilitation. Furthermore, the in-depth interviews showed that their health and well-being, personal life and relationship with partners, family and friends improved. They felt empowered, more in control and had developed increased trust towards others. Six themes were constructed from the in-depth interviews. They were: feeling totally lost, releasing experiences, developing trusting relationships, gaining control, experiencing positive changes in physical and mental health and, finally, feeling of empowerment. The overriding theme of the study was personal resurrection. The Wellness-Program contributed considerably to improved health and well-being of the women. However, further assessment of the program is recommended before making it available within
Fletcher, Shelley; Elklit, Ask; Shevlin, Mark; Armour, Cherie
This study aimed to (a) identify posttraumatic stress disorder (PTSD) trajectories in a sample of Danish treatment-seeking childhood sexual abuse (CSA) survivors and (b) examine the roles of social support, coping style, and individual PTSD symptom clusters (avoidance, reexperiencing, and hyperarousal) as predictors of the identified trajectories. We utilized a convenience sample of 439 CSA survivors attending personalized psychotherapy treatment in Denmark. Four assessments were conducted on a six monthly basis over a period of 18 months. We used latent class growth analysis (LCGA) to test solutions with one to six classes. Following this, a logistic regression was conducted to examine predictors of the identified trajectories. Results revealed four distinct trajectories which were labeled high PTSD gradual response, high PTSD treatment resistant, moderate PTSD rapid response, and moderate PTSD gradual response. Emotional and detached coping and more severe pretreatment avoidance and reexperiencing symptoms were associated with more severe and treatment resistant PTSD. High social support and a longer length of time since the abuse were associated with less severe PTSD which improved over time. The findings suggested that treatment response of PTSD in CSA survivors is characterized by distinct patterns with varying levels and rates of PTSD symptom improvement. Results revealed that social support is protective and that emotional and detached coping and high pretreatment levels of avoidance and reexperiencing symptoms are risk factors in relation to PTSD severity and course. These factors could potentially identify patients who are at risk of not responding to treatment. Furthermore, these factors could be specifically addressed to increase positive outcomes for treatment-seeking CSA survivors.
Lieberz, Klara A; Müller-Engelmann, Meike; Priebe, Kathlen; Friedmann, Franziska; Görg, Nora; Herzog, Julia Isabell; Steil, Regina
There is growing empirical evidence for an association between childhood abuse (CA) and intimate partner violence (IPV) in adulthood. We tested whether revictimized survivors of severe to extreme severities of child sexual abuse (CSA) and severe severities of child physical abuse (CPA) differed from nonvictimized healthy controls in their trait preferences in intimate partners and their current mate choice. In a sample of 52 revictimized female patients with posttraumatic stress disorder (PTSD) after CSA/CPA and 52 female healthy controls, the validated Intimate Partner Preferences Questionnaire (IPPQ) was used to assess (a) the desirability of tenderness, dominance, and aggression traits in potential partners, and (b) the presence of these traits in their current intimate partners. Factors potentially associated with partner preference and mate choice, for example, chronicity of traumatic events and lower self-esteem, were explored. Our results showed that, in general, revictimized PTSD patients did not have a preference for dominant or aggressive partners. However, revictimized women displayed a significantly larger discrepancy than did healthy controls between their preferences for tenderness traits and their ratings of the presence of tenderness traits in their current partners. Our results indicated that revictimized patients had lower self-esteem values; however, these values were associated with higher demands for tenderness traits. Furthermore, our results revealed that compared with patients who experienced early-onset childhood abuse (CA), those who experienced later onset CA were more accepting of dominant traits in potential partners. Women who had experienced IPV rated their current partners to be overly dominant. A higher tolerance of dominance traits might increase the risk of IPV in a specific subgroup of abused women (women with a later onset of abuse experiences and experiences of IPV).
Shay, J J
As family therapy of sexual abuse survivors has become more common, theoretical and technical issues have received considerable attention. Less attention has been devoted to the countertransference experience of the therapist. Unexamined therapist countertransference is a critical element in the treatment of these families, which markedly influences the nature and direction of treatment. Particular types of countertransference are presented here. In addition, the contention is made that countertransference is not only evoked by the particular presentation of the family members, but also by the therapist's unexplored political and moral beliefs.
Glass, Nancy; Perrin, Nancy; Hanson, Ginger; Mankowski, Eric; Bloom, Tina; Campbell, Jacquelyn
This study builds on the existing knowledge of risk factors for lethal intimate partner violence (IPV) and typologies of IPV abusers by exploring patterns of abusive partners' behaviors among known risk factors for intimate partner femicide (i.e., murder of women) and determines if groups of survivors with similar patterns of abusive behaviors…
Bonanno, George A; Keltner, Dacher; Noll, Jennie G; Putnam, Frank W; Trickett, Penelope K; LeJeune, Jenna; Anderson, Cameron
For survivors of childhood sexual abuse (CSA), verbal disclosure is often complex and painful. The authors examined the voluntary disclosure-nondisclosure of CSA in relation to nonverbal expressions of emotion in the face. Consistent with hypotheses derived from recent theorizing about the moral nature of emotion, CSA survivors who did not voluntarily disclose CSA showed greater facial expressions of shame, whereas CSA survivors who voluntarily disclosed CSA expressed greater disgust. Expressions of disgust also signaled sexual abuse accompanied by violence. Consistent with recent theorizing about smiling behavior, CSA nondisclosers made more polite smiles, whereas nonabused participants expressed greater genuine positive emotion. Discussion addressed the implications of these findings for the study of disclosure of traumatic events, facial expression, and the links between morality and emotion.
Zinzow, Heidi; Seth, Puja; Jackson, Joan; Niehaus, Ashley; Fitzgerald, Monica
The purpose of this study was to examine the influence of abuse and parental characteristics on attributional content and determine the relative contribution of different attributions of blame in predicting psychological symptomatology among adult survivors of childhood sexual abuse. One hundred eighty-three female undergraduates with a history of…
Karakurt, Gunnur; Silver, Kristin E
The aim of this paper is to understand the effects of childhood sexual abuse on a survivor's later life. For understanding and treating the emotional distress and interpersonal problems resulting from childhood sexual abuse, attachment theory provides a valuable framework. When this framework is combined with family systems theory, it can help therapists understand the family context where sexual abuse occurs and how this affects health and functioning throughout the lifespan. Case examples of female adult sexual abuse survivors are also explored, with insight from the intersection of systems and attachment theories.
Anderson, Geri; And Others
Interviews with 51 female sexual abuse survivors revealed that over half had a diagnosis of multiple personality disorder, and the vast majority had extensive dissociative symptomatology and related features. (Author/JDD)
Smith, M S; Smith, M T
The effectiveness of a new examination gown, as a stimulus control intervention designed to reduce distress during the pelvic exam, was investigated in a sample of sexual abuse survivors and women without abuse histories. Sixty-nine participants from a women's health ambulatory center and a private practice in gynecology were randomly assigned to the experimental gown condition or the paper drape control group. One-third of the sample reported a history of childhood sexual abuse. Survivors reported higher anxiety during exams than did women without abuse histories. Women who wore the experimental gown reported more positive emotional and physical experiences of the exam. Further research is required to examine the trend showing that survivors who wore the experimental gown reported less anxiety during the examination than survivors who wore the control drape.
Lacelle, Celine; Hebert, Martine; Lavoie, Francine; Vitaro, Frank; Tremblay, Richard E.
Research studies have provided increasing evidence for the potential adverse impact of child sexual abuse on women's sexual health. The present study examined the association between child sexual abuse and sexual health while controlling for various forms of childhood victimization. Self-report questionnaires were administered to 889 young women…
Fowler, Dawnovise N; Faulkner, Monica
In this article, meta-analytic techniques are used to examine existing intervention studies (n = 11) to determine their effects on substance abuse among female samples of intimate partner abuse (IPA) survivors. This research serves as a starting point for greater attention in research and practice to the implementation of evidence-based, integrated services to address co-occurring substance abuse and IPA victimization among women as major intersecting public health problems. The results show greater effects in three main areas. First, greater effect sizes exist in studies where larger numbers of women experienced current IPA. Second, studies with a lower mean age also showed greater effect sizes than studies with a higher mean age. Lastly, studies with smaller sample sizes have greater effects. This research helps to facilitate cohesion in the knowledge base on this topic, and the findings of this meta-analysis, in particular, contribute needed information to gaps in the literature on the level of promise of existing interventions to impact substance abuse in this underserved population. Published by Elsevier Inc.
Thompson, Nikki; Renninger, Salina
Counseling survivors of sexual abuse requires acknowledgment of the legitimacy of the client's ego defenses while helping the client abandon those defenses which have become obstacles to leading a fulfilling life. Such defenses may also impede the therapeutic process, as survivors are less likely to trust other people. Clients can arrive at a…
Hovey, Angela; Stalker, Carol A.; Schachter, Candice L.; Teram, Eli; Lasiuk, Gerri
Many survivors of child sexual abuse who engage in psychotherapy also experience physical health problems. This article summarizes the findings of a multiphased qualitative study about survivors' experiences in healthcare settings. The study informed the development of the "Handbook on Sensitive Practice for Health Care Practitioners: Lessons…
Kia-Keating, Maryam; Sorsoli, Lynn; Grossman, Frances K.
Male survivors of childhood sexual abuse face challenges resolving sexual victimization experiences with the ideals of masculinity, often experiencing intimacy problems, emotional discomfort, alienation, and anger. Little attention has been paid to how male survivors learn to develop long-term connections, disclose emotions in relationship…
Shaffer, Janice; Brown, Lynn L.; McWhirter, J. Jeffries
A four-phase group plan is presented to help survivors of childhood sexual abuse move beyond dissociative coping to more effective coping strategies. Advantages of this approach are discussed. Dissociation and the effects of dissociation are discussed. Considerations for forming a survivors group, and the four-phase format are presented in detail.…
Edmond, Tonya; Sloan, Lacey; McCarty, Dawn
Objective: This article examines survivor perspectives of the effectiveness of two different treatments for trauma symptoms among adult female survivors of childhood sexual abuse--Eye movement Desensitization and Reprocessing (EMDR) and eclectic therapy. Method: Qualitative interviews obtained in the context of a mixed-methods study were conducted…
Kostolitz, Alessandra C; Hyman, Scott M; Gold, Steven N
The high stress of childhood abuse is associated with neurobiological detriments to executive function. Child abuse survivors may also be cognitively and relationally disadvantaged as a result of being raised in emotionally impoverished families that lack cohesion, organization, flexibility, self-expression, and moral and ethical values and fail to provide opportunities for effective learning. A review of literature demonstrates how dysfunctional family of origin environments common to child abuse survivors, concomitant with the extreme stress of overt acts of abuse, can act as a barrier to the development of higher-order critical thinking skills. The article concludes by discussing ramifications of critical thinking skill deficits in child abuse survivors and highlights the importance of integrating and prioritizing critical thinking skills training in treatment.
Sorsoli, Lynn; Kia-Keating, Maryam; Grossman, Frances K.
Disclosure is a prominent variable in child sexual abuse research, but little research has examined male disclosure experiences. Sixteen male survivors of childhood sexual abuse were interviewed regarding experiences of disclosure. Analytic techniques included a grounded theory approach to coding and the use of conceptually clustered matrices.…
Objective:: The aim of this study was to explore influences that inhibit or promote child sexual abuse (CSA) disclosure. Method:: Face-to-face in-depth interviews of 24 female and male survivors of CSA were conducted, using the Long-Interview method to trace disclosure processes. Verbatim transcriptions of the interviews were analyzed by hand and…
Vaillancourt-Morel, Marie-Pier; Godbout, Natacha; Bédard, Maryline Germain; Charest, Émilie; Briere, John; Sabourin, Stéphane
Among individuals defined as having been sexually abused based on legal criteria, some will self-report having been abused and some will not. Yet, the empirical correlates of self-definition status are not well studied. Different definitions of abuse may lead to varying prevalence rates and contradictory findings regarding psychological outcomes. The present study examined whether, among legally defined sexual abuse survivors, identifying oneself as having experienced childhood sexual abuse (CSA) was associated with more severe abuse, negative emotional reactions toward the abuse, and current sexual reactions. A convenience sample of 1,021 French-speaking Canadians completed self-report questionnaires online. The prevalence of legally defined CSA was 21.3% in women and 19.6% in men, as compared to 7.1% in women and 3.8% in men for self-defined CSA. Among legally defined sexual abuse survivors, those who identified themselves as CSA survivors had been abused more frequently, were more likely to report a male aggressor, and more often described abuse by a parental figure than those who did not self-identify as abused. Further, self-defined CSA was associated with more negative postabuse reactions and sexual avoidance, whereas those not identifying as sexually abused were more likely to report sexual compulsion. © The Author(s) 2016.
Martsolf, Donna S; Draucker, Claire B
This review synthesized results of 26 outcomes research studies and two meta-analyses that evaluated abuse-focused psychotherapy techniques for survivors of childhood sexual abuse. Different therapeutic approaches delivered in individual, group, or combination formats were evaluated with pre/post test, quasi-experimental, or randomized control designs. Accumulated research findings suggest that abuse-focused psychotherapy for adults sexually abused as children is generally beneficial in reducing psychiatric distress, depression, and trauma-specific symptoms. No one therapeutic approach was demonstrated to be superior. There was little evidence about the effectiveness of individual versus group therapy or the optimal treatment duration.
Stevens, Natalie R; Tirone, Vanessa; Lillis, Teresa A; Holmgreen, Lucie; Chen-McCracken, Allison; Hobfoll, Stevan E
Posttraumatic stress symptoms (PTS) are associated with increased risk of obstetric complications among pregnant survivors of trauma, abuse and interpersonal violence, but little is known about how PTS affects women's actual experiences of obstetric care. This study investigated the rate at which abuse history was detected by obstetricians, whether abuse survivors experienced more invasive exams than is typically indicated for routine obstetric care, and whether psychological distress was associated with abuse survivors' sense of self-efficacy when communicating their obstetric care needs. Forty-one pregnant abuse survivors completed questionnaires about abuse history, current psychological distress and self-efficacy for communicating obstetric care needs and preferences. Electronic medical records (EMRs) were reviewed to examine frequency of invasive prenatal obstetric procedures (e.g. removal of clothing for external genital examination, pelvic exams and procedures) and to examine the detection rate of abuse histories during the initial obstetric visit. The majority of participants (83%) reported at least one past incident of violent physical or sexual assault. Obstetricians detected abuse histories in less than one quarter of cases. Nearly half of participants (46%) received invasive exams for non-routine reasons. PTS and depression symptoms were associated with lower self-efficacy in communicating obstetric care preferences. Women most at risk for experiencing distress during their obstetric visits and/or undergoing potentially distressing procedures may also be the least likely to communicate their distress to obstetricians. Results are discussed with implications for improving screening for abuse screening and distress symptoms as well as need for trauma-sensitive obstetric practices.
Schachter, Candice L.; Radomsky, Nellie A.; Stalker, Carol A.; Teram, Eli
OBJECTIVE: To explore how health professionals can practise in ways sensitive to adult women survivors of child sexual abuse. DESIGN: Qualitative semistructured in-depth interviews. SETTING: Small and midsize cities in Ontario and Saskatchewan. PARTICIPANTS: Twenty-seven women survivors of childhood sexual abuse. METHODS: Respondents were asked about their experiences with physical therapists and other health professionals and asked how practice could be sensitive to their needs as survivors. A grounded-theory approach was used. After independent analyses, researchers achieved consensus on the main themes. Findings were checked with participants, other survivors, and mental health professionals. MAIN FINDINGS: A crucial theme was the need to feel safe when consulting any health professional. Participants described specific ways for clinicians to facilitate the feeling of safety. Disclosure of abuse history was another key theme; analysis revealed no one "right way" to inquire about it. CONCLUSION: Women survivors of child sexual abuse want safe, accepting environments and sensitive, informed health professionals with whom to work in partnership on all their health concerns. PMID:15318678
Postmus, Judy L.; Plummer, Sara-Beth; McMahon, Sarah; Murshid, N. Shaanta; Kim, Mi Sung
Intimate partner violence (IPV) often includes economic abuse as one tactic commonly used by an abuser; unfortunately, there is a lack of empirical understanding of economic abuse. Additionally, research is limited on the predictors of economic self-sufficiency in the lives of women experiencing IPV. This paper furthers our knowledge about…
Johnson, Emmanuel Janagan; James, Christine
Child abuse has profound immediate and long-term effects on a child's development. The long-term impact of abuse of a child can be seen in higher rates of psychiatric disorders, increased rates of substance abuse and relationship difficulties [Springer, K. W., Sheridan, J., Kuo, D., & Carnes, M. (2003). "The long-term health outcomes of…
Shapiro, D L; Levendosky, A A
To examine attachment style and coping strategies as potential mediating variables between childhood sexual abuse (CSA) and psychological and interpersonal functioning in an attempt to explain variability in extent of disorder and level of functioning. Eighty adolescent females, aged 14-16 years, answered questions regarding abuse history, attachment style, coping with an interpersonal stressor, depression and trauma symptomatology, and conflict with a best friend. Structural equation modeling analyses indicated that attachment style mediates the effects of CSA and child abuse and neglect on coping and psychological distress. The indirect effects of CSA and other abuse through attachment accounted for most of the effects on coping and psychological distress. Avoidant and cognitive coping strategies also served as mediators in the models, accounting for most of the effects of the other variables on interpersonal conflict. The findings indicate that attachment style and coping strategies influence psychological and interpersonal functioning, mediating the direct effects of CSA and other types of child abuse and neglect. These results have implications for therapeutic intervention with children and adolescents who have experienced child abuse.
Roland, Catherine B.
Describes two memory-enhancing techniques, visualization and concrete reconstruction, that have been successful in counseling adult survivors of sexual abuse. Includes suggested implementations, case examples, and implications for incorporating memory techniques into counseling process. Describes various risk factors involved in using these…
Peckham, Nicholas Guy; Howlett, Susan; Corbett, Alan
Background: Sexual abuse has been associated with trauma, low self-esteem, anger, depression and challenging behaviours. This pilot study builds on a small published literature by evaluating a survivors group (SG) for women with an intellectual disability and an educational support group (ESG) for their carers. Method: The SG was delivered weekly…
Brown, Michael H.
States that the techniques of mental imagery can help adult survivors of childhood sexual abuse access the inner wisdom necessary to identify, understand, and creatively address issues from the past and develop new and healthier patterns of thinking and behaving. Documents the innovative ways psychosynthesis uses mental imagery with this client…
Kress, Victoria E.; Hoffman, Rachel; Thomas, Amanda M.
In the context of counseling sexual abuse survivors, the creative counseling technique of having clients write letters--to themselves or others--from a future context is described. A theoretical framework for writing letters to oneself from the future is presented. Specific types of letters from the future are explained, and case examples and…
Kress, Victoria E.; Adamson, Nicole A.; Yensel, Jennifer
Counselors will regularly counsel children and adolescents with histories of sexual abuse and be challenged with providing supportive and empowering interventions that serve to move the client from victim to survivor status. Therapeutic stories are a creative counseling technique that can be used when counseling child and adolescent sexual abuse…
Presents a model for conducting time-limited group therapy with adult survivors of severe childhood abuse who were diagnosed with complex post-traumatic and dissociative disorders. Group sessions are organized around verbal promises that encourage the client's active, attentive engagement. Gentle confrontation of dissociative defenses is integral…
Barron, Ian G; Topping, Keith J
Addressing gaps in the research, the current study assesses the impact of a community-based child sexual abuse prevention program on known survivor knowledge/skills, disclosures, and subjective experience. Methodologically, novel measures of program fidelity and implementation cost are applied. A pre- posttest wait-list control design was utilized with intervention (n = 10) and comparison groups (n = 10). Measures included a standardized knowledge/skill questionnaire, coding of disclosures, subjective experience questionnaires, in-depth interviews, video analysis of program adherence, and a measure of cost. Analysis involved nonparametric tests and thematic analysis of interview and video data. Cost was calculated for the group and per survivor. Survivors achieved significant gains in knowledge/skills, made further disclosures, and were positive about their program experience. No gains were identified in the control group. Costs were small. Future studies need to explore survivor experience of programs delivered in classrooms.
Elklit, Ask; Christiansen, Dorte M; Palic, Sabina; Karsberg, Sidsel; Eriksen, Sara Bek
Childhood sexual abuse can be extremely traumatic and lead to lifelong symptomatology. The present study examined the impact of several demographic, abuse, and psychosocial variables on posttraumatic stress disorder severity among a consecutive sample of treatment-seeking, adult child sexual abuse survivors (N = 480). The child sexual abuse sample was characterized by severe trauma exposure, insecure attachment, and significant traumatization, with an estimated 77% suffering from posttraumatic stress disorder, more than twice the level of the comparison group. Regression analyses revealed risk factors associated with the development of posttraumatic stress disorder in which the strongest predictors being additional traumas, negative affectivity, and somatization. The findings add to existing research confirming the stressful nature of child sexual abuse and the variables that contribute to the development and severity of posttraumatic stress disorder.
Palesh, Oxana Gronskaya; Classen, Catherine C.; Field, Nigel; Kraemer, Helena C.; Spiegel, David
This study examined the impact of telling one's story of childhood sexual abuse and its relationship with the survivor's self-capacities and history of other child maltreatment. The baseline data were collected from 134 female CSA survivors who were participating in a large intervention study. Participants were given 10 minutes to describe their…
O'Dougherty Wright, Margaret; Fopma-Loy, Joan; Oberle, Katherine
This article reviews past research on the parenting characteristics of childhood sexual abuse survivors and presents the results of a qualitative study exploring the women's perspectives on mothering as a survivor. Grounded theory was used in the collection and analysis of the data. Data sources included the narrative responses of 79 women (mean age = 38.2 years) and in-depth interviews of a purposive sample of 15 women (mean age = 39 years). They had an average of 2.2 children, ranging in age from 5 months to young adulthood. The theoretical model identified through analysis of data using the constant comparison method was entitled "The Hard Work of Mothering as a Survivor." Processes emerged that described the ways participants managed the work of mothering in light of memories of the abuse and attempts to heal from this earlier trauma. The conditions for committing to the work included becoming aware of and accepting the reality of the abuse and how it affected one's life, and taking on the hard work of developing a mothering self. This included expanding awareness, developing and evaluating a personal model of mothering, navigating typical and abuse salient parenting challenges, mothering through the pain of recovery, and battling for balance. The findings highlighted the dynamic, multifaceted nature of recovery and resilience for these mothers and the need for an increased focus on parenting in counseling with childhood sexual abuse survivors. Provision of anticipatory guidance regarding commonly experienced stressors at varying stages of the child's development and the mother's stage of recovery and methods for coping with these challenges, would benefit these mothers and promote parenting competence. Specific implications for psychotherapy and directions for future research are discussed.
Matthew, Laurie; Barron, Ian G
The existence of ritual abuse is the subject of much debate. Ritual abuse survivor perceptions of seeking help have not been explored, and studies have yet to utilize self-defined survivors as collaborative researchers. This study addresses both issues. Participatory action research was utilized to design a survey and semistructured interview to investigate ritual abuse survivor experience of seeking help. Sixty-eight participants completed the survey, and 22 were interviewed. A group approach to thematic analysis aided validity and reliability. Participants reported experiencing disbelief and a lack of ritual abuse awareness and help from support services. In contrast, participatory action research was reported by participants as educative and emancipatory. Future research should explore the benefits of participatory action research for survivors of different forms of oppression.
Staller, Karen M.; Nelson-Gardell, Debra
Objectives: To enhance understanding of the sexual abuse disclosure process from the perspective of preteen and teenage survivors. To reconsider prominent models of the disclosure process in light of our findings. Methods: We conducted a secondary analysis of data from four focus groups in which 34 preadolescent and adolescent female survivors of…
LoGiudice, Jenna Alana
For women who have experienced sexual abuse, the physical changes associated with pregnancy and the lack of control during birth can be catalysts for trauma from past abuse to resurface. This systematic review offers women's health care providers a thorough evaluation of the state of the science on survivors' childbearing experiences. The literature shows that lack of control, dissociation, and flashbacks are common themes. Re-experiencing of the trauma occurred during various stages of childbirth and was traumatizing to women. Nurses and other clinicians providing care to childbearing women can provide control to survivors during health care encounters and can form therapeutic relationships to help them have more positive childbirth experiences. © 2016 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.
Grossman, Frances K; Spinazzola, Joseph; Zucker, Marla; Hopper, Elizabeth
This article provides the outline of a new framework for treating adult survivors of childhood emotional abuse and neglect. Component-based psychotherapy (CBP) is an evidence-informed model that bridges, synthesizes, and expands upon several existing schools, or theories, of treatment for adult survivors of traumatic stress. These include approaches to therapy that stem from more classic traditions in psychology, such as psychoanalysis, to more modern approaches including those informed by feminist thought. Moreover, CBP places particular emphasis on integration of key concepts from evidence-based treatment models developed in the past few decades predicated upon thinking and research on the effects of traumatic stress and processes of recovery for survivors. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
There is increasing recognition that domestic abuse takes place outside the heteronormative paradigm of social life. This paper presents a discussion of the findings of doctoral research which explores trans people's experiences of domestic abuse, their social care needs and whether these are met by domestic abuse agencies. This paper foregrounds debate on the intersections of domestic abuse, trans communities and social care provision as this research, and previous studies, suggests that trans survivors do not seek out or benefit from social care intervention. Qualitative data, collected via narrative interviews, were collected during 2012 from participants mainly located in the United Kingdom (two participants were based in the United States). A total of 24 interviews were undertaken with trans people (n = 15) and social care practitioners (n = 9). Data were examined using a voice-centred relational technique. The findings reveal that barriers are multiple and complex but work could be undertaken to encourage help-seeking behaviours. Barriers include expectations of a transphobic response and 'Othering' practices; lack of entitlement felt by trans people; lack of knowledge/misunderstandings about trans social care needs; heteronormative bias of existing services; and practitioner attitudes fixed to notions about gender as binary. The paper ends by proposing a framework for practice with trans survivors which incorporates a person-centred, narrative approach. © 2015 John Wiley & Sons Ltd.
Wilson, Debra Rose
Among the many sequelae of childhood sexual abuse is a maladaptive response to stress. Stress has been linked to a reduction in the immune system's ability to resist disease. The purpose of this exploratory mixed-method study is to examine the experience of stress management training for 35 adult survivors of childhood sexual abuse. Data gathered for analysis include pre- and postintervention saliva samples for sIgA, Ways of Coping Questionnaire, and a postintervention qualitative interview. Stress management strategies enhance immunity (increase in salivary immunoglobulin A, p < .05) and coping (less distancing, p < .001; less escape-avoidance, p < .001; more planful problem solving, p < .01; and more positive reappraisal, p < .001). Grounded theory analysis finds three themes emerging: hypervigilance , an outward-focused hyperawareness; somatic detachment, a lack of inward focus on self; and healing pathway, the process of healing from the abuse. Healing is possible.
Roe-Sepowitz, Dominique E; Bedard, Laura E; Pate, Kerensa N; Hedberg, E C
This study examined the effects associated with a trauma and abuse-focused psychoeducation group for incarcerated women on decreasing trauma symptoms. A total of 320 women participated in 34 groups in five prisons that followed a manualized intervention. A one-group pretest-posttest design was used to examine changes on 10 Trauma Symptom Inventory subscales (Anxious Arousal, Depression, Anger/Irritability, Intrusive Experiences, Defensive Avoidance, Dissociation, Sexual Concerns, Dysfunctional Sexual Behavior, Impaired Self-Reference, and Tension Reduction Behavior). Analyses indicated significant improvement on all 10 trauma subscales. Small effect sizes were found on all of the subscales. The findings of this study are encouraging and are the first step toward more rigorous evaluation of this pilot program. These findings provide initial support for the use of group psychoeducation intervention to address traumatic stress symptoms with incarcerated women.
Morais, Hugo B; Alexander, Apryl A; Fix, Rebecca L; Burkhart, Barry R
Most studies on the mental health consequences of childhood sexual abuse (CSA) focus predominantly on CSA survivors who do not commit sexual offenses. The current study examined the effects of CSA on 498 male adolescents adjudicated for sexual offenses who represent the small portion of CSA survivors who engage in sexual offenses. The prevalence of internalizing symptoms, parental attachment difficulties, specific sexual offending behaviors, and risk for sexually offending were compared among participants with and without a history of CSA. Results indicated that participants with a history of CSA were more likely to be diagnosed with major depression and posttraumatic stress disorder than those who did not report a history of CSA. A history of CSA was also positively correlated with risk for sexually offending and with specific offense patterns and consensual sexual behaviors. No significant differences emerged on parental attachment difficulties. These results highlight that adolescents adjudicated for sexual offenses with a history of CSA present with differences in sexual and psychological functioning as well as markedly different offending patterns when compared with those without a CSA history. Clinical implications and future directions are discussed.
Irving, Laura; Liu, Ben Chi-Pun
The aim of the study was to identify the prevalence and perceived helpfulness of a variety of protective strategies that were used by female survivors of domestic abuse and to explore factors that may have influenced strategy usage. Forty participants were recruited from a voluntary sector domestic abuse service, commissioned by an outer London local authority in the United Kingdom, in early 2014. The measurement tools used were the Intimate Partner Violence Strategies Index (IPVSI) and the Coordinated Action Against Domestic Abuse (CAADA) Domestic Abuse, Stalking and "Honour"-Based Violence (DASH) Risk Assessment Checklist. The average age was 33 years ( SD = 7.9, range = 20-57); half reported to be of Asian ethnicity, 37.5% White, and 12.5% Black or Mixed ethnicity. The average DASH score was 9.8 ( SD = 13.2, range = 0-18), and an average of 18 ( SD = 6.7, range = 1-29) protective strategies were utilized by each participant. All of the most commonly used strategies were from the placating category. Although safety planning strategies were rated as the most helpful by all participants, placating strategies were also rated as helpful by two thirds of participants. Stepwise multiple regression showed that placating was the only significant predictor of DASH score (β = .375, p < .05) and accounted for 14% of the variance of DASH score. Findings showed that women utilized a diverse range of protective strategies with placating strategies being most intensely used and rated as helpful. However, placating strategy usage could be a risk factor as opposed to a protective factor. This study has also demonstrated that greater placating strategies were used by White than South Asian women, and women who were employed used more formal strategies. This research has extended the knowledge base of protective strategies that professionals can draw from to underpin decisions and interventions when working with domestic abuse survivors.
Wahab, Suzaily; Tan, Susan Mooi Koon; Marimuthu, Sheila; Razali, Rosdinom; Muhamad, Nor Asiah
Research in the field of child sexual abuse is lacking in Malaysia. The aims of this study are to identify the association between sociodemographic factors and depression among sexually abused females. A cross-sectional study was conducted among 51 young sexually abused female attendees at the Suspected Child Abuse and Neglect (SCAN) clinic of Hospital Kuala Lumpur, a tertiary referral centre. Upon obtaining informed consent from participant and guardian, participants were screened for depression using the Strength and Difficulty Questionnaire (SDQ) and interviewed using the Schedule for Affective Disorders and Schizophrenia for School Aged Children (K-SADS) for depressive disorders and K-SADS-PL (Present and Lifetime version) to diagnose depression. Sociodemographic data and details of the abuse were also obtained. Of the survivors, 33.3% were depressed. Univariate analysis showed significant association between legal guardianship, living environment and duration of abuse with depression, however, multivariate analyses later showed that the sole predictor for depression was living environment. Respondents who lived with others were 23-times more likely to be depressed as compared to those who lived with their parents. Depression is common among young survivors of sexual abuse. Those who lived with parents appeared to have a better outcome. Thus, further research to explore possible protective factors associated with living with parents is vital. This will help clinicians develop strategies to empower parents and families help these young survivors get back on track with their lives despite the abuse. Copyright © 2013 Wiley Publishing Asia Pty Ltd.
Wondie, Yemataw; Zemene, Workie; Tafesse, Biruk; Reschke, Konrad; Schröder, Harry
Child sexual abuse (CSA) continues to be a pressing public health concern around the globe. Few existing reports, however, indicate the alarming rate at which the problem is increasing in sub-Saharan Africa. The present study is designed to investigate the psychosocial consequences of sexual abuse among child survivors in Ethiopia who were abused mainly through early marriage, rape, and child prostitution. Data are collected from 318 such CSA survivors-and 318 matched, non-sexually abused, normal controls- using the Children's Impact of Traumatic Events Scale-Revised and the Rosenberg Self-Esteem Scale. The results reveal the CSA survivors to be significantly more symptomatic than the control group: They demonstrated a lower degree of social support, a lower degree of empowerment, as well as a higher degree of guilt and increased likelihood of viewing the world as dangerous. Finally, these CSA survivors show a lower degree of positive self-worth than their non-sexually abused counterparts. These findings have important implications for the formulation of appropriate preventions and interventions to be undertaken by various stakeholders ranging from family to policy makers.
Riggs, Shelley A; Sahl, Gayla; Greenwald, Ellen; Atkison, Heather; Paulson, Adrienne; Ross, Colin A
The current study explored the role of early family environment and adult attachment style in explaining long-term outcomes among child abuse survivors. Adult patients (N = 80) in a trauma treatment program were assessed for clinical diagnosis and administered a multiscale questionnaire. Hierarchical regression analyses were significant for dissociative identity disorder (DID), substance abuse, anxiety disorder, posttraumatic stress, somatization, and six personality disorder dimensions. Adult attachment styles were significant predictors of most outcome variables. Of particular note was the strong contribution of attachment avoidance to DID. Five family environment scales (Independence, Organization, Control, Conflict, Expressiveness) also contributed to various psychopathological outcomes. Evidence emerged supporting a mediating role for attachment style in the link between family independence and five personality disorder dimensions.
Meston, Cindy M.; Rellini, Alessandra H.; Heiman, Julia R.
In this study, the authors assessed 48 female survivors of child sexual abuse (CSA) and 71 female control participants using measures of adult sexual function, psychological function (i.e., depression and anxiety), and sexual self-schemas. The primary purpose of this study was to examine whether differences existed between women with and without a…
Hébert, Martine; Tourigny, Marc; Cyr, Mireille; McDuff, Pierre; Joly, Jacques
Our study sought to explore patterns of disclosure of child sexual abuse (CSA) in a sample of adult men and women. A telephone survey conducted with a representative sample of adults (n = 804) from Quebec assessed the prevalence of CSA and disclosure patterns. Analyses were carried out to determine whether disclosure groups differed in terms of psychological distress and symptoms of posttraumatic stress, and a logistic regression was used to examine factors associated with prompt disclosure. Prevalence of CSA was 22.1% for women and 9.7% for men. About 1 survivor out of 5 had never disclosed the abuse, with men more likely not to have told anyone, than women. Only 21.2% of adults reported prompt disclosure (within a month of the first abusive event), while 57.5% delayed disclosure (more than 5 years after the first episode). CSA victims who never disclosed the abuse and those who delayed disclosure were more likely to obtain scores of psychological distress and posttraumatic stress achieving clinical levels, compared with adults without a history of CSA. In the multivariate analysis, experiencing CSA involving a perpetrator outside the immediate family and being female were factors independently associated with prompt disclosure. A significant number of adult women and men reported experiencing CSA, and most victims attested to either not disclosing or significantly delaying abuse disclosure.
Harte, Christopher B; Hamilton, Lisa D; Meston, Cindy M
This study examined predictors of attrition from a clinical trial examining the effects of an expressive writing intervention for sexual problems among female survivors of child sexual abuse. Participants were 124 women all reporting sexual difficulties, who were randomized to a trauma-focused condition (n = 45), an experimental sexual schema-focused condition (n = 37), or a control condition (n = 42). Thirty-five women (28%) dropped out before completing posttreatment assessments. Younger age, less education, and increased use of positive coping strategies were each independently associated with dropout. Results have implications for both researchers and clinicians working with this population, and it is hoped that these data can help bolster retention of those who are more likely to discontinue treatment.
Fletcher, Shelley; Elklit, Ask; Shevlin, Mark; Armour, Cherie
The aim of this study was to identify significant predictors of length of time spent in treatment. In a convenience sample of 439 Danish survivors of child sexual abuse, predictors of time spent in treatment were examined. Assessments were conducted on a 6-month basis over a period of 18 months. A multinomial logistic regression analysis revealed that the experience of neglect in childhood and having experienced rape at any life stage were associated with less time in treatment. Higher educational attainment and being male were associated with staying in treatment for longer periods of time. These factors may be important for identifying those at risk of terminating treatment prematurely. It is hoped that a better understanding of the factors that predict time spent in treatment will help to improve treatment outcomes for individuals who are at risk of dropping out of treatment at an early stage.
Carr, Alan; Flanagan, Edel; Dooley, Barbara; Fitzpatrick, Mark; Flanagan-Howard, Roisín; Shevlin, Mark; Tierney, Kevin; White, Megan; Daly, Margaret; Egan, Jonathan
Two hundred and forty seven survivors of institutional abuse in Ireland were classified with the Experiences in Close Relationships Inventory as having fearful (44%), preoccupied (13%), dismissive (27%), or secure (17%) adult attachment styles. The group with the secure adult attachment style had the most positive profile, while the most negative profile occurred for the fearful group in terms of DSM IV diagnoses and scores on the Trauma Symptom Inventory, the Global Assessment of Functioning Scale, the World Health Organization Quality of Life 100 scale, and the Kansas Marital Satisfaction Scale. The profile of the preoccupied group was more similar to that of the fearful group. The profile of the dismissive group was more similar to that of the secure group.
Wood, Karen; Van Esterik, Penny
To explore the effects of childhood sexual abuse (CSA) on women's breastfeeding and infant feeding decisions and experiences. Qualitative, participatory study using semistructured in-depth interviews. Tamara's House, a healing centre for women who were sexually abused in childhood, located in Saskatoon, Sask. Six mothers who were sexually abused in childhood. In-depth interviews were conducted and transcribed verbatim. Thematic analysis was iterative and participatory. The emerging themes that resulted from initial analysis by the researchers were presented at a meeting held jointly with academics, survivors, and professionals in the field to achieve consensus. Throughout the process, findings were considered in relation to related literature on breasts, breastfeeding, and CSA. History of CSA complicated the women's infant feeding decisions and experiences. For 2 women, birthing and breastfeeding facilitated healing from the effects of the abuse. Shame, touch, breasts, dissociation, medical care, and healing emerged as analytic themes. A history of CSA can affect a woman's experience of breastfeeding, including acting as a trigger for remembering or reexperiencing the abuse. Women who were sexually abused as children need to experience a sense of safety, acceptance, sensitivity, and understanding. Physicians need to be aware of the effects of CSA on infant feeding and women's health, and might need to be trained in a sensitive-practice approach to working with patients who were sexually abused as children.
Harris, Maxine; Fallot, Roger D; Berley, Rebecca Wolfson
Complex relationships among trauma, substance abuse, and mental disorders raise significant questions for the study of long-term recovery. The purpose of this qualitative study was to examine key themes in sustaining recovery among women with co-occurring disorders who had survived trauma. In semistructured interviews conducted at one of the nine sites of the Women, Co-occurring Disorders, and Violence Study, 27 female trauma survivors described the influences they considered most important in sustaining and hindering their recovery, with an emphasis on recovery from substance abuse. Recurring themes in the interviews were identified. Seven themes emerged from this analysis. Four of these themes supported recovery: connection, self-awareness, a sense of purpose and meaning, and spirituality. Three others served as obstacles to recovery: battles with depression and despair, destructive habits and patterns, and lack of personal control. The women in this study reported that, although caring relationships provided important supports for sustained recovery, some of these same relationships increased emotional stress and conflict and thus may impede recovery. It is important for women and clinicians to place a high priority on the development of boundary management and other relationship skills. In addition, clinicians need to attend to negative feelings such as boredom and loneliness and to help women develop a range of meaningful activities that are consistent with a strong sense of identity. Individual relapse prevention skills by themselves seem insufficient to sustained abstinence.
This research paper shows the ways in which survivors of domestic abuse can move on with their lives and take action to prevent their re-victimisation by returning to education. The primary aim was to explore the role of education as an agent of change, effecting positive and empowering changes to survivors' lives, thereby enhancing their life…
This article describes the views of Tibetan women who have experienced physical violence from male intimate partners. How they conceptualise abuse, their views on acceptable versus unacceptable hitting, and the acts besides hitting which they felt to be unacceptable or abusive, are explored. Views of survivors' relatives/friends and men who have hit their wives are also included. Western-based domestic violence theory is shown to be incommensurate with abuse in particular socio-cultural settings. As feminist scholars emphasize listening deeply to voices of women in the global South, this article demonstrates how such listening might be undertaken when the views expressed by women diverge from feminism. © The Author(s) 2016.
Reports an error in "Treating adult survivors of childhood emotional abuse and neglect: A new framework" by Frances K. Grossman, Joseph Spinazzola, Marla Zucker and Elizabeth Hopper ( American Journal of Orthopsychiatry , 2017, Vol 87, 86-93). In the article, in the second sentence of the third paragraph of the "The Empirical Base for CBP" section, "construction of a life narrative" should have read "construction of a trauma narrative." The full corrected sentence follows: "Therefore, the trauma treatment component traditionally focused upon construction of a trauma narrative must be expanded to address the effects of trauma on our clients' entire life narratives, including their development of a sense of self and social identity." (The following abstract of the original article appeared in record 2017-01147-002.) This article provides the outline of a new framework for treating adult survivors of childhood emotional abuse and neglect. Component-based psychotherapy (CBP) is an evidence-informed model that bridges, synthesizes, and expands upon several existing schools, or theories, of treatment for adult survivors of traumatic stress. These include approaches to therapy that stem from more classic traditions in psychology, such as psychoanalysis, to more modern approaches including those informed by feminist thought. Moreover, CBP places particular emphasis on integration of key concepts from evidence-based treatment models developed in the past few decades predicated upon thinking and research on the effects of traumatic stress and processes of recovery for survivors. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Easton, Scott D; Leone-Sheehan, Danielle M; O'Leary, Patrick J
Clergy-perpetrated sexual abuse (CPSA) during childhood represents a tragic betrayal of trust that inflicts damage on the survivor, the family, and the parish community. Survivors often report CPSA has a disturbing impact on their self-identity. Despite intense media coverage of clergy abuse globally in the Catholic Church (and other faith communities) over several decades, relatively few empirical studies have been conducted with survivors. Beyond clinical observations and advocacy group reports, very little is known about survivors' perceptions of how the abuse impacted their long-term self-identity. Using data collected during the 2010 Health and Well-Being Survey, this qualitative analysis represents one of the first large-scale studies with a non-clinical sample of adult male survivors of CPSA from childhood (N = 205). The negative effects of the sexual abuse on participants were expressed across six domains of self-identity: (a) total self, (b) psychological self, (c) relational self, (d) gendered self, (e) aspirational self, and (f) spiritual self. These findings highlight the range and depth of self-suffering inflicted by this pernicious form of sexual violence. The findings are useful for developing clinical services for survivors, shaping public and institutional policies to address clergy-perpetrated sexual abuse, and guiding future research with this population. © The Author(s) 2016.
Byrne, Jane; Smart, Cordet; Watson, Gilli
Sequelae following child sexual abuse pervade the lives of adult survivors, significantly impacting on pregnancy and childbirth. Symptoms of this distress are recognized, but meanings for women are less understood. This research aimed to examine the meaning for women themselves of the impact of child sexual abuse on experiences of pregnancy, childbirth, and the postnatal period. Taking a critical feminist perspective, three open-ended interviews with three survivors enabled women's narratives of pregnancy and childbirth to be heard, explored the structure of these narratives, including how experiences were connected, and identified key themes and how selves and others were positioned. Women themselves contributed to the analysis of their own narratives. The different struggles of each woman occurred within three domains of experience: identity, embodiment, and parenting. They were underpinned by a fluctuation between empowerment and disempowerment. These findings, although based on detailed analysis of the experiences of only three women, dovetail with, integrate, and extend the existent literature, offering a framework for understanding the complexity of meaning making for women. Further research might develop this. The framework may facilitate clinicians' understandings of what it is like for some women having children who have experienced child sexual abuse.
Meston, Cindy M.; Lorenz, Tierney A.
Physiological responses to sexual stimuli may contribute to the increased rate of sexual problems seen in women with childhood sexual abuse (CSA) histories. We compared two physiological stress responses as predictors of sexual function and satisfaction, sympathetic nervous system (SNS) activation and cortisol in women with (CSA, N = 136) and without CSA histories (NSA, N = 102). In CSA survivors, cortisol response to sexual stimuli did not significantly predict sexual functioning; however, in NSA women, cortisol increases were associated with poorer sexual functioning, and decreases with higher functioning. For women with CSA histories, lower SNS activity was associated with poorer sexual functioning. For CSA survivors with low lifetime trauma, lower SNS activity was associated with higher sexual satisfaction; for women with high lifetime trauma, the reverse was true. Decreased SNS activity during sexual stimuli predicted higher sexual functioning in NSA women with low lifetime exposure to traumatic events, but lower sexual functioning in those with high exposure. Differences between women with and without CSA histories in the association between cortisol and SNS response and sexual functioning and satisfaction suggests that CSA causes disruptions in both short and long-term stress responses to sexual stimuli that perpetuate into adulthood. PMID:24748915
Cantón-Cortés, David; Cantón, José
The purpose of this study was to examine the effects of child sexual abuse (CSA) on the use of coping strategies and post-traumatic stress disorder (PTSD) scores in young adults, as well as the role of avoidance and approach coping strategies in those PTSD scores in CSA victims. The role of coping strategies was studied by considering their possible interactive effect with the continuity of abuse and the relationship with the perpetrator; the effect of coping strategies on PTSD was also compared between CSA victim and non-CSA victim participants. The sample was comprised of 138 victims of CSA and another 138 participants selected as a comparison group. Data about child sexual abuse were obtained from a questionnaire developed for this purpose. Coping strategies were assessed with the How I Deal with Things Scale (Burt & Katz, 1987), while PTSD scores were assessed with the "Escala de Gravedad de Síntomas del Trastorno de Estrés Postraumático" (Severity of Symptoms of PTSD Scale; Echeburúa et al., 1997). Participants who had been victims of CSA showed significantly higher PTSD scores and lower approach coping strategies scores. However, differences in avoidance coping strategies between groups were not consistent and did not always follow the expected direction. Only the use of avoidance coping strategies was related to PTSD, participants who used these showing higher scores. The effects of avoidance strategies were stronger in continued than in isolated abuse, in intrafamilial than in extrafamilial abuse and in CSA victims than in non-victims. These results confirm the idea of CSA as a high-risk experience that can affect the victim's coping strategies and lead to PTSD to a lesser or greater extent depending on the coping strategy used. Moreover, the role of these strategies varies depending on whether or not the participant is a victim of CSA and on the characteristics of abuse (continuity and relationship with the perpetrator). In terms of intervention, a
Lueger-Schuster, Brigitte; Knefel, Matthias; Glück, Tobias M; Jagsch, Reinhold; Kantor, Viktoria; Weindl, Dina
Child maltreatment (CM) in foster care settings (i.e., institutional abuse, IA) is known to have negative effects on adult survivor's mental health. This study examines and compares the extent of CM (physical, emotional, and sexual abuse; physical and emotional neglect) and lifetime traumatization with regard to current adult mental health in a group of survivors of IA and a comparison group from the community. Participants in the foster care group (n = 220) were adult survivors of IA in Viennese foster care institutions, the comparison group (n = 234) consisted of persons from the Viennese population. The comparison group included persons who were exposed to CM within their families. Participants completed the Childhood Trauma Questionnaire, the Life Events Checklist for DSM-5, the PTSD Checklist for DSM-5, the International Trauma Questionnaire for ICD-11, and the Brief Symptom Inventory-18 and completed a structured clinical interview. Participants in the foster care group showed higher scores in all types of CM than the comparison group and 57.7% reported exposure to all types of CM. The foster care group had significantly higher prevalence rates in almost all mental disorders including personality disorders and suffered from higher symptom distress in all dimensional measures of psychopathology including depression, anxiety, somatization, dissociation, and the symptom dimensions of PTSD. In both groups, adult life events and some but not all forms of CM predicted PTSD and adult life events partly mediated the association of PTSD and CM. Explanations for the severe consequences of CM and IA are discussed. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
Goldman, Juliette D. G.; Bode, Andrew
Many children raised in orphanages suffered ongoing child abuse and neglect including sexual abuse, and nearly all were denied an adequate education. This paper explores adult females' perceptions of the impacts on their education of child sexual abuse they suffered while living in orphanages in Australia. In-depth qualitative and anonymous…
Pargament, Kenneth I.; Murray-Swank, Nichole A.; Mahoney, Annette
In this paper, we offer a way to understand the spiritual dimension of clergy-perpetrated sexual abuse. Spirituality is defined as a search for the sacred--a process of discovery, conservation, and transformation that evolves over the lifespan. We describe the ways in which clergy-perpetrated sexual abuse impacts negatively on the individual's…
Collin-Vézina, Delphine; De La Sablonnière-Griffin, Mireille; Palmer, Andrea M; Milne, Lise
Uncovering the pathways to disclosures of child sexual abuse (CSA) and the factors influencing the willingness of victims to talk about the abuse is paramount to the development of powerful practice and policy initiatives. Framed as a long interview method utilizing a grounded theory approach to analyze data, the objective of the current study was to provide a preliminary mapping of the barriers to CSA disclosures through an ecological systemic lens, from a sample of 67 male and female CSA adult survivors, all of whom had recently received counselling services. The current project led to the identification of three broad categories of barriers that were each comprised of several subthemes, namely: Barriers from Within (internalized victim-blaming, mechanisms to protect oneself, and immature development at time of abuse); Barriers in Relation to Others (violence and dysfunction in the family, power dynamics, awareness of the impact of telling, and fragile social network); and Barriers in Relation to the Social World (labelling, taboo of sexuality, lack of services available, and culture or time period). This study points to the importance of using a broad ecological framework to understand the factors that inhibit disclosure of CSA, as barriers to disclosure do not constrain solely the victims. Results are discussed in light of their implications for research, prevention and intervention programs, and social policies and media campaigns, as the burden is on the larger community to create a climate of safety and transparency that makes the telling of CSA possible. Copyright © 2015 Elsevier Ltd. All rights reserved.
Campbell, Doris W; Campbell, Jacquelyn C; Yarandi, Hossein N; O'Connor, Annie Lewis; Dollar, Emily; Killion, Cheryl; Sloand, Elizabeth; Callwood, Gloria B; Cesar, Nicole M; Hassan, Mona; Gary, Faye
Limited research following disasters suggests that internally displaced women are disproportionately vulnerable to violence and abuse. An interdisciplinary collaborative of researchers and practitioners in Haiti, the US Virgin Islands, and the US Mainland investigated gender-based violence (GBV) pre- and post-earthquake and health outcomes among Haitian women living in tent cities/camps following the 2010 earthquake. A comparative descriptive correlational design using culturally sensitive and language appropriate computer-assisted interviews of 208 internally displaced women 2011-2013. Found high rates of violence and abuse both before (71.2 %) and after (75 %) p = 0.266, the earthquake primarily perpetrated by boy friends or husbands. Significantly more mental and physical health problems were reported by abused than non-abused women. The majority (60-78 %) of abused women did not report personal or community tolerance for violence and abuse, but acknowledged a community context of limited involvement. Coordinated planning and implementation of needed interventions are essential to provide a balanced approach to the care of displaced women after natural disasters with sensitivity to the abusive experiences of many women both before and after the disasters.
Campbell, Jacquelyn C.; Yarandi, Hossein N.; O’Connor, Annie Lewis; Dollar, Emily; Killion, Cheryl; Sloand, Elizabeth; Callwood, Gloria B.; Cesar, Nicole M.; Hassan, Mona; Gary, Faye
Objectives Limited research following disasters suggests that internally displaced women are disproportionately vulnerable to violence and abuse. An interdisciplinary collaborative of researchers and practitioners in Haiti, the US Virgin Islands, and the US Mainland investigated gender-based violence (GBV) pre- and post-earthquake and health outcomes among Haitian women living in tent cities/camps following the 2010 earthquake. Methods A comparative descriptive correlational design using culturally sensitive and language appropriate computer-assisted interviews of 208 internally displaced women 2011–2013. Results Found high rates of violence and abuse both before (71.2 %) and after (75 %) p = 0.266, the earthquake primarily perpetrated by boy friends or husbands. Significantly more mental and physical health problems were reported by abused than non-abused women. The majority (60–78 %) of abused women did not report personal or community tolerance for violence and abuse, but acknowledged a community context of limited involvement. Conclusions Coordinated planning and implementation of needed interventions are essential to provide a balanced approach to the care of displaced women after natural disasters with sensitivity to the abusive experiences of many women both before and after the disasters. PMID:27624625
Granot, Michal; Yovell, Yoram; Somer, Eli; Beny, Ahuva; Sadger, Ronit; Uliel-Mirkin, Ronit; Zisman-Ilani, Yaara
Evidence points toward shared characteristics between female survivors of sexual abuse and women with dyspareunia. This study explored, for the first time, similarities and differences between women who were exposed to sexual abuse to those with dyspareunia, in order to examine whether insecure attachment styles and high somatization level are associated with trauma among women with dyspareunia. Attachment styles were explored using the Experience in Close Relationships Scale to reflect participants' levels of anxiety and avoidance. Somatization was assessed using the Brief Symptom Inventory focusing on the frequency of painful and non-painful bodily complaints. Trauma was categorized into three levels: sexual trauma, nonsexual trauma, and no trauma. Sexually abused (SA) women (n = 21) compared to women with dyspareunia (dys) (n = 44) exhibited insecure attachment styles, as expressed by high levels of avoidance (SA 4.10 ± 0.99 vs. dys 3.08 ± 1.04, t (61) = 2.66, p = .01) and anxiety (SA 4.29 ± 1.22 vs. dys 3.49 ± 1.04, t (61) = 3.61, p = .001), and higher somatization (21.00 ± 8.25 vs. 13.07 ± 7.57, t (59) = 3.63, p = .001). Attachment and somatization level did not differ significantly between women with dyspareunia without trauma to those with nonsexual trauma. Our findings emphasized the unique role of sexual trauma as a contributing factor to the augmentation of perceived bodily symptoms and to insecure attachment style. This illuminates the importance of disclosing previous sexual abuse history among women with dyspareunia.
Hage, Sally M.
Systematic analysis of interview data for 6 African American and 4 European American women who were survivors of battering and who are marginalized in society indicated that the women used active strategies (e.g., social support resources) to preserve their sense of self and agency within the conditions of violence. Previous experiences of abuse…
Reilly, Rosemary C.; D'Amico, Miranda
This inquiry describes the role of mentoring for undergraduate women survivors of trauma. It employed a comparative case approach. Interviews elicited stories from participants reflecting the role mentors have played in their life course and educational experiences. Four major themes emerged: Fantasy mentors, mentor as mirror, mentor as nurturer…
Kriedler, Maryhelen C.; Fluharty, Leslie Barnes
Discusses the evolution of a group therapy protocol for adult survivors of incest and the theoretical model on which it is based, the learned helplessness model of depression. Learned helplessness theory supports the assumption that victims internalize trauma. Group activities were aimed at changing negative self-beliefs and at providing…
Easton, Scott D
Child sexual abuse (CSA) can have a profound effect on the long-term mental health of boys/men. However, not all men with histories of CSA experience psychopathology. To improve prevention and intervention services, more research is needed to understand why some male survivors experience mental health problems and others do not. The purpose of this study was to examine factors related to mental distress among a large, non-clinical sample of men with histories of CSA (N=487). Using a cross-sectional design with purposive sampling from three national survivor organizations, data were collected through an anonymous Internet-based survey. Multivariate analyses found that only one of the four CSA severity variables-use of physical force by the abuser-was related to mental distress. Additional factors that were related to mental distress included the number of other childhood adversities, years until disclosure, overall response to disclosure, and conformity to masculine norms. Overall, the final model predicted 36% of the variance in the number of mental health symptoms. Mental health practitioners should include masculine norms, disclosure history, and childhood adversities in assessments and intervention planning with male survivors. To more fully explicate risk factors for psychopathology in this population, future studies with probability samples of men that focus on mediational processes and use longitudinal designs are needed. Copyright © 2013 Elsevier Ltd. All rights reserved.
Candib, Lucy M; Savageau, Judith A; Weinreb, Linda; Reed, George
Health care professionals like other adults have a substantial exposure to childhood and adult victimization, but the prevalence of abuse experiences among practicing family physicians has not been examined. Also unclear is the impact of such personal experiences of abuse on physicians' screening practices for childhood abuse among their patients and the personal and professional barriers to such screening. We surveyed Massachusetts family physicians about their screening practices of adult patients for a history of childhood abuse and found that 33.6% had some experience of personal trauma, with 42.4% of women and 24.3% of men reporting some kind of lifetime personal abuse, including witnessing violence between their parents. These rates are comparable to or higher than those reported in prior studies of physicians' histories of abuse. Physicians with a past history of trauma were more likely to feel confident in screening and less likely to perceive time as a barrier to screening. Given the high prevalence of prior childhood and victimization of both men and women physicians with the associated effects on their clinical work, we recommend that educational and training settings adopt specific competencies to provide safe and confidential environments where trainees can safely explore these issues and the potential impact on their clinical practice and well-being.
Fitzgerald, Monica M; Shipman, Kimberly L; Jackson, Joan L; McMahon, Robert J; Hanley, Honora M
Although women with histories of child sexual abuse (CSA) perceive themselves as less competent mothers and report greater parenting difficulties than nonabused women, few investigators have actually observed the parenting behaviors of CSA survivors. The primary aim of this study was to examine whether incest history was related to maternal perceptions of parenting efficacy and interactional patterns with their children. The secondary aim of this study was to explore the constructs of internal working models of relationships and maternal psychological adjustment as potential mediators of the relation between incest history and parenting. A community sample of 17 incest survivors, 18 nonabused women and their 3-6 year-old children participated. Mothers completed self-report measures of parenting efficacy, parental bonding (i.e., internal working models of relationships), and psychological adjustment. In addition, mothers interacted with their children in a problem-solving task. Although incest survivors reported less parenting self-efficacy than did nonabused mothers, their interactional styles with their children were positive overall and comparable to those of nonabused mothers. Specifically, survivors displayed moderate to high levels of support, assistance, and confidence, and their children showed high levels of affection towards their mothers. Incest survivors reported less bonding with their own mothers in childhood and poorer current psychological adjustment. Findings suggest that incest survivors' perceptions of their parenting abilities may be more negative than their actual parenting behaviors.
LoGiudice, Jenna A; Beck, Cheryl T
In the United States, one in every 5 women will experience sexual violence. Survivors are at risk for difficult pregnancies, substance abuse, stress, fear, and preterm births. A history of sexual abuse can impact several aspects of a woman's childbirth, thereby affecting her long-term physical and emotional well-being. The adverse pregnancy outcomes, combined with the prevalence of sexual abuse, underscore the need for research to understand survivors' experiences. This study's purpose was to understand the lived experience of pregnancy, labor, and birth from survivors. A qualitative, descriptive phenomenological research design was utilized. The purposeful sample included 8 female, self-identifying survivors of sexual abuse with at least one childbearing experience. Analysis identified 302 significant statements that formed 7 overarching themes: 1) No one asked me. Just ask me!; 2) An emotional roller coaster: From excitement to grief for what could have been a better experience; 3) All of a sudden I was that little girl again and/or I compartmentalized it: The all-or-nothing experience; 4) Am I even here?: Nothing was explained and I had no voice; 5) All too familiar: No support, nowhere to turn; 6) Holding on to the choices I can make: Who my doctor is and how I feed my baby; and 7) Overprotection: Keeping my child safe. The final result was the essence of childbearing for survivors in this study. They were not screened for a history of sexual abuse. Enjoyment and excitement were juxtaposed with guilt and fear. They had no voice, lacked support, and overwhelmingly desired control. They overprotected their children, from infancy into adulthood. The childbearing experience was a complex, emotional roller coaster permeated by the past. Women's health care providers can utilize the results to provide therapeutic care to survivors to prevent revictimization. The results elucidate the importance of screening for a history of sexual abuse and discussing the
Babcock, Rebecca L; DePrince, Anne P
Child abuse perpetrated by a close other, such as a parent, is linked to a wide range of detrimental effects, including an increased risk of self-blame. The current study evaluated whether experiences of childhood betrayal trauma were linked to self-blame following victimization in adulthood. A diverse sample of women (n = 230) from an urban city were recruited based on having experienced an incident of intimate partner abuse (IPA) reported to the local police. Women reported on their trauma histories and levels of self-blame for the target IPA incident. Results showed that a history of childhood betrayal trauma exposure predicted the degree of self-blame for the IPA incident. Women who experienced severe IPA during the target incident also indicated higher levels of self-blame. Findings from this study suggest that it may be important to target self-blame appraisals in interventions with adults exposed to abuse in childhood.
Hébert, Martine; Bergeron, Manon
This study evaluates the effects of a group intervention for women sexually abused in childhood or adulthood. The sample consisted of 41 women involved in a group intervention based on a feminist approach offered by help centers for sexual assault victims in Quebec and 11 women in a wait-list comparison group. Results reveal that the group intervention reduced psychological distress and consequences associated with sexual abuse and that gains were maintained at three-month follow- up. Analyses of potential factors related to differential gains indicated that abuse-related variables and concurrent individual interventions were not linked to outcomes. Exploratory analyses suggested that women experiencing severe physical partner violence showed greater gains with respect to self-blame/stigmatization, sexual anxiety, and anxiety related to assertiveness.
Brabeck, Kalina M; Guzmán, Michele R
Women's responses to partner abuse are shaped by their particular sociocultural contexts. In this study, quantitative data were collected from 75 Mexican-origin women who survived intimate partner abuse, to identify variables associated with help-seeking to survive relationship abuse. Help-seeking was defined as use of formal (e.g., shelter) and informal (e.g., family) sources. Variables included two cultural variables: machismo (i.e., adherence to traditional gender roles) and familismo (i.e., valuing family cohesion and reciprocity), and four sociostructural variables: income, education, English proficiency, and immigrant status. Results indicated participants with higher levels of familismo sought informal help more frequently than those with lower levels. Women with grade school education, no English proficiency, and undocumented status sought formal help less frequently than those not constrained by these barriers.
Hu, J Z; Ye, C; Pugmire, R J; Grant, D M
It is shown in this paper that a previously reported 90 degrees sample flipping (13)C 2D CSA-CSA correlation experiment may be carried out alternatively by employing constant slow sample rotation about the magic angle axis and by synchronizing the read pulse to 13 of the rotor cycle. A high-resolution 3D CSA-CSA-CSA correlation experiment based on the magic angle turning technique is reported in which the conventional 90 degrees 2D CSA-CSA powder pattern for each carbon in a system containing a number of inequivalent carbons may be separated according to the isotropic chemical shift value. The technique is demonstrated on 1,2,3-trimethoxybenzene in which all of the overlapping powder patterns that cannot be segregated by the 2D CSA-CSA experiment are resolved successfully by the 3D CSA-CSA-CSA experiment, including even the two methoxy groups (M(1) and M(3)) whose isotropic shifts, confirmed by high-speed MAS, are separated by only 1 ppm. A difference of 4 ppm in the principal value component (delta(33)) between M(1) and M(3) is readily obtained. Copyright 2000 Academic Press.
Mills, Letty J.; Daniluk, Judith C.
This qualitative, phenomenological study explores the experiences of dance therapy for 5 women who had been sexually abused as children. Using in-depth, largely unstructured interviews, the women reflect on their dance therapy experiences: and on their perceptions of the role of these experiences in their psychological healing. (Contains 46…
Orbke, Samantha; Smith, Heather L.
Roughly one third of children subjected to abusive environments grow into healthy and capable adults, demonstrating remarkable resiliency, despite risks for developing maladaptive self-structures and destructive behaviors (Werner, "American Journal of Orthopsychiatry" 59:72-81 1989; Kendall-Tackett "et al.", "Psychological Bulletin" 113:164-180…
Hebert, Martine; Bergeron, Manon
This study evaluates the effects of a group intervention for women sexually abused in childhood or adulthood. The sample consisted of 41 women involved in a group intervention based on a feminist approach offered by help centers for sexual assault victims in Quebec and 11 women in a wait-list comparison group. Results reveal that the group…
Leahy, Trisha; Pretty, Grace; Tenenbaum, Gershon
This retrospective study explores, through quantitative and qualitative methods, the relationship of two variables (perpetrator relationship and perpetrator methodology) to posttraumatic and dissociative symptomatology. The quantitative sample comprised a nonpsychiatric group (N = 39) of Australian adults reporting sexual abuse histories. A MANOVA…
Kress, Victoria E.; Hoffman, Rachel M.
This article describes a solution-focused and Ericksonian group counseling model that can be used with adolescent girls who have been sexually abused. An overview of the components of this approach is provided. A postintervention focus group provided additional results and ideas for the future development of the group counseling model.
Mitchell, Juliann; Morse, Jill
This book is a research-based resource for professionals treating women who are sexually abused by female perpetrators, mainly mothers and grandmothers. The book first focuses on the female perpetrator, defines the treatments that have proven successful, and provides an overview of the available literature. Also addressed are the myths and…
McElroy, Eoin; Shevlin, Mark; Elklit, Ask; Hyland, Philip; Murphy, Siobhan; Murphy, Jamie
Background Childhood sexual abuse (CSA) is a common occurrence and a robust, yet non-specific, predictor of adult psychopathology. While many demographic and abuse factors have been shown to impact this relationship, their common and specific effects remain poorly understood. Objective This study sought to assess the prevalence of Axis I disorders in a large sample of help-seeking victims of sexual trauma, and to examine the common and specific effects of demographic and abuse characteristics across these different diagnoses. Method The participants were attendees at four treatment centres in Denmark that provide psychological therapy for victims of CSA (N=434). Axis I disorders were assessed using the Millon Clinical Multiaxial Inventory-III (MCMI-III). Multivariate logistic regression analysis was used to examine the associations between CSA characteristics (age of onset, duration, number of abusers, number of abusive acts) and 10 adult clinical syndromes. Results There was significant variation in the prevalence of disorders and the abuse characteristics were differentially associated with the outcome variables. Having experienced sexual abuse from more than one perpetrator was the strongest predictor of psychopathology. Conclusions The relationship between CSA and adult psychopathology is complex. Abuse characteristics have both unique and shared effects across different diagnoses. Highlights of the article The prevalence of Axis I disorders were assessed in a large sample of sexual abuse and incest survivors. The impact of demographic and abuse characteristics were also examined. There was significant variation in the prevalence of disorders. Abuse characteristics were differentially associated with the disorders. Abuse from multiple perpetrators was the strongest overall predictor of psychopathology. PMID:27064976
Yahav, Rivka; Oz, Sheri
Regardless of the therapy modality, research continues to point to the therapeutic relationship as a major salient factor in clinical success or failure. When a patient is sexually abused by his or her therapist, this therapeutic relationship is cynically exploited in a way that does not properly serve the essential needs of the patient. When this patient then seeks reparative therapy, the subsequent therapist needs to pay close attention to issues of the relationship which were breached by the previous clinician. In this article, two case studies showing very different dynamics will be presented in order to demonstrate: (1) relevant factors related to transference, countertransference, projective identification, and the analytic third pertaining to the former, abusive therapy; and (2) needs versus wishes, and issues related to boundaries and self-disclosure in the corrective therapy.
Fassler, I.R.; Amodeo, M.; Griffin, M.L.; Clay, C.M.; Ellis, M.A.
Objective:: Child sexual abuse (CSA) has been associated with adverse adult psychosocial outcomes, although some reports describe minimal long-term effects. The search for explanations for the heterogeneous outcomes in women with CSA has led to an examination of a range of CSA-related factors, from the severity of individual CSA incidents to the…
Chouliara, Z; Karatzias, T; Gullone, A
Research on survivors' experiences of recovering from childhood sexual abuse (CSA) has been limited and focused on those with severe mental health difficulties. This study elicited experiences of recovery from CSA in male and female survivors who have/have not utilized mental health services. The tangible end-point was to propose a theoretical model of personally meaningful recovery. This is a qualitative study, which utilized semi-structured individual interviews following the critical incident technique. Transcripts were analysed using Interpretative Phenomenological Analysis to identify recurrent themes. A total 22 adult survivors of CSA. Main themes identified were: The Affected Self, Factors Hindering Recovery, Factors Enhancing Recovery, The Hurdles of Recovery and the Recovering Self. The affected self included: lack of boundary awareness and self-blame, over self-reliance, over-vigilance and guilt, shame, aloneness and social stigma. The recovering self was characterized by increasing confidence, assertiveness, ability to self-care and self-acceptance, and by embracing vulnerability. These findings have potentially major implications for clinical practice, service provision, policy development and professional training in this field. The importance of disclosure in the healing process seemed paramount and can have major implications for current service protocols. © 2013 John Wiley & Sons Ltd.
Zink, Therese; Klesges, Lisa; Stevens, Susanna; Decker, Paul
Childhood sexual abuse (CSA) is common and is associated with both mental and physical health problems in adulthood. Using data from an age- and sex-stratified population survey of 600 Olmsted County, Minnesota, residents, a Sexual Abuse Severity Score was developed. The abuse characteristics of 156 CSA respondents were associated with…
Engh Kraft, Lisbet; Rahm, GullBritt; Eriksson, Ulla-Britt
Child sexual abuse (CSA) is a global public health problem with major consequences for the individual child and society. An earlier Swedish study showed that the school nurses did not initially talk about nor mention CSA as one form of child abuse. For the child to receive adequate support, the disclosure is a precondition and is dependent on an…
Scholes, Laura; Jones, Christian; Nagel, Michael
Freda Briggs (2007), a leader in the field of child protection in Australia continues to raise concerns about the vulnerability and victimisation of boys that she believes is substantially under-recognised. She argues that boys have not been well supported by child sexual abuse (CSA) prevention programs with child protection curriculum not yet…
Rowland, David L.; Zabin, Laurie S.; Emerson, Mark
Explored the impact of household environment and childhood sexual abuse (CSA) on psychosocial development. Data on low-income, urban CSA victims, and non-CSA women indicated that household conditions indicative of parental dysfunction, antisocial behavior, and instability set the stage for CSA by interfering with parental protection. Victims'…
Steine, Iris M; Winje, Dagfinn; Krystal, John H; Bjorvatn, Bjørn; Milde, Anne Marita; Grønli, Janne; Nordhus, Inger Hilde; Pallesen, Ståle
In the present study, we examined the role of cumulative childhood maltreatment experiences for several health related outcomes in adulthood, including symptoms of psychological distress as well as perceived social support and hardiness. The sample comprised adult survivors of sexual abuse (N=278, 95.3% women, mean age at first abusive incident=6.4 years). One-way ANOVAs revealed a statistically significant dose-response relation between cumulative childhood maltreatment scores and self-reported symptoms of posttraumatic stress (PTSS), anxiety, depression, eating disorders, dissociation, insomnia, nightmare related distress, physical pain, emotional pain, relational problems, self-harm behaviors as well as on a measure of symptom complexity. Cumulative childhood maltreatment was also associated with lower levels of work functioning. An inverse dose-response relation was found for perceived social support and hardiness. Using a Bonferroni corrected alpha level, cumulative childhood maltreatment remained significantly associated with all outcome measures with the exception of eating disorder symptoms after controlling for abuse-related independent variables in hierarchical regression analyses. Results add to previous literature by showing that dose-response relation between cumulative childhood adversities and adult symptom outcomes could also be identified in a sample characterized by high exposure to adversities, and lends support to the notion put forth by previous authors that cumulative childhood adversities seem to be related to the severity of adult health outcomes in a rule-governed way. Copyright © 2017 Elsevier Ltd. All rights reserved.
Boles, Sharon M.; Joshi, Vandana; Grella, Christine; Wellisch, Jean
This study reports on the effects of having a history of childhood sexual abuse (CSA) on treatment outcomes among substance abusing men and women (N = 2,434) in a national, multisite study of drug treatment outcomes. A history of CSA was reported by 27.2% of the women and 9.2% of the men. Controlling for gender, compared to patients without CSA,…
Filipas, Henrietta H.; Ullman, Sarah E
The present study examined the psychological sequelae of child sexual abuse (CSA) and the factors that contributed to revictimization in the form of adult sexual assault (ASA) using a survey of 577 female college students. CSA characteristics, maladaptive coping in response to CSA, degree of self-blame at the time of the abuse and currently, and…
Alaggia, Ramona; Turton, Jennifer V.
Although the co-occurrence of woman abuse and child sexual abuse is high little research exists exploring the impact of woman abuse on maternal response to child sexual abuse (CSA). Findings from two qualitative studies indicate the form of woman abuse to have differential impact on maternal response. Mothers who were abused in non-physical ways,…
Turner, Daniel; Rettenberger, Martin; Lohmann, Lena; Eher, Reinhard; Briken, Peer
Research has identified stable and dynamic characteristics in child sexual abusers working with children (CSA-W) that may distinguish them from other child sexual abusers (CSA). However, in previous research CSA-W have usually been included in the group of extra-familial CSA (CSA-E). Two hundred and forty-eight forensic-sexological reports about CSA conducted by the Federal Evaluation Centre for Violent and Sexual Offenders in the Austrian Prison System were evaluated retrospectively. One hundred and nineteen intra-familial CSA (CSA-I), 66 CSA-E, and 38 CSA-W were compared with regard to static risk factors, indicators of psychopathy, and pedophilic sexual interests. CSA-E had the highest risk of recidivism as measured by the Static-99 total score, followed by CSA-W. Furthermore, CSA-E had more previous convictions than CSA-W. Both CSA-E and CSA-I had higher total scores on the Psychopathy Checklist-Revised than CSA-W. CSA-W had the highest prevalence of pedophilia diagnoses according to DSM-IV-TR criteria, as well as the highest rate of pedophilia with an orientation toward male children, and the highest frequency of male victims. CSA-W also had the highest total scores in the Screening Scale for Pedophilic Interests. CSA-W seem to constitute a group with particular risk factors and criminogenic needs, that is, they show more indicators of pedophilic sexual interests but less general antisociality and psychopathy, and would thus seem to be distinguishable from other CSA. Future research should focus in particular on evaluating differences in the grooming strategies used by CSA-W to commit and disclose child sexual abuse, as well as on the resources of this particular offender group. Copyright © 2013 Elsevier Ltd. All rights reserved.
Levendosky, Alytia A.; Buttenheim, Margaret
Presents a case study of the treatment of a pre-adolescent female survivor of incest. The treatment integrated relational and trauma theory perspectives in focusing on reducing self-blame, preventing further isolation, creating a safe, secure environment, and helping the patient develop positive connections with others and feelings of…
Easton, Scott D; Leone-Sheehan, Danielle M; Sophis, Ellen J; Willis, Danny G
Recent research indicates that child sexual abuse often undermines the health of boys and men across the lifespan. However, some male survivors experience a turning point marking a positive change in their health trajectories and healing process. Although frequently discussed in reference to physical health problems or addictions, very little is known about turning points with respect to child sexual abuse for men. The purpose of this secondary qualitative analysis was to describe the different types of turning points experienced by male survivors who completed the 2010 Health and Well-Being Survey (N = 250). Using conventional content analysis, researchers identified seven types of turning points that were classified into three broad categories: influential relationships (professional and group support, personal relationships), insights and new meanings (cognitive realizations, necessity to change, spiritual transformation), and action-oriented communication (disclosure of CSA, pursuit of justice). Implications for clinical practice and future research are discussed.
Malpass, Alice; Sales, Kim; Feder, Gene
This paper explores ideas of symbolic violence inherent in the research encounter (Bourdieu 1999). After defining symbolic violence and how the concept enters into domestic violence and abuse (DVA) research, we discuss the challenges arising from a (DVA) survivor taking on the role of interviewer in a qualitative study nested within a UK primary care based trial: IRIS (Identification and Referral to Improve Safety). KS, a survivor of DVA, conducted interviews with 12 women who had been referred to a domestic violence agency by primary care clinicians taking part in the IRIS trial in two UK cities (Bristol and east London) during 2009. Field notes were kept during all of the research meetings with KS and these were included in analysis. Our analysis maps the research pathway of 'non-violent communication' and discusses the role of social symmetry and proximity in the research encounter. We conclude that while a welcoming disposition, empathy and active listening are all generic skills to qualitative research; if a researcher can enter fieldwork with a claim of social proximity and symmetry, their use of these generic skills is enhanced through a process of shared objectification and empowerment talk. We explore the limitations of social proximity, its relationship to feminist and anthropological theories of 'insider' research and its relevance to primary care research. © 2015 Foundation for the Sociology of Health & Illness.
Bachar, Eytan; Canetti, Laura; Hadar, Hilit; Baruch, Julia; Dor, Yehuda; Freedman, Sara
The aim of the present study is to determine whether narcissistic vulnerability can aid in clarifying the debate regarding the relationship between childhood sexual abuse (CSA) and adulthood adjustment to traumatic events. 157 survivors (mean age = 31.1, SD = 10.9) of a traumatic event (war activities and road and work accidents) were assessed 1 week, 1, and 4 months following the event. Of the 157 participants, 15 reported experiencing CSA, and 26 reported experiencing childhood physical abuse (CPA). In the first-week assessment, patients were administered the Narcissistic Vulnerability Scale (NVS) and the Beck Depression Inventory (BDI). In the follow-up assessments, subjects were interviewed on the Clinician-Administered PTSD Scale. Narcissistic vulnerability was found, both in 1- and 4-month follow-ups, to increase the likelihood of participants who experienced CSA to develop PTSD symptoms later in their adult life, when exposed to other additional trauma. Narcissistic vulnerability, in both follow-ups, did not increase the likelihood of participants who experienced CPA to develop PTSD symptoms later in their life when exposed to other additional trauma. The NVS predicted the development of PTSD symptoms in the whole sample, both in the 1- and 4-month follow-ups, above and beyond the prediction of the BDI. In other words, narcissistic vulnerability can add additional information above and beyond general negative emotionality. In conclusion, it is recommended to take into consideration the interplay between CSA and the individual's narcissistic vulnerability when assessing the long term effects of CSA such as acute or chronic PTSD.
Ullman, Sarah E; Najdowski, Cynthia J; Filipas, Henrietta H
This study examined the unique effects of child sexual abuse simultaneously with post-traumatic stress disorder symptom clusters, problem drinking, and illicit drug use in relation to sexual revictimization in a community sample of female adult sexual assault victims. Participants (N=555) completed two surveys a year apart. Child sexual abuse predicted more post-traumatic stress disorder symptoms in adult sexual assault victims. Posttraumatic stress disorder numbing symptoms directly predicted revictimization, whereas other post-traumatic stress disorder symptoms (reexperiencing, avoidance, and arousal) were related to problem drinking, which in turn predicted revictimization. Thus, numbing symptoms and problem drinking may be independent risk factors for sexual revictimization in adult sexual assault victims, particularly for women with a history of childhood sexual abuse.
Engh Kraft, Lisbet; Rahm, GullBritt; Eriksson, Ulla-Britt
Child sexual abuse (CSA) is a global public health problem with major consequences for the individual child and society. An earlier Swedish study showed that the school nurses did not initially talk about nor mention CSA as one form of child abuse. For the child to receive adequate support, the disclosure is a precondition and is dependent on an available person prepared to listen. The aim of the study was to explore the ability of the school nurses to detect and support sexually abused children. It is a secondary analysis of focus group interviews with school nurses. Thematic analysis was performed. Results showed that the school nurses avoided addressing CSA due to arousal of strong emotions, ambivalence, and a complicated disclosure process. In order to detect CSA and support abused children, attentiveness of sexual abuse as a possible cause of physical and mental ill-health is crucial.
McDonagh, Annmarie; Friedman, Matthew; McHugo, Gregory; Ford, Julian; Sengupta, Anjana; Mueser, Kim; Demment, Christine Carney; Fournier, Debra; Schnurr, Paula P.
The authors conducted a randomized clinical trial of individual psychotherapy for women with posttraumatic stress disorder (PTSD) related to childhood sexual abuse (n = 74), comparing cognitive-behavioral therapy (CBT) with a problem-solving therapy (present-centered therapy; PCT) and to a wait-list (WL). The authors hypothesized that CBT would be…
Ullman, Sarah E.; Najdowski, Cynthia J.; Filipas, Henrietta H.
This study examined the unique effects of child sexual abuse simultaneously with post-traumatic stress disorder symptom clusters, problem drinking, and illicit drug use in relation to sexual revictimization in a community sample of female adult sexual assault victims. Participants (N = 555) completed two surveys a year apart. Child sexual abuse…
Dong, Maxia; Anda, Robert F.; Dube, Shanta R.; Giles, Wayne H.; Felitti, Vincent J.
This retrospective cohort study assessed the relationship of childhood sexual abuse (CSA) to other categories of adverse childhood experiences (ACEs), such as childhood abuse, neglect, and parental separation/divorce. Adults reporting CSA experienced a 1.6- to 3.4-fold greater likelihood of experience each category of ACE. The ACE score was also…
Feiring, Candice; Cleland, Charles M.; Simon, Valerie A.
Potential pathways from childhood sexual abuse (CSA) to negative self-schemas to subsequent dissociative symptoms and low global self-esteem were examined in a prospective longitudinal study of 160 ethnically diverse youth with confirmed CSA histories. Participants were interviewed at the time of abuse discovery, when they were 8 to 15 years of…
Hurtado, Alicia; Katz, Craig L; Ciro, Dianne; Guttfreund, Daniel; Nosike, Digna
Child sexual abuse (CSA) remains a global health problem that must be addressed. In a country with limited resources such as El Salvador, we sought an alternative way to disseminate CSA prevention information to elementary school children. The aim of this study was to evaluate the effectiveness of a child sexual abuse (CSA) prevention exhibit at a children's museum. We asked 189 children to answer a questionnaire about CSA prevention before entering a museum exhibit on the subject and then asked 59 different children to answer the questionnaire after visiting the exhibit. Children's knowledge scores on CSA prevention significantly improved after visiting the exhibit (P < .012). A museum exhibit that addresses CSA prevention is an effective way of communicating CSA prevention to children. Copyright © 2014 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.
Plummer, Malory; Cossins, Annie
Various psychological theories exist in the literature to explain the behavior of men who commit child sex offences, including the belief that child sexual abuse (CSA) is a predisposing factor for the transition from victim to offender. These theories are, however, unable to explain the fact that while most victims of CSA are female, most perpetrators of CSA are male. The sex specificity of CSA in terms of victims and offenders suggests that the experience of CSA and its psychosocial effects may be different for boys, compared to girls. We hypothesize that CSA experiences may involve risk factors that affect the development of sexually abusive behavior for boys, rather than girls. Our aim was to determine whether the literature provides evidence of a cycle of abuse from victim to offender, and, if so, to document its characteristics. We undertook a comprehensive literature review of studies on both victims and offenders, including studies which revealed the following: age of onset of CSA, duration of abuse, gender of the abuser, the relationship between victim and abuser, grooming behaviors, the types and severity of abuse, and disclosure of abuse. While we found no evidence for the existence of a cycle of abuse for female CSA victims, we discovered evidence to support the existence of a cycle of abuse for male CSA victims who had experienced particular abuse characteristics. As an original contribution to the literature, we identified four factors that may be associated with a boy's transition from victim to offender as well as the methodological issues to be addressed in future research. Based on criminological theories, we argue that these four factors share a common theme, that is, that they represent experiences of power (for the abuser) and powerlessness (for the victim). © The Author(s) 2016.
Martin, Erin K.; Silverstone, Peter H.
Here we describe the development of an evidence-based education program for adults about childhood sexual abuse (CSA), called Prevent It! Uniquely, the primary goal of this program was to change the behavior of participants, as well as to increase knowledge about CSA and positive attitudes toward it. A comprehensive review shows no previous similar approach. The program includes a detailed manual to allow standardized administration by trained facilitators, as well as multiple video segments from CSA survivors and professionals. A total of 23 program workshops were run, with 366 adults participating. Of these, 312 (85%) agreed to take part in the study. All completed baseline ratings prior to the program and 195 (63% of study sample) completed follow-up assessments at 3-months. There were no significant differences between the demographic make-up of the baseline group and the follow-up group. Assessments included demographic data, knowledge, attitudes, and several measures of behavior (our primary outcome variable). Behavioral questions asked individuals to select behaviors used in the previous 3-months from a list of options. Questions also included asking “how many times in the previous 3-months” have you “talked about healthy sexual development or Child sexual abuse (CSA) with a child you know”; “suspected a child was sexually abused”; “taken steps to protect a child”; or “reported suspected sexual abuse to police or child welfare”? The majority of attendees were women, with the commonest age group being between 30 and 39 years old. Approximately 33% had experienced CSA themselves. At 3-month follow-up there were highly statistically significant improvements in several aspects of behavior and knowledge, and attitudes regarding CSA. For example, the number of subjects actively looking for evidence of CSA increased from 46% at baseline to 81% at follow-up, while the number of subjects who actively took steps to protect children increased from
Fleming, J; Mullen, P E; Sibthorpe, B; Attewell, R; Bammer, G
The aim of this paper was to examine the association between reporting childhood sexual abuse (CSA) and alcohol abuse in a community sample of women using multivariate analysis which took into account a range of potential confounding variables (such as a family history of alcoholism) and effect modifiers (such as having an alcoholic partner). A two-stage retrospective case-control study was used to investigate the relationship between reporting CSA and alcohol abuse in women. Seven hundred and ten women randomly selected from the Australian federal electoral rolls. The Alcohol Use Disorders Identification Test (AUDIT) was used to measure alcohol abuse. A series of questions based on those developed by Wyatt (1985) were used to ascertain the prevalence of CSA. The final model showed that the relationship between a history of CSA and alcohol abuse reflected a complex interaction between CSA and a range of other factors in a woman's background. CSA was not by itself a significant predictor of alcohol abuse (OR = 0.61; 95% CI = 0.31-1.20). However, a history of CSA became significant in combination with co-factors which included: having a mother who was perceived as cold and uncaring; having an alcoholic partner; and believing that alcohol is a sexual disinhibitor. This study indicates that CSA alone is not a causative factor in the development of alcohol abuse among women and highlights the importance of examining the family background of women with alcohol problems.
When the sexual abuse of children is revealed, it is often found that other nonabusing adults were aware of the abuse but failed to act. During the past twenty years or so, the concealment of child sexual abuse (CSA) within organizations has emerged as a key challenge for child protection work. Recent events at Pennsylvania State University (PSU)…
Little, L; Hamby, S L
This paper reports preliminary data on a sample of therapists with memory of childhood sexual abuse. Therapists who reported experiencing childhood sexual abuse (CSA, n = 131) were compared with therapists who suspected sexual abuse but had no memories (n = 24) on variables related to abuse characteristics, outcomes, and perceived difficulties working with clients with a CSA history. Therapists who suspected abuse, in contrast to those who made definite reports, were more likely to report that the perpetrator was a family member, that their CSA did not involve physical contact, that there was alcoholism in their families of origin, and that the CSA had negative effects on their relationships with their own children, ability to trust others, sexual satisfaction, and work life. Therapists who suspected abuse also reported more difficulty treating CSA clients because of interpersonal pulls during sessions, arousal without memories of abuse, and some countertransferential behaviors. These findings indicate that issues related to personal trauma should be addressed during training and practice.
Parsons, Jeffrey T.; Bimbi, David S.; Koken, Juline A.; Halkitis, Perry N.
This exploratory investigation examined the relationship between childhood sexual abuse (CSA) and related psychosocial characteristics and sexual behaviors among 46 gay/bisexual male escorts who advertise via the Internet. More than a quarter of men (28.3%) reported some history of CSA. Men reporting CSA were more likely to be from an ethnic…
Lauterbach, Dean; Armour, Cherie
Very few studies have investigated the longitudinal trajectory of depression and anxiety related symptomatology among child victims of maltreatment or among those at risk for maltreatment. The current study examined latent class trajectories of anxiety/depression symptoms in a sample of 1354 (n = 657 boys, n = 697 girls) victimized or at risk children using data collected from the Longtitudinal Studies of Child Abuse and Neglect (LONGSCAN). Four trajectory groups were identified labeled low-stable, moderate-stable, moderate-increasing, and high-decreasing. This study also sought to investigate predictors of group membership. Relative to the low-stable group, membership in the three more pathological groups (i.e., moderate-stable, moderate-increasing, and high-decreasing) was predicted by a greater number of maltreatment allegations, more visits to a primary care physician for psychological issues, less perceived support by primary maternal caregiver, and lower rated popularity of the child. Implications for early identification of child maltreatment victims in primary health care settings was discussed.
Weniger, Godehard; Siemerkus, Jakob; Barke, Antonia; Lange, Claudia; Ruhleder, Mirjana; Sachsse, Ulrich; Schmidt-Samoa, Carsten; Dechent, Peter; Irle, Eva
Present neuroimaging findings suggest two subtypes of trauma response, one characterized predominantly by hyperarousal and intrusions, and the other primarily by dissociative symptoms. The neural underpinnings of these two subtypes need to be better defined. Fourteen women with childhood abuse and the current diagnosis of dissociative amnesia or dissociative identity disorder but without posttraumatic stress disorder (PTSD) and 14 matched healthy comparison subjects underwent functional magnetic resonance imaging (fMRI) while finding their way in a virtual maze. The virtual maze presented a first-person view (egocentric), lacked any topographical landmarks and could be learned only by using egocentric navigation strategies. Participants with dissociative disorders (DD) were not impaired in learning the virtual maze when compared with controls, and showed a similar, although weaker, pattern of activity changes during egocentric learning when compared with controls. Stronger dissociative disorder severity of participants with DD was related to better virtual maze performance, and to stronger activity increase within the cingulate gyrus and the precuneus. Our results add to the present knowledge of preserved attentional and visuospatial mnemonic functioning in individuals with DD. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Community-supported agriculture (CSA) began as a loosely formalised, vaguely socialistic agreement between consumers and farmers through which the consumers were provided with fresh produce from the farms. When the institution became more structured, education gained a near-equal footing with the nutritional offerings. My research indicated that…
Senn, Theresa E.; Carey, Michael P.; Vanable, Peter A.; Coury-Doniger, Patricia; Urban, Marguerite A.
Childhood sexual abuse (CSA) is associated with a wide range of negative outcomes. The authors investigated the relation between CSA and sexual risk behavior in 827 patients recruited from a sexually transmitted disease (STD) clinic. Overall, CSA was reported by 53% of women and 49% of men and was associated with greater sexual risk behavior,…
Chen, JingQi; Dunne, Michael P.; Han, Ping
Objective: Active involvement by parents may contribute substantially to the success of school-based programs to prevent child sexual abuse (CSA). In China, little is known about parental understanding of CSA. This study investigated Chinese parents' knowledge, attitudes, and communication practices with their children about CSA. Method: Six…
Catania, Joseph A.; Paul, Jay; Osmond, Dennis; Folkman, Susan; Pollack, Lance; Canchola, Jesse; Chang, Jason; Neilands, Torsten
Objective: Mediators of childhood sexual abuse (CSA) and HIV risk behavior were examined for men-who-have-sex-with-men (MSM). Method: Data from a dual frame survey of urban MSM (N = 1078) provided prevalence estimates of CSA, and a test of two latent variable models (defined by partner type) of CSA-risk behavior mediators. Results: A 20%…
Feiring, Candice; Simon, Valerie A.; Cleland, Charles M.; Barrett, Ellen P.
Although experiencing childhood sexual abuse (CSA) puts youth at risk for involvement in relationship violence, research is limited on the potential pathways from CSA to subsequent dating aggression. The current study examined prospective pathways from externalizing behavior problems and stigmatization (abuse-specific shame and self-blame…
Feiring, Candice; Simon, Valerie A.; Cleland, Charles M.
Potential pathways from childhood sexual abuse (CSA) to subsequent romantic intimacy problems were examined in a prospective longitudinal study of 160 ethnically diverse youth with confirmed CSA histories. Participants were interviewed at the time of abuse discovery, when they were 8-15 years of age, and again 1-6 years later. Stigmatization…
Fergusson, David M.; Boden, Joseph M.; Horwood, L. John
Objective: This research examined linkages between exposure to childhood sexual abuse (CSA) and childhood physical punishment/abuse (CPA) and mental health issues in early adulthood. Method: The investigation analyzed data from a birth cohort of over 1,000 New Zealand young adults studied to the age of 25. Results: Exposure to CSA and CPA was…
Schober, Daniel J.; Fawcett, Stephen B.; Thigpen, Sally; Curtis, Anna; Wright, Renee
Objective: This empirical case study describes Prevent Child Abuse Georgia's effort to prevent child sexual abuse (CSA) by educating communities throughout the state on supporting preventive behaviour. The initiative consisted of three major components: (1) dissemination of CSA prevention messages and materials; (2) a statewide helpline that…
Fanslow, Janet L.; Robinson, Elizabeth M.; Crengle, Sue; Perese, Lana
Objective: The objective is to describe the prevalence of child sexual abuse (CSA) among women in New Zealand, document ethnic specific rates, and outline the frequency of abuse experienced and the most commonly identified perpetrators. Associations between CSA and later adverse consequences were also explored. Methods: Retrospective report from a…
Schultz, Tammy; Passmore, J. Lawrence; Yoder, C. Y.
Over the past decade, a contentious debate regarding delayed memories of childhood sexual abuse (CSA) has existed. In order to address this debate, 240 female participants completed questions about CSA, the Dissociative Experience Scale (Bernstein & Putnam, 1986), Perceived Emotional Closeness with Perpetrator Scale (Schultz, Passmore, &…
Okur, Pinar; van der Knaap, Leontien M; Bogaerts, Stefan
Despite the available literature on disclosure of child sexual abuse (CSA), little is known about how gender affects disclosure. This article aims to quantitatively examine whether gender differences exist in formal (to legal or child protection authorities) and informal (to a family member or friend) disclosure of CSA and, if so, to assess whether this relation is associated with abuse characteristics and attitudes toward gender roles. The study also aimed to examine whether gender differences exist in reasons not to disclose CSA. Data of a sample of 586 participants, who reported to have experienced CSA committed by a single person, have been used for the analyses. There were no gender differences for formal disclosure, but the informal disclosure rate of CSA was 2.4 times higher for women than men, and this effect remained significant after controlling for abuse characteristics and attitudes, even though the gender difference decreased slightly. Furthermore, women and men reported different reasons for not disclosing CSA in their personal network. Women were more worried than men that family and friends would discover the abuse and reported more insecurity of what to do in this situation. Professionals in the field of CSA should consider a gender perspective when developing guidelines. Men have rarely been the subject of studies of disclosure after CSA. Professionals should focus more on general mental health outcomes of men that are not related with CSA directly, but where the effects of CSA may exert more indirectly through associations with other problems in life.
Goodman, Gail S; Goldfarb, Deborah; Quas, Jodi A; Lyon, Alexandra
Tens of thousands of child sexual abuse (CSA) cases are reported to authorities annually. Although some of the child victims obtain psychological counseling or therapy, controversy exists about the potential consequences for the accuracy of victims' memory of CSA, both in childhood and adulthood. Yet, delaying needed therapeutic intervention may have detrimental effects on the victims' well-being and recovery. To address this controversy, this study examined whether psychological counseling during a CSA prosecution predicts accuracy or inaccuracy of long-term memory for CSA. Participants (N = 71) were CSA victims who took part in a longitudinal study of memory and legal involvement. Data regarding participants' counseling attendance during the prosecution and details of their CSA cases were gathered throughout legal involvement and shortly thereafter (Time 1). Ten to 16 years later (Time 2), participants were questioned about a range of topics, including the alleged abuse. Time 1 counseling attendance significantly predicted more correct answers to abuse-related questions and (for corroborated cases) fewer overreporting responses at Time 2. Counseling was unrelated to underreporting responses. These results held even with other potential influences, such as abuse severity, victim-defendant relationship, posttraumatic stress disorder criteria met, testifying in the case, and delay, were statistically controlled. Although further research is needed, this study provides evidence that psychological counseling received by CSA victims during or shortly after prosecutions may improve later memory for abuse-related information. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Bhuvaneswar, Chaya; Shafer, Audrey
Narratives by survivors of abuse offer compelling entries into the experiences of abuse and its effects on health. Reading such stories can enlarge the clinician's understanding of the complexities of abuse. Furthermore, attention to narrative can enhance the therapeutic options for abuse victims not only in mental health arenas, but also in other medical contexts. In this article we define the genre of survivor narratives, examine one such narrative in particular (Push by Sapphire, 1996), and explore the clinical implications of narrative in abuse victims' clinical care.
Fleming, J M
To ascertain the prevalence of childhood sexual abuse (CSA) in a community sample of Australian women. Retrospective study, done in 1994, of cross-sectional data on the prevalence of CSA, collected as part of a larger two-stage case-control study of the possible relationship between CSA and alcohol abuse. Data were appropriately weighted to adjust for the different selection probabilities of cases and controls. 710 Women randomly selected from Australian federal electoral rolls. One hundred and forty-four women (20%) had experienced CSA. In 14 of these 144 women (10%), the abuse involved either vaginal or anal intercourse (i.e., 2% of the sample population experienced such abuse). The mean age at first episode of CSA was 10 years, and most (71%) of the women were aged under 12 years at the time. Perpetrators of the abuse were usually male (98%) and usually known to the child; 41% were relatives. The mean age of abusers was 34 years, with a median age difference of 24 years from that of the abused individual. Only 10% of CSA experiences were ever reported to the police, a doctor or a helping agency (e.g., community organisations, such as sexual assault services). The high rates of CSA (estimated to be 20% of all women) and low rates of reporting (10%) indicate the need for general practitioners and other health professionals to be aware that a history of such abuse may be common in women in the general population.
Holmes, William C.
Objectives: To estimate how many heterosexual and gay/bisexual men self-define abusive childhood sexual experiences (CSEs) to be childhood sexual abuse (CSA) and to assess whether CSA self-definition is associated with risky behavioral and psychiatric outcomes in adulthood. Methods: In Philadelphia County, 197 (66%) of 298 recruited men…
In accordance with its primary mission to reduce crashes, injuries, and fatalities involving large trucks and buses, the Federal Motor Carrier Safety Administration (FMCSA) initiated the Comprehensive Safety Analysis 2010 (CSA 2010) Operational Model...
"In accordance with its primary mission to reduce crashes, injuries, and fatalities involving large trucks and buses, the Federal Motor Carrier Safety Administration (FMCSA) initiated the Comprehensive Safety Analysis 2010 (CSA 2010) Operational Mode...
Feiring, Candice; Cleland, Charles
Objective: The purpose of this study was to examine patterns of change in attributions for childhood sexual abuse (CSA) over a 6-year period and whether such patterns were related to abuse severity, age, gender, and subsequent symptoms of depression and PTSD. Methodology: One-hundred and sixty children, 8-15 years old, were interviewed within 8…
Adams, Adrienne E; Sullivan, Cris M; Bybee, Deborah; Greeson, Megan R
Economic abuse is part of the pattern of behaviors used by batterers to maintain power and control over their partners. However, no measure of economic abuse exists. This study describes the development of the Scale of Economic Abuse, which was designed to fill this gap. Interviews were conducted with 103 survivors of domestic abuse, each of whom responded to measures of economic, physical, and psychological abuse as well as economic hardship. Results provide evidence for the reliability and validity of the scale. This study is an important first step toward understanding the extent and impact of economic abuse experienced by survivors.
Thornton, Clifton P; Veenema, Tener Goodwin
Early identification and intervention for victims of child sexual abuse (CSA) is essential to halting the spread of HIV in Latino populations because children who are sexually abused are at an increased risk of contracting HIV. The recent influx of unaccompanied children into the United States exposed histories of victimization, vulnerability to CSA, and suggested an epidemic of CSA in Latin America. CSA has been identified as a contributory event to HIV infection. The aim of our research was to identify factors associated with CSA and Latin Americans. A systematic review and a document search were conducted on factors associated with CSA in Latin America. Victimization was associated with lifelong risk factors for HIV. Males were consistently underrepresented in the published CSA literature and machismo attitudes may contribute to abuses of sexual power by males and contribute to males not reporting or under-reporting victimization. Copyright © 2015 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.
Lynskey, M T; Fergusson, D M
The aims of this study were to identify the factors which discriminated young people exposed to childhood sexual abuse (CSA) who developed psychiatric disorder or adjustment difficulties in young adulthood from those young people exposed to CSA who did not develop psychiatric disorder or adjustment difficulties by age 18. Data were gathered on a birth cohort of 1,025 New Zealand children studied from birth to the age of 18 on (a) exposure to CSA; (b) patterns of psychiatric disorder and adjustment difficulties at age 18 years; (c) factors that may have influenced responses to CSA including characteristics of the abuse, parental bonding, parental characteristics, and adolescent peer affiliations. Just over 10% of the cohort reported CSA. Those reporting CSA were at increased risks of a range of difficulties at age 18 (depression, anxiety, conduct disorder, alcohol abuse/dependence, other substance abuse/dependence, post sexual abuse trauma, attempted suicide). However, not all of those exposed to CSA developed difficulties and approximately a quarter of those exposed to CSA did not meet criteria for any adjustment difficulty. Further analysis suggested that the extent of adjustment difficulties in those exposed to CSA was influenced by two additional factors: (a) the extent of affiliations with delinquent or substance using peers in adolescence; and (b) the extent of paternal care or support in childhood. The findings of this study suggest that while young people exposed to CSA are at increased risks of psychiatric disorder and adjustment difficulties in young adulthood, not all individuals exposed to CSA will develop adjustment difficulties. Important factors protecting against the development of adjustment difficulties in young people experiencing CSA appear to be the nature and quality of peer and family relationships.
Martin, Erin K.; Silverstone, Peter H.
Child sexual abuse (CSA) occurs frequently in society to children aged between 2 and 17. It is significantly more common in girls than boys, with the peak age for CSA occurring when girls are aged 13–17. Many children experience multiple episodes of CSA, as well as having high rates of other victimizations (such as physical assaults). One of the problems for current research in CSA is different definitions of what this means, and no recent review has clearly differentiated more severe forms of CSA, and how commonly this is disclosed. In general we suggest there are four types of behavior that should be included as CSA, namely (1) non-contact, (2) genital touching, (3) attempted vaginal and anal penetrative acts, and (4) vaginal and anal penetrative acts. Evidence suggests that CSA involving types (2), (3), and (4) is more likely to have significant long-term outcomes, and thus can be considered has having higher-impact. From the research to date approximately 15% of girls aged 2–17 experience higher-impact CSA (with most studies suggesting that between 12 and 18% of girls experience higher-impact CSA). Approximately 6% of boys experience higher-impact CSA (with most studies suggesting that between 5 and 8% experience higher-impact CSA). The data also suggests that in over 95% of cases the CSA is never disclosed to authorities. Thus, CSA is frequent but often not identified, and occurs “below the surface” in the vast majority of higher-impact cases. Helping adults to understand “below the surface” CSA might help them to recognize it early, but there are very few indicators specific to CSA, making this a challenging goal to achieve. Nonetheless, given that CSA frequently occurs with other types of abuse, a training program that focuses on both CSA and other abuse may offer a method to allow both early recognition and prevention by adults in the general population. PMID:23874306
Hu, Mei-Hua; Huang, Go-Shine; Huang, Jing-Long; Wu, Chang-Teng; Chao, An-Shine; Lo, Fu-Sung; Wu, Han-Ping
Child sexual abuse (CSA) is a global problem that affects children of all ages, and the evaluation of these victims by psychologic and gynecologic experts in pediatric emergency departments is an important issue. Few data are available on the characteristics of children admitted to pediatric emergency department with recurrent CSA and delayed reported CSA. The aim of the present study was to describe the clinical features of, and risk factors for, recurrent CSA and delayed reported CSA. The study retrospectively analyzed victims of CSA who were admitted to a pediatric emergency department. Chi-square tests and univariate analyses were performed to assess the risk factors of recurrent or delayed reported CSA. Of the 91 CSA cases, 32 (35.2%) were recurrent assaults. Of the 70 cases recorded the duration of the event, 22 (31.4%) were delayed report cases. Comparisons of the non-recurrent and recurrent CSA assault groups revealed a significant increase in comorbidities (odds ratio [OR]: 4.46, 95% confidence interval [CI]: 1.54-12.93), acute psychiatric problems (OR: 3.18, CI: 1.26-8.06), attempted suicide (OR: 4.23, CI: 1.28-13.99), and the need for treatment with antipsychotic medications (OR: 5.57, CI: 1.37-22.65). Compared with non-delayed reported cases, the delay reported cases of CSA were significantly more likely to have anxiety (P < .05). The CSA victims in the present study exhibited acute medical and/or psychosocial problems, which indicate that pediatric emergency professionals have a responsibility to look for and recognize particular characteristics in these victims.
Hu, Mei-Hua; Huang, Go-Shine; Huang, Jing-Long; Wu, Chang-Teng; Chao, An-Shine; Lo, Fu-Sung; Wu, Han-Ping
Abstract Child sexual abuse (CSA) is a global problem that affects children of all ages, and the evaluation of these victims by psychologic and gynecologic experts in pediatric emergency departments is an important issue. Few data are available on the characteristics of children admitted to pediatric emergency department with recurrent CSA and delayed reported CSA. The aim of the present study was to describe the clinical features of, and risk factors for, recurrent CSA and delayed reported CSA. The study retrospectively analyzed victims of CSA who were admitted to a pediatric emergency department. Chi-square tests and univariate analyses were performed to assess the risk factors of recurrent or delayed reported CSA. Of the 91 CSA cases, 32 (35.2%) were recurrent assaults. Of the 70 cases recorded the duration of the event, 22 (31.4%) were delayed report cases. Comparisons of the non-recurrent and recurrent CSA assault groups revealed a significant increase in comorbidities (odds ratio [OR]: 4.46, 95% confidence interval [CI]: 1.54–12.93), acute psychiatric problems (OR: 3.18, CI: 1.26–8.06), attempted suicide (OR: 4.23, CI: 1.28–13.99), and the need for treatment with antipsychotic medications (OR: 5.57, CI: 1.37–22.65). Compared with non-delayed reported cases, the delay reported cases of CSA were significantly more likely to have anxiety (P < .05). The CSA victims in the present study exhibited acute medical and/or psychosocial problems, which indicate that pediatric emergency professionals have a responsibility to look for and recognize particular characteristics in these victims. PMID:29620636
Canton-Cortes, David; Canton, Jose
Objective: The purpose of this study was to examine the effects of child sexual abuse (CSA) on the use of coping strategies and post-traumatic stress disorder (PTSD) scores in young adults, as well as the role of avoidance and approach coping strategies in those PTSD scores in CSA victims. The role of coping strategies was studied by considering…
Edelstein, Robin S; Ghetti, Simona; Quas, Jodi A; Goodman, Gail S; Alexander, Kristen Weede; Redlich, Allison D; Cordón, Ingrid M
In the present study, attachment-related differences in long-term memory for a highly emotional life event, child sexual abuse (CSA), were investigated. Participants were 102 documented CSA victims whose cases were referred for prosecution approximately 14 years earlier. Consistent with the proposal that avoidant individuals defensively regulate the processing of potentially distressing information (Bowlby, 1980), attachment avoidance was negatively associated with memory for particularly severe CSA incidents. This finding was not mediated by the extent to which participants reported talking about the abuse after it occurred, although post abuse discussion did enhance long-term memory. In addition, accuracy was positively associated with maternal support following the abuse and extent of CSA-related legal involvement. Attachment anxiety was unrelated to memory accuracy, regardless of abuse severity. Implications of the findings for theories of avoidant defensive strategies and emotional memory are discussed.
Unikel-Santoncini, Claudia; Ramos-Lira, Luciana; Juárez-García, Francisco
To analyze the association between childhood sexual abuse (CSA) and disordered eating (DE). A probabilistic sample of 2,358 female high school students of public schools in the Estado de Mexico was used. DE was more prevalent among CSA sufferers (p < or = 0.05). Preoccupation with gaining weight, binging and restrictive behaviors were associated to CSA (p < or = 0.05). The probability of DE was 7 times higher when the CSA experience had not been revealed and 36 times when CSA happened before 14 years of age. The association between CSA and DE is clear in the sample studied, as well as with some of its specific characteristics, which highlights the need to deepen in this research field and to incorporate the evaluation of CSA and its consequences in adolescents' mental health.
Simon, Valerie A.; Feiring, Candice; Cleland, Charles M.
Objective Trauma processing is central to healthy recovery, but few studies examine how youth process experiences of child sexual abuse (CSA). The current study builds on our prior work identifying individual differences in CSA processing strategies (i.e., Constructive, Absorbed, Avoidant) to examine whether abuse stigmatization, PTSD symptoms, and negative reactions from others experienced during the year after abuse discovery were associated with subsequent CSA processing strategies. Method Participants included 160 ethnically diverse youth (8−15 years, 73% female) with confirmed cases of CSA. Predictors were measured at abuse discovery (T1) and 1 year later (T2). Individual differences in CSA processing strategies were assessed 6 years after discovery (T3) from participants’ abuse narratives. Results The persistence of abuse stigmatization from T1 to T2 significantly increased the odds of using either an Avoidant or Absorbed (vs. Constructive) strategy at T3. Higher levels of PTSD symptoms at T1 as well as their persistence from T1 to T2 each significantly increased the odds of having an Absorbed versus Constructive strategy. The persistence of perceived negative reactions from others from T1 to T2 increased the odds of an Absorbed versus Avoidant strategy. Effect sizes ranged from medium to large (M d = 0.636). Conclusions Results further validate prior work identifying distinct CSA processing strategies and suggest the persistence of abuse-specific disruptions over the year after abuse discovery may be associated with subsequent problems processing CSA experiences. PMID:28936363
Al-Mahroos, Fadheela; Al-Amer, Eshraq
Child sexual abuse (CSA) is a common problem with severe short and long-term consequences to the abused child, the family and to society. The aim of this study was to evaluate the extent of CSA, and demographic and other characteristics of the abused and their families. Retrospective and descriptive study based on a review of medical records of CSA cases from 2000-2009 at Sulmaniya Medical Complex, the main secondary and tertiary medical care facility in Bahrain. The review included demographic data, child and family characteristics, manifestations and interventions. The 440 children diagnosed with CSA had a mean age of 8 years (range, 9 months to 17 years); 222 were males (50.5%) and 218 were females (49.5%). There was a steady increase in cases from 31 per year in 2000 to 77 cases in 2009. Children disclosed abuse in 26% of cases, while health sector professionals recognized 53% of the cases. Genital touching and fondling (62.5%) were the most common form of CSA, followed by sodomy in 39%. Gonorrhea was documented in 2% of the cases and pregnancy in 4% of the females. The illiteracy rate among the fathers and mothers was 9% and 12%, respectively, which is higher than the rate among the adult general population. Children came from all socio-economic classes. There was referral to police in 56%, public prosecution in 31% of the cases, but only 8% reached the court. During ten years there has been a 2.5% increase in reported cases of CSA. Improving the skill of professionals in identifying CSA indicators and a mandatory reporting law might be needed to improve the rate of recognition and referral of CSA cases. Further general population-based surveys are needed to determine more accurately the scope of CSA and the risk and protective factors in the family and community.
Al-Mahroos, Fadheela; Al-Amer, Eshraq
BACKGROUND AND OBJECTIVE: Child sexual abuse (CSA) is a common problem with severe short and long-term consequences to the abused child, the family and to society. The aim of this study was to evaluate the extent of CSA, and demographic and other characteristics of the abused and their families. DESIGN AND SETTING: Retrospective and descriptive study based on a review of medical records of CSA cases from 2000-2009 at Sulmaniya Medical Complex, the main secondary and tertiary medical care facility in Bahrain. PATIENTS AND METHODS: The review included demographic data, child and family characteristics, manifestations and interventions. RESULTS: The 440 children diagnosed with CSA had a mean age of 8 years (range, 9 months to 17 years); 222 were males (50.5%) and 218 were females (49.5%). There was a steady increase in cases from 31 per year in 2000 to 77 cases in 2009. Children disclosed abuse in 26% of cases, while health sector professionals recognized 53% of the cases. Genital touching and fondling (62.5%) were the most common form of CSA, followed by sodomy in 39%. Gonorrhea was documented in 2% of the cases and pregnancy in 4% of the females. The illiteracy rate among the fathers and mothers was 9% and 12%, respectively, which is higher than the rate among the adult general population. Children came from all socio-economic classes. There was referral to police in 56%, public prosecution in 31% of the cases, but only 8% reached the court. CONCLUSION: During ten years there has been a 2.5% increase in reported cases of CSA. Improving the skill of professionals in identifying CSA indicators and a mandatory reporting law might be needed to improve the rate of recognition and referral of CSA cases. Further general population-based surveys are needed to determine more accurately the scope of CSA and the risk and protective factors in the family and community. PMID:21808114
McNally, Richard J.; Heeren, Alexandre; Robinaugh, Donald J.
ABSTRACT Background: The network approach to mental disorders offers a novel framework for conceptualizing posttraumatic stress disorder (PTSD) as a causal system of interacting symptoms. Objective: In this study, we extended this work by estimating the structure of relations among PTSD symptoms in adults reporting personal histories of childhood sexual abuse (CSA; N = 179). Method: We employed two complementary methods. First, using the graphical LASSO, we computed a sparse, regularized partial correlation network revealing associations (edges) between pairs of PTSD symptoms (nodes). Next, using a Bayesian approach, we computed a directed acyclic graph (DAG) to estimate a directed, potentially causal model of the relations among symptoms. Results: For the first network, we found that physiological reactivity to reminders of trauma, dreams about the trauma, and lost of interest in previously enjoyed activities were highly central nodes. However, stability analyses suggest that these findings were unstable across subsets of our sample. The DAG suggests that becoming physiologically reactive and upset in response to reminders of the trauma may be key drivers of other symptoms in adult survivors of CSA. Conclusions: Our study illustrates the strengths and limitations of these network analytic approaches to PTSD. PMID:29038690
This article describes a method of developing physician education materials using analysis of domestic violence patient experiences and patients' descriptions of their experiences. The process began with interviews of 21 domestic violence survivors, focusing on what they wanted to teach physicians. Qualitative analysis of these interviews identified 4 main themes regarding what survivors wanted physicians to understand about life in an abusive relationship: that domestic violence is universal, that it is more than just physical assaults, that it is all about power and control, and that it affects the entire family. Because what survivors wanted from physicians differed depending on where they were in their abusive relationships, recommendations were developed for each of 5 common situations: when a patient may not yet recognize the abuse, when s/he may not be ready or able to disclose the abuse, when s/he chooses to remain in an abusive relationship, when s/he is seeking care for an acute assault, and when s/he has left the relationship but not yet healed. Interview excerpts representing each of the identified themes are used to create a 30-minute educational documentary. A written companion guide covers the traditional aspects of domestic violence education. In teaching about domestic violence or other health problems where it is difficult for physicians to understand their patients intuitively, an educator's most important role may be to direct learners to listen to the experience and wisdom of patients. PMID:11841527
Richardson, J; Feder, G; Eldridge, S; Chung, W S; Coid, J; Moorey, S
Health professionals do not wish to routinely screen women for a history of domestic violence or childhood sexual abuse. However, over 80% believe that these are significant health care issues. Routine screening should not be prioritised until evidence of benefit has been established. PMID:11407053
Kilimnik, Chelsea D; Pulverman, Carey S; Meston, Cindy M
Childhood sexual abuse (CSA) has been a topic of interest in sexual health research for decades, yet literature on the sexual health correlates of CSA has been hindered by methodologic inconsistencies that have resulted in discrepant samples and mixed results. To review the major methodologic inconsistencies in the field, explore the scientific and clinical impact of these inconsistencies, and propose methodologic approaches to increase consistency and generalizability to the general population of women with CSA histories. A comprehensive literature review was conducted to assess the methodologic practices used in examining CSA and sexual health outcomes. Methodologic decisions of researchers examining sexual health outcomes of CSA. There are a number of inconsistencies in the methods used to examine CSA in sexual health research across the domains of CSA operationalization, recruitment language, and measurement approaches to CSA experiences. The examination of CSA and sexual health correlates is an important research endeavor that needs rigorous methodologic approaches. We propose recommendations to increase the utility of CSA research in sexual health. We recommend the use of a developmentally informed operationalization of childhood and adolescence, rather than age cutoffs. Researchers are encouraged to use a broad operationalization of sexual abuse such that different abuse characteristics can be measured, reported, and examined in the role of sexual health outcomes. We recommend inclusive recruitment approaches to capture the full range of CSA experiences and transparency in reporting these methods. The field also could benefit from the validation of existing self-report instruments for assessing CSA and detailed reporting of the instruments used in research studies. The use of more consistent research practices could improve the state of knowledge on the relation between CSA and sexual health. Kilimnik CD, Pulverman CS, Meston CM. Methodologic Considerations
Ahrens, Kym R.; Katon, Wayne; McCarty, Carolyn; Richardson, Laura P.; Courtney, Mark E.
Purpose: To evaluate the association between history of childhood sexual abuse (CSA) and having transactional sex among adolescents who have been in foster care. Methods: We used an existing dataset of youth transitioning out of foster care. Independent CSA variables included self report of history of sexual molestation and rape when participants…
Scholes, Laura; Jones, Christian; Stieler-Hunt, Colleen; Rolfe, Ben
In spite of research demonstrating conceptual weakness in many child sexual abuse (CSA) prevention programmes and outdated modes of delivery, students continue to participate in a diversity of initiatives. Referring to the development of a games-based approach to CSA prevention in Australia, this paper examines empirically based attributes of…
Walker-Descartes, Ingrid; Sealy, Yvette M.; Laraque, Danielle; Rojas, Mary
Objective: The aim of the study was to examine caregiver management strategies for child sexual abuse (CSA) when presented with hypothetical scenarios that vary in physical invasiveness. Methods: One hundred fifty three caregivers were given 3 scenarios of CSA with 7 management strategies presented in the 21-item Taking Action Strategies (TAS)…
Goldberg, Daniel B.
The application of theory in this article expanded on Chickering and Reisser's ([Chickering, A. W., 1993]) 7-vectors framework by considering the effects of childhood sexual abuse (CSA) on the normal experience of student development in higher education. The article includes an overview of the prevalence and effects of CSA and a case study of a…
Reese-Weber, Marla; Smith, Dana M.
The association between a history of child sexual abuse (CSA) and specific negative outcomes (attachment, feelings of power, and self-esteem) was explored as was the relationship between those negative outcomes and sexual victimization during the first semester of college. Two groups of freshman college women (67 who had experienced CSA and 55 who…
Kinzl, Johann F.; And Others
This study evaluated 202 female university students for early familial experience and childhood sexual abuse (CSA) in relation to adult sexual disorders: (1) victims of multiple CSA more frequently reported sexual desire disorders; and (2) single-incident victims and nonvictims reported no significantly different rates of sexual dysfunction.…
Schraufnagel, Trevor J.; Davis, Kelly Cue; George, William H.; Norris, Jeanette
Objective: Childhood sexual abuse (CSA) among boys has been associated with a variety of subsequent maladaptive behaviors. This study explored a potential connection between CSA and an increased likelihood of risky sexual behavior in adulthood. Further, the study examined whether or not alcohol use may contribute to this relationship. Method: As…
Lorenz, Tierney Ahrold; Meston, Cindy May
Objectives: To better understand the link between childhood sexual abuse (CSA) and adult sexual functioning and satisfaction, we examined cognitive differences between women with (N = 128) and without (NSA, N = 99) CSA histories. Methods: We used the Linguistic Inquiry Word Count, a computerized text analysis program, to investigate language…
Background: The assessment of victims of child sexual abuse (CSA) is now a recognized aspect of clinical work for both CAMH and adult services. As juvenile perpetrators of CSA are responsible for a significant minority of the sexual assaults on other children, CAMH services are increasingly approached to assess these oversexualized younger…
Cyr, Mireille; McDuff, Pierre; Wright, John
The purpose of this study was to advance knowledge of dating violence behaviors among adolescent victims of child sexual abuse (CSA), first, by determining the prevalence of psychological and physical dating violence and the reciprocity of violence, and second, by investigating the influence of certain CSA characteristics to dating violence.…
Boden, Joseph M.; Horwood, L. John; Fergusson, David M.
Objective: This paper examined the relationship between exposure to sexual and physical abuse (CSA and CPA) in childhood and later educational achievement outcomes in late adolescence and early adulthood in a birth cohort of over 1,000 children studied to age 25. Method: Retrospective data on CSA and CPA were gathered at ages 18 and 21 and used to…
Kozak, Rebecca Shoaf; Gushwa, Melinda; Cadet, Tamara J
Child sexual abuse (CSA) continues to be a major public health issue with significant short- and long-term consequences. However, little contemporary research has examined the relationship between CSA and delinquent and violent behavior in adolescence. Children who have been sexually abused experience a unique form of victimization compared to children who have endured other forms of maltreatment, as CSA can result in feelings of shame, powerlessness and boundary violations. The purpose of this study was to examine the effect of CSA on delinquent and violent behavior in adolescence. We examined self-report data at the age 18 interview from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) on measures of sexual abuse experience, and engagement in delinquent and violent behavior in the past year. All participants reported either a history of maltreatment or were identified at-risk based on demographic risk factors. Participants included 368 males and 445 females who self-reported experiences of CSA and delinquent and violent behavior (N = 813). Findings indicated that, when controlling for gender and race, the odds of engagement in delinquent and violent behavior for those who have experienced CSA are 1.7 times higher than for those who have not. Additionally, female victims of CSA were .52 times less likely to engage in violent and delinquent behavior compared to their male counterparts. Further efforts are needed to examine the effects of CSA on violent and delinquent behavior to better guide treatment efforts that prevent juvenile justice involvement.
Dion, Jacinthe; Collin-Vezina, Delphine; De La Sablonniere, Mireille; Philippe-Labbe, Marie-Pierre; Giffard, Tania
Child sexual abuse (CSA) lead to short-term sequelae and long-lasting pervasive outcomes. Research has started addressing CSA as a potential risk factor for later addictions, including pathological gambling. Among Aboriginal peoples, it is plausible that the legacy of residential schooling and other historical traumas have led to unresolved grief…
Vigil, Jacob M.; Geary, David C.; Byrd-Craven, Jennifer
Life history theory provided a framework for examining the relations among child sexual abuse (CSA), childhood adversity, and patterns of reproductive development and behavior. A community survey that assessed CSA, life history variables (e.g., age of menarche), and social and family background was administered to 623 women (mean age=26.9 years).…
Chen, J.; Dunne, M.P.; Han, P.
Objective:: Little is known about Child Sexual Abuse (CSA) in Chinese societies. This study examined CSA experiences and associations with demographic factors, self-reported health and risky behaviors among senior high school students in four provinces in central and northern China. Method:: Students in four schools in Hubei, Henan, Hebei, and…
Stephenson, Kyle R.; Hughan, Corey P.; Meston, Cindy M.
Objective: To assess the degree to which a history of childhood sexual abuse (CSA) moderates the association between sexual functioning and sexual distress in women. Method: Women with (n = 105, M age = 33.71, 66.1% Caucasian) and without (n = 71, M age = 32.63, 74.7% Caucasian) a history of CSA taking part in a larger clinical trial completed…
Fryda, Candice M.; Hulme, Polly A.
One prevention strategy for childhood sexual abuse (CSA) involves educational programs delivered to children in the school environment. The purpose of this integrative literature review was to determine the state of the science on school-based CSA prevention programs. The authors extracted data from 26 articles that fit inclusion criteria to…
Testa, Maria; VanZile-Tamsen, Carol; Livingston, Jennifer A.
Childhood sexual abuse (CSA) has been proposed to influence both women's adult sexual risk behaviors and the quality of their intimate relationships. Among a household sample of women (n = 732), good fit was obtained for a model in which CSA predicted Wave 1 male partner sexual risk and aggression characteristics, resulting in lower relationship…
Chang, Hsin-Yi; Feng, Jui-Ying; Tseng, Ren-Mei
Child physical abuse impacts the physical and psychological health of survivors. Healing child abuse is an essential process that helps survivors reorganize the meaning of the trauma and pursue a normal life. Considering the trauma of child physical abuse within the social context allows the experiences of individual survivors to be reflected in their process of healing. To explore the social interaction and construction process of healing experienced by survivors of child physical abuse. A qualitative research design using grounded theory was applied. Purposive and theoretical sampling was used to recruit survivors of childhood physical abuse who had experienced healing. Semi-structured, in-depth interviews were used and data were analyzed using open, axial, and selective coding. The process of healing child physical abuse in this study was a process of sprouting and twining. Three core categories emerged: thriving, relationships, and ethics. The healing process was analogous to a seed growing in poor soil, sprouting out from the ground, and striving to live by seeking support. The survivors constantly established interactive relationships with their selves and with others and struggled to keep family bonds grounded and growing within the frame of ethics. The healing process of sprouting and twining for child physical abuse survivors in Taiwan integrates thriving, relationships, and ethics. Professionals working with child-physical-abuse survivors must recognize conflicts in ethics. Strategies should be developed to assist survivors to cope with the impact of childhood trauma in order to facilitate the healing process.
Cantón-Cortés, David; Cortés, María Rosario; Cantón, José
The aim of the current study was to examine the effects of secure, avoidant, and anxious attachment styles on depressive symptomatology in child sexual abuse (CSA) among young female adult victims. The role of attachment style was studied by considering possible interactive effects with the type of abuse, the relationship with the perpetrator, and the continuity of abuse. Participants were 168 female victims of CSA. Information about the abuse was obtained from a self-reported questionnaire. Attachment style was assessed with the Attachment Style Measure (ASM), and the Beck Depression Inventory (BDI) was used to assess depressive symptomatology. Secure and anxious attachment styles were correlated with low and high depression scores respectively. The effects of attachment style were stronger in cases where the abuse consisted of oral sex/penetration, a non-family member as perpetrator, and in isolated, compared with continued, abuse. These results confirm that characteristics of CSA (type of abuse, relationship with the perpetrator, and continuity of abuse) can affect the impact of attachment style on depressive symptomatology. © The Author(s) 2014.
Ogle, Christin M.; Block, Stephanie D.; Harris, LaTonya S.; Goodman, Gail S.; Pineda, Annarheen; Timmer, Susan; Urquiza, Anthony; Saywitz, Karen J.
The present study examined the specificity of autobiographical memory in adolescents and adults with versus without child sexual abuse (CSA) histories. Eighty-five participants, approximately half of whom per age group had experienced CSA, were tested on the Autobiographical Memory Interview. Individual difference measures, including for trauma-related psychopathology, were also administered. Findings revealed developmental differences in the relation between autobiographical memory specificity and CSA. Even with depression statistically controlled, reduced memory specificity in CSA victims relative to controls was observed among adolescents but not among adults. A higher number of Posttraumatic Stress Disorder criteria met predicted more specific childhood memories in participants who reported CSA as their most traumatic life event. These findings contribute to the scientific understanding of childhood trauma and autobiographical memory functioning and underscore the importance of considering the role of age and degree of traumatization within the study of autobiographical memory. PMID:23627947
Lorenz, Tierney K.; Harte, Christopher B.; Meston, Cindy M.
Introduction Women with histories of childhood sexual abuse (CSA) have higher rates of sexual difficulties, as well as high sympathetic nervous system (SNS) response to sexual stimuli. Aim To examine whether treatment-related changes in autonomic balance, as indexed by heart rate variability (HRV), were associated with changes in sexual arousal and orgasm function. Methods In Study 1, we measured HRV while writing a sexual essay in 42 healthy, sexually functional women without any history of sexual trauma. These data, along with demographics, were used to develop HRV norms equations. In Study 2, 136 women with a history of CSA were randomized to one of three active expressive writing treatments that focused on their trauma, sexuality, or daily life (control condition). We recorded HRV while writing a sexual essay at pre-treatment, post-treatment, and 2 week, 1 month, and 6 month follow-ups; we also calculated the expected HRV for each participant based on the norms equations from Study 1. Main Outcome Measures Heart rate variability, Female Sexual Function Index (FSFI), Sexual Satisfaction Scale – Women (SSS-W) Results The difference between expected and observed HRV decreased over time, indicating that, post-treatment, CSA survivors displayed HRV closer to the expected HRV of a demographics-matched woman with no history of sexual trauma. Also, over time, participants whose HRV became less dysregulated showed the biggest gains in sexual arousal and orgasm function. These effects were consistent across condition. Conclusions Treatments that reduce autonomic imbalance may improve sexual wellbeing among CSA populations. PMID:25963394
Hébert, Martine; Moreau, Catherine; Blais, Martin; Lavoie, Francine; Guerrier, Mireille
Child sexual abuse (CSA) is identified as a significant risk factor for later victimization in the context of adult intimate relationships, but less is known about the risk associated with CSA in early romantic relationships. This paper aims to document the association between CSA and teen dating victimization in a large representative sample of Quebec high-school students. As part of the Youths’ Romantic Relationships Project, 8,194 teens completed measures on CSA and psychological, physical and sexual dating violence. After controlling for other interpersonal traumas, results show that CSA contributed to all three forms of dating victimization among both boys and girls. The heightened risk of revictimization appears to be stronger for male victims of CSA. Intervention and prevention efforts are clearly needed to reduce the vulnerability of male and female victims of sexual abuse who are entering the crucial phase of adolescence and first romantic relationships. PMID:29308104
Schafer, Katherine R; Gupta, Shruti; Dillingham, Rebecca
A personal history of childhood sexual abuse (CSA) is prevalent and deleterious to health for people living with HIV (PLWH), and current statistics likely underrepresent the frequency of these experiences. In the general population, the prevalence of CSA appears to be higher in men who have sex with men (MSM) than heterosexual men, but there are limited data available for HIV-infected MSM. CSA is associated with poor mental and physical health and may contribute to high rates of HIV risk behaviors, including unprotected sex and substance abuse. CSA exposure is also associated with low engagement in care for PLWH. More information is needed regarding CSA experiences of HIV-infected MSM to optimize health and wellbeing for this population and to prevent HIV transmission. This article reviews the epidemiology, implications, and interventions for MSM who have a history of CSA. Copyright © 2013 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.
Draucker, Claire Burke; Mazurczyk, Jill
Childhood sexual abuse (CSA) is thought to be a precursor to substance use and sexual risk behaviors during adolescence. To inform adolescent prevention efforts, information is needed to explicate the nature of the relationships between CSA and these health risks. The aim of this study was to summarize the current literature on the associations between a history of CSA and substance use and sexual risk behaviors during adolescence. We conducted a systematic literature search and an integrative review. Current evidence implicates CSA as a robust precursor to the use of a wide variety of substances and multiple sexual risk behaviors during adolescence. Screening for CSA in adolescents at risk and incorporating strategies that enhance CSA recovery in adolescent prevention programs are warranted. Future research that includes longitudinal designs, uses multiple methods of assessment, and identifies pathways between CSA and adolescent health risks is recommended. Copyright © 2013 Elsevier Inc. All rights reserved.
Kim, Shin-Jeong; Kang, Kyung-Ah
Child sexual abuse (CSA) threatens children's safety and even their lives. CSA is increasing steadily, despite the government's efforts to decrease and prevent its incidence. The purpose of this study was to evaluate the effects of the Child Sexual Abuse Prevention Education (C-SAPE) program on fifth-grade elementary school students' competence in…
Al-Saif, Dalia M; Al-Eissa, Majid; Saleheen, Hassan; Al-Mutlaq, Huda; Everson, Mark D; Almuneef, Maha A
Child sexual abuse (CSA) requires specialized knowledge and training that includes forensic interview skills. The aim of this study was to determine variations in professionals' attitudes toward CSA by measuring three aspects of forensic attitudes (sensitivity, specificity, and skepticism) and evaluating disagreements concerning the assessment of CSA cases in Saudi Arabia. A cross-sectional, web-based study, in which the Child Forensic Attitude Scale was used to measure professionals' attitudes, was conducted. Professionals who dealt with suspected cases of CSA as part of their jobs or were in professions that necessitated involvement with such cases, were selected as participants. Of 327 participants, 53% were aged ≤40 years, and 54% were men. In addition, 24% were doctors/nurses, 20% were therapists/psychiatrists, 24% were social workers, 17% were educators, 9% were law enforcement professionals, and 5% were medical examiners. Attitude subscale scores differed significantly according to participants' sex, specialty, and training. Women, healthcare professionals, and those who had participated in more than five training courses were more concerned about the underreporting of abuse (high sensitivity) relative to other professionals. In comparison, men, medical examiners, law enforcement officers, and undertrained professionals tended to underreport suspected sexual abuse cases (high specificity). High specificity in attitudes toward suspected cases of CSA could affect professionals' judgment and contribute to low reporting rates. Certain strategies, including increasing self-awareness of personal bias, specific CSA recognition courses, and team approaches to case assessment and management, should be implemented to control the influence of subjective factors.
... subcommittee will meet to discuss ideas, concepts, and suggestions on FMCSA's CSA program. On Wednesday and... CSA Subcommittee will discuss information, concepts, and ideas concerning FMCSA's CSA program. The...: Motorcoach HOS The Motorcoach HOS Subcommittee will meet to discuss information, concepts, and ideas it...
Vrolijk-Bosschaart, Thekla F; Verlinden, Eva; Langendam, Miranda W; De Smet, Vivienne; Teeuw, Arianne H; Brilleslijper-Kater, Sonja N; Benninga, Marc A; Lindauer, Ramón J L
Children with alleged child sexual abuse (CSA) need to be assessed systematically. The use of validated instruments during the assessment, like the Child Sexual Behavior Inventory (CSBI), could add diagnostic value. We aim to assess the diagnostic utility of the CSBI to differentiate between sexually abused and non-abused children. We conducted a systematic review. We searched the electronic databases MEDLINE and PsychInfo for studies comparing CSBI scores in sexually abused children and non-abused children (2-12 years old). Two independent reviewers extracted data and assessed the methodological quality. We included 7 (out of 1048) articles. The CSBI total scores were significantly higher in CSA-victims compared with non-abused children (in case-control settings). However, in children with suspected CSA, the results were ambiguous. One study reported significant differences. Another study reported weak diagnostic ability for the CSBI-3 in children with suspected CSA (a sensitivity and specificity of 0.50, with a positive predictive value of 0.28, and a negative predictive value of 0.72). Research on the diagnostic utility of the CSBI for suspected CSA is limited and shows disappointing results. Until more research is done, the CSBI should not be used on its own to differentiate between sexually abused and non-abused children.
Newton, Jeremy W; Hobbs, Sue D
The current study investigated effects of simulated memory impairment on recall of child sexual abuse (CSA) information. A total of 144 adults were tested for memory of a written CSA scenario in which they role-played as the victim. There were four experimental groups and two testing sessions. During Session 1, participants read a CSA story and recalled it truthfully (Genuine group), omitted CSA information (Omission group), exaggerated CSA information (Commission group), or did not recall the story at all (No Rehearsal group). One week later, at Session 2, all participants were told to recount the scenario truthfully, and their memory was then tested using free recall and cued recall questions. The Session 1 manipulation affected memory accuracy during Session 2. Specifically, compared with the Genuine group's performance, the Omission, Commission, or No Rehearsal groups' performance was characterized by increased omission and commission errors and decreased reporting of correct details. Victim blame ratings (i.e., victim responsibility and provocativeness) and participant gender predicted increased error and decreased accuracy, whereas perpetrator blame ratings predicted decreased error and increased accuracy. Findings are discussed in relation to factors that may affect memory for CSA information. Copyright © 2015 John Wiley & Sons, Ltd.
Beach, Steven R. H.; Brody, Gene H.; Lei, Man Kit; Gibbons, Frederick X.; Gerrard, Meg; Simons, Ronald L.; Cutrona, Carolyn E.; Philibert, Robert A.
Genetic, environmental, and epigenetic influences and their transactions were examined in a sample of 155 women from the Iowa Adoptee sample (IAS) who had been removed from their biological parents shortly after birth, and assessed when participants were an average of 41.10 years old. We observed an interactive effect of child sex abuse (CSA) and biological parent psychopathology (i.e., genetic load) on substance abuse as well as a main effect of CSA on substance abuse in adulthood. We also observed main effects of CSA and genetic load on depression and on antisocial characteristics. As predicted, CSA, but not genetic load or later substance abuse, was associated with epigenetic change. In addition, the interaction between genetic load and CSA predicted epigenetic change, indicating a potential genetic basis for differential impact of CSA on epigenetic change. Finally, epigenetic change partially mediated the effect of CSA on antisocial characteristics. The results suggest the relevance of genetic and epigenetic processes for future theorizing regarding marital and family precursors of several forms of adult psychopathology. Implications for preventive intervention are discussed. PMID:23421829
Daigneault, Isabelle; Hebert, Martine; McDuff, Pierre
Objectives: (1) Document the prevalence of childhood sexual abuse (CSA), childhood physical assault, psychological, physical and sexual intimate partner violence (IPV) in a nationally representative sample. (2) Assess the predictive value of CSA and other characteristics of the respondents and their current partners as potential risk factors for…
Young, M. Scott; Harford, Kelli-Lee; Kinder, Bill; Savell, Jodi K.
A large body of research has documented the harmful effects of childhood sexual abuse (CSA) on adult mental health among females, but less work has examined this issue among males. This study examined whether gender moderated the relationship between CSA and adult mental health among a mixed-gender sample of 406 undergraduates. A Pearson…
Edwards, Nivischi N.; Lambie, Glenn W.
Childhood sexual abuse (CSA) is prevalent among women. Person-centered counseling (PCC) is an effective core therapeutic approach to use when treating women with this issue. This article provides (a) an overview of CSA, (b) an orientation to PCC, and (c) a case example illustrating the primary application of this approach.
Bowman, Katherine Gail; Ryberg, Jacalyn Wickline; Becker, Heather
The purpose of this study is to compare Mexican American adolescent mothers with and without childhood sexual abuse (CSA) histories to examine the influence of CSA on dissociation, selection of infant feeding method, and intimate parenting anxiety. Participants are 78 English-speaking adolescents between 15 and 19 years of age and recruited from…
Walsh, Kerryann; Zwi, Karen; Woolfenden, Susan; Shlonsky, Aron
Objective: To assess evidence of the effectiveness of school-based education programs for the prevention of child sexual abuse (CSA). The programs deliver information about CSA and strategies to help children avoid it and encourage help seeking. Methods: Systematic review including meta-analysis of randomized controlled trials (RCTs), cluster…
Loeb, Tamra B.; Gaines, Tommi; Wyatt, Gail E.; Zhang, Muyu; Liu, Honghu
Women with histories of child sexual abuse (CSA) are more likely than those without such experiences to report a variety of negative sexual outcomes. This study examines the explanatory power of a CSA summed composite versus dichotomous (presence/absence) measurement in predicting a comprehensive negative sexual behavior outcome. Study…
Chan, Ko Ling; Yan, Elsie; Brownridge, Douglas A.; Tiwari, Agnes; Fong, Daniel Y. T.
This study investigated the prevalence and impact of childhood sexual abuse (CSA) on future intimate partner violence (IPV) in dating relationship in Hong Kong, China. A total of 1,154 Chinese adult respondents engaged in dating relationships were interviewed face-to-face about their CSA histories, childhood witnessing of parental violence, adult…
Jones, Deborah J.; Lewis, Terri; Litrownik, Alan; Thompson, Richard; Proctor, Laura J.; Isbell, Patricia; Dubowitz, Howard; English, Diana; Jones, Bobby; Nagin, Daniel; Runyan, Desmond
A robust literature links childhood sexual abuse (CSA) to later substance use and sexual risk behavior; yet, relatively little empirical attention has been devoted to identifying the mechanisms linking CSA to risky behavior among youth, with even less work examining such processes in boys. With the aim of addressing this gap in the literature, the…
Moore, Elya E.; Romaniuk, Helena; Olsson, Craig A.; Jayasinghe, Yasmin; Carlin, John B.; Patton, George C.
Objectives: Childhood sexual abuse (CSA) is associated with both short- and long-term adverse mental and physical health consequences, yet there remains considerable controversy about the prevalence of CSA in the general population. There is also little prospective data on unwanted sexual contact (USC) collected during adolescence. Methods: Data…
van Roode, Thea; Dickson, Nigel; Herbison, Peter; Paul, Charlotte
Objectives: To determine the impact of child sexual abuse (CSA) on adult sexual behaviors and outcomes over three age periods. Methods: A longitudinal study of a birth cohort born in Dunedin, New Zealand in 1972/1973 was used. Information on CSA was sought at age 26, and on sexual behaviors and outcomes at ages 21, 26, and 32. Comparisons were…
Hulme, P A
The purpose of this study was to (1) determine the symptomatology of women primary care patients who experienced childhood sexual abuse (CSA), using both a self-report survey and a chart review, and (2) determine their health care utilization patterns, using chart and information system reviews. An ex post facto research design was used. Women primary care patients who experienced CSA were compared with those who reported no CSA. Participants were recruited from a random sample of women patients from a large primary care clinic. They were mailed the survey; chart and information system reviews were conducted on those who returned surveys. Of the 395 participants, 23% reported past CSA on the survey. Women who experienced CSA reported 44 out of 51 physical and psychosocial symptoms more frequently than their counterparts who reported no past CSA. Further, they experienced these symptoms more intensely and in greater number. In their charts, however, far fewer differences in symptoms between groups were found. Nonetheless, women who experienced CSA visited the primary care clinic an average of 1.33 more times than women with no CSA, and they incurred an average of $150 more in primary care charges over a 2-year period. The findings indicate that many women primary care patients who experienced CSA suffer multiple symptoms that are not reflected in their charts. In addition, the findings demonstrate that not only is CSA associated with increased primary care visits, but also increased primary care costs, as measured by charges.
undergraduate students who participated in this study. References Balge, K., & Milner, J. S. (2000). Emotion-recognition ability in mothers at high...recruits (N=5,394) and college students (N=716) completed self-report measures of their history of child abuse (i.e., CPA and child sexual abuse [CSA...reported in undergraduate samples (e.g., Crouch, Milner, & Caliso, 1995; de Paul, Milner, & Mugica, 1995; de Paul, Perez-Albeniz, Paz, Alday, & Mocoroa
Carey, Michael P.; Coury-Doniger, Patricia
Objective Childhood sexual abuse (CSA) is associated with increased sexual risk behavior in adulthood, and this association may be mediated by traumagenic dynamics constructs (i.e., traumatic sexualization, trust, guilt, and powerlessness). However, few studies have investigated whether such relationships hold for women who do not identify as having experienced CSA despite meeting objective criteria that CSA occurred. This study sought to determine whether individuals who met research criteria for CSA and who self-defined as sexually abused differed on traumagenic dynamics constructs and current sexual risk behavior from individuals who met research criteria for CSA and who did not self-define as sexually abused. Methods Participants were 481 women recruited from a publicly-funded STD clinic. Participants completed a computerized survey assessing childhood sexual experiences and adult sexual risk behavior. Results Of the total sample, 206 (43%) met research criteria for CSA. Of the women meeting research criteria for CSA, 142 (69%) self-defined as sexually abused. Women who met research criteria for CSA reported more traumatic sexualization, more trust of a partner, more powerlessness, less sexual guilt, more episodes of unprotected sex, more sex partners, and greater likelihood of sex trading, compared to women who did not meet research criteria for CSA. Among women meeting research criteria, those who self-defined as sexually abused did not differ from those who did not self-define on any of the traumagenic dynamics constructs or on current sexual risk behavior, controlling for CSA characteristics. Conclusions Individuals who were sexually abused as children by behavioral research criteria are at risk for engaging in sexual risk behavior as adults, regardless of whether or not they perceive the experience to be CSA. Future research is needed to understand how non-definers perceive these childhood sexual experiences. PMID:21620162
Oleinikov, Andrew V; Francis, Susan E; Dorfman, Jeffrey R; Rossnagle, Eddie; Balcaitis, Stephanie; Getz, Tony; Avril, Marion; Gose, Severin; Smith, Joseph D; Fried, Michal; Duffy, Patrick E
The variant surface antigen VAR2CSA is a pregnancy malaria vaccine candidate, but its size and polymorphism are obstacles to development. We expressed 3D7-type VAR2CSA domains in Escherichia coli as insoluble His-tagged proteins (Duffy binding-like [DBL] domains DBL1, DBL3, DBL4, and DBL5) that were denatured and refolded or as soluble glutathione S-transferase-tagged protein (DBL6). Anti-DBL5 antiserum cross-reacted with surface proteins of chondroitin sulfate A (CSA)-binding laboratory strains (3D7-CSA and FCR3-CSA) and a clinical pregnancy malaria isolate, whereas anti-DBL6 antiserum reacted only to 3D7 surface protein. This is the first report that E. coli-expressed VAR2CSA domains induce antibody to native VAR2CSA.
Rudolph, Julia; Zimmer-Gembeck, Melanie J; Shanley, Dianne C; Walsh, Kerrryann; Hawkins, Russell
We investigated whether parents who reported more positive parenting practices (i.e., monitoring, involvement, and communication) reported more discussion of child sexual abuse (CSA) with their children. Parents from Australia and the UK (N = 248), with children aged 6 to 11 years, completed an online survey. About half of parents reported directly discussing CSA, whereas 35% reported telling their children that CSA perpetrators may be family members. Rates of discussion were higher for other CSA-related topics such as body integrity and abduction. Correlational analyses showed that parents who reported speaking to their children about CSA also reported more positive parenting practices, more discussion of other sensitive topics, and assessed CSA risk for children (in general) to be higher. Discussion of CSA risk was not associated with parents' CSA knowledge, confidence or appraisal of own-child risk. Parents higher in positive parenting believed their children to be at less CSA risk. Parents who appraised higher own-child risk reported less positive parenting practices and were less confident about their parenting and their ability to protect their children from CSA. The findings are the first to report on the associations of parenting practices with parents' CSA discussion with their children.
Baril, Karine; Tourigny, Marc; Paillé, Pierre; Pauzé, Robert
Considering the importance of mother's support in the adaptation of a sexually abused child, it is relevant to determine if the mothers and children involved in an intergenerational cycle of child sexual victimization differ from dyads in which only the child has been abused. The purpose of this study was to compare mother-child dyads with sexually abused children according to whether the mother had herself been victim of child sexual abuse. The sample included 87 dyads with sexually abused children aged 3-18 years old and their mothers (44 reporting maternal and child abuse), followed by social welfare services of the province of Quebec (Canada). The two groups of mothers were compared on their past family abuse experiences and past family relations, their mental health history, their current psychological distress, their parenting behaviors, and their current levels of family functioning. Children were compared on their adaptation. Multivariate analyses indicated that mothers reporting child sexual abuse were more likely to report more other maltreatments in their childhood and greater prevalence of lifetime history of alcohol abuse disorders, dysthymia, and panic disorder compared with mothers who had not experienced CSA. Compared to children whose mothers had not experienced CSA, those whose mothers had experienced CSA showed higher rates of problems behaviors and were more likely to report having been sexually abused by a trusted person. These results highlight the specific clinical needs for the assessment and treatment for sexually abused children whose mothers experienced child sexual abuse.
Usta, J; Farver, J
Child sexual abuse (CSA) is rarely addressed in the Arab world. This study examined the prevalence, risk factors and consequences associated with CSA in Lebanese children before, during and after the 2006 Hezbollah-Israeli war. A total of 1028 Lebanese children (556 boys; 472 girls) were administered an interview questionnaire that included the International Child Abuse Screening Tool, the Trauma Symptom Checklist and the Family Functioning in Adolescence Questionnaire. In total, 249 (24%) children reported at least one incident of CSA; 110 (11%) occurred before the war, 90 (8%) took place in the 1-year period after the war to the time of the data collection and 49 (5%) occurred during the 33-day war. There were no gender differences in CSA reports before or after the war, but boys reported more incidents during the war than did girls. Girls who reported CSA had higher trauma-related symptoms for sleep disturbance, somatization, Post Traumatic Stress Disorder (PTSD) and anxiety than did boys. There were geographic differences in the reports of abuse that may be associated with poverty and living standards. Logistic regression analyses correctly classified 89.9% of the cases and indicated that children's age, family size, fathers' education level and family functioning significantly predicted CSA during the period following the war. The prevalence of CSA in the current study is within the reported international range. Given the increase in the incidents of CSA during the war and the significant findings for family-related risk factors, there is an urgent need to provide multi-component culturally appropriate interventions that target the child and the family system in times of peace and conflict.
Ogilvie, Beverly; Daniluk, Judith
Studied mother-daughter incest. Common themes were extracted from in-depth interviews with survivors of mother-perpetrated sexual abuse, some of which parallel the experience of survivors of other forms of child sexual abuse, and some of which are more specific to mother-daughter incest. Discusses themes and counseling implications. (JBJ)
Messman-Moore, T.L.; Brown, A.L.
Objective:: Child maltreatment and family functioning were examined as predictors of adult rape in a sample of 925 college women. Method:: Information was obtained from retrospective self-report questionnaires. Child sexual abuse (CSA) was assessed with the Life Experiences Questionnaire, child emotional abuse (CEA) and physical abuse (CPA) were…
Hershkowitz, Irit; Melkman, Eran P; Zur, Ronit
A large national sample of 4,775 reports of child physical and sexual abuse made in Israel in 2014 was analyzed in order to examine whether assessments of credibility would vary according to abuse type, physical or sexual, and whether child and event characteristics contributing to the probability that reports of abuse would be determined as credible would be similar or different in child physical abuse (CPA) and child sexual abuse (CSA) cases. Results revealed that CPA reports were less likely to be viewed as credible (41.9%) compared to CSA reports (56.7%). Multigroup path analysis, however, indicated equivalence in predicting factors. In a unified model for both types of abuse, salient predictors of a credible judgment were older age, lack of a cognitive delay, and the alleged abusive event being a onetime less severe act. Over and beyond the effects of these factors, abuse type significantly contributed to the prediction of credibility judgments.
Simon, Valerie A.; Smith, Erin; Fava, Nicole; Feiring, Candice
Meanings made of childhood sexual abuse (CSA) experiences are important to psychosocial adjustment. The current study examined adolescents’ and young adults’ perceptions of posttraumatic change (PTC) in the self, relationships, sexuality, and worldviews attributed to prior CSA experiences. We sought to document the prevalence of positive and negative PTC and examine their unique and joint associations with psychosocial adjustment. Participants included 160 youth with confirmed cases of CSA (73% female; 8–14 years at abuse discovery) who were part of a longitudinal study of the long-term effects of CSA. Six years after discovery, youth were interviewed about their abuse experiences. Interviews were coded for the valence and strength of PTC. The majority of youth reported PTC, and negative changes were more frequent and stronger than positive changes. Controlling for age, gender, abuse severity, and negative PTC, positive PTC was associated with lower abuse stigmatization for all youth. Controlling for age, gender, abuse severity, and positive PTC, negative PTC was associated with greater abuse stigmatization, post-traumatic stress disorder, sexual problems, and dating aggression for all youth. Relations of positive PTC with depression and support from friends and romantic partner were moderated by negative PTC, such that positive PTC was associated with better adjustment for youth with low versus high levels of negative PTC. Results highlight the importance of both negative and positive PTC for understanding meanings made of CSA experiences and their implications for psychosocial adjustment and intervention. PMID:26092440
Fried, Michal; Duffy, Patrick E
Placental malaria (PM) due to Plasmodium falciparum is a major cause of maternal, fetal and infant mortality, but the mechanisms of pathogenesis and protective immunity are relatively well-understood for this condition, providing a path for vaccine development. P. falciparum parasites bind to chondroitin sulfate A (CSA) to sequester in the placenta, and women become resistant over 1-2 pregnancies as they acquire antibodies that block adhesion to CSA. The protein VAR2CSA, a member of the PfEMP1 variant surface antigen family, mediates parasite adhesion to CSA, and is the leading target for a vaccine to prevent PM. Obstacles to PM vaccine development include the large size (∼ 350 kD), high cysteine content, and sequence variation of VAR2CSA. A number of approaches have been taken to identify the combination of VAR2CSA domains and alleles that can induce broadly active antibodies that block adhesion of heterologous parasite isolates to CSA. This review summarizes these approaches, which have examined VAR2CSA fragments for binding activity, antigenicity with naturally acquired antibodies, and immunogenicity in animals for inducing anti-adhesion or surface-reactive antibodies. Two products are expected to enter human clinical studies in the near future based on N-terminal VAR2CSA fragments that have high binding affinity for CSA, and additional proteins preferentially expressed by placental parasites are also being examined for their potential contribution to a PM vaccine. Copyright © 2015. Published by Elsevier Ltd.
This article, based on an analysis of unstructured interviews, identifies that the emotional bond between survivors of child sexual abuse and the people who perpetrated the abuse against them is similar to that of the powerful bi-directional relationship central to Stockholm Syndrome as described by Graham (1994). Aspects of Stockholm Syndrome…
Najman, Jake M; Dunne, Michael P; Purdie, David M; Boyle, Francis M; Coxeter, Peter D
This study examined self-reported adult sexual functioning in individuals reporting a history of childhood sexual abuse (CSA) in a representative sample of the Australian population. A sample of 1793 persons, aged 18-59 years, were randomly selected from the electoral roll for Australian states and territories in April 2000. Respondents were interviewed about their health status and sexual experiences, including unwanted sexual experiences before the age of 16 years. More than one-third of women and approximately one-sixth of men reported a history of CSA. Women were more likely than men to report both non-penetrative and penetrative experiences of CSA. For both sexes, there was a significant association between CSA and symptoms of sexual dysfunction. In assessing the specific nature of the relationship between sexual abuse and sexual dysfunction, statistically significant associations were, in general, evident for women only. CSA was not associated with the level of physical or emotional satisfaction respondents experienced with their sexual activity. The total number of lifetime sexual partners was significantly and positively associated with CSA for females, but not for males; however, the number of sexual partners in the last year was not related to CSA. CSA in the Australian population is common and contributes to significant impairment in the sexual functioning of adults, especially women. These consequences appear not to extend to the other areas of sexual activity considered in this study.
.... Evaluation and Testing CSA Group with the manufacturer's assistance prepares a motor control list...-0053] Energy Efficiency Program for Industrial Equipment: Petition of CSA Group for Classification as a...: This notice announces receipt of a petition from CSA Group (CSA) seeking classification as a nationally...
Tashjian, Sarah M; Goldfarb, Deborah; Goodman, Gail S; Quas, Jodi A; Edelstein, Robin
The present pilot study sought to identify predictors of delays in child sexual abuse (CSA) disclosure, specifically whether emotional and physical abuse by a parental figure contributes to predicting delays over and above other important victim factors. Alleged CSA victims (N=79), whose parental figures were not the purported sexual abuse perpetrators, were interviewed and their case files reviewed, across two waves of a longitudinal study. Regression analyses indicated that experiencing both emotional and physical abuse by a parental figure was uniquely predictive of longer delays in disclosure of CSA perpetrated by someone other than a parental figure. Victim-CSA perpetrator relationship type and sexual abuse duration also significantly predicted CSA disclosure delay, whereas victim age at the time of the police report, victim gender, and victims' feelings of complicity were not significant unique predictors. Child abuse victims' expectations of lack of parental support may underlie these findings. Parent-child relationships are likely crucial to timely disclosure of CSA, even when a parent is not the CSA perpetrator. Copyright © 2016 Elsevier Ltd. All rights reserved.
Jones, Deborah J.; Runyan, Desmond K.; Lewis, Terri; Litrownik, Alan J.; Black, Maureen M.; Wiley, Tisha; English, Diana E.; Proctor, Laura J.; Jones, Bobby L.; Nagin, Daniel S.
Childhood sexual abuse (CSA) has been associated with HIV/AIDS risk behavior; however, much of this work is retrospective and focuses on women. The current study used semiparametric mixture modeling with youth (n = 844; 48.8% boys) from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) to examine the link between trajectories of CSA (2 to 12 y.o.) and HIV/AIDS risk behavior at age 14 (i.e., sexual intercourse & alcohol use). Trajectory analyses revealed a link between a history of CSA and the development of risky behavior. In addition, trajectories for physical and emotional abuse, but not neglect or witnessed violence, contributed to risky behavior over and above the role of CSA. Child gender did not moderate the findings. Findings highlight the signficance of CSA histories, as well as the broader context of maltreatment, for better understanding the development of risk behaviors in both girls and boys. PMID:20706919
Horton, Jessica; Friedenstab, Steve
This article describes a special third-grade classroom unit based on the reality show "Survivor." The goal of this engaging and interactive unit was to teach students about physical and behavioral adaptations that help animals survive in various desert biomes. The activity combines research, argument, and puppet play over one week of…
Allers, Christopher T.; And Others
Presents case studies and discussions regarding 3 observed characteristics of unresolved childhood sexual abuse in adult survivors over 65 years of age. Specifically, chronic depression, elder abuse, and misdiagnosis of residual abuse trauma as dementia or mental illness are compared to parallel issues identified by researchers working with…
Senn, Theresa E.; Carey, Michael P.; Coury-Doniger, Patricia
Childhood sexual abuse (CSA) is associated with sexual risk behavior in adulthood, but little research has investigated processes that might mediate this relation. The purpose of this study was to investigate whether constructs suggested by the traumagenic dynamics (TD) model (a theory of the effects of CSA) or constructs suggested by the Information-Motivation-Behavioral skills (IMB) model (a theory of the antecedents of sexual risk behavior) better mediated the relation between CSA and sexual risk behavior in adulthood. Participants were 481 women attending an STI clinic (66% African American) who completed a computerized survey as well as behavioral simulations assessing condom application and sexual assertiveness skills. Forty-five percent of the sample met criteria for CSA and CSA was associated with sexual risk behavior in adulthood. In multiple mediator models, the TD constructs mediated the relation between CSA and the number of sexual partners whereas the IMB constructs mediated the relation between CSA and unprotected sex. In addition, the TD constructs better mediated the relation between CSA and the number of sexual partners; the TD and IMB constructs did not differ in their ability to mediate the relation between CSA and unprotected sex. Sexual risk reduction interventions for women who were sexually abused should target not only the constructs from health behavior models (e.g., motivation and skills to reduce sexual risk), but also constructs that are specific to sexual abuse (e.g., traumatic sexualization and guilt). PMID:22282323
Hughes, Tonda L; Johnson, Timothy P; Wilsnack, Sharon C; Szalacha, Laura A
This study examined the relationships between childhood and family background variables, including sexual and physical abuse, and subsequent alcohol abuse and psychological distress in adult lesbians. Structural equation modeling was used to evaluate relationships between childhood sexual and physical abuse and parenting variables and latent measures of lifetime alcohol abuse and psychological distress in a large community-based sample of lesbians. Childhood sexual abuse (CSA) directly predicted lifetime alcohol abuse, and childhood physical abuse (CPA) directly predicted lifetime psychological distress. In addition, CSA indirectly increased the risk of lifetime alcohol abuse through its negative effect on age at first heterosexual intercourse. Childhood physical abuse had only indirect effects on lifetime alcohol abuse through its strong relationship to lifetime psychological distress. Parental drinking problems and parental strictness directly predicted lifetime psychological distress; parental drinking problems indirectly predicted lifetime alcohol abuse through the mediators of age of drinking onset and lifetime psychological distress. White lesbians, younger lesbians, and those with lower levels of education were at greatest risk of psychological distress. While the cross-sectional design precludes causal conclusions, study findings--especially those related to CSA--are consistent with previous research on predominantly heterosexual women in the general population. Lesbians who experienced CSA were at heightened risk of lifetime alcohol abuse and those who experienced CPA were at heightened risk of lifetime psychological distress relative to lesbians without abuse histories. Given the dearth of research on childhood abuse and sexual orientation, studies are needed that examine the similarities and differences between lesbians' and heterosexual women's experiences of, and responses to, childhood abuse.
Sastry, D. Nagesa; Revanasiddappa, M.; Suresh, T.; Kiran, Y. T. Ravi; Raghavendra, S. C.
This paper highlights the Electromagnetic Interference (EMI) Shielding Effectiveness and electromagnetic wave attenuation behavior of Polyaniline/Camphor Sulphonic Acid (PANI-CSA) - tungsten oxide (WO3) composites. Insitu polymerization of aniline monomer with camphor sulphonic acid (CSA) as a dopant was carried out in the presence of ammonium persulphate an oxidizing agent to synthesize PANI-CSA tungsten oxide composites (PANI/CSA-WO3) by chemical oxidation method. The composites have been synthesized with various compositions (10, 20, 30, 40 and 50 wt %) of tungsten oxide in PANI/CSA matrix. The EMI shielding measurements were carried out in the broad microwave spectrum covering the frequency range from 12 to 18 GHz (Ku-Band). The results show the influence of tungsten oxide in PANI/CSA over the EMI shielding Effectiveness. The composites have shown excellent microwave absorption behavior confirmed by the EMI Shielding Effectiveness values of the order of -15 to -16 dB.
Bowman, Katherine Gail; Ryberg, Jacalyn Wickline; Becker, Heather
The purpose of this study is to compare Mexican American adolescent mothers with and without childhood sexual abuse (CSA) histories to examine the influence of CSA on dissociation, selection of infant feeding method, and intimate parenting anxiety. Participants are 78 English-speaking adolescents between 15 and 19 years of age and recruited from the southwestern United States. Nearly one third of the sample ( n = 24, 30.77%) reports CSA histories. There is no correlation between CSA history and intimate parenting anxiety, no difference between breast-feeding and formula-feeding mothers in CSA severity, and intimate parenting anxiety does not predict dissociation. These findings are inconsistent with previous research. Supportive resources may explain the inconsistency and play a role in adolescent mothers' responses to CSA. Further research is necessary to explore these possibilities.
Daray, Federico M; Rojas, Sasha M; Bridges, Ana J; Badour, Christal L; Grendas, Leandro; Rodante, Demián; Puppo, Soledad; Rebok, Federico
Child sexual abuse (CSA) is a causal agent in many negative adulthood outcomes, including the risk for life-threatening behaviors such as suicide ideation and suicide attempts. Traumatic events such as CSA may pose risk in the healthy development of cognitive and emotional functioning during childhood. In fact, high impulsivity, a risk factor for suicidal behavior, is characteristic of CSA victims. The current study aims to understand the relations among CSA, impulsivity, and frequency of lifetime suicide attempts among a female patient sample admitted for suicidal behavior. Participants included 177 female patients between the ages of 18 and 63 years admitted at two hospitals in Buenos Aires, Argentina. Number of previous suicide attempts and CSA were assessed via structured interviews, while impulsivity was assessed with the Barratt Impulsiveness Scale (BIS-11). A model of structural equations was employed to evaluate the role of impulsivity in the relation between CSA and suicide attempts. CSA (β=.18, p<.05) and impulsivity (β=.24, p<.05) were associated with the number of previous suicide attempts. However, impulsivity was not significantly associated with CSA (β=.09, p>.05). CSA and impulsivity are independently associated with lifetime suicide attempts among female patients with recent suicidal behavior. Copyright © 2016 Elsevier Ltd. All rights reserved.
Kristman-Valente, Allison N; Brown, Eric C; Herrenkohl, Todd I
Analyses used data from an extended longitudinal study to examine the relationship between childhood physical and sexual abuse (CPA and CSA, respectively) and adolescent and adult smoking behavior. Two questions guided the study: (1) Is there an association between childhood abuse and adolescent and adult smoking behavior? (2) Does the relationship between childhood abuse and later cigarette smoking differ for males and females? A censored-inflated path model was used to assess the impact of child abuse on adolescent and adult lifetime smoking prevalence and smoking frequency. Gender differences in significant model paths were assessed using a multiple-group approach. Results show no significant relation between CPA or CSA and risk of having ever smoked cigarettes in adolescence or adulthood. However, for males, both CPA and CSA had direct effects on adolescent smoking frequency. For females, only CSA predicted increased smoking frequency in adolescence. Adolescent smoking frequency predicted adult smoking frequency more strongly for females compared with males. CPA and CSA are risk factors for higher frequency of smoking in adolescence. Higher frequency of cigarette smoking in adolescence increases the risk of higher smoking frequency in adulthood. Results underscore the need for both primary and secondary prevention and intervention efforts to reduce the likelihood of childhood abuse and to lessen risk for cigarette smoking among those who have been abused. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Technical Report ARWSB-TR-17026 Initial Assessment of CSA Group Niobium- Boron Based Coatings on 4340 Steel C.P. Mulligan...REPORT TYPE Technical 3. DATES COVERED (From - To) 4. TITLE AND SUBTITLE Initial Assessment of CSA Group Niobium- Boron Based Coatings on 4340...metallographic mounts reported as (1) thin and (2) thick Niobium- Boron (Nb-B) type coatings on steel. CSA Group is interested in providing coatings for potential
Does the impact of child sexual abuse differ from maltreated but non-sexually abused children? A prospective examination of the impact of child sexual abuse on internalizing and externalizing behavior problems.
Lewis, Terri; McElroy, Erika; Harlaar, Nicole; Runyan, Desmond
Child sexual abuse (CSA) continues to be a significant problem with significant short and long term consequences. However, extant literature is limited by the reliance on retrospective recall of adult samples, single-time assessments, and lack of longitudinal data during the childhood and adolescent years. The purpose of this study was to compare internalizing and externalizing behavior problems of those with a history of sexual abuse to those with a history of maltreatment, but not sexual abuse. We examined whether gender moderated problems over time. Data were drawn from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) at ages 4, 6, 8, 10, 12, 14, and 16 (N=977). The Child Behavior Checklist was used to assess internalizing and externalizing problems. Maltreatment history and types were obtained from official Child Protective Services (CPS) records. Generalized Estimating Equations (GEE) were used to assess behavior problems over time by maltreatment group. Findings indicated significantly more problems in the CSA group than the maltreated group without CSA over time. Internalizing problems were higher for sexually abused boys compared to girls. For sexually abused girls internalizing problems, but not externalizing problems increased with age relative to boys. This pattern was similar among maltreated but not sexually abused youth. Further efforts are needed to examine the psychological effects of maltreatment, particularly CSA longitudinally as well as better understand possible gender differences in order to best guide treatment efforts. Copyright © 2015 Elsevier Ltd. All rights reserved.
Vrolijk-Bosschaart, Thekla F; Brilleslijper-Kater, Sonja N; Widdershoven, Guy A; Teeuw, Arianne Rian H; Verlinden, Eva; Voskes, Yolande; van Duin, Esther M; Verhoeff, Arnoud P; Benninga, Marc A; Lindauer, Ramón J L
So far, a recognizable pattern of clinical symptoms for child sexual abuse (CSA), especially in young male children, is lacking. To improve early recognition of CSA, we reviewed physical complaints, physical examination, and tests on sexually transmitted infections (STIs) in confirmed victims (predominantly preschool boys) of CSA from the Amsterdam sexual abuse case (ASAC). We retrospectively analyzed the outcomes of the primary assessment using mixed methods: descriptive analysis of physical complaints, physical exams, and STI tests from medical files and a qualitative analysis on expert's interpretations of physical complaints and children's behavior during physical examination. We included 54 confirmed CSA victims, median age 3.2 (0-6) years, 43 boys (80%), and 11 girls (20%). Physical complaints were reported in 50%, of which gastrointestinal and anogenital complaints were most common. None of the children showed CSA-specific genital signs at physical examination. Most prominent finding during physical examination was a deviant behavioral response (anxiety, withdrawal, too outgoing) in 15 children (28%), especially in children who experienced anal/vaginal penetration. Testing for STIs was negative. Physical complaints and physical signs at examinations were non-specific for CSA. Deviant behavioral reactions during physical examination were the most prominent finding. Precise observation of a child's behavior during physical examination is needed. What is known • Child sexual abuse (CSA) affects many children on both the short and the long term but remains unrecognized in most cases. • So far, there is a lack of studies on symptom patterns of CSA in male, preschool children. What is new • None of the children showed CSA-specific findings at physical and anogenital examination; STIs were not found in the confirmed victims of CSA. • The most prominent finding was the deviant behavioral response of the children examined, especially in children who
Peleikis, Dawn E.; Mykletun, Arnstein; Dahl, Alv A.
Objective: This study from Norway examines the relative influence of child sexual abuse (CSA) and family background risk factors (FBRF) on the risk for current mental disorders and the quality of current intimate relationships in women with CSA treated for anxiety disorders and/or depression. Women with these disorders frequently seek treatment,…
Blain, Leah M.; Muench, Fred; Morgenstern, Jon; Parsons, Jeffrey T.
Objectives: Compulsive sexual behavior (CSB) is an impairing yet understudied clinical phenomenon. The experience of child sexual abuse (CSA) has been implicated as an etiological factor in the development of some cases of CSB (Kuzma & Black, 2008); however, research regarding the role of CSA and related psychopathology in CSB symptomatology has…
Hurtado, Alicia; Katz, Craig; Ciro, Dianne; Guttfreund, Daniel
Research on how to prevent child sexual abuse (CSA) in developing nations is practically non-existent. We sought to determine Salvadoran teachers' knowledge, attitudes, experience and barriers to CSA detection and reporting to assess the need for a CSA prevention programme and to assess barriers in conducting such a programme. One hundred teachers completed a questionnaire while they visited the Tin Marin Children's Museum in San Salvador. Nineteen of these teachers also participated in a focus group. We found that 89% of teachers reported at least two signs and symptoms of child abuse. One hundred per cent of teachers agreed that it is their responsibility to teach students about sexual abuse. Unusual for a study of this kind, parental migration was mentioned as making children vulnerable to CSA, and fear of gang violence and retribution was identified as interfering with teachers' ability to protect children. We conclude that Salvadoran teachers were knowledgeable about CSA detection and reporting and would support a programme in which they are trained to speak to their students about this topic. Barriers to reporting child abuse, such as teachers' safety and fear, need to be addressed in future CSA prevention programmes.
Aspelmeier, Jeffery E.; Elliott, Ann N.; Smith, Christopher H.
Objective: The present study tests a model linking attachment, childhood sexual abuse (CSA), and adult psychological functioning. It expands on previous work by assessing the degree to which attachment security moderates the relationship between a history of child sexual abuse and trauma-related symptoms in college females. Method: Self-reports of…
Liu, Richard T.; Jager-Hyman, Shari; Wagner, Clara A.; Alloy, Lauren B.; Gibb, Brandon E.
Objective: Although past research has documented a link between adverse childhood experiences--particularly childhood emotional (CEA), physical (CPA), and sexual abuse (CSA)--and depression, relatively few studies have examined the unique impact of each of these highly co-occurring abuse types. Moreover, relatively little is known about the…
Tarakeshwar, Nalini; Fox, Ashley; Ferro, Carol; Khawaja, Shazia; Kochman, Arlene; Sikkema, Kathleen J.
A qualitative study was conducted with 28 women who are human immunodeficiency virus (HIV)-positive and have experienced childhood sexual abuse (CSA) in order to examine (1) the challenges generated by the experience of sexual abuse and related coping strategies, (2) the impact of the HIV diagnosis on their coping strategies, and (3) the links…
Giglio, Jessie J.; Wolfteich, Paula M.; Gabrenya, William K.; Sohn, Mary L.
Child sexual abuse changes the lives of countless children. Child sexual abuse victims experience short and long term negative outcomes that affect their daily functioning. In this study, undergraduate students' perceptions of CSA were obtained using vignettes with an adult or child perpetrator and a general questionnaire. Results indicated…
Newcomb, Michael D.; Munoz, David T.; Carmona, Jennifer Vargas
Objective: Research investigating the impact of child sexual abuse (CSA) in community samples of adolescents has been limited. This study aims to identify sexual abuse among ethnically diverse high school adolescents of both genders and evaluate their psycho-emotional consequences. Method: Through the use of self-report instruments, a sample of…
Danielson, Carla Kmett; Amstadter, Ananda; Dangelmaier, Ruth E.; Resnick, Heidi S.; Saunders, Benjamin E.; Kilpatrick, Dean G.
We investigated the link between child maltreatment, including child sexual assault (CSA) and child physical assault (CPA), and addiction-related symptomatology in a subsample of adolescents from the National Survey of Adolescents, all of whom met DSM-IV criteria for substance abuse or dependence (n=281). Over 60% of the sample reported a history of CSA and/or CPA. Results indicated significant differences in typography of substance abuse and dependence symptoms and rates of comorbid lifetime PTSD based on assault history, specific assault incident characteristics, and sex. Clinical implications for substance abusing youth with maltreatment histories are discussed. PMID:20151043
Danielson, Carla Kmett; Amstadter, Ananda; Dangelmaier, Ruth E; Resnick, Heidi S; Saunders, Benjamin E; Kilpatrick, Dean G
We investigated the link between child maltreatment, including child sexual assault (CSA) and child physical assault (CPA), and addiction-related symptomatology in a subsample of adolescents from the National Survey of Adolescents, all of whom met DSM-IV criteria for substance abuse or dependence (n=281). Over 60% of the sample reported a history of CSA and/or CPA. Results indicated significant differences in typography of substance abuse and dependence symptoms and rates of comorbid lifetime PTSD based on assault history, specific assault incident characteristics, and sex. Clinical implications for substance abusing youth with maltreatment histories are discussed.
Unger, Jo Ann; Norton, G Ron; De Luca, Rayleen V
This study explored the relationship between childhood sexual abuse and gender role attitudes. Female university students rated themselves and their parents on gender role attitudes and history of childhood sexual abuse. Traditional participant gender role attitude and social isolation were associated with reporting being sexually abused as a child and may thus be risk factors for, or the result of a history of, CSA in women. Traditional participant gender role attitude and low income were associated with victim distress and therefore may be detrimental to coping with a history of childhood sexual abuse. Although replication of these results is needed, discovery of attitudinal and demographic variables associated with CSA may be important in the prevention and treatment of CSA.
Euser, Saskia; Alink, Lenneke R A; Tharner, Anne; van Ijzendoorn, Marinus H; Bakermans-Kranenburg, Marian J
We investigated the 2010 year prevalence of child sexual abuse (CSA) in residential and foster care and compared it with prevalence rates in the general population. We used two approaches to estimate the prevalence of CSA. First, 264 professionals working in residential or foster care (sentinels) reported CSA for the children they worked with (N = 6,281). Second, 329 adolescents staying in residential or foster care reported on their own experiences with CSA. Sentinels and adolescents were randomly selected from 82 Dutch out-of-home care facilities. We found that 3.5 per 1,000 children had been victims of CSA based on sentinel reports. In addition, 58 per 1,000 adolescents reported having experienced CSA. Results based on both sentinel report and self-report revealed higher prevalence rates in out-of-home care than in the general population, with the highest prevalence in residential care. Prevalence rates in foster care did not differ from the general population. According to our findings, children and adolescents in residential care are at increased risk of CSA compared to children in foster care. Unfortunately, foster care does not fully protect children against sexual abuse either, and thus its quality needs to be further improved.
Rheingold, Alyssa A; Campbell, Carole; Self-Brown, Shannon; de Arellano, Michael; Resnick, Heidi; Kilpatrick, Dean
Given that mass media techniques have been an effective tool within the public health field for affecting behavioral change, these strategies may prove successful for the primary prevention of child sexual abuse (CSA). This study was an independent evaluation of a CSA media campaign. Two hundred parents were recruited from eight sites across the United States. Results indicated that the combined mass media campaign affected knowledge about CSA at the time of intervention compared to no intervention. No significant differences were found in regards to CSA attitudes. A significant positive impact on primary prevention response behaviors assessed using hypothetical vignettes was found; however, no significant findings were noted for several other behavioral responses. Knowledge and behavioral gains were not maintained at the one-month follow-up. Small sample size at follow-up may have affected findings. Results of this study imply that media campaigns alone may not significantly affect primary prevention of CSA.
Walker, Eric C; Sheffield, Rachel; Larson, Jeffry H; Holman, Thomas B
This study examined the relationship between a history of childhood sexual abuse (CSA) for one or both members of a romantic couple and perceptions of contempt and defensiveness for self and partner. Data from the Relationship Evaluation (RELATE) were analyzed for 10,061 couples. The findings suggest that when either or both partner(s) has a history of CSA, contempt and defensiveness in the couple relationship are greater than when neither reports a history of CSA. Furthermore, the males' experience of CSA had a greater impact on their perceptions of self and partner's contempt and defensiveness than females' experience of CSA. Explanations of gender differences are offered and implications for future research and practice are suggested. © 2011 American Association for Marriage and Family Therapy.
Crane, Catherine; Duggan, Danielle S
To explore the association between age of onset of childhood sexual abuse (CSA) and overgeneral memory (OGM) in a clinical sample. Presence and age of onset of CSA and levels of OGM were assessed in 49 patients attending hospital following a recurrence of suicidal behaviour. Twenty six participants reported CSA. Earlier age of onset of CSA was associated with greater OGM, indexed by fewer specific and more categoric memories. The association was not accounted for either by elevated levels of depression in those reporting earlier abuse, nor by levels of general verbal fluency. The findings are consistent with previous work and support the hypothesis that abuse occurring earlier in development results in more pronounced OGM.
Randolph, Mary E.; Reddy, Diane M.
Sexual abuse, particularly childhood sexual abuse, has been linked to chronic pelvic pain and to sexual dysfunction, though the sexual functioning of survivors of sexual abuse has not been studied in a chronic pain population. Sixty-three women with chronic pelvic pain completed measures of sexual function, sexual abuse, and pain. Using an index…
Carter, Jacqueline C.; Bewell, Carmen; Blackmore, Elizabeth; Woodside, D. Blake
Objective: The aim of this study was to examine the impact of childhood sexual abuse (CSA) on clinical characteristics and premature termination of treatment in anorexia nervosa (AN). Method: The participants were 77 consecutive patients with AN admitted to an inpatient eating disorders unit. The patients were assessed in terms of eating disorder…
Tanaka, Masako; Suzuki, Yumi E; Aoyama, Ikuko; Takaoka, Kota; MacMillan, Harriet L
Estimating the national prevalence of child sexual abuse (CSA) and its association with health and developmental outcomes is the first step in developing prevention strategies. While such data are available from many countries, less is known about the epidemiology of CSA in Japan. For this systematic review, we searched English databases: Embase, Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily and Ovid MEDLINE(R), Ovid OLDMEDLINE(R), PsycINFO, and Japanese databases: Cinii, J-Stage, Children's Rainbow Center Japan, Japan Child and Family Research Institute, Japanese Journal of Child Abuse and Neglect to identify articles published before July 2015 examining the lifetime prevalence of CSA in Japan using non-clinical samples. Data were extracted from published reports. We initially identified 606 citations and after abstract review, retrieved 120 publications. Six studies that met the selection criteria and additional two relevant studies were reviewed. The range of contact CSA for females was 10.4%-60.7%, and the prevalence of this type of CSA for males was 4.1%. The range of penetrative CSA for females was 1.3%-8.3% and that for males was 0.5%-1.3%. A number of methodological issues were identified, including a lack of validated measures of CSA, and low response rates. In contrast to a lower prevalence of penetrative CSA, the prevalence of contact CSA among Japanese females may be comparable or higher in relation to international estimates. Future research on children's perceptions of and exposure to sexual abuse, crime and exploitation in Japan is discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.
Wojciechowska, Joanna; Krefft, Maja; Hirnle, Lidia; Kołodziej, Anna
Introduction Child sexual abuse (CSA) is generally defined as child exploitation that leads to achievement of sexual satisfaction. According to data from European countries, sexual abuse of children affects 10–40% of girls and 5–20% of boys. Material and methods The Medline, and Web of Science databases were searched with no date limitation on May 2015 using the terms ‘child abuse’ in conjunction with ‘urinary tract’, ‘urologist’, ‘urological dysfunction’, ‘urologic symptoms’, ‘LUTS’ or ‘urinary infection’. Results Awareness of the CSA problem among paediatricians and urologists is very important, because they are often the only physicians who are able to recognize the problem. CSA diagnosis is possible only through the proper collection of a medical history and a thorough physical examination. Urologists have to remember that children exposed to sexual abuse rarely exhibit abnormal genital findings. In fact, absence of genital findings is the rule rather than the exception. In most cases, the final diagnosis of sexual abuse is based on the child's history and behavior, along with the onset and exacerbation of urologic symptoms. Conclusions In this article, we present a review of studies and literature concerning urinary symptoms in sexually abused children to clarify the problem for a broad group of urologists. We present common symptoms and premises that can point to the right diagnosis and basic guidelines of proceeding after suspicion of abuse. PMID:27123337
Cockbain, Ella; Brayley, Helen; Sullivan, Joe
Extensive social psychological research emphasises the importance of groups in shaping individuals’ thoughts and actions. Within the child sexual abuse (CSA) literature criminal organisation has been largely overlooked, with some key exceptions. This research was a novel collaboration between academia and the UK's Child Exploitation and Online Protection Centre (CEOP). Starting from the premise that the group is, in itself, a form of social situation affecting abuse, it offers the first systematic situational analysis of CSA groups. In-depth behavioural data from a small sample of convicted CSA group-offenders (n = 3) were analysed qualitatively to identify factors and processes underpinning CSA groups’ activities and associations: group formation, evolution, identity and resources. The results emphasise CSA groups’ variability, fluidity and dynamism. The foundations of a general framework are proposed for researching and assessing CSA groups and designing effective interventions. It is hoped that this work will stimulate discussion and development in this long-neglected area of CSA, helping to build a coherent knowledge-base. PMID:26494978
Choi, Hyunjung; Klein, Carolin; Shin, Min-Sup; Lee, Hoon-Jin
With the participation of 46 prostituted women in Korea, this study investigates the relationship between prostitution experiences, a history of childhood sexual abuse (CSA), and symptoms of posttraumatic stress disorder (PTSD) and disorders of extreme stress not otherwise specified (DESNOS). Prostituted women showed higher levels of PTSD and DESNOS symptoms compared to a control group. Women who had experienced both CSA by a significant other and prostitution showed the highest levels of traumatic stress. However, posttraumatic reexperiencing and avoidance and identity, relational, and affect regulation problems were significant for prostitution experiences even when the effects of CSA were controlled.
... homes. The mistreatment may be Physical, sexual, or emotional abuse Neglect or abandonment Financial abuse - stealing of money or belongings Possible signs of elder abuse include unexplained bruises, burns, and injuries. There ...
Avril, Marion; Hathaway, Marianne J; Cartwright, Megan M; Gose, Severin O; Narum, David L; Smith, Joseph D
VAR2CSA is the main candidate for a vaccine against pregnancy-associated malaria, but vaccine development is complicated by the large size and complex disulfide bonding pattern of the protein. Recent X-ray crystallographic information suggests that domain boundaries of VAR2CSA Duffy binding-like (DBL) domains may be larger than previously predicted and include two additional cysteine residues. This study investigated whether longer constructs would improve VAR2CSA recombinant protein secretion from Pichia pastoris and if domain boundaries were applicable across different VAR2CSA alleles. VAR2CSA sequences were bioinformatically analysed to identify the predicted C11 and C12 cysteine residues at the C-termini of DBL domains and revised N- and C-termimal domain boundaries were predicted in VAR2CSA. Multiple construct boundaries were systematically evaluated for protein secretion in P. pastoris and secreted proteins were tested as immunogens. From a total of 42 different VAR2CSA constructs, 15 proteins (36%) were secreted. Longer construct boundaries, including the predicted C11 and C12 cysteine residues, generally improved expression of poorly or non-secreted domains and permitted expression of all six VAR2CSA DBL domains. However, protein secretion was still highly empiric and affected by subtle differences in domain boundaries and allelic variation between VAR2CSA sequences. Eleven of the secreted proteins were used to immunize rabbits. Antibodies reacted with CSA-binding infected erythrocytes, indicating that P. pastoris recombinant proteins possessed native protein epitopes. These findings strengthen emerging data for a revision of DBL domain boundaries in var-encoded proteins and may facilitate pregnancy malaria vaccine development.
Avril, Marion; Hathaway, Marianne J; Cartwright, Megan M; Gose, Severin O; Narum, David L; Smith, Joseph D
Background VAR2CSA is the main candidate for a vaccine against pregnancy-associated malaria, but vaccine development is complicated by the large size and complex disulfide bonding pattern of the protein. Recent X-ray crystallographic information suggests that domain boundaries of VAR2CSA Duffy binding-like (DBL) domains may be larger than previously predicted and include two additional cysteine residues. This study investigated whether longer constructs would improve VAR2CSA recombinant protein secretion from Pichia pastoris and if domain boundaries were applicable across different VAR2CSA alleles. Methods VAR2CSA sequences were bioinformatically analysed to identify the predicted C11 and C12 cysteine residues at the C-termini of DBL domains and revised N- and C-termimal domain boundaries were predicted in VAR2CSA. Multiple construct boundaries were systematically evaluated for protein secretion in P. pastoris and secreted proteins were tested as immunogens. Results From a total of 42 different VAR2CSA constructs, 15 proteins (36%) were secreted. Longer construct boundaries, including the predicted C11 and C12 cysteine residues, generally improved expression of poorly or non-secreted domains and permitted expression of all six VAR2CSA DBL domains. However, protein secretion was still highly empiric and affected by subtle differences in domain boundaries and allelic variation between VAR2CSA sequences. Eleven of the secreted proteins were used to immunize rabbits. Antibodies reacted with CSA-binding infected erythrocytes, indicating that P. pastoris recombinant proteins possessed native protein epitopes. Conclusion These findings strengthen emerging data for a revision of DBL domain boundaries in var-encoded proteins and may facilitate pregnancy malaria vaccine development. PMID:19563628
Crockett, Cailin; Brandl, Bonnie; Dabby, Firoza Chic
Violence against older women exists in the margins between domestic violence and elder abuse, with neither field adequately capturing the experiences of older women survivors of intimate partner violence (IPV). This commentary explores this oversight, identifying how the lack of gender analysis in the elder abuse field exacerbates older survivors' invisibility when the wider violence against women (VAW) field lacks a lifespan approach to abuse. Examining the impact of generational and aging factors on how older women experience IPV, we assert that the VAW field may be overlooking a wider population of survivors than previously thought.
Berg, Martha K; Hobkirk, Andréa L; Joska, John A; Meade, Christina S
Childhood sexual abuse (CSA) is a critical global health issue associated with poor psychosocial outcomes. Individuals with CSA histories are at risk for drug use, which is a growing problem in the Western Cape of South Africa. The present study of methamphetamine users in this region examined whether substance use coping, a contextually relevant type of avoidance-based coping, mediates the relation between CSA and depressive symptoms. Participants included 161 men and 108 women seeking treatment for methamphetamine use. Participants completed a computer-assisted survey and a face-to-face interview with clinic staff to evaluate history of CSA, current substance use severity and coping, and current depressive symptoms. Nearly a third of participants reported a history of CSA, and the average methamphetamine use severity score exceeded the threshold of high risk. A history of CSA was significantly associated with higher substance use coping and more depression symptoms. Substance use coping was a significant mediator of the association between CSA and depression symptoms. In this study of high-risk methamphetamine users, substance use coping emerged as a common means of managing stress, especially for those with a history of CSA, which was further linked to depressive symptoms. These findings underscore the potential benefit of integrating coping interventions and mental health treatment into substance abuse treatment programs, particularly for those with a history of childhood abuse and violence. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Letourneau, Elizabeth J.; Schaeffer, Cindy M.; Bradshaw, Catherine P.; Feder, Kenneth A.
Child sexual abuse (CSA) is a serious public health problem that increases risk for physical and mental health problems across the life course. Young adolescents are responsible for a substantial portion of CSA offending, yet to our knowledge, no validated prevention programs that target CSA perpetration by youth exist. Most existing efforts to address CSA rely on reactive criminal justice policies or programs that teach children to protect themselves; neither approach is well validated. Given the high rates of desistance from sexual offending following a youth’s first CSA-related adjudication, it seems plausible that many youth could be prevented from engaging in their first offense. The goal of this article is to examine how school-based universal prevention programs might be used to prevent CSA perpetrated by adolescents. We review the literature on risk and protective factors for CSA perpetration and identify several promising factors to target in an intervention. We also summarize the literature on programs that have been effective at preventing adolescent dating violence and other serious problem behaviors. Finally, we describe a new CSA prevention program under development and early evaluation and make recommendations for program design characteristics, including unambiguous messaging, parental involvement, multisession dosage, skills practice, and bystander considerations. PMID:28413921
Easton, Scott D; Renner, Lynette M; O'Leary, Patrick
Men who were sexually abused during childhood are at risk for a variety of long-term mental health problems, including suicidality. However, little is known about which factors are related to recent suicide attempts for this vulnerable, under-researched population. The purpose of this study was to examine the relationship between abuse severity, mental health, masculine norms and recent suicide attempts among men with histories of child sexual abuse (CSA). We analyzed survey data gathered from a purposive sample of 487 men who were sexually abused during childhood. The age of the sample ranged from 19 to 84 years (μ = 50.4 years). Recent suicide attempts served as the dependent variable in the study. Self-reported measures of sexual abuse severity, child physical abuse, mental health, masculine norms, and demographic information (age, race) represented the independent variables. The results from logistic regression modeling found that five variables - duration of the sexual abuse, use of force during the sexual abuse, high conformity to masculine norms, level of depressive symptoms, and suicidal ideation - increased the odds of a suicide attempt in the past 12 months. To improve mental health services for men with histories of CSA, mental health practitioners should incorporate sexual abuse severity, current mental health, and adherence to masculine norms into assessment and treatment planning. Copyright © 2013 Elsevier Ltd. All rights reserved.
Miller, Adam B; Schaefer, Karen E; Renshaw, Keith D; Blais, Rebecca K
Childhood sexual abuse (CSA) is relatively common and is associated with a multitude of negative outcomes in adulthood, including posttraumatic stress disorder (PTSD) and lower marital satisfaction. However, CSA has been understudied in military samples. The purpose of the present study was to examine the relative contributions of CSA and combat exposure to PTSD and marital satisfaction. Two hundred eighteen National Guard/Reserve veterans who deployed overseas between 2001 and 2008 completed self-report measures of CSA, marital satisfaction, combat exposure, and PTSD symptom severity. Data were analyzed using linear regression and path analysis to evaluate a comprehensive model including all variables. CSA accounted for unique variance in PTSD symptom severity independent of combat exposure. CSA also had a negative direct association with marital satisfaction, independent of combat exposure and PTSD symptom severity. In contrast, combat exposure had only a negative indirect association with marital satisfaction via PTSD when all variables were examined simultaneously. CSA accounted for unique variance in both PTSD symptom severity and marital satisfaction in this sample of combat veterans. Clinically, results suggest that assessment and treatment of CSA is indicated for military veterans suffering from PTSD. Further, treatment of CSA may improve marital satisfaction, which may positively affect psychological functioning in the veteran. Copyright © 2013 Elsevier Ltd. All rights reserved.
Simon, Valerie A; Feiring, Candice; Kobielski McElroy, Sarah
The need to make meaning of childhood sexual abuse (CSA) is common and often persists long after the abuse ends. Although believed to be essential for healthy recovery, there is a paucity of research on how youth process their CSA experiences. The current study identified individual differences in the ways youth process their CSA and examined associations with psychosocial adjustment. A sample of 108 youth with confirmed abuse histories enrolled in the study within 8 weeks of abuse discovery, when they were between 8 and 15 years old. Six years later, they participated in interviews about their CSA experiences, reactions, and perceived effects. Using a coding system developed for this study, youths' CSA narratives were reliably classified with one of three processing strategies: Constructive (13.9%), Absorbed (50%), or Avoidant (36.1%). Absorbed youth reported the highest levels of psychopathological symptoms, sexual problems, and abuse-specific stigmatization, whereas Constructive youth tended to report the fewest problems. Avoidant youth showed significantly more problems than Constructive youth in some but not all areas. Interventions that build healthy processing skills may promote positive recovery by providing tools for constructing adaptive meanings of the abuse, both in its immediate aftermath and over time.
Simon, Valerie A.; Feiring, Candice; McElroy, Sarah Kobielski
The need to make meaning of childhood sexual abuse (CSA) is common and often persists long after the abuse ends. Although believed to be essential for healthy recovery, there is a paucity of research on how youth process their CSA experiences. The current study identified individual differences in the ways youth process their CSA and examined associations with psychosocial adjustment. A sample of 108 youth with confirmed abuse histories enrolled in the study within 8 weeks of abuse discovery, when they were between 8 and 15 years old. Six years later, they participated in interviews about their CSA experiences, reactions, and perceived effects. Using a coding system developed for this study, youths’ CSA narratives were reliably classified with one of three processing strategies: Constructive (13.9%), Absorbed (50%), or Avoidant (36.1%). Absorbed youth reported the highest levels of psychopathological symptoms, sexual problems, and abuse-specific stigmatization, whereas Constructive youth tended to report the fewest problems. Avoidant youth showed significantly more problems than Constructive youth in some but not all areas. Interventions that build healthy processing skills may promote positive recovery by providing tools for constructing adaptive meanings of the abuse, both in its immediate aftermath and over time. PMID:20498128
Kiminik, Chelsea D.; Meston, Cindy M.
Introduction Women’s sexuality is influenced by their perceptions of their bodies. Negative body appraisals have been implicated in the development and maintenance of sexual concerns in women with a history of childhood sexual abuse (CSA). The sexuality of these women is often expressed in extremes of approach and avoidant sexual tendencies, which have been related to the sexual inhibition and sexual excitation pathways of the dual control model. Aim To test the influence of body esteem on the sexual excitation and inhibition responses of women with and without a history of CSA. Methods One hundred thirty-nine women with CSA and 83 non-abused women reported on their abuse history, depressive symptomology, sexual response, and affective appraisals of their body. Main Outcome Measures Validated self-report measurements of sexual excitation and inhibition responses (Sexual Excitation/Sexual Inhibition Inventory for Women) and body esteem (Body Esteem Scale) were administered. Results Body esteem was significantly associated with sexual inhibition responses of women regardless of CSA history status but was significantly related only to the sexual excitation responses of women with a CSA history. Perceived sexual attractiveness was a unique predictor of sexual excitation in women with a history of CSA. Conclusion Women with a history of CSA have lower body esteem than non-abused women, particularly in self-perceived sexual attractiveness, and these perceptions appear to influence their sexual responses by acting on the sexual excitation and inhibition response pathways. PMID:27692843
Kilimnik, Chelsea D; Meston, Cindy M
Women's sexuality is influenced by their perceptions of their bodies. Negative body appraisals have been implicated in the development and maintenance of sexual concerns in women with a history of childhood sexual abuse (CSA). The sexuality of these women is often expressed in extremes of approach and avoidant sexual tendencies, which have been related to the sexual inhibition and sexual excitation pathways of the dual control model. To test the influence of body esteem on the sexual excitation and inhibition responses of women with and without a history of CSA. One hundred thirty-nine women with CSA and 83 non-abused women reported on their abuse history, depressive symptomology, sexual response, and affective appraisals of their body. Validated self-report measurements of sexual excitation and inhibition responses (Sexual Excitation/Sexual Inhibition Inventory for Women) and body esteem (Body Esteem Scale) were administered. Body esteem was significantly associated with sexual inhibition responses of women regardless of CSA history status but was significantly related only to the sexual excitation responses of women with a CSA history. Perceived sexual attractiveness was a unique predictor of sexual excitation in women with a history of CSA. Women with a history of CSA have lower body esteem than non-abused women, particularly in self-perceived sexual attractiveness, and these perceptions appear to influence their sexual responses by acting on the sexual excitation and inhibition response pathways. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.
Female survivors of domestic violence may experience symptoms of low self-esteem, insecurity, difficulty with problem solving, low self-efficacy, and high anxiety with regard to their economic future. Creative methods are needed to help abuse survivors overcome these factors so they are able to set and attain career goals. Equine assisted therapy…
Engstrom, Malitta; Winham, Katherine; Gilbert, Louisa
Childhood sexual abuse (CSA) is often considered an important distal factor in HIV sexual risk behaviors; however, there are limited and mixed findings regarding this relationship among women experiencing substance use problems. In addition, research with this population of women has yet to examine differences in observed CSA-HIV sexual risk behaviors relationships by CSA type and characteristics. This study examines relationships between CSA coding, type, and characteristics and HIV sexual risk behaviors with main intimate partners among a random sample of 390 women in methadone treatment in New York City who completed individual interviews with trained female interviewers. Findings from logistic regression analyses indicate that CSA predicts substance use with sexual activity, with variations by CSA coding, type, and characteristics; however, the role of CSA is more limited than expected. Having a main partner with HIV risk mediates some relationships between CSA and drinking four or more drinks prior to sex. Intimate partner violence is the most consistent predictor of sexual risk behaviors. Other salient factors include polysubstance use, depression, social support, recent incarceration, relationship characteristics, and HIV status. This study contributes to understanding of relationships between CSA and HIV sexual risk behaviors and key correlates associated with HIV sexual risk behaviors among women in methadone treatment. It also highlights the complexity of measuring CSA and its association with sexual risk behaviors and the importance of comprehensive approaches to HIV prevention that address psychological, relational, situational, and substance use experiences associated with sexual risk behaviors among this population.
Blain, Leah M; Muench, Fred; Morgenstern, Jon; Parsons, Jeffrey T
Compulsive sexual behavior (CSB) is an impairing yet understudied clinical phenomenon. The experience of child sexual abuse (CSA) has been implicated as an etiological factor in the development of some cases of CSB (Kuzma & Black, 2008); however, research regarding the role of CSA and related psychopathology in CSB symptomatology has been limited in the literature. The present study aimed to examine the uniqueness of the association of CSA with CSB as compared to other experiences of child maltreatment; the role of posttraumatic stress disorder (PTSD) symptomatology in CSB symptoms for individuals reporting CSA; and clinical differences between individuals with and without histories of CSA. Hypotheses were tested using data from a sample of 182 gay and bisexual men reporting CSB symptoms. CSA prevalence was high in the tested sample (39%). CSA severity was a unique predictor of CSB symptoms, above child physical and emotional abuse, and poly-victimization status was not significantly related to CSB symptoms. Contrary to hypotheses, PTSD symptoms did not significantly mediate the role of CSA severity, although PTSD symptoms explained additional variance in CSB symptoms, with the final model accounting for over a quarter of the variance in CSB symptoms (27%). Finally, men with a history of CSA reported more CSB, depressive, and anxious symptoms than those without a history of CSA. Findings from the present study support the hypothesis that CSA may be uniquely related to CSB symptoms, above other forms of child maltreatment, and indicate that men with a CSA history are likely to present more severe clinical comorbidities. Clinical implications and future research directions are discussed. Copyright © 2012 Elsevier Ltd. All rights reserved.
Dolezal, Curtis; Carballo-Diéguez, Alex
There is a lack of consensus on how to define childhood sexual abuse (CSA). In this study we explore the perceptions of CSA among men who had such experiences. One hundred Latino men (predominately gay) who had childhood sexual experiences with an older partner (CSEOP) were asked whether they considered their experiences sexual abuse (41 said no; 59 said yes). Those who felt abused were younger when the events happened and were more likely to have been physically forced, physically hurt, threatened, and emotionally hurt. Negative correlates of CSEOP in adulthood were also explored. Men who considered themselves the victims of CSA differed from those without CSEOP in having more alcohol use, unprotected anal sex, and male sex partners.
Hernandez, Guadalupe; Lam, Brian Trung
This study explored the relationship between family functioning and parenting beliefs and feelings among women with a history of child sexual abuse (CSA). This study utilized secondary data obtained in 2001 from the National Data Archive on Child Abuse and Neglect. The sample included 107 women. Most respondents had a highly functional family;…
Twaite, James A.; Rodriguez-Srednicki, Ofelia
Two hundred and eighty-four adults from the metropolitan New York area reported on their history of childhood sexual abuse (CSA), childhood physical abuse (CPA), and on the nature of their exposure to the terrorist attack on the World Trade Center. The respondents also completed the Impact of Events Scale-Revised (IES-R), the Attachment Style…
Mantula, Fennie; Saloojee, Haroon
Although child sexual abuse is a significant public health problem globally, its incidence, prevention, and management is less well described in resource-poor settings. In poorer settings prevention initiatives assume even more importance since resources for managing abused children are severely limited. This article examines the current status of policy and practice related to the prevention of child sexual abuse in Zimbabwe. It identifies implementation challenges and highlights opportunities that could be embraced to reduce CSA in Zimbabwe, based on evidence synthesized from recent work. Although Zimbabwe has a well-established legal and regulatory framework to protect children from child sexual abuse, implementation of existing policies is weak. Financial, human, and material resource constraints are frequently cited to explain limited prevention activity. Effective strategies for the prevention of child sexual abuse should focus on implementing existing legislation, targeting schoolchildren, and getting community involvement. A dedicated budget would help entrench these strategies, but gains can be achieved even in the absence of this.
... puts a child at risk of harm. Child abuse can be physical, sexual or emotional. Neglect, or not providing for a child's needs, is also a form of abuse. Most abused children suffer greater emotional than physical damage. An abused child may become ...
Avril, Marion; Kulasekara, Bridget R; Gose, Severin O; Rowe, Chris; Dahlbäck, Madeleine; Duffy, Patrick E; Fried, Michal; Salanti, Ali; Misher, Lynda; Narum, David L; Smith, Joseph D
Pregnancy-associated malaria (PAM) is characterized by the placental sequestration of Plasmodium falciparum-infected erythrocytes (IEs) with the ability to bind to chondroitin sulfate A (CSA). VAR2CSA is a leading candidate for a pregnancy malaria vaccine, but its large size ( approximately 350 kDa) and extensive polymorphism may pose a challenge to vaccine development. In this study, rabbits were immunized with individual VAR2CSA Duffy binding-like (DBL) domains expressed in Pichia pastoris or var2csa plasmid DNA and sera were screened on different CSA-binding parasite lines. Rabbit antibodies to three recombinant proteins (DBL1, DBL3, and DBL6) and four plasmid DNAs (DBL1, DBL3, DBL5, and DBL6) reacted with homologous FCR3-CSA IEs. By comparison, antibodies to the DBL4 domain were unable to react with native VAR2CSA protein unless it was first partially proteolyzed with trypsin or chymotrypsin. To investigate the antigenic relationship of geographically diverse CSA-binding isolates, rabbit immune sera were screened on four heterologous CSA-binding lines from different continental origins. Antibodies did not target conserved epitopes exposed in all VAR2CSA alleles; however, antisera to several DBL domains cross-reacted on parasite isolates that had polymorphic loops in common with the homologous immunogen. This study demonstrates that VAR2CSA contains common polymorphic epitopes that are shared between geographically diverse CSA-binding lines.
Elder abuse is a common and yet often unrecognised problem in our community. With up to 5% of the community dwelling older population being victims of abuse, the general practitioner has a pivotal role in identifying this abuse. This article provides an outline of the definition of elder abuse, describes the types of abuse seen and the reasons for occurrence of abuse. It summarises the role of the GP in the identification and management of abuse and provides guidance on intervention strategies. Case studies are used to illustrate the issues discussed. Elder abuse is defined as any pattern of behaviour which causes physical, psychological, financial or social harm to an older person. The role of the GP in identifying abuse is critical. The vast majority of older people visit their GP at least once a year, and the GP often has a long standing relationship with their patient and the patient's family. They are therefore ideally placed to identify elder abuse.
Smith, Helen A; Markovic, Nina; Danielson, Michelle E; Matthews, Alicia; Youk, Ada; Talbott, Evelyn O; Larkby, Cynthia; Hughes, Tonda
Among adult women an association between childhood sexual abuse (CSA) and obesity has been observed. Research with lesbian women has consistently identified high rates of obesity as well as frequent reports of CSA, but associations between sexual abuse and obesity have not been fully explored. Our aim was to investigate the relationship between sexual abuse (SA) history and obesity among heterosexual (n = 392) and lesbian (n = 475) women (age 35-64) who participated in the Epidemiologic STudy of HEalth Risk in Women (ESTHER) Project in Pittsburgh, Pennsylvania. Obesity was defined as body mass index (BMI) > or =30. Covariates included self-reported SA, sexual orientation, demographic factors, and history of a depression or anxiety diagnosis. SA history was assessed by three factors: (1) SA experienced under the age of 18 by a family member or (2) by a nonfamily member and (3) forced, unwanted sexual experience(s) at age > or =18. Data were analyzed using chi-square tests and logistic regression models. Multiple logistic regression analyses revealed that obesity was associated with African American race, lesbian sexual orientation, intrafamilial CSA, and history of mental health diagnosis. Protective factors were having a household income of at least $75,000 and having a bachelor's degree or higher. Results suggest that lesbian women may be at greater risk of obesity than heterosexual women and that intrafamilial CSA--regardless of sexual orientation--may play a role in the development of obesity.
Cobb, Amanda R; Tedeschi, Richard G; Calhoun, Lawrence G; Cann, Arnie
The negative consequences of intimate partner violence are well documented. This study investigated the possibility that some survivors of intimate partner violence may also experience posttraumatic growth because of their struggle with this highly stressful circumstance. In addition, the relationships between posttraumatic growth and relationship status, type of abuse, depression, and availability of models of posttraumatic growth were examined. Most women reported posttraumatic growth. Overall abuse experienced and depression were unrelated to posttraumatic growth, but abuse was related to one domain of growth. Contact with a model of posttraumatic growth and having left an abusive relationship were both positively related to posttraumatic growth.
Kärgel, Christian; Massau, Claudia; Weiß, Simone; Walter, Martin; Kruger, Tillmann H C; Schiffer, Boris
Pedophilia is a disorder recognized for its impairment to the individual and for the harm it may cause to others. However, the neurobiology of pedophilia and a possible propensity to sexually abuse children are not well understood. In this study, we thus aimed at providing new insights in how functional integration of brain regions may relate to pedophilia or child sexual abuse (CSA). By using functional magnetic resonance imaging (fMRI) technique, we compared functional connectivity at rest (RSFC) between pedophiles who engaged (P+CSA; N = 12) or did not engage (P-CSA; N = 14) in CSA and healthy controls (HCs; N = 14) within two networks: (i) the default mode network and (ii) the limbic network that has been linked to pedophilia before. Pedophiles who engaged in CSA show diminished RSFC in both networks compared with HC and P-CSA. Most importantly, they showed diminished RSFC between the left amygdala and orbitofrontal as well as anterior prefrontal regions. Though significant age differences between groups could not be avoided, correlation control analysis did not provide evidence for the assumption that the RSFC effects were related to age differences. We found significantly diminished RSFC in brain networks critically involved in widespread motivational and socio-emotional processes. These results extend existing models of the functional neuroanatomy of pedophilia and CSA as altered RSFC between these regions were related to CSA rather than pedophilia and thus may account for an increased propensity to engage in CSA in people suffering from pedophilia. © 2015 International Society for Sexual Medicine.
Dale, Sannisha K; Weber, Kathleen M; Cohen, Mardge H; Kelso, Gwendolyn A; Cruise, Ruth C; Brody, Leslie R
Childhood sexual abuse (CSA) places women at risk for HIV infection and once infected, for poor mental health outcomes, including lower quality of life and depressive symptoms. Among HIV-positive and demographically matched HIV-negative women, we investigated whether resilience and HIV status moderated the relationships between CSA and health indices as well as the relationships among CSA, depressive symptoms, and health-related quality of life (HRQOL). Participants included 202 women (138 HIV+, 64 HIV-, 87 % African American) from the Women's Interagency HIV Study Chicago CORE Center site. Results indicated that in both HIV-positive and HIV-negative women, higher resilience significantly related to lower depressive symptoms and higher HRQOL. CSA related to higher depressive symptoms only for women scoring low in resilience. Interventions to promote resilience, especially in women with a CSA history, might minimize depressive symptoms and poor HRQOL among HIV-positive and HIV-negative women.
Dale, Sannisha K.; Weber, Kathleen M.; Cohen, Mardge H.; Kelso, Gwendolyn A.; Cruise, Ruth C.; Brody, Leslie R.
Childhood sexual abuse (CSA) places women at risk for HIV infection and once infected, for poor mental health outcomes, including lower quality of life and depressive symptoms. Among HIV-positive and demographically matched HIV-negative women, we investigated whether resilience and HIV status moderated the relationships between CSA and health indices as well as the relationships among CSA, depressive symptoms, and health-related quality of life (HRQOL). Participants included 202 women (138 HIV+, 64 HIV−, 87% African American) from the Women’s Interagency HIV Study (WIHS) Chicago CORE Center site. Results indicated that in both HIV-positive and HIV-negative women, higher resilience significantly related to lower depressive symptoms and higher HRQOL. CSA related to higher depressive symptoms only for women scoring low in resilience. Interventions to promote resilience, especially in women with a CSA history, might minimize depressive symptoms and poor HRQOL among HIV-positive and HIV-negative women. PMID:25085079
Cantón-Cortés, David; Cantón, José; Justicia, Fernando; Cortés, María Rosario
Employing structural equation modeling, the direct and indirect effects of the severity of Child Sexual Abuse (CSA), attributions of blame for the abuse, and coping strategies on Post-traumatic Stress Disorder (PTSD) symptomatology are analyzed. The effects of other types of child maltreatment on PTSD were also controlled. The sample comprised 163 female college students who were victims of CSA. The results suggested that victims of more severe abuse showed higher levels of avoidant coping, self blame, and family blame. Having suffered other kinds of abuse or neglect was also related to higher family blame attributions. Lastly, both attributions of blame scales were indirectly related to PTSD symptomatology through avoidant coping. The strong relationships between attributions of blame, coping strategies, and PTSD suggest that it might be useful to intervene early with children who have suffered CSA in an effort to modify the attributions they make about the abuse and the way they cope with it.
Bottoms, Bette L; Peter-Hagene, Liana C; Epstein, Michelle A; Wiley, Tisha R A; Reynolds, Carrie E; Rudnicki, Aaron G
Many adult survivors of childhood abuse hide their victimization, avoiding disclosure that could identify perpetrators, end the abuse, and bring help to the victim. We surveyed 1,679 women undergraduates to understand disclosure of childhood sexual, physical, and emotional abuse, and, for the first time, witnessed domestic violence, which many consider to be emotionally abusive. A substantial minority of victims failed to ever disclose their sexual abuse (23%), physical abuse (34%), emotional abuse (20%), and witnessed domestic violence (29%). Overall, abuse-specific factors were better predictors of disclosure than individual-level characteristics. Disclosure of sexual abuse was related to experiencing more frequent abuse (by the same and by multiple perpetrators), being more worried about injury and more upset at the time of the abuse, and self-labeling as a victim of abuse. Disclosure of physical abuse was related to experiencing more frequent abuse (by the same and multiple perpetrators), being less emotionally close to the perpetrator, being older when the abuse ended, being more worried and upset, and self-labeling as a victim. Disclosure of emotional abuse was associated with being older when the abuse ended, and being more worried and upset. Disclosure was unrelated to victim demographic characteristics or defensive reactions (dissociative proneness, fantasy proneness, repressive coping style, and temporary forgetting), except that among physical and emotional abuse victims, repressors were less likely to disclose than non-repressors. Disclosure of witnessing domestic violence was not significantly related to any factors measured. © The Author(s) 2014.
Hamdullahpur, Kevin; Jacobs, Kahá Wi J; Gill, Kathryn J
Adverse childhood experiences (ACEs) and adult mental health were explored in a sample of urban Aboriginal ( n = 83) and non-Aboriginal ( n = 89) women. Childhood sexual abuse (CSA) was associated with negative home environments, teenage pregnancy, lifetime suicide attempts, and treatment seeking. Aboriginal women with CSA witnessed higher levels of physical/sexual abuse of family members. The severity of current psychological distress was associated with a history of childhood neglect. The results indicate that CSA rarely occurs in isolation, and that multiple ACEs are strongly associated with suicide attempts and treatment seeking in adulthood. Future studies should focus on the role of CSA in suicidality, as well as familial, community, and cultural protective factors.
Görg, Nora; Priebe, Kathlen; Böhnke, Jan R; Steil, Regina; Dyer, Anne S; Kleindienst, Nikolaus
Posttraumatic Stress Disorder (PTSD) related to childhood sexual abuse (CSA) is often associated with a wide range of trauma-related aversive emotions such as fear, disgust, sadness, shame, guilt, and anger. Intense experience of aversive emotions in particular has been linked to higher psychopathology in trauma survivors. Most established psychosocial treatments aim to reduce avoidance of trauma-related memories and associated emotions. Interventions based on Dialectical Behavior Therapy (DBT) also foster radical acceptance of the traumatic event. This study compares individual ratings of trauma-related emotions and radical acceptance between the start and the end of DBT for PTSD (DBT-PTSD) related to CSA. We expected a decrease in trauma-related emotions and an increase in acceptance. In addition, we tested whether therapy response according to the Clinician Administered PTSD-Scale (CAPS) for the DSM-IV was associated with changes in trauma-related emotions and acceptance. The data was collected within a randomized controlled trial testing the efficacy of DBT-PTSD, and a subsample of 23 women was included in this secondary data analysis. In a multilevel model, shame, guilt, disgust, distress, and fear decreased significantly from the start to the end of the therapy whereas radical acceptance increased. Therapy response measured with the CAPS was associated with change in trauma-related emotions. Trauma-related emotions and radical acceptance showed significant changes from the start to the end of DBT-PTSD. Future studies with larger sample sizes and control group designs are needed to test whether these changes are due to the treatment. ClinicalTrials.gov, number NCT00481000.
Wiele, Stephen M.
In addition to csa2sac, the SAC7 program is required. It is the same as the original SAC program, except that it is compiled for 64-bit Windows operating systems and has a slightly different command line input. It is available online (http://water.usgs.gov/software/SAC/) as part of the SACGUI installation program. The program name, “SAC7.exe,” is coded into csa2sac, and must not be changed.
Marwaha, S; Bebbington, P
The significance of affective changes in psychosis is increasingly acknowledged, as is the role of early traumatic events. In a previous paper, using data from the English Adult Psychiatric Morbidity Survey 2007 (APMS2007), strong associations between child sexual abuse (CSA) and psychosis were demonstrated, with some evidence of mediation by affect. In the current paper, we subjected the same dataset to formal tests of mediation. For CSA involving sexual intercourse, 38.5% of the link was mediated, 30.0% by depression and 8.5% by anxiety. For all forms of contact abuse, 38.2% was mediated, 29.1% by depression and 9.1% by anxiety.
Yan, Li; Zhu, Qianqian; Tu, Xiaowen; Zuo, Xiayun; Yu, Chunyan; Lou, Chaohua
Background Bullying is one of the most important factors associated with child abuse. However, robust tests supporting the assumption that being bullied can contribute to child sexual abuse (CSA) among left-behind children (LBC) remain sparse. This study aims to investigate the association of bullying victimization with CSA among LBC in China. Methods A cross-sectional study was conducted in six middle schools of Sichuan and Anhui province in 2015. The bullying victimization was assessed by seven items from the Revised Olweus Bully/Victim Questionnaire. The experience of CSA was measured by ten items CSA scale with good consistency. Results A total of 1,030 children met the sampling criteria, including 284 LBC and 746 non-LBC. The prevalence of CSA was 22.89% in LBC and 20.19% in non-LBC (p > 0.05). Bullying victimization was related to CSA among both LBC (adjusted Odds Ratio [aOR] = 2.52, 95% CI [1.34–4.73]) and non-LBC (aOR = 2.35, 95% CI [1.58–3.53]). The association between bullying victimization and CSA was much higher among left-behind girls (left-behind girls: aOR = 7.36, 95% CI [2.16–24.99]; non-left-behind girls: aOR = 2.38, 95% CI [1.08–5.27]). Also, LBC of a young age (11–15), children with siblings, living in rural areas and non-traditional family structure who were bullied were more likely to suffer CSA than their non-LBC peers. Conclusions Bullying victimization is associated with a significant increase in CSA among both LBC and non-LBC. Anti-bullying programs should target vulnerable populations including female LBC and LBC with siblings to reduce the risk of CSA. PMID:29888125
Yan, Li; Zhu, Qianqian; Tu, Xiaowen; Zuo, Xiayun; Yu, Chunyan; Lou, Chaohua; Lian, Qiguo
Bullying is one of the most important factors associated with child abuse. However, robust tests supporting the assumption that being bullied can contribute to child sexual abuse (CSA) among left-behind children (LBC) remain sparse. This study aims to investigate the association of bullying victimization with CSA among LBC in China. A cross-sectional study was conducted in six middle schools of Sichuan and Anhui province in 2015. The bullying victimization was assessed by seven items from the Revised Olweus Bully/Victim Questionnaire. The experience of CSA was measured by ten items CSA scale with good consistency. A total of 1,030 children met the sampling criteria, including 284 LBC and 746 non-LBC. The prevalence of CSA was 22.89% in LBC and 20.19% in non-LBC ( p > 0.05). Bullying victimization was related to CSA among both LBC (adjusted Odds Ratio [aOR] = 2.52, 95% CI [1.34-4.73]) and non-LBC (aOR = 2.35, 95% CI [1.58-3.53]). The association between bullying victimization and CSA was much higher among left-behind girls (left-behind girls: aOR = 7.36, 95% CI [2.16-24.99]; non-left-behind girls: aOR = 2.38, 95% CI [1.08-5.27]). Also, LBC of a young age (11-15), children with siblings, living in rural areas and non-traditional family structure who were bullied were more likely to suffer CSA than their non-LBC peers. Bullying victimization is associated with a significant increase in CSA among both LBC and non-LBC. Anti-bullying programs should target vulnerable populations including female LBC and LBC with siblings to reduce the risk of CSA.
Wan, Zhi Hui; Wen, Fang Jing; Hu, Ke
Cheyne-Stokes respiration with central sleep apnea (CSR-CSA) is very common in patients with chronic congestive heart failure (CHF). A current concept of the key pathophysiological mechanism leading to CSR-CSA is a fluctuation of PaCO2 below and above the apneic threshold. A number of therapeutic approaches for CSR-CSA have been proposed-all with varying success, some of which include various modes of positive airway pressure among other strategies. However, CO2 oscillations seen in CSR-CSA have yet to be looked at as a specific therapeutic target by current treatments. Previous studies have shown that delivery of constant CO2 is efficacious in eliminating CSR-CSA by raising PaCO2, but there are serious concerns about the potential side effects, such as unwanted elevations in ventilation, work of breathing, and sympathetic nerve activity (SNA), and consequently CO2 inhalation therapy has not been recommended as a routine option for therapy. However, recent new studies into CO2 inhalation therapy have been made that may reshape its role as therapeutic. In this review, we will focus on the recent developments of administration of dynamic CO2 in the management of CSR-CSA in CHF patients.
Ruscio, A M
Although empirical investigations have established a relationship between childhood sexual abuse and numerous long-term consequences, surprisingly little research has addressed the possible effects of childhood victimization on the later child-rearing practices of adult survivors. The present study examined hypothesized predictors of three parenting styles among adult survivors of sexual abuse as compared with adult children of alcoholic parents. Forty-five clinical outpatients completed a questionnaire battery assessing experiences of childhood abuse, current economic and social resources, and parenting attitudes and practices. The child-rearing practices of participants were compared with those reported by a community sample of 717 mothers. Additional analyses examined the extent to which sexual abuse and its adult sequelae predicted the parenting behaviors reported by the present sample. Both sexual abuse survivors and children of alcoholics reported significantly higher rates of permissive parenting practices than mothers in the community sample. Multiple regression analyses further revealed unique relationships between sexual abuse and parenting, over and above the variance explained by physical abuse, current socioeconomic status, and the experience of growing up in an alcoholic home. Mothers' sexual abuse severity, social support satisfaction, and dysfunctional parenting attitudes moderated several of these relationships. The present findings suggest that sexual abuse and its adult sequelae may have negative consequences for the parenting practices of survivors, particularly for survivors' ability to provide their children with appropriate structure, consistent discipline, and clear behavioral expectations. Implications for the psychosocial development of survivors' children are discussed.
Chronister, Krista M.; Harley, Eliza; Aranda, Christina L.; Barr, Leah; Luginbuhl, Paula
Intimate partner violence (IPV) costs women nearly 8 million days of paid work annually. Greater attention to violence survivors' employment and career development can facilitate women escaping abusive relationships and promotes their overall rehabilitation and healing. A first step to increasing attention to survivors' career development includes…
Boroughs, Michael S.; Valentine, Sarah E.; Ironson, Gail H.; Shipherd, Jillian C.; Safren, Steven A.; Taylor, S. Wade; Dale, Sannisha K.; Baker, Joshua S.; Wilner, Julianne G.; O'Cleirigh, Conall
Men who have sex with men (MSM) are the group most at risk for HIV and represent the majority of new infections in the United States. Rates of childhood sexual abuse (CSA) among MSM have been estimated as high as 46%. CSA is associated with increased risk of HIV and greater likelihood of HIV sexual risk behavior. The purpose of this study was to identify the relationships between CSA complexity indicators and mental health, substance use, sexually transmitted infections (STIs) and HIV sexual risk among MSM. MSM with CSA histories (n = 162) who were screened for an HIV-prevention efficacy trial completed comprehensive psychosocial assessments. Five indicators of complex CSA experiences were created: CSA by family member, CSA with penetration, CSA with physical injury, CSA with intense fear, and first CSA in adolescence. Adjusted regression models were used to identify relationships between CSA complexity and outcomes. Participants reporting CSA by family member were at 2.6 odds of current alcohol use disorder (OR: 2.64: CI 1.24 – 5.63), 2 times higher odds of substance use disorder (OR 2.1: CI 1.02 – 2.36), and 2.7 times higher odds of reporting an STI in the past year (OR 2.7: CI 1.04 – 7.1). CSA with penetration was associated with increased likelihood of current PTSD (OR 3.17: CI 1.56 – 6.43), recent HIV sexual risk behavior (OR 2.7: CI 1.16 – 6.36) and a greater number of casual sexual partners (p = .02). Both CSA with Physical Injury (OR 4.05: CI 1.9 – 8.7) and CSA with Intense Fear (OR 5.16: CI 2.5 – 10.7) were related to increased odds for current PTSD. First CSA in adolescence was related to increased odds of major depressive disorder. These findings suggest that CSA, with one or more complexities, creates patterns of vulnerabilities for MSM, including PTSD, substance use, and sexual risk taking and suggests the need for detailed assessment of CSA and the development of integrated HIV prevention programs that address mental health and substance
Lee, Jayoung; Wallace, Sam; Puig, Ana; Choi, Bo Young; Nam, Suk Kyung; Lee, Sang Min
This study empirically tested and compared three different models of factor structure with a sample of therapists working with sexual offenders, survivors of sexual abuse, or both. Results indicated that a modified five-factor model was the most appropriate. Practical implications for sexual offender/abuse survivor therapists are discussed.…
Walsh, Kate; Fortier, Michelle A.; DiLillo, David
Coping has been suggested as an important element in understanding the long-term functioning of individuals with a history of child sexual abuse (CSA). The present review synthesizes the literature on coping with CSA, first by examining theories of coping with trauma, and, second by examining how these theories have been applied to studies of coping in samples of CSA victims. Thirty-nine studies were reviewed, including eleven descriptive studies of the coping strategies employed by individuals with a history of CSA, eighteen correlational studies of the relationship between coping strategies and long-term functioning of CSA victims, and ten investigations in which coping was examined as a mediational factor in relation to long-term outcomes. These studies provide initial information regarding early sexual abuse and subsequent coping processes. However, this literature is limited by several theoretical and methodological issues, including a failure to specify the process of coping as it occurs, a disparity between theory and research, and limited applicability to clinical practice. Future directions of research are discussed and include the need to understand coping as a process, identification of coping in relation to adaptive outcomes, and considerations of more complex mediational and moderational processes in the study of coping with CSA. PMID:20161502
Lorenz, Tierney Ahrold; Meston, Cindy May
To better understand the link between childhood sexual abuse (CSA) and adult sexual functioning and satisfaction, we examined cognitive differences between women with (N = 128) and without (NSA, N = 99) CSA histories. We used the Linguistic Inquiry Word Count, a computerized text analysis program, to investigate language differences between women with and without CSA histories when writing about their daily life (neutral essay) and their beliefs about sexuality and their sexual experiences (sexual essay). Compared to NSA women, women with CSA histories used fewer first person pronouns in the neutral essay but more in the sexual essay, suggesting women with CSA histories have greater self-focus when thinking about sexuality. Women who reported CSA used more intimacy words and more language consistent with psychological distancing in the sexual essay than did NSA women. Use of positive emotion words in the sexual essay predicted sexual functioning and satisfaction in both groups. These findings support the view that language use differs in significant ways between women with and without sexual abuse histories, and that these differences relate to sexual functioning and satisfaction. PMID:22387124
Soloff, Paul H; Feske, Ulrike; Fabio, Anthony
A history of childhood sexual abuse (CSA) increases the risk of suicidal behavior and the lifetime number of suicide attempts in adults with BPD. Despite a strong association, specific variables mediating the relationship between CSA and adult suicidal behavior in BPD have not been identified. This study examined risk factors for suicidal behavior as potential mediators of the relationship between CSA and suicide attempts in 151 men and women with BPD. Diagnostic, clinical, and psychosocial risk factors, as well as CSA, and suicidal behaviors, were assessed by standardized interviews or self-rated measures. Psychotic and schizotypal symptoms, and poor social adjustment, were associated with both CSA and suicidal behavior, and partially mediated the relationship between CSA and attempter status. Psychotic and schizotypal symptoms in BPD define a vulnerability to cognitive and perceptual distortions under stress. They increase the likelihood of suicidal behavior in BPD, especially in the absence of mitigating social support. A theoretical model for suicidal behavior in BPD is presented which integrates direct, mediated, and moderated pathways between childhood sexual abuse and temperament, adolescent and adult risk factors, and suicidal behavior.
Stephenson, Kyle R.; Hughan, Corey P.; Meston, Cindy M.
Objective To assess the degree to which a history of CSA moderates the association between sexual functioning and sexual distress in women. Method Women with (n = 105, M age = 33.71, 66.1% Caucasian) and without (n = 71, M age = 32.63, 74.7% Caucasian) a history of CSA taking part in a larger clinical trial completed self-report questionnaires at intake including the Sexual Satisfaction Scale for Women (SSS-W), the Female Sexual Function Index (FSFI), and the Trauma History Questionnaire (THQ). Results Desire, arousal, lubrication, and orgasm interacted with sexual abuse status in predicting sexual distress such that sexual functioning was more weakly associated with distress for women with a history of CSA. This disconnect was more pronounced for women who were abused by a family member. Conclusion CSA status serves as an important moderator of the association between sexual functioning and sexual distress in women. Specifically, women with a history of CSA show higher levels of distress in the context of good sexual functioning as compared to women without a history of CSA. Possible explanations and clinical implications are discussed. PMID:22391416
Melkman, Eran P; Hershkowitz, Irit; Zur, Ronit
A major challenge in cases of child sexual abuse (CSA) is determining the credibility of children's reports. Consequently cases may be misclassified as false or deemed 'no judgment possible'. Based on a large national sample of reports of CSA made in Israel in 2014, the study examines child and event characteristics contributing to the probability that reports of abuse would be judged credible. National data files of all children aged 3-14, who were referred for investigation following suspected victimization of sexual abuse, and had disclosed sexual abuse, were analyzed. Cases were classified as either 'credible' or 'no judgment possible'. The probability of reaching a 'credible' judgment was examined in relation to characteristics of the child (age, gender, cognitive delay, marital status of the parents,) and of the abusive event (abuse severity, frequency, perpetrator-victim relationship, perpetrator's use of grooming, and perpetrator's use of coercion), controlling for investigator's identity at the cluster level of the analysis. Of 1563 cases analyzed, 57.9% were assessed as credible. The most powerful predictors of a credible judgment were older age and absence of a cognitive delay. Reports of children to married parents, who experienced a single abusive event that involved perpetrator's use of grooming, were also more likely to be judged as credible. Rates of credible judgments found are lower than expected suggesting under-identification of truthful reports of CSA. In particular, those cases of severe and multiple abuse involving younger and cognitively delayed children are the ones with the lowest chances of being assessed as credible. Copyright © 2017 Elsevier Ltd. All rights reserved.
David-Neto, E; Nahas, W; Sampaio, E C; Ianhez, L E; Sabbaga, E; Arap, S
We compared the results of 44 renal transplants in children, of whom 24 were treated with CSA/AZA and 20 with prednisone in combination with AZA and/or CSA. There were no differences in age distribution or mean ages at transplant between the two treatment groups. The CSA/AZA group had a longer follow-up (29 +/- 33 vs 17 +/- 18 months). At the last follow-up, five children in the CSA/AZA and none in the prednisone group had lost their grafts. Serum creatinine increased in both groups from 0.7 +/- 0.1 mg/dl and 0.9 +/- 0.1 mg/dl at the end of the first month to 1.1 +/- 0.2 mg/dl in the 36th month (CSA/AZA group) (P < 0.0001) and to 1.5 +/- 0.6 mg/dl in the 18th month (prednisone group) (P < 0.05), respectively. Total cholesterol level was 189 +/- 52 mg/dl and 178 +/- 60 mg/dl and LDL level was 117 +/- 48 mg/dl and 115 +/- 51 mg/dl for the prednisone and CSA/AZA groups, respectively. HDL was greater in the CSA/AZA group (50 +/- 10 vs 41 +/- 10 mg/dl) (P < 0.03), and VLDL was greater in the prednisone group (31 +/- 13 vs 22 +/- 8 mg/dl) (P < 0.05). Serum triglyceride was greater in the prednisone group (174 +/- 93 vs 112 +/- 50 mg/dl) (P < 0.03). The standard deviation score for height of the children in the prednisone group did not change (-2.4 +/- 1.4 vs -2.1 +/- 1.4 SDS), whereas the SDS height score for the CSA/AZA children increased from -3.1 +/- 1.7 to -2.6 +/- 1.5, -1.9 +/- 1.4 and -1.7 +/- 1.4, at 12, 24 and 36 months, respectively (P < 0.001). CSA/AZA is a good immunosuppressive regime for the first renal transplant in children, but only 75% tolerated AZA/CSA without same damage to their grafts.
Feiring, Candice; Simon, Valerie A; Cleland, Charles M; Barrett, Ellen P
Although experiencing childhood sexual abuse (CSA) puts youth at risk for involvement in relationship violence, research is limited on the potential pathways from CSA to subsequent dating aggression. The current study examined prospective pathways from externalizing behavior problems and stigmatization (abuse-specific shame and self-blame attributions) to anger and dating aggression. One hundred sixty youth (73% female, 69% ethnic/racial minorities) with confirmed CSA histories were interviewed at the time of abuse discovery (T1, when they were 8-15 years of age), and again 1 and 6 years later (T2 and T3). Externalizing behavior and abuse-specific stigmatization were assessed at T1 and T2. Anger and dating aggression were assessed at T3. The structural equation model findings supported the proposed relations from stigmatization following the abuse to subsequent dating aggression through anger. Only externalizing behavior at T1 was related to later dating aggression, and externalizing was not related to subsequent anger. This longitudinal research suggests that clinical interventions for victims of CSA be sensitive to the different pathways by which youth come to experience destructive conflict behavior in their romantic relationships.
Cohen, Lisa R; Tross, Susan; Pavlicova, Martina; Hu, Mei-Chen; Campbell, Aimee N; Nunes, Edward V
Substance use and a history of childhood sexual abuse (CSA) are risk factors for unprotected sex among women, yet questions remain as to how their combined influence may differentially affect sexual risk. The current study investigated how complex relationships among drug use and CSA may contribute to unprotected sexual occasions (USO). A Generalized Linear Mixed Model was used to examine the interaction between current cocaine/stimulants and opioid use and CSA on number of USOs in a sample of 214 sexually active women in outpatient methadone maintenance treatment. For women with CSA, an increase in days of cocaine/stimulant use was associated with a significant increase in USOs. In contrast, an increase in days of opiate use was associated with a significant decrease in USOs. For the group of women who did not report CSA, there was a significant increase in USOs with increased opiate use. Findings indicate that CSA is related to unprotected sexual occasions depending on drug type and severity of use. Women with CSA using cocaine are at particularly high risk for having unprotected sex and should be specifically targeted for HIV prevention interventions.
Hopper, E K; Gonzalez, L D
Human trafficking is a form of interpersonal trauma that has significant mental health impacts on survivors. This study examined psychological symptoms in 131 survivors of sex and labor trafficking, including people trafficked into or within the U.S. High rates of depression (71%) and PTSD (61%) were identified. Two thirds of survivors also met criteria for multiple categories of Complex PTSD (C-PTSD), including affect dysregulation and impulsivity; alterations in attention and consciousness; changes in interpersonal relationships; revictimization; somatic dysregulation; and alterations in self-perception. Although there were not significant differences in the prevalence rates of diagnoses of PTSD or depression between survivors of sex and labor trafficking, important group differences were identified. Compared to survivors of labor trafficking, sex trafficking survivors had higher prevalence rates of pre-trafficking childhood abuse and a higher incidence of physical and sexual violence during trafficking. They reported more severe post-trauma reactions than labor trafficking survivors, including more PTSD and C-PTSD symptoms. They were also more likely to meet criteria for comorbid PTSD and depression, while labor trafficking survivors were more likely than sex trafficking survivors to meet criteria for depression alone. An analysis of gender differences found that trafficking survivors who identified as transgender endorsed more PTSD and C-PTSD symptoms, than male or female survivors. Childhood abuse exposure was linked to PTSD and C-PTSD in trafficking survivors, and trafficking type was predictive of the number of trauma-related symptoms beyond the role of pre-trafficking child abuse. Implications for assessment and intervention with trafficking survivors are discussed.
Goodman, Gail S.; Ogle, Christin M.; Block, Stephanie D.; Harris, LaTonya S.; Larson, Rakel P.; Augusti, Else-Marie; Cho, Young Il; Beber, Jonathan; Timmer, Susan; Urquiza, Anthony
The purpose of the present research was to examine Deese-Roediger-McDermott (DRM) false memory for trauma-related and nontrauma-related lists in adolescents and adults with and without documented histories of child sexual abuse (CSA). Individual differences in psychopathology and adult attachment were also explored. Participants were administered free recall and recognition tests after hearing CSA, negative, neutral, and positive DRM lists. In free recall, CSA and negative lists produced the most false memory. In sharp contrast, for recognition, CSA lists enjoyed the highest d’ scores. CSA-group adolescents who evinced greater PTSD symptoms had higher rates of false memory compared to: 1) nonCSA-group adolescents with higher PTSD symptom scores (free recall), and 2) CSA-group adolescents with lower PTSD symptom scores (recognition). Regression analyses revealed that individuals with higher PTSD scores and greater fearful-avoidant attachment tendencies showed less proficient memory monitoring for CSA lists. Implications for trauma and memory development and for translational research are discussed. PMID:23786687
Latack, Jessica A; Rodriguez-Seijas, Craig; Stohl, Malka; Blanco, Carlos; Hasin, Deborah S; Eaton, Nicholas R
Exposure to childhood sexual abuse (CSA) is associated with elevated rates of mental disorders, sexual risk behavior, and sexually transmitted infections (STIs) in adulthood. Mental disorders themselves are associated with an increased risk for HIV/AIDs and STIs as well, and thus may mediate the association between CSA and HIV/AIDS and other STIs. The links among CSA, disorders, and STIs are unclear, however. The current study tested the hypothesis that the association of CSA with STIs is mediated by adult transdiagnostic psychopathology. We examined the potential mediating role of transdiagnostic psychopathology factors-internalizing (INT) and externalizing (EXT)-in the association between CSA and receiving a past-year diagnosis of HIV, AIDS, or another STI in a large, national probability sample of adults (N=34,653). Using indirect effects modeling, we found that 54.4% of the association between CSA and subsequent HIV/AIDS/STI diagnosis operated through transdiagnostic psychopathology. The proposed mediation model was supported, indicating that individuals reporting CSA had higher estimated levels of latent general liabilities for INT and EXT disorders, and it was largely these liabilities that accounted for the link between CSA and heightened risk of adult HIV, AIDS, and STI diagnoses. Copyright © 2015 Elsevier Inc. All rights reserved.
Brock, Kathleen J.; Mintz, Laurie B.; Good, Glenn E.
Identifies a previously unexamined group of sexual abuse survivors (those from functional families) and addresses methodological flaws in previous research. Results indicate that women in the abused-dysfunctional group reported the highest level of psychological distress. Psychological distress reported by abused-functional women paralleled that…
Pollard, Jake E.; Snarr, Jason; Chaudhary, Vinod; Jennings, Jacob D.; Shaw, Hannah; Christiansen, Bobbie; Wright, Jonathan; Jia, Wenyi; Bishop, Russell E.; Savage, Paul B.
Objectives Though most bacteria remain susceptible to endogenous antimicrobial peptides, specific resistance mechanisms are known. As mimics of antimicrobial peptides, ceragenins were expected to retain antibacterial activity against Gram-positive and -negative bacteria, even after prolonged exposure. Serial passaging of bacteria to a lead ceragenin, CSA-13, was performed with representative pathogenic bacteria. Ciprofloxacin, vancomycin and colistin were used as comparators. The mechanisms of resistance in Gram-negative bacteria were elucidated. Methods Susceptible strains of Staphylococcus aureus, Pseudomonas aeruginosa and Acinetobacter baumannii were serially exposed to CSA-13 and comparators for 30 passages. MIC values were monitored. Alterations in the Gram-negative bacterial membrane composition were characterized via mass spectrometry and the susceptibility of antimicrobial-peptide-resistant mutants to CSA-13 was evaluated. Results S. aureus became highly resistant to ciprofloxacin after <20 passages. After 30 passages, the MIC values of vancomycin and CSA-13 for S. aureus increased 9- and 3-fold, respectively. The Gram-negative organisms became highly resistant to ciprofloxacin after <20 passages. MIC values of colistin for P. aeruginosa and A. baumannii increased to ≥100 mg/L after 20 passages. MIC values of CSA-13 increased to ∼20–30 mg/L and plateaued over the course of the experiment. Bacteria resistant to CSA-13 displayed lipid A modifications that are found in organisms resistant to antimicrobial peptides. Conclusions CSA-13 retained potent antibacterial activity against S. aureus over the course of 30 serial passages. Resistance generated in Gram-negative bacteria correlates with modifications to the outer membranes of these organisms and was not stable outside of the presence of the antimicrobial. PMID:22899801
Ditlev, Sisse B; Florea, Raluca; Nielsen, Morten A; Theander, Thor G; Magez, Stefan; Boeuf, Philippe; Salanti, Ali
Placental malaria is a major health problem for both pregnant women and their fetuses in malaria endemic regions. It is triggered by the accumulation of Plasmodium falciparum-infected erythrocytes (IE) in the intervillous spaces of the placenta and is associated with foetal growth restriction and maternal anemia. IE accumulation is supported by the binding of the parasite-expressed protein VAR2CSA to placental chondroitin sulfate A (CSA). Defining specific CSA-binding epitopes of VAR2CSA, against which to target the immune response, is essential for the development of a vaccine aimed at blocking IE adhesion. However, the development of a VAR2CSA adhesion-blocking vaccine remains challenging due to (i) the large size of VAR2CSA and (ii) the extensive immune selection for polymorphisms and thereby non-neutralizing B-cell epitopes. Camelid heavy-chain-only antibodies (HcAbs) are known to target epitopes that are less immunogenic to classical IgG and, due to their small size and protruding antigen-binding loop, able to reach and recognize cryptic, conformational epitopes which are inaccessible to conventional antibodies. The variable heavy chain (VHH) domain is the antigen-binding site of camelid HcAbs, the so called Nanobody, which represents the smallest known (15 kDa) intact, native antigen-binding fragment. In this study, we have used the Nanobody technology, an approach new to malaria research, to generate small and functional antibody fragments recognizing unique epitopes broadly distributed on VAR2CSA.
Rovira-Vallbona, Eduard; Monteiro, Isadora; Bardají, Azucena; Serra-Casas, Elisa; Neafsey, Daniel E; Quelhas, Diana; Valim, Clarissa; Alonso, Pedro; Dobaño, Carlota; Ordi, Jaume; Menéndez, Clara; Mayor, Alfredo
Plasmodium falciparum infected erythrocytes (IE) accumulate in the placenta through the interaction between Duffy-binding like (DBL) domains of parasite-encoded ligand VAR2CSA and chondroitin sulphate-A (CSA) receptor. Polymorphisms in these domains, including DBL2X and DBL3X, may affect their antigenicity or CSA-binding affinity, eventually increasing parasitemia and its adverse effects on pregnancy outcomes. A total of 373 DBL2X and 328 DBL3X sequences were obtained from transcripts of 20 placental isolates infecting Mozambican women, resulting in 176 DBL2X and 191 DBL3X unique sequences at the protein level. Sequence alignments were divided in segments containing combinations of correlated polymorphisms and the association of segment sequences with placental parasite density was tested using Bonferroni corrected regression models, taking into consideration the weight of each sequence in the infection. Three DBL2X and three DBL3X segments contained signatures of high parasite density (P<0.003) that were highly prevalent in the parasite population (49-91%). Identified regions included a flexible loop that contributes to DBL3X-CSA interaction and two DBL3X motifs with evidence of positive natural selection. Limited antibody responses against signatures of high parasite density among malaria-exposed pregnant women could not explain the increased placental parasitemia. These results suggest that a higher binding efficiency to CSA rather than reduced antigenicity might provide a biological advantage to parasites with high parasite density signatures in VAR2CSA. Sequences contributing to high parasitemia may be critical for the functional characterization of VAR2CSA and the development of tools against placental malaria.
... drugs, including opioids Drug abuse also plays a role in many major social problems, such as drugged driving, violence, stress, and child abuse. Drug abuse can lead to homelessness, crime, and missed work or problems with keeping a job. It harms ...
Foreman, Susan; Seligman, Linda
Discusses legal and developmental aspects of adolescent abuse, as distinguished from child abuse. The role of the school counselor in identifying and counseling abused adolescents and their families is discussed and several forms of intervention and support services are described. (JAC)
Testing a model of the relationship between childhood sexual abuse and psychosis in a first-episode psychosis group: the role of hallucinations and delusions, posttraumatic intrusions, and selective attention.
Bendall, Sarah; Hulbert, Carol Anne; Alvarez-Jimenez, Mario; Allott, Kelly; McGorry, Patrick D; Jackson, Henry James
Several theories suggest that posttraumatic intrusive symptoms are central to the relationship between childhood trauma (CT) and hallucinations and delusions in psychosis. Biased selective attention has been implicated as a cognitive process underlying posttraumatic intrusions. The current study sought to test theories of the relationship between childhood sexual abuse (CSA), hallucinations and delusions, posttraumatic intrusions, and selective attention in first-episode psychosis (FEP). Twenty-eight people with FEP and 21 nonclinical controls were assessed for CT and psychotic and posttraumatic stress symptoms and completed an emotional Stroop test using CSA-related and other words. Those with FEP and CSA had more severe hallucinations and delusions than those with FEP and without CSA. They also reported posttraumatic intrusions at clinical levels and showed selective attention to CSA-related words. The results are consistent with the posttraumatic intrusions account of hallucinations and delusions in those with CSA and psychosis.
Stroud, D D
With the increasing popularity of family therapies in cases of childhood sexual abuse (CSA), many studies have discussed the importance of familial support in the successful recovery of victims. Therefore, a systematic study exploring family support of victims was undertaken to shed light on the level of family support perceived by adult victims of CSA. It was anticipated that victims of intrafamilial CSA would report more family dissatisfaction and perceive less family support than extrafamilial victims. As hypothesized, intrafamilial victims reported significantly more general family dissatisfaction and specifically, perceived significantly less father, parent, and brother support. Additionally, the gender of the victim played a significant role: Male victims reported less father, parent and sister support and less family protectiveness after disclosure when compared to female victims. Based on the results, clinicians should be aware that issues of gender and relatedness may play a significant part in the effectiveness of their CSA clients' family support systems.
Robertson, Hillary A; Chaudhary Nagaraj, Nitasha; Vyas, Amita N
Family violence, including child sexual abuse (CSA), is a significant public health problem in the United States. It is particularly difficult to assess family violence and CSA among South Asians because it is often hidden due to cultural and familial stigma. A web-based survey was administered to a convenience sample (n = 368) of South Asian adults in the US. One-fourth (25.2 %) of the sample reported CSA; 13.8 % reported abuse involving exposure; 21.5 % reported abuse involving touching; 4.5 % reported attempted sexual intercourse; and 3.5 % reported forced sexual intercourse. Adjusted odds ratios found that participants who reported any relationship violence were significantly more likely to have experienced CSA (OR 2.28; 95 % CI 1.26-4.13); and suicide attempt was significantly associated with CSA (OR 3.96; 95 % CI 1.27-12.3). The findings presented in this formative study will assist in guiding future studies and interventions for South Asians in the United States.
Williams, Rachel; Taylor, Janette Y.
This article describes an arts and narrative intervention program using visual art, storytelling, music, journaling, and support groups with incarcerated abused women to address the following questions: How can visual art and music empower incarcerated female survivors of domestic violence? Can art, music, storytelling, journaling, and support…
Babakhanyan, Anna; Leke, Rose G. F.; Salanti, Ali; Bobbili, Naveen; Gwanmesia, Philomina; Leke, Robert J. I.; Quakyi, Isabella A.; Chen, John J.; Taylor, Diane Wallace
In pregnant women, Plasmodium falciparum-infected erythrocytes expressing the VAR2CSA antigen bind to chondroitin sulfate A in the placenta causing placental malaria. The binding site of VAR2CSA is present in the ID1-ID2a region. This study sought to determine if pregnant Cameroonian women naturally acquire antibodies to ID1-ID2a and if antibodies to ID1-ID2a correlate with absence of placental malaria at delivery. Antibody levels to full-length VAR2CSA and ID1-ID2a were measured in plasma samples from 745 pregnant Cameroonian women, 144 Cameroonian men, and 66 US subjects. IgM levels and IgG avidity to ID1-ID2a were also determined. As expected, antibodies to ID1-ID2a were absent in US controls. Although pregnant Cameroonian women developed increasing levels of antibodies to full-length VAR2CSA during pregnancy, no increase in either IgM or IgG to ID1-ID2a was observed. Surprisingly, no differences in antibody levels to ID1-ID2a were detected between Cameroonian men and pregnant women. For example, in rural settings only 8–9% of males had antibodies to full-length VAR2CSA, but 90–96% had antibodies to ID1-ID2a. In addition, no significant difference in the avidity of IgG to ID1-ID2a was found between pregnant women and Cameroonian men, and no correlation between antibody levels at delivery and absence of placental malaria was found. Thus, the response to ID1-ID2a was not pregnancy specific, but predominantly against cross-reactivity epitopes, which may have been induced by other PfEMP1 antigens, malarial antigens, or microbes. Currently, ID1-ID2a is a leading vaccine candidate, since it binds to the CSA with the same affinity as the full-length molecule and elicits binding-inhibitory antibodies in animals. Further studies are needed to determine if the presence of naturally acquired cross-reactive antibodies in women living in malaria endemic countries will alter the response to ID1-ID2a following vaccination with ID1-ID2a. PMID:24505415
Twaite, James A; Rodriguez-Srednicki, Ofelia
Two hundred and eighty-four adults from the metropolitan New York area reported on their history of childhood sexual abuse (CSA), childhood physical abuse (CPA), and on the nature of their exposure to the terrorist attack on the World Trade Center. The respondents also completed the Impact of Events Scale-Revised (IES-R), the Attachment Style Questionnaire (ASQ) and the Dissociative Experiences Scale (DES). Those reporting histories of CSA and/or CPA were found to endorse more serious symptoms of PTSD, as did those who witnessed the terrorist attack live. The presence of secure attachments and dissociative symptoms were related significantly to both CSA and CPA, and to scores on the IES-R. Adult attachment and dissociation were found to mediate the relationship between childhood abuse and severity of PTSD.
McElroy, Eoin; Shevlin, Mark; Elklit, Ask; Hyland, Philip; Murphy, Siobhan; Murphy, Jamie
Childhood sexual abuse (CSA) is a common occurrence and a robust, yet non-specific, predictor of adult psychopathology. While many demographic and abuse factors have been shown to impact this relationship, their common and specific effects remain poorly understood. This study sought to assess the prevalence of Axis I disorders in a large sample of help-seeking victims of sexual trauma, and to examine the common and specific effects of demographic and abuse characteristics across these different diagnoses. The participants were attendees at four treatment centres in Denmark that provide psychological therapy for victims of CSA (N=434). Axis I disorders were assessed using the Millon Clinical Multiaxial Inventory-III (MCMI-III). Multivariate logistic regression analysis was used to examine the associations between CSA characteristics (age of onset, duration, number of abusers, number of abusive acts) and 10 adult clinical syndromes. There was significant variation in the prevalence of disorders and the abuse characteristics were differentially associated with the outcome variables. Having experienced sexual abuse from more than one perpetrator was the strongest predictor of psychopathology. The relationship between CSA and adult psychopathology is complex. Abuse characteristics have both unique and shared effects across different diagnoses.
Ko Ling Chan; Yan, Elsie; Brownridge, Douglas A; Tiwari, Agnes; Fong, Daniel Y T
This study investigated the prevalence and impact of childhood sexual abuse (CSA) on future intimate partner violence (IPV) in dating relationship in Hong Kong, China. A total of 1,154 Chinese adult respondents engaged in dating relationships were interviewed face-to-face about their CSA histories, childhood witnessing of parental violence, adult sexual victimization (ASV) by others and IPV victimization with their current dating partner. Self-reports also measured levels of suicidal ideation, self-esteem, and demographic details. Overall, 1.7% reported some form of CSA with a higher percentage being women. No gender differences were found in the prevalence of either ASV or IPV. Results showed that CSA had an independent effect on physical IPV and suicidal ideation. The odds of IPV were increased by behavioral and psychological factors of victims such as alcohol and drug abuse, sex with partner, and low self-esteem. The odds of suicidal ideation were also increased by drug abuse, childhood witnessing of parental psychological aggression, and low self-esteem. Clinical implications of results included screening for CSA victims and suicidal victims when treating IPV patients, tailoring treatment according to individual IPV victim's problems, correcting behaviors that are associated with risks of IPV, such as engagement in casual sex and substance abuse, and focusing not only on tangible services but also on the social and psychological aspects that are placing the victims at risk for IPV.
Sciolla, Andres; Glover, Dorie A.; Loeb, Tamra B.; Zhang, Muyu; Myers, Hector F.; Wyatt, Gail E.
A history of childhood sexual abuse (CSA) has been associated with adult depression, but data on abuse severity and disclosure are scant, particularly among low income ethnic minorities. CSA often co-occurs with other adversities, which also increase the risk of depression. This study examined the peri-trauma variable of abuse severity and the post-trauma variables of disclosure and self-blame as predictors of current depression symptoms in 94 low-income African American and Latina women with histories of CSA. After controlling for non-sexual childhood adversity and adult burden (i.e., chronic stress), severe CSA overall was associated with higher depression scores, especially among Latinas who disclosed their abuse. Depression symptoms among African American women were highest in those who disclosed and reported high levels of self-blame at the time of the incident. The link between depression and specific peri- and post-CSA factors in minority women may help guide future interventions. PMID:21716061
Harris, Latonya S; Block, Stephanie D; Ogle, Christin M; Goodman, Gail S; Augusti, Else-Marie; Larson, Rakel P; Culver, Michelle A; Pineda, Annarheen R; Timmer, Susan G; Urquiza, Anthony
Individuals with histories of childhood trauma may adopt a nonspecific memory retrieval strategy to avoid unpleasant and intrusive memories. In a sample of 93 adolescents and adults with or without histories of child sexual abuse (CSA), we tested the hypothesis that nonspecific memory retrieval is related to an individual's general tendency to use avoidant (i.e., distancing) coping as a personal problem-solving or coping strategy, especially in victims of CSA. We also examined age differences and other individual differences (e.g., trauma-related psychopathology) as predictors of nonspecific memories. Distancing coping was significantly associated with less specific autobiographical memory. Younger age, lower vocabulary scores, and non-CSA childhood maltreatment (i.e., physical and emotional abuse) also uniquely predicted less autobiographical memory specificity, whereas trauma-related psychopathology was associated with more specific memory. Implications for the development of autobiographical memory retrieval in the context of coping with childhood maltreatment are discussed.
Alexander, Pamela C.; Anderson, Catherine L.; Brand, Bethany; Schaeffer, Cindy M.; Grelling, Barbara Z.; Kretz, Lisa
Ninety-two adult female incest survivors were interviewed and completed measures of current functioning. Hierarchical regression analyses suggested that adult attachment behavior was significantly associated with personality structure, depression, and distress; and abuse severity was associated with posttraumatic stress disorder symptoms and…
Kirschner, Sam; Kirschner, Diana
The past decade has witnessed a growing awareness of the prevalence and consequences of childhood sexual abuse. This paper presents findings from numerous studies which indicate that adult survivors of incest suffer from devastating personal and interpersonal difficulties. Recent studies on incest claim that some 20 percent of females and over 16…
Cole, Pamela M.; And Others
This study examined the self-reported parenting experience and practices of women who were either incest victims of their fathers as children (n=20), whose fathers were alcoholic but not sexually abusive (n=25), or who had no known risk in childhood (n=39). Incest survivors reported less confidence and sense of control as parents. (Author/DB)
Bowland, Sharon; Edmond, Tonya; Fallot, Roger D.
This study evaluated the effectiveness of an 11-session, spiritually focused group intervention with older women survivors (age 55 years and older) of interpersonal trauma (child abuse, sexual assault, or domestic violence) in reducing trauma-related depressive symptoms, posttraumatic stress, and anxiety. Forty-three community-dwelling women…
Letourneau, Elizabeth J; Brown, Derek S; Fang, Xiangming; Hassan, Ahmed; Mercy, James A
The present study provides an estimate of the U.S. economic impact of child sexual abuse (CSA). Costs of CSA were measured from the societal perspective and include health care costs, productivity losses, child welfare costs, violence/crime costs, special education costs, and suicide death costs. We separately estimated quality-adjusted life year (QALY) losses. For each category, we used the best available secondary data to develop cost per case estimates. All costs were estimated in U.S. dollars and adjusted to the reference year 2015. Estimating 20 new cases of fatal and 40,387 new substantiated cases of nonfatal CSA that occurred in 2015, the lifetime economic burden of CSA is approximately $9.3 billion, the lifetime cost for victims of fatal CSA per female and male victim is on average $1,128,334 and $1,482,933, respectively, and the average lifetime cost for victims of nonfatal CSA is of $282,734 per female victim. For male victims of nonfatal CSA, there was insufficient information on productivity losses, contributing to a lower average estimated lifetime cost of $74,691 per male victim. If we included QALYs, these costs would increase by approximately $40,000 per victim. With the exception of male productivity losses, all estimates were based on robust, replicable incidence-based costing methods. The availability of accurate, up-to-date estimates should contribute to policy analysis, facilitate comparisons with other public health problems, and support future economic evaluations of CSA-specific policy and practice. In particular, we hope the availability of credible and contemporary estimates will support increased attention to primary prevention of CSA. Copyright © 2018. Published by Elsevier Ltd.
Ajduković, Marina; Sušac, Nika; Rajter, Miroslav
Aim To examine age and gender differences in the prevalence and incidence of child sexual abuse, the level of acquaintance of the child and the perpetrator, and correlations between experiencing family violence and sexual abuse on a nationally representative sample of 11, 13, and 16 years old children. Method A probabilistic stratified cluster sample included 2.62% of the overall population of children aged 11 (n = 1223), 13 (n = 1188), and 16 (n = 1233) from 40 primary and 29 secondary schools. A modified version of ISPCAN Child Abuse Screening Tool – Children's Version was used. Five items referred to child sexual abuse (CSA) for all age groups. Results In Croatia, 10.8% of children experienced some form of sexual abuse (4.8% to 16.5%, depending on the age group) during childhood and 7.7% of children experienced it during the previous year (3.7% to 11.1%, depending on the age group). Gender comparison showed no difference in the prevalence of contact sexual abuse, whereas more girls than boys experienced non-contact sexual abuse. Correlations between sexual abuse and physical and psychological abuse in the family were small, but significant. Conclusion Comparisons with international studies show that Croatia is a country with a low prevalence of CSA. The fact that the majority of perpetrators of sexual abuse are male and female peers indicates the urgent need to address risks of sexual victimization in the health education of children. PMID:24170726
Ajdukovic, Marina; Susac, Nika; Rajter, Miroslav
To examine age and gender differences in the prevalence and incidence of child sexual abuse, the level of acquaintance of the child and the perpetrator, and correlations between experiencing family violence and sexual abuse on a nationally representative sample of 11, 13, and 16 years old children. A probabilistic stratified cluster sample included 2.62% of the overall population of children aged 11 (n=1223), 13 (n=1188), and 16 (n=1233) from 40 primary and 29 secondary schools. A modified version of ISPCAN Child Abuse Screening Tool - Children's Version was used. Five items referred to child sexual abuse (CSA) for all age groups. In Croatia, 10.8% of children experienced some form of sexual abuse (4.8% to 16.5%, depending on the age group) during childhood and 7.7% of children experienced it during the previous year (3.7% to 11.1%, depending on the age group). Gender comparison showed no difference in the prevalence of contact sexual abuse, whereas more girls than boys experienced non-contact sexual abuse. Correlations between sexual abuse and physical and psychological abuse in the family were small, but significant. Comparisons with international studies show that Croatia is a country with a low prevalence of CSA. The fact that the majority of perpetrators of sexual abuse are male and female peers indicates the urgent need to address risks of sexual victimization in the health education of children.
The Amsterdam Sexual Abuse Case (ASAC)-study in day care centers: longitudinal effects of sexual abuse on infants and very young children and their parents, and the consequences of the persistence of abusive images on the internet.
Lindauer, Ramón J L; Brilleslijper-Kater, Sonja N; Diehle, Julia; Verlinden, Eva; Teeuw, Arianne H; Middeldorp, Christel M; Tuinebreijer, Wilco; Bosschaart, Thekla F; van Duin, Esther; Verhoeff, Arnoud
Little research has been done on the signs of child sexual abuse (CSA) in infants and very young children, or on the consequences that such abuse - including the persistence of the abusive pornographic images on the internet - might have for the children and their parents. The effects of CSA can be severe, and a variety of risk- and protective factors, may influence those effects. CSA may affect the psychosocial-, emotional-, cognitive-, and physical development of children, their relationships with their parent(s), and the relations between parents. In the so called 'the Amsterdam sexual abuse case' (ASAC), infants and very young children were victimized by a day-care employee and most of the victims were boys. Research involving the children and their parents would enable recognition of the signs of CSA in very young children and understanding the consequences the abuse might have on the long term. The proposed research project consists of three components: (I) An initial assessment to identify physical- or psychological signs of CSA in infants and very young children who are thought to have been sexually abused (n = 130); (II) A cross-sequential longitudinal study of children who have experienced sexual abuse, or for whom there are strong suspicions; (III) A qualitative study in which interviews are conducted with parents (n = 25) and with therapists treating children from the ASAC. Parents will be interviewed on the perceived condition of their child and family situation, their experiences with the service responses to the abuse, the effects of legal proceedings and media attention, and the impact of knowing that pornographic material has been disseminated on the internet. Therapists will be interviewed on their clinical experiences in treating children and parents. The assessments will extend over a period of several years. The outcome measures will be symptoms of posttraumatic stress disorder (PTSD), dissociative symptoms, age-inappropriate sexual behaviors
Jonas, S; Bebbington, P; McManus, S; Meltzer, H; Jenkins, R; Kuipers, E; Cooper, C; King, M; Brugha, T
Evidence is accumulating that child sexual abuse (CSA) is associated with many psychiatric disorders in adulthood. This paper uses the detailed information available from the 2007 Adult Psychiatric Morbidity Survey of England (APMS 2007) to quantify links between CSA and a range of psychiatric conditions. The prevalence of psychiatric disorder was established in a random sample of the English household population (n=7403), which also provided sociodemographic and experiential information. We analyzed six types of common mental disorder, alcohol abuse and drug abuse, and people who screened positively for post-traumatic stress disorder (PTSD) and eating disorders. All were strongly and highly significantly associated with CSA, particularly if non-consensual sexual intercourse was involved, for which odds ratios (ORs) ranged from 3.7 to 12.1. These disorders were also related to adult sexual abuse (ASA), although the likelihood of reverse causality is then increased. Revictimization in adulthood was common, and increased the association of CSA with disorder. For several disorders, the relative odds were higher in females but formal tests for moderation by gender were significant only for common mental disorders and only in relation to non-consensual sexual intercourse. The population attributable fraction (PAF) was higher in females in all cases. The detailed and high-quality data in APMS 2007 provided important confirmation both of the strength of association of CSA with psychiatric disorder and of its relative non-specificity. Our results have major implications at the public health level and the individual level, in particular the need for better recognition and treatment of the sequelae of CSA.
The assessment of victims of child sexual abuse (CSA) is now a recognized aspect of clinical work for both CAMH and adult services. As juvenile perpetrators of CSA are responsible for a significant minority of the sexual assaults on other children, CAMH services are increasingly approached to assess these oversexualized younger children or sexually abusive adolescents. A developmental approach to assessment and treatment intervention is essential in all these cases. This review examines research on the characteristics of child victims and perpetrators of CSA. It describes evidence-based approaches to assessment and treatment of both groups of children. A selective review of MEDLINE, Psycinfo, Cochrane Library, and other databases was undertaken. Recommendations are made for clinical practice and future research. The characteristics of CSA victims are well known and those of juvenile perpetrators of sexual abuse are becoming recognized. Assessment approaches for both groups of children should be delivered within a safeguarding context where risk to victims is minimized. Risk assessment instruments should be used only as adjuncts to a full clinical assessment. Given high levels of psychiatric comorbidity, assessment, treatment, and other interventions should be undertaken by mental health trained staff. Victims and perpetrators of CSA present challenges and opportunities for professional intervention. Their complex presentations mean that their needs should be met by highly trained staff. However, their youth and developmental immaturity also give an opportunity to nip problem symptoms and behaviors in the bud. The key is in the earliest possible intervention with both groups. Future research should focus on long-term adult outcomes for both child victims and children who perpetrate CSA. Adult outcomes of treated children could identify problems and/or strengths in parenting the next generation and also the persistence and/or desistence of sexualized or abusive
Relyea, Mark; Ullman, Sarah E.
This study used a large community sample of women sexual assault survivors to prospectively assess 17 theorized predictors across four types of sexual assault revictimization: unwanted contact, coercion, substance-involved assault (SIA), and force. Results indicated that predictors varied across types of revictimization: Unwanted contact and coercion appeared more common in social contexts more hostile toward survivors, whereas forcible assaults and SIAs occurred in circumstances where survivors were vulnerable to being targeted by perpetrators. Overall, the strongest predictors were social environments hostile to survivors, race, childhood sexual abuse, decreased refusal assertiveness, and having more sexual partners. We discuss implications for intervention and research. PMID:27555596
Schonbucher, Verena; Maier, Thomas; Mohler-Kuo, Meichun; Schnyder, Ulrich; Landolt, Markus A.
This qualitative study aimed to study the process of disclosure by examining adolescents from the general population who had experienced child sexual abuse (CSA). Twenty-six sexually victimized adolescents (23 girls, 3 boys; age: 15-18 years) participated in a qualitative face-to-face in-depth interview on different aspects of disclosure. A…
Crowley, M. Sue
The study explored types of memory for childhood sexual abuse (CSA) in a clinical sample of 30 women and identified factors that led some women (n = 24) to report recovered memories. Questionnaires produced three types of memory: always (n = 6), recovered (n = 14), both (n = 10); however, analysis of narrative data also revealed the use of…
Everson, Mark D.; Sandoval, Jose Miguel
Objectives: Evaluators examining the same evidence often arrive at substantially different conclusions in forensic assessments of child sexual abuse (CSA). This study attempts to identify and quantify subjective factors that contribute to such disagreements so that interventions can be devised to improve the reliability of case decisions. Methods:…
Bedi, Saaniya; Nelson, Elliot C.; Lynskey, Michael T.; McCutcheon, Vivia V.; Heath, Andrew C.; Madden, Pamela A. F.; Martin, Nicholas G.
Earlier studies have found an elevated risk for psychopathology and suicidal behavior associated with childhood sexual abuse (CSA); however, the degree to which risk is mediated by depression and posttraumatic stress disorder (PTSD) in women and men remains unclear. We examined these issues in data from a family study of childhood maltreatment (N…
Boden, Joseph M.; Fergusson, David M.; Horwood, L. John
Objective: The present study examined the associations between the experience of sexual abuse in childhood (CSA) and the number of abortions in adolescence and early adulthood. Method: A 25-year prospective longitudinal study of the health, development, and adjustment of a birth cohort of 1,265 New Zealand children (630 females). Measures included…
Parks, Kathleen A.; Hequembourg, Amy L.; Dearing, Ronda L.
Heavy alcohol consumption (Testa & Parks, 1996) and childhood sexual abuse (CSA; Messman-Moore & Long, 2003) have been associated with adult sexual victimization. We examined the social behavior of 42 women under two alcohol conditions (high dose and low dose) in a bar laboratory. Women were videotaped interacting with a man they had just met.…
Danielson, Carla Kmett; Amstadter, Ananda B.; Dangelmaier, Ruth E.; Resnick, Heidi S.; Saunders, Benjamin E.; Kilpatrick, Dean G.
We investigated the link between child maltreatment, including child sexual assault (CSA) and child physical assault (CPA), and addiction-related symptomatology in a subsample of adolescents from the National Survey of Adolescents, all of whom met DSM-IV criteria for substance abuse or dependence (N = 281). More than 60% of the sample reported a…
Ige, Olusimbo K.; Fawole, Olufunmilayo I.
This study examined parents' perceptions of child sexual abuse as well as prevention practices in an urban community in southwest Nigeria. Questionnaires were collected from 387 parents and caregivers of children younger than 15 years of age. Results showed that many parents felt CSA was a common problem in the community, and most parents…
Al-Zboon, Eman; Ahmad, Jamal
This study aimed at examining Jordanian pre-service special education teachers' professionalism and preparation on the topic of child sexual abuse (CSA). Qualitative research data from interviews with 20 pre-service special education teachers were analysed using thematic analysis. The results showed that these participants generally hold avoiding…
Godbout, Natacha; Sabourin, Stephane; Lussier, Yvan
This study compared the usefulness of single- and multiple-indicator strategies in a model examining the role of child sexual abuse (CSA) to predict later marital satisfaction through attachment and psychological distress. The sample included 1,092 women and men from a nonclinical population in cohabiting or marital relationships. The single-item…
Lemieux, Suzanne R.; Byers, E. Sandra
The present study examined the association between child sexual abuse (CSA) and a range of positive and negative aspects of women's sexual well-being. We also investigated the extent to which women's cognitive-affective sexual appraisals mediated these relationships. Participants were 272 female community college and university students. CSA…
Fuller-Thomson, Esme; Bejan, Raluca; Hunter, John T.; Grundland, Tamara; Brennenstuhl, Sarah
Objectives: This study examined the relationship between childhood sexual abuse (CSA) and myocardial infarction in men and women, while controlling for social determinants (i.e., socioeconomic status, social support, mental health) and traditional cardiovascular risk factors (i.e., age, race, obesity, smoking, physical inactivity, diabetes…
Sartor, Carolyn E; Grant, Julia D; Duncan, Alexis E; McCutcheon, Vivia V; Nelson, Elliot C; Calvert, Wilma J; Madden, Pamela A F; Heath, Andrew C; Bucholz, Kathleen K
The aim of the current study was to determine whether the higher rates of childhood sexual abuse (CSA) but lower rates of cigarette smoking in African-American vs. European-American women can be explained in part by a lower magnitude of association between CSA and smoking in African-American women. Data were drawn from a same-sex female twin study of substance use (n=3521; 14.3% African-American). Cox proportional hazards regression analyses using CSA to predict smoking initiation and progression to regular smoking were conducted separately by race/ethnicity. Co-twin status on the smoking outcome was used to adjust for familial influences on smoking (which may overlap with family-level influences on CSA exposure). After adjusting for co-twin status, CSA was associated with smoking initiation in European Americans (hazard ratio (HR)=1.43, 95% confidence intervals (CI): 1.26-1.62) and with smoking initiation ≤16 in African Americans (HR=1.70, CI: 1.26-2.29). CSA was associated with regular smoking onset ≤15 in European Americans (HR=1.63, CI: 1.21-2.18), with no change in HR after adjusting for co-twin status. In the African-American subsample, the HR for CSA was reduced to non-significance after adjusting for co-twin status (from HR=3.30, CI: 1.23-8.89 to HR=1.16, CI: 0.71-1.92 for regular smoking ≤15). CSA is associated with moderate elevation in risk for initiating smoking among African-American and European-American women. By contrast, CSA is associated with elevated risk for (adolescent onset) regular smoking only in European-American women. Furthermore, there is significant overlap between risk conferred by CSA and familial influences on regular smoking in African-American but not European-American women. Copyright © 2016 Elsevier Ltd. All rights reserved.
Dunlop, Boadie W; Hill, Eric; Johnson, Benjamin N; Klein, Daniel N; Gelenberg, Alan J; Rothbaum, Barbara O; Thase, Michael E; Kocsis, James H
Sexual dysfunction is common among depressed adults. Childhood sexual abuse (CSA) and depressive symptomology are among the risk factors for sexual dysfunction, and these factors may interact to predict adult relationship functioning. Several models have been developed postulating interactions between these variables. We tested models of the effects of CSA and elucidate the associations between CSA, sexual dysfunction, depression severity, anxiety, and relationship quality in chronically depressed adults. Baseline data from 808 chronically depressed outpatients enrolled in the Research Evaluating the Value of Augmenting Medication with Psychotherapy study were evaluated using structural equation modeling. The Inventory of Depressive Symptomology, self-report version (IDS-SR) assessed depression severity, and the Mood and Anxiety Symptom Questionnaire Anxious Arousal subscale assessed anxiety. Sexual function was assessed with the Arizona Sexual Experiences Scale (ASEX), and the Quality of Marriage Index (QMI) assessed relationship quality for patients in stable relationships. CSA scores predicted depression severity on the IDS-SR, as well as lower relationship quality and sexual satisfaction. ASEX scores were significantly associated with depression severity but were not correlated with the QMI. Two models were evaluated to elucidate these associations, revealing that (i) depression severity and anxious arousal mediated the relationship between CSA and adult sexual function, (ii) anxious arousal and sexual functioning mediated the association between CSA and depression symptoms, and (iii) when these models were combined, anxious arousal emerged as the most important mediator of CSA on depression which, in turn, mediated associations with adult sexual satisfaction and relationship quality. Although CSA predicts lower relationship and sexual satisfaction among depressed adults, the long-term effects of CSA appear to be mediated by depressive and anxious symptoms. It
Sauber, Elizabeth W; O'Brien, Karen M
This study advanced knowledge regarding the mechanisms through which intimate partner violence relates to psychological and financial distress with a sample of diverse low-income women. Data were collected from 147 female domestic violence survivors who were abused by a male partner within the past 6 months. Three hierarchical regression analyses revealed that psychological, physical, and economic abuse were predictive of posttraumatic stress, depression, and economic self-sufficiency among survivors. Guided by the Conservation of Resources Theory, the loss of financial, work, and interpersonal resources also predicted these three outcomes, above and beyond abuse experiences (i.e., economically controlling behaviors, economic sabotage, and interpersonal resource loss were unique predictors). In addition, bootstrap mediation analyses showed that interpersonal resource loss partially mediated the relationship between psychological abuse and mental health outcomes. Together, these findings can be used to inform future interventions to promote the financial and psychological well-being of survivors.
Euser, Saskia; Alink, Lenneke R. A.; Tharner, Anne; van IJzendoorn, Marinus H.; Bakermans-Kranenburg, Marian J.
Background: Children without disabilities in out-of-home care have a higher risk of child sexual abuse [CSA (Euser et al. 2013)]. In this study, we examined the year prevalence of CSA in out-of-home care for children with a mild intellectual disability, and compared it with the prevalence in out-of-home care for non-disabled children and children…
Boroughs, Michael S; Valentine, Sarah E; Ironson, Gail H; Shipherd, Jillian C; Safren, Steven A; Taylor, S Wade; Dale, Sannisha K; Baker, Joshua S; Wilner, Julianne G; O'Cleirigh, Conall
Men who have sex with men (MSM) are the group most at risk for HIV and represent the majority of new infections in the United States. Rates of childhood sexual abuse (CSA) among MSM have been estimated as high as 46 %. CSA is associated with increased risk of HIV and greater likelihood of HIV sexual risk behavior. The purpose of this study was to identify the relationships between CSA complexity indicators and mental health, substance use, sexually transmitted infections, and HIV sexual risk among MSM. MSM with CSA histories (n = 162) who were screened for an HIV prevention efficacy trial completed comprehensive psychosocial assessments. Five indicators of complex CSA experiences were created: CSA by family member, CSA with penetration, CSA with physical injury, CSA with intense fear, and first CSA in adolescence. Adjusted regression models were used to identify relationships between CSA complexity and outcomes. Participants reporting CSA by family member were at 2.6 odds of current alcohol use disorder (OR 2.64: CI 1.24-5.63), two times higher odds of substance use disorder (OR 2.1: CI 1.02-2.36), and 2.7 times higher odds of reporting an STI in the past year (OR 2.7: CI 1.04-7.1). CSA with penetration was associated with increased likelihood of current PTSD (OR 3.17: CI 1.56-6.43), recent HIV sexual risk behavior (OR 2.7: CI 1.16-6.36), and a greater number of casual sexual partners (p = 0.02). Both CSA with Physical Injury (OR 4.05: CI 1.9-8.7) and CSA with Intense Fear (OR 5.16: CI 2.5-10.7) were related to increased odds for current PTSD. First CSA in adolescence was related to increased odds of major depressive disorder. These findings suggest that CSA, with one or more complexities, creates patterns of vulnerabilities for MSM, including post-traumatic stress disorder, substance use, and sexual risk taking, and suggests the need for detailed assessment of CSA and the development of integrated HIV prevention programs that address mental health and
Xie, Qian Wen; Sun, Xiaoyue; Chen, Mengtong; Qiao, Dong Ping; Chan, Ko Ling
The reporting of suspected CSA cases to authorities in a timely manner is important in preventing continued abuse and protecting abused children at early ages. The current study seeks to explore parents' intentions of reporting their own children's CSA experiences to authorities as well as their reporting willingness when they become aware of possible CSA cases happening to children in other families. Two rounds of semi-structured interviews were conducted among a sample of 26 parents in Beijing; these parents were purposefully selected so as to be diverse in terms of gender, age, and socioeconomic status. The data were analyzed thematically. The findings showed that the reporting of suspected CSA to authorities was a choice made by only a few Chinese parents; it was often even a last resort. By using a holistic-interactionistic approach, the interaction between Chinese parents' intentions of reporting CSA and the Chinese socio-cultural context was analyzed as a dynamic and continuously ongoing process. The impacts of the definition and perceptions of CSA on reporting, the balance of children's rights and parents' power, and the double effect of informal social control are discussed. The implications, both locally and globally, are also discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.
Brabant, Marie-Eve; Hébert, Martine; Chagnon, François
This study explored the clinical profiles of 77 female teenager survivors of sexual abuse and examined the association of abuse-related and personal variables with suicidal ideations. Analyses revealed that 64% of participants experienced suicidal ideations. Findings from classification and regression tree analysis indicated that depression, posttraumatic stress symptoms, and hopelessness discriminated profiles of suicidal and nonsuicidal survivors. The elevated prevalence of suicidal ideations among adolescent survivors of sexual abuse underscores the importance of investigating the presence of suicidal ideations in sexual abuse survivors. However, suicidal ideation is not the sole variable that needs to be investigated; depression, hopelessness and posttraumatic stress symptoms are also related to suicidal ideations in survivors and could therefore guide interventions.
... Section 249.10 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS SENIOR FARMERS' MARKET NUTRITION PROGRAM.../or CSA program that is disqualified from participating in the WIC Farmers' Market Nutrition Program...
... Section 249.10 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS SENIOR FARMERS' MARKET NUTRITION PROGRAM.../or CSA program that is disqualified from participating in the WIC Farmers' Market Nutrition Program...
... Section 249.10 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS SENIOR FARMERS' MARKET NUTRITION PROGRAM.../or CSA program that is disqualified from participating in the WIC Farmers' Market Nutrition Program...
ISS030-E-156455 (26 Jan. 2012) --- European Space Agency astronaut Andre Kuipers, Expedition 30 flight engineer, sets up the Compound Specific Analyzer - Combustion Products (CSA-CP) in the Destiny laboratory of the International Space Station. The purpose of the analyzer is to measure the concentrations of carbon monoxide, hydrogen cyanide, hydrogen chloride and oxygen.
... effectively identify and prioritize high-risk and other unsafe motor carriers for enforcement interventions... interventions by more accurately identifying safety sensitive carriers (i.e., carriers transporting people and carriers hauling hazardous materials (HM)), so that such firms can be selected for CSA interventions at...
... intervention resources and made available to the public on the SMS public Web site in July 2012. However, based... addressing industry biases; (2) Better applications of SMS results for Agency interventions by more... hauling hazardous materials (HM)), so that such firms can be selected for CSA interventions at more...
Turell, S C; Armsworth, M W
This study was an exploratory analysis of the variables which differentiated incest survivors who self-mutilate from those who do not. A sample of women incest survivors (N = 84) were divided into two groups based on the presence or absence of self-mutilation. Participants included both community and clinical populations. A packet consisting of a demographic questionnaire, Sexual Attitudes Survey, Diagnostic Inventory of Personality and Symptoms, Dissociative Events Scale and the Beck Depression Inventory was completed by each participant. Demographic, incest, and family of origin variables distinguished the self-mutilating women from those who did not. These include ethnicity and educational experiences; duration, frequency, and perpetrator characteristics regarding the incest; and multiple abuses, instability, birth order, and loss of mother in one's family of origin. Psychological and physical health concerns also differentiated between the two groups. Many variables may differentiate between women incest survivors who self-mutilate from those who do not. A rudimentary checklist to describe the lives of incest survivors who self-mutilate resulted from these findings. The importance of the concept of embodiment is also discussed.
Kent, Lindsey; And Others
Five cases of fetal abuse by mothers suffering from depression are discussed. Four of the women had unplanned pregnancies and had considered termination of the pregnancy. Other factors associated with fetal abuse include pregnancy denial, pregnancy ambivalence, previous postpartum depression, and difficulties in relationships. Vigilance for…
Alexander, P C; Teti, L; Anderson, C L
This study explored the main and interactive effects of sexual abuse history and relationship satisfaction on self-reported parenting, controlling for histories of physical abuse and parental alcoholism. The community sample consisted of 90 mothers of 5- to 8-year-old children. The sample was limited to those mothers currently in an intimate relationship, 19 of whom reported a history of childhood sexual abuse. Participants completed the Child Behavior Checklist, the Parenting Stress Inventory, the Family Cohesion Index, and questions assessing parent-child role reversal, history of abuse and parental alcoholism, and current relationship satisfaction. Results of analyses and multivariate analyses of covariance suggested that sexual abuse survivors with an unsatisfactory intimate relationship were more likely than either sexual abuse survivors with a satisfactory relationship or nonabused women to endorse items on a questionnaire of role reversal (defined as emotional overdependence upon one's child). Role reversal was not significantly predicted by histories of physical abuse or parental alcoholism or child's gender. While parenting stress was inversely predicted by the significant main effect of relationship satisfaction, neither parenting stress nor child behavior problems were predicted by the main effect of sexual abuse history or by the interaction between sexual abuse history and relationship satisfaction. These results suggest the unique relevance of sexual abuse history and relationship satisfaction in the prediction of a specific type of parent-child role reversal--namely, a mother's emotional overdependence upon her child.
Buchbinder, Eli; Goldblatt, Hadass
This article describes and analyzes the relationship disenchantment of couplehood among female survivors of violence and their family-of-origin experiences of abuse. Twenty Israeli women who were survivors of violence participated in this qualitative research. Each woman underwent three in-depth interviews, two for data collection and one for…
Blakemore, Tamara; Herbert, James Leslie; Arney, Fiona; Parkinson, Samantha
While awareness of institutional child sexual abuse has grown in recent years, there remains limited understanding of its occurrence and outcomes as a distinct form of abuse. Drawing on research commissioned by the Australian Royal Commission into Institutional Responses to Child Sexual Abuse, this article presents a rapid review of available evidence on the impacts of institutional abuse on victim/survivors. Literature searches identified 75 sources spanning international peer reviewed work and reports to Government that document or quantify the impacts of mostly historical child sexual abuse occurring in religious, educational, sporting and residential or out-of-home care settings. Consistent with child sexual abuse in other contexts, institutional child sexual abuse is found to be associated with numerous, pervasive and connected impacts upon the psychological, physical, social, educative and economic wellbeing of victims/survivors. Further, institutional child sexual abuse is associated with vicarious trauma at the individual, family and community level, and with impacts to the spiritual wellbeing of victims/survivors of abuse that occurs in religious settings. The identified literature suggests the trauma of institutional child sexual abuse may be exacerbated by the interplay of abuse dynamics in institutional settings, which may reduce or impede circumstances supporting disclosure, belief, support and protection from future harm. Acknowledging the limitations of the present study and the available evidence, this narrative synthesis provides insights into the complex impacts of institutional child sexual abuse. Copyright © 2017 Elsevier Ltd. All rights reserved.
Abel, G G; Rouleau, J L
The sexual abuses described in this article are occurring so frequently that they constitute a public health problem. Superficially they appear to be quite dissimilar because they involve individuals of different ages, different settings, and different power relationships. Basic to each of them, however, is an absence of consent by the victim and the misuse of power by the perpetrator in order to accomplish the abuse. We now have an adequate understanding of each of these abuses and it is now time to make a concerted effort to stop these abuses. This will require the combined efforts of the education of the public, improved identification of the abuses, treatment of the victims, and an appropriate criminal justice response combined with treatment of the perpetrator.
Rellini, Alessandra H; Elinson, Samantha; Janssen, Erick; Meston, Cindy M
Women with a history of childhood sexual abuse (CSA) are at greater risk for experiencing sexual problems in their adult lives. Yet, little is known about the possible role of cognitive and affective mechanisms in the development of sexual arousal difficulties in this population. This study investigated the role of pre-existing affect (affect prior to exposure to sexual stimuli) on genital responses, subjective sexual arousal, and affect elicited during the presentation of erotic film excerpts in a community sample of 25 women with and 25 women without a history of CSA. The CSA group showed greater pre-existing negative affect and smaller genital responses to the erotic film stimuli compared to the NSA group. Findings support a moderating effect of CSA, in that pre-existing negative affect was associated with strength of genital responses in the NSA but not in the CSA group. The results did not support a mediation model of pre-existing negative affect as an explanation for smaller physiological sexual responses in the CSA group. Taken together, the findings suggest that pre-existing affect may be more relevant for women with no history of CSA and call for more research on factors implicated in impaired sexual responses in women with a history of CSA.
Ribeiro, António J M; Holliday, Gemma L; Furnham, Nicholas; Tyzack, Jonathan D; Ferris, Katherine; Thornton, Janet M
M-CSA (Mechanism and Catalytic Site Atlas) is a database of enzyme active sites and reaction mechanisms that can be accessed at www.ebi.ac.uk/thornton-srv/m-csa. Our objectives with M-CSA are to provide an open data resource for the community to browse known enzyme reaction mechanisms and catalytic sites, and to use the dataset to understand enzyme function and evolution. M-CSA results from the merging of two existing databases, MACiE (Mechanism, Annotation and Classification in Enzymes), a database of enzyme mechanisms, and CSA (Catalytic Site Atlas), a database of catalytic sites of enzymes. We are releasing M-CSA as a new website and underlying database architecture. At the moment, M-CSA contains 961 entries, 423 of these with detailed mechanism information, and 538 with information on the catalytic site residues only. In total, these cover 81% (195/241) of third level EC numbers with a PDB structure, and 30% (840/2793) of fourth level EC numbers with a PDB structure, out of 6028 in total. By searching for close homologues, we are able to extend M-CSA coverage of PDB and UniProtKB to 51 993 structures and to over five million sequences, respectively, of which about 40% and 30% have a conserved active site. © The Author(s) 2017. Published by Oxford University Press on behalf of Nucleic Acids Research.
Bucki, Robert; Niemirowicz, Katarzyna; Wnorowska, Urszula; Byfield, Fitzroy J; Piktel, Ewelina; Wątek, Marzena; Janmey, Paul A; Savage, Paul B
Ceragenins constitute a novel family of cationic antibiotics characterized by a broad spectrum of antimicrobial activities, which have mostly been assessed in vitro. Using a polarized human lung epithelial cell culture system, we evaluated the antibacterial activities of the ceragenin CSA-13 against two strains of Pseudomonas aeruginosa (PAO1 and Xen5). Additionally, the biodistribution and bactericidal activity of a CSA-13-IRDye 800CW derivate were assessed using an animal model of peritoneal infection after PAO1 challenge. In cell culture, CSA-13 bactericidal activities against PAO1 and Xen5 were higher than the activities of the human cathelicidin peptide LL-37. Increased CSA-13 activity was observed in polarized human lung epithelial cell cultures subjected to butyric acid treatment, which is known to increase endogenous LL-37 production. Eight hours after intravenous or intraperitoneal injection, the greatest CSA-13-IRDye 800CW accumulation was observed in mouse liver and kidneys. CSA-13-IRDye 800CW administration resulted in decreased bacterial outgrowth from abdominal fluid collected from animals subjected to intraperitoneal PAO1 infection. These observations indicate that CSA-13 may synergistically interact with antibacterial factors that are naturally present at mucosal surfaces and it maintains its antibacterial activity in the infected abdominal cavity. Cationic lipids such as CSA-13 represent excellent candidates for the development of new antibacterial compounds. Copyright © 2015, American Society for Microbiology. All Rights Reserved.
Li, Nan; Zabin, Laurie S; Ahmed, Saifuddin
The article describes the prevalence and risk factors of childhood sexual abuse (CSA) among youth in Hanoi, Shanghai, and Taipei. Data used in this study are from the Three-City Asian Study of Adolescents and Youth, 2006-2007. Descriptive analysis and logistic regression models were used. The self-reported lifetime prevalence of CSA was 5.2% in Taipei, 1.3% in Shanghai, and 0.5% in Hanoi. The overall prevalence was 2.2% for females and 1.7% for males. The average age of first CSA was 10.5 years. Household instability, migration before age 14, and low maternal warmth were found to be positively associated with CSA, whereas discussing problems with father and being close to mother were negatively associated with CSA, after adjusting for sociodemographic characteristics. Our findings suggested the importance of prevention programs for preteen aged children, public education to raise awareness, and further prospective studies to identify various risk markers for CSA in Asia. © 2013 APJPH.
Davis, Kelly Cue; Schraufnagel, Trevor J.; Jacques-Tiura, Angela J.; Norris, Jeanette; George, William H.; Kiekel, Preston A.
Objective Although research has established childhood sexual abuse (CSA) as a risk factor for men’s perpetration of sexual aggression, there has been little investigation of the factors undergirding this association. This study represents one of the first to use a laboratory-based sexual aggression analogue coupled with an alcohol administration protocol to investigate the pathways through which CSA and alcohol influence men’s self-reported sexual aggression intentions. Method After completing background questionnaires, male social drinkers (N = 220) were randomly assigned to a control, placebo, low alcohol dose or high alcohol dose condition. Following beverage consumption, participants read a sexual scenario in which the female partner refused to have unprotected sexual intercourse, after which they completed dependent measures. Results Path analysis indicated that men with a CSA history and intoxicated men perceived the female character as more sexually aroused and reported stronger sexual entitlement cognitions, both of which were in turn associated with greater condom use resistance and higher sexual aggression intentions. Exploratory analyses revealed that intoxication moderated the effects of CSA history on sexual entitlement cognitions, such that sexual entitlement cognitions were highest for men who had a CSA history and consumed alcohol. Conclusions Findings suggest that CSA history may facilitate sexual assault perpetration through its effects on in-the-moment cognitions, and that these effects may be exacerbated by alcohol intoxication. PMID:22754720
Coles, Jan; Lee, Adeline; Taft, Angela; Mazza, Danielle; Loxton, Deborah
Childhood sexual abuse (CSA) occurs across the world, with a prevalence of 20% internationally. Our aim was to investigate the associations between CSA, CSA plus adult violence experiences, and selected self-reported physical and mental health in a community sample of women. Data from 7,700 women aged 28-33 years from the 1973-1978 cohort who completed Survey 4 of the Australian Longitudinal Study on Women's Health (ALSWH) were analyzed. Questions about prior abuse experience such as child sexual abuse, IPV, adult physical and sexual assaults, andphysical and mental health. Women who experienced CSA were 1.4 times more likely to experience bodily pain (adjusted odds ratio [AOR] = 1.37, confidence interval [CI] = [1.19, 1.58]), 1.3 times more likely to have poorer general health (AOR = 1.33, CI = [1.15, 1.54]), and 1.4 times more likely to be depressed in the past 3 years (AOR = 1.44, CI = [1.22, 1.71]) compared with those without abuse.. Women who experienced both CSA and adult violence were 2.4 to 3.1 times more likely to experience poor general (AOR = 2.35, CI = [1.76, 3.14]) and mental health (AOR = 2.69, CI = [1.98, 3.64]), and suffer from depression (AOR = 2.84, CI = [2.13, 3.78]) and anxiety (AOR = 3.10, CI = [2.12, 4.53]) compared with women with no abuse. This study demonstrates the importance of CSA in pain and poorer long-term mental and physical health.. It emphasizes how prior CSA may amplify pain and poorer long-term mental and physical health among women who are again exposed to violence in adulthood. © The Author(s) 2014.
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Riger, Stephanie; Bennett, Larry W; Sigurvinsdottir, Rannveig
Substance abuse commonly co-occurs with intimate partner violence among both perpetrators and survivors. Specialized courts that focus on intimate partner violence provide a unique opportunity to address both problems simultaneously, but research has yet to identify whether this happens. In this qualitative study of a domestic violence court in a large midwestern metropolitan area, key informants were interviewed to understand how the Court treats substance abuse. Results indicate that substance abuse typically is not identified among perpetrators or survivors going through the Court unless it is mentioned in a police report. Barriers to such identification are the organization of the Court, bounded definition of actors' roles in the Court, limited resources, and negative attitudes towards survivors. These results suggest that specialized courts that attend to only one problem may overlook the possibility of addressing issues that commonly co-occur.
Sachs-Ericsson, Natalie; Cromer, Kiara; Hernandez, Annya; Kendall-Tackett, Kathleen
The current article reviews recent research demonstrating the relationship between childhood physical and sexual abuse and adult health problems. Adult survivors of childhood abuse have more health problems and more painful symptoms. We have found that psychiatric disorders account for some, but not all, of these symptoms, and that current life stress doubles the effect of childhood abuse on health problems. Possible etiologic factors in survivors' health problems include abuse-related alterations in brain functioning that can increase vulnerability to stress and decrease immune function. Adult survivors are also more likely to participate in risky behaviors that undermine health or to have cognitions and beliefs that amplify health problems. Psychiatric disorders, although not the primary cause of difficulties, do have a role in exacerbating health and pain-related problems. We conclude by outlining treatment recommendations for abuse survivors in health care settings.
Tekin, Atilla; Meriç, Ceren; Sağbilge, Ezgi; Kenar, Jülide; Yayla, Sinan; Özer, Ömer Akil; Karamustafalioğlu, Oğuz
Childhood traumatic events are known as developmental factors for various psychiatric disorders. The aim of this study was to investigate the effects of childhood sexual and physical abuse (CSA/CPA), and co-morbid depression on sexual functions in patients with social anxiety disorder (SAD). Data obtained from 113 SAD patients was analysed. Childhood traumatic experiences were evaluated using the Childhood Trauma Questionnaire, and the Arizona Sexual Experience Scale was used for the evaluation of the sexual functions. The data from interviews performed with SCID-I were used for determination of Axis I diagnosis. The Beck Anxiety Scale, Beck Depression Scale and Liebowitz Social Anxiety Scale were administered to each patient. History of childhood physical abuse (CPA) was present in 45.1% of the SAD patients, and 14.2% had a history of childhood sexual abuse (CSA). Depression co-diagnosis was present in 30.1% of SAD patients and 36.3% had sexual dysfunction. History of CSA and depression co-diagnosis were determined as two strong predictors in SAD patients (odds ratio (OR) for CSA, 7.83; 95% CI, 1.97-31.11; p = 0.003 and OR for depression, 3.66; 95% CI, 1.47-9.13; p = 0.005). CSA and depression should be considered and questioned as an important factor for SAD patients who suffer from sexual dysfunction.
Mothers (n=26) who were incest survivors were compared with 28 mothers with no such history for 7 areas of parenting skills: role-image, objectivity, expectations, rapport, communication, limit-setting, and role-support. Significant differences were found on all seven scales, characterized by a tendency for the incest survivors to be less skillful…
Walker-Williams, Hayley J.; Fouché, Ansie
Purpose: This study evaluated the benefits of a ''survivor to thriver'' strengths-based group intervention program to facilitate posttraumatic growth in women survivors of child sexual abuse. Method: A quasi-experimental, one group, pretest, posttest, time-delay design was employed using qualitative methods to evaluate the benefits of the…
Najman, Jake M; Nguyen, My Linh T; Boyle, Frances M
Although childhood sexual abuse (CSA) is associated with a wide range of health problems later in life, there is also evidence of substantial individual differences. This study describes the mental and physical health of a population sample of Australians, randomly selected from the Commonwealth electoral roll, who have reported their CSA histories. Some 58% of those located from the electoral roll agreed to a telephone interview (n=1,784). Health status was measured using the Short Form 36 questionnaire. Men who had experienced non-penetrative and penetrative sexual abuse in childhood had 2.25 (95% CI=1.32-3.82) and 5.93 (95% CI=2.72-12.95) times respectively the rate of impaired mental health, but no higher rates of impaired physical health. Women who had experienced non-penetrative and penetrative sexual abuse in childhood had 1.87 (95% CI=1.19-2.95) and 3.15 (95% CI=1.87-5.33) times respectively the rate of impaired mental health and 1.87 (95% CI=1.19-2.92) and 2.31 (95% CI=1.34-3.97) times respectively the rate of impaired physical health. However, participants who had experienced CSA were no less likely than those who had not experienced CSA to be in optimum physical and mental health. None of the possible confounding or moderating variables tested appeared to mitigate the impact of CSA on health outcomes. Those with the highest levels of mental and physical health appear to be unaffected by the experience of CSA.
Whilst evidence is mounting that childhood sexual abuse (CSA) can be a cause of auditory verbal hallucinations (AVH), it is unclear what factors mediate this relation. Recent evidence suggests that post-traumatic symptomatology may mediate the CSA-AVH relation in clinical populations, although this hypothesis has not yet been tested in the general population. There is also reason to believe that obsessive ideation could mediate the CSA-AVH relation. To test for evidence to falsify the hypotheses that post-traumatic symptomatology, obsessions, compulsions, anxiety and depression mediate the relation between CSA and AVH in a general population sample. Indirect effects of CSA on AVH via potential mediators were tested for, using a regression-based approach employing data from the 2007 Adult Psychiatric Morbidity Survey (n = 5788). After controlling for demographics, IQ and child physical abuse, it was found that CSA, IQ, post-traumatic symptomatology and compulsions predicted lifetime experience of AVH. Mediation analyses found significant indirect effects of CSA on AVH via post-traumatic symptomatology [odds ratio (OR): 1.11; 95% confidence interval (CI):1.00-1.29] and compulsions (OR: 1.10, 95% CI: 1.01-1.28). These findings offer further support for the hypothesis that post-traumatic symptomatology is a mediator of the CSA-AVH relation. Although no evidence was found for obsessional thoughts as a mediating variable, a potential mediating role for compulsions is theoretically intriguing. This study's findings reiterate the need to ask about experiences of childhood adversity and post-traumatic symptomology in people with AVH, as well as the likely therapeutic importance of trauma-informed and trauma-based interventions for this population.
Phillips, Gregory; Magnus, Manya; Kuo, Irene; Rawls, Anthony; Peterson, James; Montanez, Luz; West-Ojo, Tiffany; Jia, Yujiang; Opoku, Jenevieve; Greenberg, Alan E
Childhood sexual abuse (CSA) has been reported to be disproportionately higher among men who have sex with men (MSM) than among heterosexual men; it has also been found to be significantly positively associated with HIV status and HIV risk factors, including unprotected anal intercourse. The purpose of this study was to assess the correlates of CSA in a sample of community-recruited MSM, investigate race as a potential effect modifier, and describe the independent association between CSA and HIV infection in Washington, DC. A total of 500 MSM were recruited by venue-based sampling in 2008 as part of the National HIV Behavioral Surveillance. More than one-half of MSM identified as White, while one-third identified as Black. CSA was reported by 17.5 % of the 451 MSM, with the first instance of abuse occurring at a median age of 8.3 (interquartile range = 5.0, 11.0). In multivariable analysis, HIV-positive men were significantly more likely to report a history of CSA compared to HIV-negative men after adjusting for intimate partner violence in the last 12 months, having been arrested in the last 12 months, and depressive symptoms. HIV-positive MSM had more than four times the odds of reporting CSA after controlling for other correlates (aOR = 4.19; 95 % CI 2.26, 7.75). Despite hypothesizing that race modified the effect of CSA on HIV infection we found this was not the case in this sample. More research is needed to investigate the potential pathway between a history of CSA and HIV infection, and how this contributes to driving the HIV epidemic among MSM in Washington, DC.
Krahé, Barbara; Berger, Anja
This study aimed to examine the pathways from child sexual abuse to sexual assault victimization and perpetration in adolescence and early adulthood, considering risky sexual behavior and lowered sexual self-esteem as mediator variables. In a two-wave longitudinal study with 2251 college students in Germany, male and female participants provided reports of sexual aggression victimization and perpetration since age 14 (T1) and again a year later (T2), covering the last 12 months. In addition, child sexual abuse (CSA; before the age of 14), risky sexual behavior, and sexual self-esteem were assessed at T1, and risky sexual behavior and sexual-self-esteem were assessed again at T2. Experience of CSA was significantly associated with greater likelihood of sexual aggression victimization and perpetration, lower sexual self-esteem, and more risky sexual behavior in both gender groups at T1 and was directly related to victimization at T2 among male participants. In both gender groups, CSA indirectly contributed to a higher probability of sexual victimization at T2 via its impact on victimization T1. In males, the indirect path from CSA to T2 perpetration via T1 perpetration was also significant. Through its negative impact on sexual self-esteem, CSA indirectly increased the probability of sexual victimization among women and the probability of sexual aggression perpetration among men. Risky sexual behavior mediated the pathway from CSA to sexual victimization at T2 for men and women and the pathway from CSA to sexual aggression perpetration for women. The findings contribute to the understanding of gendered effects of CSA on revictimization and the victim-to-perpetrator cycle. Copyright © 2016 Elsevier Ltd. All rights reserved.
Richter, Linda; Makusha, Tawanda; Komárek, Arnošt; Daniels, Joseph; Coates, Tom
Using data from four sites in three African countries, this community randomized study examined the association between childhood sexual and/or physical abuse (CSA and/or CPA) and HIV disclosure, HIV-related stigma, stress, and social support among adults with and without a history of abuse. A history of abuse among men was associated with higher levels of adult-reported stress and HIV-related stigma, and with significantly lower rates of HIV test result disclosure to current partners. Women with a history of CSA and/or CPA had significantly higher perceived stigma, discrimination and stress. Although childhood abuse was significantly associated with adult stress and stigmatization, participants with histories of CSA and/or CPA also reported significantly higher perceived social support compared to people without such experiences. These findings may reflect support received in response to disclosure of CSA or CPA or emotional ambivalence in relationships that have been found to be associated with child abuse. We conclude that it is critical for HIV prevention interventions to advocate for the primary prevention of child abuse, for early identification of adolescents and adults who report experiencing childhood abuse, and to address stigma and stress-related attitudinal, behavioral and relationship difficulties experiences as an aftermath of early abuse that increase their risk of HIV.
Hamelin, Christine; Salomon, Christine; Cyr, Diane; Gueguen, Alice; Lert, France
Few studies have addressed the long-term consequences of adverse childhood experiences among women in Oceania, in particular among indigenous women. This paper aims to report prevalences of childhood sexual abuse (CSA) and to asses the negative sexual health consequences in adulthood by comparing indigenous Kanak to non-Kanak women in New Caledonia. Data come from a population survey on violence against women and health. Face-to-face interviews were conducted in 2002-2003 with adult women randomly selected from the electoral list. Separate models for Kanak (n=329) and non-Kanak women (n=426) were performed. Regression models adjusted for relevant socio-demographics factors were conducted to estimate the odds ratios for the associations between childhood sexual abuse and adult sexual health outcomes. A non-significant difference between Kanak (11.8%) and non-Kanak women (14.4%) was found for the prevalence of CSA. Among Kanak women, CSA increases the risk of sexually transmitted infections, of non-desired sexual intercourse with an intimate partner and of experience of adult sexual violence. However, use of modern contraception as an adult was more frequent among CSA Kanak victims, as compared to other Kanak women. Among non-Kanak women, only abortion appeared significantly associated with CSA. The findings show that in all ethnic communities of New Caledonia, a history of child sexual abuse is not rare among women. They also shed light on the long-term consequences of CSA, suggesting that the effect of CSA may differ according to ethnic membership and subsequent social stratification and gender norms. Efforts to break the silence around violence against girls and establish a stronger foundation are required in New Caledonia. Prevention programs on violence against women and sexual health that take into account the cultural and social heterogeneity are needed. Copyright © 2010 Elsevier Ltd. All rights reserved.
Thrane, Susan; Janitzek, Christoph M; Agerbæk, Mette Ø; Ditlev, Sisse B; Resende, Mafalda; Nielsen, Morten A; Theander, Thor G; Salanti, Ali; Sander, Adam F
Placental malaria caused by Plasmodium falciparum is a major cause of mortality and severe morbidity. Clinical testing of a soluble protein-based vaccine containing the parasite ligand, VAR2CSA, has been initiated. VAR2CSA binds to the human receptor chondroitin sulphate A (CSA) and is responsible for sequestration of Plasmodium falciparum infected erythrocytes in the placenta. It is imperative that a vaccine against malaria in pregnancy, if administered to women before they become pregnant, can induce a strong and long lasting immune response. While most soluble protein-based vaccines have failed during clinical testing, virus-like particle (VLP) based vaccines (e.g., the licensed human papillomavirus vaccines) have demonstrated high efficacy, suggesting that the spatial assembly of the vaccine antigen is a critical parameter for inducing an optimal long-lasting protective immune response. We have developed a VLP vaccine display platform by identifying regions of the HPV16 L1 coat protein where a biotin acceptor site (AviTagTM) can be inserted without compromising VLP-assembly. Subsequent biotinylation of Avi-L1 VLPs allow us to anchor monovalent streptavidin (mSA)-fused proteins to the biotin, thereby obtaining a dense and repetitive VLP-display of the vaccine antigen. The mSA-VAR2CSA antigen was delivered on the Avi-L1 VLP platform and tested in C57BL/6 mice in comparison to two soluble protein-based vaccines consisting of naked VAR2CSA and mSA-VAR2CSA. The mSA-VAR2CSA Avi-L1 VLP and soluble mSA-VAR2CSA vaccines induced higher antibody titers than the soluble naked VAR2CSA vaccine after three immunizations. The VAR2CSA Avi-L1 VLP vaccine induced statistically significantly higher endpoint titres compared to the soluble mSA-VAR2CSA vaccine, after 1st and 2nd immunization; however, this difference was not statistically significant after 3rd immunization. Importantly, the VLP-VAR2CSA induced antibodies were functional in inhibiting the binding of parasites to CSA
CHU, JAMES A.
Both clinical experience and recent research statistics support the observation that childhood abuse survivors are vulnerable to revictimization as adults. The responsibility for revictimization, such as physical or sexual assault, belongs to the perpetrators. However, the factors that make abuse survivors more vulnerable to exploitation need to be examined and understood in order to provide adequate treatment and protection. This discussion integrates an understanding of three powerful forces—the repetition compulsion, post-traumatic syndromes, and profound relational disturbances—that permit the process of revictimization to occur. PMID:22700102
López, Sílvia; Faro, Concepció; Lopetegui, Lourdes; Pujol-Ribera, Enriqueta; Monteagudo, Mònica; Cobo, Jesús; Fernández, María Isabel
To analyse perceived sexual satisfaction, sexual dysfunction, satisfaction with affective relationships and confidence and communication in existing relationships, related to a past history of childhood sexual abuse (CSA) and type suffered, among women treated as part of the Catalonian Sexual and Reproductive Health Care Programme (PASSIR). Multicentric, descriptive, cross-sectional study. A total of 1,013 women over the age of 18 years, who underwent psychological therapy at any of the 24 PASSIR centres, were enrolled. A structured, anonymised, self-administered Sex History Questionnaire adapted from Wyatt (1985) & Dubé et al. (2005), and the Female Sexual Function Index (Rosen, 2000), were used. Statistical analysis was descriptive, bivariate and multivariate. Women who suffered childhood sexual abuse had a significantly higher prevalence of sexual dysfunction, with lower perceived sexual satisfaction. CSA with penetration or attempted penetration was associated with greater arousal difficulties and greater rejection. Women who experienced CSA were less confident and experienced greater communication difficulties with their partner. It is necessary to identify potential childhood sexual abuse among women who seek therapy due to relationship problems. It is also necessary to continue research into protective factors and therapeutic interventions to alleviate the consequences of CSA in adult life. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.
Rudolph, Julia; Zimmer-Gembeck, Melanie J
Due to the high incidence, and widespread detrimental health consequences, of child sexual abuse (CSA), effective prevention remains at the forefront of public and mental health research, prevention and intervention agendas. To date much of the focus of prevention has been on school-based education programs designed to teach children skills to evade adult sexual advances, and disclose past or ongoing abuse. Evaluation of sexual abuse prevention programs demonstrate their effectiveness in increasing children's knowledge of CSA concepts and protection skills, but little is known about their effects on children's capacity to prevent abuse. Moreover, concerns persist about the unintended side-effects for young children such as anxiety, worry and wariness of touch. This paper summarizes the recent history of CSA prevention and the critique of child-focused protection programs in order to demonstrate the need to compliment or replace these programs by focusing more on protectors in the children's ecology, specifically parents, in order to create safer environments in which abuse is less likely to occur. © The Author(s) 2016.
... Break Up Respectfully Abuse Sexual Harassment and Sexual Bullying Love and Romance Getting Over a Break-Up Dealing With Bullying Posttraumatic Stress Disorder Sexual Attraction and Orientation Teens ...
In this paper, trauma, sexual abuse, and some of the potential resulting long-term effects, are explored in terms of the problem of embodiment and the formation of personal identity and psychological integrity. That is, what effect does severe sexual abuse have on an individual's, particularly a child's, sense of living in his or her body and, by extension, living in the world? First, trauma and dissociation are analyzed and linked to the development and maintenance of a "posttraumatic" sense of personal identity. Then, several disorders associated with sexual abuse--dissociation, multiple personality disorder, eating disorders, somatization disorder, self-mutilation, suicide, and suicide attempts--are examined in terms of their phenomenological coherence and relation to the problem of embodiment. This conceptual framework may be of use to clinicians and researchers assessing and treating the survivors of sexual abuse.
Singh, K.; Gittis, A.G.; Nguyen, P.
Plasmodium falciparum-infected erythrocytes bind to chondroitin sulfate A (CSA) in the placenta via the VAR2CSA protein, a member of the P. falciparum erythrocyte membrane protein-1 family, leading to life-threatening malaria in pregnant women with severe effects on their fetuses and newborns. Here we describe the structure of the CSA binding DBL3x domain, a Duffy binding-like (DBL) domain of VAR2CSA. By forming a complex of DBL3x with CSA oligosaccharides and determining its structure, we have identified the CSA binding site to be a cluster of conserved positively charged residues on subdomain 2 and subdomain 3. Mutation or chemical modification of lysinemore » residues at the site markedly diminished CSA binding to DBL3x. The location of the CSA binding site is an important step forward in the molecular understanding of pregnancy-associated malaria and offers a new target for vaccine development.« less
Theimer, Kate; Hansen, David J
Youth who are blamed for their sexual abuse may experience increased negative outcomes, such as amplified self-blame. Similarly, blaming nonoffending parents can impede their ability to support their child following disclosure. Understanding the factors that influence how people perceive victim, caregiver, and perpetrator responsibility is imperative for the protection and treatment of families who have experienced sexual abuse. Little research has explored victim and abuse characteristics that influence the perception of sexual abuse. As such, the purpose of this study was to examine the roles of behavior problems and frequency of abuse in the attribution of blame in a hypothetical sexual abuse case. In addition, the relationship between several respondent characteristics and assignment of responsibility were explored as secondary aims. The study used a two (behavior problems: three suspensions in one school semester vs. no mention of behavior problems) by two (one abuse occurrence vs. five abuse occurrences) between-subjects design. Seven hundred forty-two participants read one of the four child sexual abuse (CSA) vignettes and completed measures related to responsibility. ANOVAs revealed those who read a vignette where the youth experienced multiple abuse incidents rated the victim as more responsible regardless of whether or not the youth was described as having behavior problems. Results indicate that respondents may have attributed more blame to the victim due to the belief that she could have done something to stop the abuse after the first incident. The abuse frequency manipulation when combined with the behavior manipulation appeared to relate to how respondents perceived the victim's parents. Males and younger respondents attributed more blame to the victim; however, sexual abuse or assault history did not associate with victim responsibility ratings. Clinical and research implications were discussed.
Liu, J; Chappell, L H
To study the action mode of cyclosporin A (CsA) against Schistosoma mansoni in vitro. MF1 mice were infected with Schistosoma mansoni cercariae for 6 weeks when the adult worms were recovered by portal perfusion. The male worms of S. mansoni recovered were exposed to varying concentrations of CsA at 8, 16, and 24 h in vitro. Drug induced damage to the male worm surface was chrono-biologically observed throughout these experiments by SEM. After the male worms of S. mansoni were incubated with 1 microgram/ml CsA for 8-24 h, the tegument showed swelling of ridges with appearance of holes on their surface and detachment of a part of spines. The above damage of the tegument became more evident in male worms after incubation with 10, 15, 20 micrograms/ml CsA for 8-24 h. Moreover, incubation of male worms with 25 micrograms/ml CsA for 8-24 h resulted in significant deformation and disruption of tegument, rupture of ridges and detachment of spines. The tegumental damage of male worms of S. mansoni was dose- and time-dependent. The antischistosomal action of CsA is direct, the schistosome tegument appears to be the main site for CsA attack.
Ren, Ying; Yang, Hui; Zhu, Ping; Fan, Chun-mei; Wang, Yan-hong; Li, Jia; Liu, Hui
To observe the therapeutic effect of cyclosporine A (CsA) on bleomycin (BLM) induced pulmonary fibrosis and to investigate its mechanism. One hundred and twenty C57BL/6 female mice were divided randomly into five groups: BLM model group, control saline group, CsA30 mg treatment group, CsA50 mg treatment group and control treatment group. Treatment groups and model groups were administrated BLM intratracheally to induce interstitial pulmonary disease model, with control saline group administrated with equal volume of normal saline instead. Mice in treatment groups were intraperitoneal injected with CsA, while control treatment group were injected with equal volume of normal saline instead. On the 4th, 7th and 14th day after administration, 8 mice of each group were sacrificed, and the peripheral blood was obtained to count total leucocytes with counting chamber and quantify CD4(+); T cells, CD14(+); monocytes and CD19(+); B cells by flow cytometry (FCM). Bronchoalveolar levage fluid was harvested for cell counting and Giemsa staining. Lung tissues were harvested for immunohistochemical staining and pathological examination. The quantity of total leucocyte was higher in BLM model group than those in control saline group.The proportion of CD14(+); T cells and CD19(+);B cells in BLM model group were increased markedly than those in control saline group on the 4th, 7th and 14th day post BLM. With CsA treatment, The proportion of CD14(+); T cells was lower than BLM model group at the same time point, especially on the 4th day. The proportion of CD19(+); B cells were significantly lower than those of BLM model group at the same time point(7 d, 14 d). The total and classification of cells of BLM model group were increased markedly than those in control saline group, and decreased obviously in the treatment groups at the same time point. Examination of lung tissues: With the prolonged time of BLM administration, it showed wider alveolar septum, more collagen deposition, as
Chen, Jing; Cai, Yiyun; Cong, Enzhao; Liu, Ying; Gao, Jingfang; Li, Youhui; Tao, Ming; Zhang, Kerang; Wang, Xumei; Gao, Chengge; Yang, Lijun; Li, Kan; Shi, Jianguo; Wang, Gang; Liu, Lanfen; Zhang, Jinbei; Du, Bo; Jiang, Guoqing; Shen, Jianhua; Zhang, Zhen; Liang, Wei; Sun, Jing; Hu, Jian; Liu, Tiebang; Wang, Xueyi; Miao, Guodong; Meng, Huaqing; Li, Yi; Hu, Chunmei; Li, Yi; Huang, Guoping; Li, Gongying; Ha, Baowei; Deng, Hong; Mei, Qiyi; Zhong, Hui; Gao, Shugui; Sang, Hong; Zhang, Yutang; Fang, Xiang; Yu, Fengyu; Yang, Donglin; Liu, Tieqiao; Chen, Yunchun; Hong, Xiaohong; Wu, Wenyuan; Chen, Guibing; Cai, Min; Song, Yan; Pan, Jiyang; Dong, Jicheng; Pan, Runde; Zhang, Wei; Shen, Zhenming; Liu, Zhengrong; Gu, Danhua; Wang, Xiaoping; Liu, Xiaojuan; Zhang, Qiwen; Li, Yihan; Chen, Yiping; Kendler, Kenneth S; Shi, Shenxun; Flint, Jonathan
Our prior study in Han Chinese women has shown that women with a history of childhood sexual abuse (CSA) are at increased risk for developing major depression (MD). Would this relationship be found in our whole data set? Three levels of CSA (non-genital, genital, and intercourse) were assessed by self-report in two groups of Han Chinese women: 6017 clinically ascertained with recurrent MD and 5983 matched controls. Diagnostic and other risk factor information was assessed at personal interview. Odds ratios (ORs) were calculated by logistic regression. We confirmed earlier results by replicating prior analyses in 3,950 new recurrent MD cases. There were no significant differences between the two data sets. Any form of CSA was significantly associated with recurrent MD (OR 4.06, 95% confidence interval (CI) [3.19-5.24]). This association strengthened with increasing CSA severity: non-genital (OR 2.21, 95% CI 1.58-3.15), genital (OR 5.24, 95% CI 3.52-8.15) and intercourse (OR 10.65, 95% CI 5.56-23.71). Among the depressed women, those with CSA had an earlier age of onset, longer depressive episodes. Recurrent MD patients those with CSA had an increased risk for dysthymia (OR 1.60, 95%CI 1.11-2.27) and phobia (OR 1.41, 95%CI 1.09-1.80). Any form of CSA was significantly associated with suicidal ideation or attempt (OR 1.50, 95% CI 1.20-1.89) and feelings of worthlessness or guilt (OR 1.41, 95% CI 1.02-2.02). Intercourse (OR 3.47, 95%CI 1.66-8.22), use of force and threats (OR 1.95, 95%CI 1.05-3.82) and how strongly the victims were affected at the time (OR 1.39, 95%CI 1.20-1.64) were significantly associated with recurrent MD. In Chinese women CSA is strongly associated with recurrent MD and this association increases with greater severity of CSA. Depressed women with CSA have some specific clinical traits. Some features of CSA were associated with greater likelihood of developing recurrent MD.
Chen, Jing; Cai, Yiyun; Cong, Enzhao; Liu, Ying; Gao, Jingfang; Li, Youhui; Tao, Ming; Zhang, Kerang; Wang, Xumei; Gao, Chengge; Yang, Lijun; Li, Kan; Shi, Jianguo; Wang, Gang; Liu, Lanfen; Zhang, Jinbei; Du, Bo; Jiang, Guoqing; Shen, Jianhua; Zhang, Zhen; Liang, Wei; Sun, Jing; Hu, Jian; Liu, Tiebang; Wang, Xueyi; Miao, Guodong; Meng, Huaqing; Li, Yi; Hu, Chunmei; Li, Yi; Huang, Guoping; Li, Gongying; Ha, Baowei; Deng, Hong; Mei, Qiyi; Zhong, Hui; Gao, Shugui; Sang, Hong; Zhang, Yutang; Fang, Xiang; Yu, Fengyu; Yang, Donglin; Liu, Tieqiao; Chen, Yunchun; Hong, Xiaohong; Wu, Wenyuan; Chen, Guibing; Cai, Min; Song, Yan; Pan, Jiyang; Dong, Jicheng; Pan, Runde; Zhang, Wei; Shen, Zhenming; Liu, Zhengrong; Gu, Danhua; Wang, Xiaoping; Liu, Xiaojuan; Zhang, Qiwen; Li, Yihan; Chen, Yiping; Kendler, Kenneth S.; Shi, Shenxun; Flint, Jonathan
Background Our prior study in Han Chinese women has shown that women with a history of childhood sexual abuse (CSA) are at increased risk for developing major depression (MD). Would this relationship be found in our whole data set? Method Three levels of CSA (non-genital, genital, and intercourse) were assessed by self-report in two groups of Han Chinese women: 6017 clinically ascertained with recurrent MD and 5983 matched controls. Diagnostic and other risk factor information was assessed at personal interview. Odds ratios (ORs) were calculated by logistic regression. Results We confirmed earlier results by replicating prior analyses in 3,950 new recurrent MD cases. There were no significant differences between the two data sets. Any form of CSA was significantly associated with recurrent MD (OR 4.06, 95% confidence interval (CI) [3.19–5.24]). This association strengthened with increasing CSA severity: non-genital (OR 2.21, 95% CI 1.58–3.15), genital (OR 5.24, 95% CI 3.52–8.15) and intercourse (OR 10.65, 95% CI 5.56–23.71). Among the depressed women, those with CSA had an earlier age of onset, longer depressive episodes. Recurrent MD patients those with CSA had an increased risk for dysthymia (OR 1.60, 95%CI 1.11–2.27) and phobia (OR 1.41, 95%CI 1.09–1.80). Any form of CSA was significantly associated with suicidal ideation or attempt (OR 1.50, 95% CI 1.20–1.89) and feelings of worthlessness or guilt (OR 1.41, 95% CI 1.02–2.02). Intercourse (OR 3.47, 95%CI 1.66–8.22), use of force and threats (OR 1.95, 95%CI 1.05–3.82) and how strongly the victims were affected at the time (OR 1.39, 95%CI 1.20–1.64) were significantly associated with recurrent MD. Conclusions In Chinese women CSA is strongly associated with recurrent MD and this association increases with greater severity of CSA. Depressed women with CSA have some specific clinical traits. Some features of CSA were associated with greater likelihood of developing recurrent MD. PMID:24489940
Sen. Lieberman, Joseph I. [ID-CT
Senate - 11/14/2012 Upon reconsideration, cloture on the bill not invoked in Senate by Yea-Nay Vote. 51 - 47. Record Vote Number: 202. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:
Lin, Danhua; Li, Xiaoming; Fan, Xinghua; Fang, Xiaoyi
Objective: The current study was designed to explore the prevalence of child sexual abuse (CSA) and its association with health risk behaviors (i.e., smoking, alcohol use, binge drinking, suicidal ideation, and suicide attempt) among rural children and adolescents in China. Methods: A sample of 683 rural children and adolescents (8 to 18 years of…
Hamelin, Christine; Salomon, Christine; Cyr, Diane; Gueguen, Alice; Lert, France
Objectives: Few studies have addressed the long-term consequences of adverse childhood experiences among women in Oceania, in particular among indigenous women. This paper aims to report prevalences of childhood sexual abuse (CSA) and to asses the negative sexual health consequences in adulthood by comparing indigenous Kanak to non-Kanak women in…
Chan, Ko Ling
Objective: The current study investigated the prevalence and impact of childhood sexual abuse (CSA) on adult sexual victimization (ASV) in Hong Kong, China. This study also examines correlates of demographic characteristics, depression, suicidal ideation, and self-esteem with ASV. Methods: A total of 5,049 Chinese adult respondents were…
The aim of this article was to assess the effects of child sexual abuse (CSA) on emotion regulation (ER) in adolescents and to evaluate the relationships between non suicidal self-injury (NSSI), emotional eating, insomnia and emotion disregulation (ED). Fifty two adolescents, aged 10-18 years, without who weren't diagnosed a psychiatric disease before abuse and completed 6-months of follow-up after abuse included the study. Control group consisted of 33 healthy voluntary participants without any known psychiatric disorders. Patients and volunteers who participated in the study were assessed with the Inventory of Statements About Self-injury (ISAS), Dutch Eating Behavior Questionnaire (DEBQ), Pittsburgh Sleep Quality Index (PSQI), Insomnia severity index (ISI), and the Difficulties in Emotion Regulation Scale (DERS). In our study, PSQI scores, DERS total scores and DEBQ emotional eating subscores were significantly higher in the CSA victims (In orderly; p = 0,034, p < 0.001, p = 0,023). 55.7% of the CSA victims reported self-injurious behavior, while 15.5% of healthy voluntary participants reporting self-injurious behavior. The CSA victims reporting NSSI had higher DERS scores than CSA victims without NSSI. (p = 0.024). The CSA victims with post-traumatic stress disorder (PTSD) and CSA victims without PTSD had a positive correlation between DEBQ emotional eating subscores and DERS total scores (In orderly: r = 0.762, p = 0.031; r = 0.872, p < 0.001). There was a positive correlation between the PSQI scores and DERS scores in the CSA victims with PTSD (r = 0.827, p = 0.023). Further studies are needed to assess the relationship between self-injury, emotional eating, insomnia and ED, and to determine how sexual abuse effect the ER in a clinical sample of CSA. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
Müller, Andrea; Hächler, Herbert; Stephan, Roger; Lehner, Angelika
Here we describe the presence of two very similar but unusual variants of AmpC cephalosporinase in each Cronobacter sakazakii and C. malonaticus isolates conferring resistance exclusively to first generation cephalosporins. During a survey on the antibiotic resistance patterns of C. sakazakii and C. malonaticus strains isolated from a milk powder production facility, originally two different phenotypes regarding the susceptibility/resistance for the two beta-lactam antibiotics ampicillin (amp) and cephalothin (ceph) were observed: (i) isolates being susceptible for both antibiotics (amp(S)/ceph(S)), and (ii) strains exhibiting susceptibility to ampicillin but resistance to cephalothin (amp(S)/ceph(R)). The latter phenotype (amp(S)/ceph(R)) was observed in the majority of the environmental strains from the facility. Analysis of whole genome sequences of C. sakazakii revealed a gene putatively coding for an AmpC beta-lactamase. Consequently, the ampC genes from both species and both phenotypes were subjected to a cloning approach. Surprisingly, when expressed in Escherichia coli, all transformants exhibited the amp(S)/ceph(R) phenotype regardless of (i) the phenotypic backgrounds or (ii) the AmpC amino acid sequences of the original strains from which the clones were derived. The novel AmpC beta-lactamases were designated CSA-1 and CSA-2 (from C. sakazakii) and CMA-1 and CMA-2 (from C. malonaticus). The observed variations in the minimum inhibitory concentration (MIC) levels for cephalothin (wt compared to transformants) suggest that this feature is a target of a yet unknown regulatory mechanism present in the natural Cronobacter background but absent in the neutral E. coli host.
Haller, Deborah L; Miles, Donna R
This study examined associations between childhood abuse and personality disturbances in 228 drug-dependent women. Thirty-six percent denied abuse, 50% reported emotional, 42% physical, and 42% sexual abuse. Million Clinical Multiarial Inventory (MCMI-III) scores > 74 provided evidence of personality disturbance and scores on Minnesota Multiphasic Personality Inventory-2 (MMPI-2) scales measuring somatic complaints, depression, anxiety and postraumatic stress disorder (PTSD) served as covariates. Emotional and physical abuse survivors were at increased risk for borderline, masochistic, and avoidant disturbances and decreased risk for narcissistic disturbances. Emotional abuse survivors were also less likely to be sadistic whereas physical abuse survivors were more likely to be paranoid. Sexual abuse survivors were twice as likely be antisocial; however, no association was found with borderline personality. Finally, an increased prevalence of severe personality disturbances was observed among those experiencing multiple types of abuse. Childhood trauma predisposes drug-dependent women to develop troublesome personality characteristics that are independent of drug addiction and other psychological problems associated with childhood trauma.
Young, Walter C.; And Others
Thirty-seven adult dissociative disorder patients who reported ritual abuse in childhood by satanic cults are described. A clinical syndrome is presented that includes dissociative states with satanic overtones, posttraumatic stress disorder, survivor guilt, unusual fears, and substance abuse. Questions concerning reliability, credibility, and…
Tomori, Cecilia; McFall, Allison M; Srikrishnan, Aylur K; Mehta, Shruti H; Nimmagadda, Nymisha; Anand, Santhanam; Vasudevan, Canjeevaram K; Solomon, Suniti; Solomon, Sunil S; Celentano, David D
Childhood sexual abuse (CSA) is a significant global public health problem, which is associated with negative psychosocial outcomes and high-risk sexual behaviors in adults. Men who have sex with men (MSM) often report higher prevalence of CSA history than the general population, and CSA may play a key role in MSM's greater vulnerability to HIV. This study examined the prevalence of CSA history and its impact on the number of recent HIV-related risk behaviors (unprotected anal intercourse, high number of male and female sexual partners, alcohol use, drug use, and sex work in prior 6 months) and lifetime risk behaviors and experiences (high number of lifetime male and female sexual partners, early sexual debut, injection drug use, sex work, and intimate partner violence) among 11,788 adult MSM recruited via respondent driven sampling across 12 sites in India, with additional insights from thematic analysis of qualitative research with 363 MSM from 15 sites. Nearly a quarter (22.4 %) of participants experienced CSA, with substantially higher prevalence of CSA in the South and among kothis (feminine sexual identity). Qualitative findings revealed that older, trusted men may target young and, especially, gender nonconforming boys, and perpetrators' social position facilitates nondisclosure. CSA may also initiate further same-sex encounters, including sex work. In multivariable analysis, MSM who experienced CSA had 21 % higher rate of recent (adjusted rate ratio [aRR = 1.21], 95 % confidence interval [CI]: 1.14-1.28), and 2.0 times higher lifetime (aRR = 2.04, 95 % CI: 1.75-2.38) HIV-related behaviors/experiences compared with those who did not. This large, mixed-methods study found high overall prevalence of CSA among MSM (22.4 %), with substantially higher prevalence among MSM residing in the South and among more feminine sexual identities. Qualitative findings highlighted boys' vulnerabilities to CSA, especially gender nonconformity, and CSA's role in
Lam, Kindy Yuk-Ip
The role of disclosure on psychological well-being of adolescents with child sexual abuse experience was investigated in a subsample of 74 disclosers among 800 adolescents recruited in the community in Hong Kong. The results supported that CSA experiences have differential impact on adolescents' psychological well-being. Family characteristics of the disclosers accounted for only a small amount of the variance in an array of psychological well-being measures. CSA characteristics were robust predictors of disclosers' sexual eroticism and externalizing behavioral symptoms. Disclosers' cognitive appraisal of CSA experience and quality of parental attachment were strong predictors of their self-esteem and internalizing behavioral problems. After controlling for the aforementioned factors, negative disclosure experience still significantly predicted lower self-esteem, higher sexual anxiety, more internalizing behavior, and more severe post-traumatic stress disorder responses. Research to understand the factors that generate negative disclosure experiences is needed for developing effective intervention strategies to mitigate the negative consequences of disclosure.
Ramirez, Jennifer C; Milan, Stephanie
We examined whether a history of self-reported childhood sexual abuse (CSA) moderates the relationship between obesity and mental health symptoms (depression, anxiety, and posttraumatic stress disorder) in an ethnically diverse sample of low-income women. A community sample of 186 women completed self-report measures and had their weight and height measured. Body mass index and CSA had an interactive effect on all mental health measures, such that obese women with a CSA history reported substantially higher levels of all symptoms. These results give greater specificity to the obesity-mental health link reported in previous studies and provide possible directions for targeted intervention. © The Author(s) 2015.
Essabar, Laila; Khalqallah, Abdenbi; Dakhama, Badr Sououd Benjelloun
Child sexual abuse (CSA) is a global problem that has significant consequences for public health; it has been a prominent topic of public concern for more than a decade, but many basic facts about the problem remain unclear or in dispute. We conducted a study of 311 cases of CSA in order to highlight the epidemiological features and negative impact on victims' well-being and to emphasize the need for a multidisciplinary approach to the primary prevention and management of CSA. We noted an increase in cases number with male predominance. Most of our patients came from lower socioeconomic classes. The perpetrators were male in 100% of cases; acquaintances in 70% of cases and family members in 22 cases. Physical examination were normal in 61% of cases, however, a range of psychological and physical effects were identified with dramatic health consequences: three cases of attempted suicide, five pregnancies and one case of HIV virus infection.
Rabinovitch, Sara M.; Kerr, David C. R.; Leve, Leslie D.; Chamberlain, Patricia
Childhood sexual abuse (CSA) histories are prevalent among adolescent girls in the juvenile justice system (JJS) and may contribute to their high rates of suicidal behavior. Among 166 JJS girls who participated in an intervention trial, baseline CSA and covariates were examined as predictors of suicide attempt and non-suicidal self-injury (NSSI) reported at long-term follow-up (7–12 years later). Early forced CSA was related to lifetime suicide attempt and NSSI history, and (marginally) to post-baseline attempt; effects were not mediated by anxiety or depressive symptoms. Findings suggest that earlier victimization and younger entry into JJS are linked with girls’ suicide attempt and NSSI. PMID:25370436
Carlson, Bonnie E; Maciol, Katherine; Schneider, Joanne
An exploratory study was conducted with a convenience sample of 41 adult survivors of sibling incest using a retrospective survey design. Participants were interviewed about their childhood sexual experiences with a sibling. Most participants reported vaginal or oral intercourse and coercive experiences. Half of the sample reported sexual experiences with family members, as well as other child abuse. Half of the participants showed evidence of distorted beliefs about child sexual abuse. Disclosure of the incest during childhood was rare. doi:10.1300/ J070v15n04_02.
Nerum, H; Halvorsen, L; Straume, B; Sørlie, T; Øian, P
Objective To compare the duration and outcome of the first labour in women who have been subjected to childhood sexual abuse (CSA) and women who have been raped in adulthood (RA). Design Case–control study in a clinical cohort. Setting University Hospital of North Norway. Sample In all, 373 primiparas: 185 subjected to CSA, 47 to RA and 141 controls without a history of abuse. Methods Data on birth outcomes were retrieved from the patient files. Information on sexual abuse was reported in consultation with specialised midwives in the mental health team. Birth outcomes were analysed by multinominal regression analysis. Main outcome measures Vaginal births, delivery by caesarean section, operative vaginal delivery and duration of labour. Results As compared with controls, the RA group showed a significantly higher risk for caesarean section (adjusted OR 9.9, 95% CI 3.4–29.4) and operative vaginal delivery (adjusted OR 12.2, 95% CI 4.4–33.7). There were no significant differences between the CSA and the control group. The RA group displayed significantly longer duration of labour in all phases as compared with the control and CSA groups. Conclusions There were major differences in the duration of labour and birth outcomes in the two abuse groups. Despite a higher proportion of obstetric risk factors at onset of labour in the CSA group, women subjected to CSA had shorter labours and less risk for caesarean section and operative vaginal deliveries than women subjected to RA. The best care for birthing women subjected to sexual abuse needs to be explored in further studies. PMID:23157417
Tobey, Trina; McAuliff, Kathleen; Rocha, Celina
Incidences and severity of child abuse have increased since the start of the recession. This study examined the relationship between employment status and severity of symptoms in children abused during a recession year. Participants included 154 females and 65 males between 2 and 17 years old referred to Dallas Children's Advocacy Center after surviving child sexual abuse, physical abuse, and/or neglect. We found that child abuse survivors whose mothers were unemployed showed higher symptom severity. Larger differences were found when participants were broken down by age, ethnicity, and living situation. Father's employment status did not affect symptom severity probably because many children lived with single mothers. We concluded that child abuse survivors whose mothers are unemployed have increased risk for psychological symptoms.
Peleikis, Dawn E; Mykletun, Arnstein; Dahl, Alv A
The aim of this paper was twofold: namely to examine current intimate relationships and social status of women with childhood sexual abuse (CSA) in the long term after outpatient psychotherapy, and to investigate the relative influence of CSA and family background risk factors (FBRF) on the indicators of this status. Fifty-six women with reported CSA and 56 without CSA, who had outpatient psychotherapy for anxiety disorders and/or depression, were personally examined 5 years after termination. Women with CSA had considerably greater sexual and mental health problems, but the same prevalence of partnerships, children and friends as the contrast. No differences were observed as to self-esteem, intimate bonds and physical quality of life. Sexual problems and low education were mainly explained by CSA, other measures by FBRF. Women treated with outpatient psychotherapy for anxiety disorders and depression had moderate problems at long-term follow-up, but more so for those women who had been exposed to CSA.
Hansen, Nathan B; Brown, Lauren J; Tsatkin, Elizabeth; Zelgowski, Brittany; Nightingale, Vienna
Little attention has been given to the occurrence of dissociative symptoms during sexual behavior in adults who have experienced childhood sexual abuse (CSA). For this study, 57 adults living with HIV infection who had experienced CSA and were entering a treatment study for traumatic stress completed study assessments and clinical interviews, including a 15-item scale of dissociative experiences during sexual behavior. Predictor variables included Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision diagnoses of posttraumatic stress disorder (PTSD) and dissociative disorders, rape by an intimate partner, duration of CSA, number of perpetrators of CSA, and current sexual satisfaction. A multiple regression analysis was conducted to identify significant associations between predictors and dissociation during sex. Mean differences by clinical diagnosis were also examined. Results indicated that PTSD, dissociative disorders, rape by an intimate partner, duration of CSA, and number of perpetrators of CSA were associated with increased dissociation during sexual behavior. Dissociation during sex likely increases vulnerability to sexual revictimization and risky sexual behavior. Standard behavioral prevention interventions may be ineffective for sexual situations when dissociation occurs, and prevention efforts should be integrated with mental health care for those who have experienced CSA.
Hansen, Nathan B.; Brown, Lauren J.; Tsatkin, Elizabeth; Zelgowski, Brittany; Nightingale, Vienna
Little attention has been given to the occurrence of dissociative symptoms during sexual behavior in adults who have experienced childhood sexual abuse (CSA). For this study, 57 adults living with HIV infection who had experienced CSA and were entering a treatment study for traumatic stress completed study assessments and clinical interviews, including a 15-item scale of Dissociative Experiences during Sexual Behavior. Predictor variables included DSM-IV-TR diagnoses of PTSD and Dissociative Disorders, Rape by an Intimate Partner, Duration of CSA, Number of Perpetrators of CSA, and Current Sexual Satisfaction. A multiple regression analysis was conducted to identify significant associations between predictors and dissociation during sex. Mean differences by clinical diagnosis were also examined. Results indicated that PTSD, Dissociative Disorders, Rape by an Intimate Partner, Duration of CSA, and Number of Perpetrators of CSA were associated with increased dissociation during sexual behavior. Dissociation during sex likely increases vulnerability to sexual revictimization and risky sexual behavior. Standard behavioral prevention interventions may be ineffective for sexual situations when dissociation occurs, and prevention efforts should be integrated with mental health care for those who have experienced CSA. PMID:22545567
Miller, Kim S.; Winskell, Kate; Pruitt, Kaitlyn L.; Saul, Janet
Despite widespread recognition of child sexual abuse (CSA) as a serious problem in sub-Saharan Africa (SSA), few far-reaching programmatic interventions addressing CSA in this setting are currently available, and those interventions that do exist tend to focus on response rather than prevention. Parents are in a unique position to engage their children in dialogues about sexuality-related issues and thereby both help prevent CSA and take swift action to stop CSA, address trauma, and minimize harm, in the event CSA does occur. The Families Matter! Program (FMP) is an evidence-based intervention for parents and caregivers of 9-12 year-olds in sub-Saharan African countries that promotes positive parenting practices and effective parent-child communication about sex-related issues and sexual risk reduction. This paper describes the enhancement of a new FMP session on CSA, drawing on authentic narratives contributed by young people to the Global Dialogues/Scenarios from Africa (GD/SfA) youth scriptwriting competition. The GD/SfA data permitted incorporation of young Africans’ voices and resulted in an interactive curriculum that is grounded in contextually-relevant and emotionally-compelling scenarios and adapted to the needs of low-literacy adult learners in SSA. Experiences are shared with a view to informing the development of interventions addressing CSA in SSA. PMID:26701277
Cutajar, Margaret C; Mullen, Paul E; Ogloff, James R P; Thomas, Stuart D; Wells, David L; Spataro, Josie
To determine the rate and risk of suicide and accidental fatal drug overdose (ie, overdose deemed not to have been suicide) in individuals who had been medically ascertained as having been sexually abused during childhood. A historical cohort linkage study of suicide and accidental drug-induced death among victims of child sexual abuse (CSA). Forensic medical records of 2759 victims of CSA who were assessed between 1964 and 1995 were obtained from the Victorian Institute of Forensic Medicine and linked with coronial data representing a follow-up period of up to 44 years. Rates of suicide and accidental fatal drug overdose recorded in coronial databases between 1991 and 2008, and rates of psychiatric disorders and substance use recorded in public mental health databases. Twenty-one cases of fatal self-harm were recorded. Relative risks for suicide and accidental fatal overdose among CSA victims, compared with age-limited national data for the general population, were 18.09 (95% CI, 10.96-29.85; population-attributable risk, 0.37%), and 49.22 (95% CI, 36.11-67.09; population-attributable risk, 0.01%) respectively. Relative risks were higher for female victims. Similar to the general population, CSA victims who died as a result of self-harm were predominantly aged in their 30s at time of death. Most had contact with the public mental health system and half were recorded as being diagnosed with an anxiety disorder. Our data highlight that CSA victims are at increased risk of suicide and accidental fatal drug overdose. CSA is a risk factor that mediates suicide and fatal overdose.
Subica, Andrew M
Trauma and posttraumatic stress disorder (PTSD) frequently co-occur with serious mental illness, yet the unique mental and physical health influences of childhood physical abuse (CPA), childhood sexual abuse (CSA), and forced sexual trauma on individuals with serious mental illness remain unevaluated. The present study of 172 individuals with serious mental illness investigated the adverse effects of CPA, CSA, and forced sexual trauma on severity of PTSD and depression, and overall mental and physical health functioning. Data analysis consisted of chi-square tests, independent t tests, bivariate odds ratios, and linear regressions. Prevalence of CPA (44.8%), CSA (29.1%), and forced sexual trauma (33.1%) were elevated, and nearly one third of participants (31.4%) reported clinical PTSD. Participants exposed to CSA or forced sexual trauma evidenced bivariate ORs ranging from 4.13 to 7.02 for PTSD, 2.44 to 2.50 for major depression, and 2.14 to 2.31 for serious physical illness/disability. Sexual trauma exposure associated with heightened PTSD and depression, and reduced mental and physical health functioning, with CSA uniquely predicting PTSD, depression, and physical health difficulties. CPA less significantly affected these clinical domains. Sexual traumas have profound negative effects on mental and physical health outcomes among individuals with serious mental illness; increased screening and treatment of sexual traumas is needed. Copyright © 2013 International Society for Traumatic Stress Studies.
Senn, Theresa E; Braksmajer, Amy; Urban, Marguerite A; Coury-Doniger, Patricia; Carey, Michael P
HIV and childhood sexual abuse (CSA) are intersecting public health problems for women. We pilot tested an integrated sexual risk reduction intervention for women with a history of CSA that addressed both the consequences of CSA [based on the Traumagenic Dynamics (TD) framework] and the antecedents of sexual risk behavior (based on the Information-Motivation-Behavioral Skills [IMB] model). Women with a history of CSA who were attending a public STI clinic (n = 84) were randomly assigned to a five-session integrated TD/IMB (experimental) group intervention or to a time-matched IMB-guided sexual risk reduction (control) group intervention. Preliminary findings indicated that women in the integrated TD/IMB intervention reduced their average number of episodes of unprotected sex with a primary partner, their alcohol use, and their likelihood of being in a violent relationship, relative to women in the IMB-only group. Our findings suggest that sexual risk reduction interventions that address both the consequences of CSA and the antecedents of sexual risk behavior may be efficacious in reducing sexual risk behavior among women who were sexually abused.
Zerubavel, Noga; Messman-Moore, Terri L; DiLillo, David; Gratz, Kim L
Betrayal trauma theory proposes a relation between intimate partner violence (IPV) and dissociation, suggesting that dissociation among victims of IPV may function to restrict awareness of abuse in order to preserve attachments perceived as vital. We investigated two factors that may moderate the relation between IPV and dissociation-childhood sexual abuse (CSA) severity and fear of abandonment-among 348 women currently in a relationship. The relation between frequency of IPV (sexual and physical) and dissociation (amnesia and depersonalization) was moderated by CSA severity and fear of abandonment. Specifically, among women with clinically relevant fear of abandonment, the strength of the relation between IPV and dissociation became stronger as CSA severity increased. This study is the first to demonstrate the moderating roles of fear of abandonment and CSA history in the relation between IPV and dissociation among women. Findings suggest that it may be important to target fear of abandonment in interventions with IPV victims who have a CSA history. Results suggest that fear of abandonment warrants greater attention in research on IPV revictimization.
Fong, Hiu-fai; Bennett, Colleen E; Mondestin, Valerie; Scribano, Philip V; Mollen, Cynthia; Wood, Joanne N
The objective of this study was to describe caregiver perceptions about mental health services (MHS) after child sexual abuse (CSA) and to explore factors that affected whether their children linked to services. We conducted semi-structured, in-person interviews with 22 non-offending caregivers of suspected CSA victims<13 years old seen at a child advocacy center in Philadelphia. Purposive sampling was used to recruit caregivers who had (n=12) and had not (n=10) linked their children to MHS. Guided by the Health Belief Model framework, interviews assessed perceptions about: CSA severity, the child's susceptibility for adverse outcomes, the benefits of MHS, and the facilitators and barriers to MHS. Interviews were audio-recorded, transcribed, coded, and analyzed using modified grounded theory. Recruitment ended when thematic saturation was reached. Caregivers expressed strong reactions to CSA and multiple concerns about adverse child outcomes. Most caregivers reported that MHS were generally necessary for children after CSA. Caregivers who had not linked to MHS, however, believed MHS were not necessary for their children, most commonly because they were not exhibiting behavioral symptoms. Caregivers described multiple access barriers to MHS, but caregivers who had not linked reported that they could have overcome these barriers if they believed MHS were necessary for their children. Caregivers who had not linked to services also expressed concerns about MHS being re-traumatizing and stigmatizing. Interventions to increase MHS linkage should focus on improving communication with caregivers about the specific benefits of MHS for their children and proactively addressing caregiver concerns about MHS. Copyright © 2015 Elsevier Ltd. All rights reserved.
Travassos, Mark A; Coulibaly, Drissa; Bailey, Jason A; Niangaly, Amadou; Adams, Matthew; Nyunt, Myaing M; Ouattara, Amed; Lyke, Kirsten E; Laurens, Matthew B; Pablo, Jozelyn; Jasinskas, Algis; Nakajima, Rie; Berry, Andrea A; Takala-Harrison, Shannon; Kone, Abdoulaye K; Kouriba, Bourema; Rowe, J Alexandra; Doumbo, Ogobara K; Thera, Mahamadou A; Laufer, Miriam K; Felgner, Philip L; Plowe, Christopher V
The Plasmodium falciparum erythrocyte membrane protein 1 (PfEMP1) family mediates parasite sequestration in small capillaries through tissue-specific cytoadherence. The best characterized of these proteins is VAR2CSA, which is expressed on the surface of infected erythrocytes that bind to chondroitin sulfate in the placental matrix. Antibodies to VAR2CSA prevent placental cytoadherence and protect against placental malaria. The size and complexity of the VAR2CSA protein pose challenges for vaccine development, but smaller constitutive domains may be suitable for subunit vaccine development. A protein microarray was printed to include five overlapping fragments of the 3D7 VAR2CSA extracellular region. Malian women with a history of at least one pregnancy had antibody recognition of four of these fragments and had stronger reactivity against the two distal fragments than did nulliparous women, children, and men from Mali, suggesting that the C-terminal extracellular VAR2CSA domains are a potential focus of protective immunity. With carefully chosen sera from longitudinal studies of pregnant women, this approach has the potential to identify seroreactive VAR2CSA domains associated with protective immunity against pregnancy-associated malaria. © The American Society of Tropical Medicine and Hygiene.
Ditlev, Sisse B; Nielsen, Morten A; Resende, Mafalda; Agerbæk, Mette Ø; Pinto, Vera V; Andersen, Pernille H; Magistrado, Pamela; Lusingu, John; Dahlbäck, Madeleine; Theander, Thor G; Salanti, Ali
Malaria during pregnancy in Plasmodium falciparum endemic regions is a major cause of mortality and severe morbidity. VAR2CSA is the parasite ligand responsible for sequestration of Plasmodium falciparum infected erythrocytes to the receptor chondroitin sulfate A (CSA) in the placenta and is the leading candidate for a placental malaria vaccine. Antibodies induced in rats against the recombinant DBL4ε domain of VAR2CSA inhibit the binding of a number of laboratory and field parasite isolates to CSA. In this study, we used a DBL4ε peptide-array to identify epitopes targeted by DBL4ε-specific antibodies that inhibit CSA-binding of infected erythrocytes. We identified three regions of overlapping peptides which were highly antigenic. One peptide region distinguished itself particularly by showing a clear difference in the binding profile of highly parasite blocking IgG compared to the IgG with low capacity to inhibit parasite adhesion to CSA. This region was further characterized and together these results suggest that even though antibodies against the synthetic peptides which cover this region did not recognize native protein, the results using the mutant domain suggest that this linear epitope might be involved in the induction of inhibitory antibodies induced by the recombinant DBL4ε domain.
Beeson, James G; Ndungu, Francis; Persson, Kristina E M; Chesson, Joanne M; Kelly, Greg L; Uyoga, Sophie; Hallamore, Sandra L; Williams, Thomas N; Reeder, John C; Brown, Graham V; Marsh, Kevin
During pregnancy, specific variants of Plasmodium falciparum-infected erythrocytes (IEs) can accumulate in the placenta through adhesion to chondroitin sulfate A (CSA) mediated by expression of PfEMP1 encoded by var2csa-type genes. Antibodies against these variants are associated with protection from maternal malaria. We evaluated antibodies among Kenyan, Papua New Guinean, and Malawian men and Kenyan children against two different CSA-binding P. falciparum isolates expressing var2csa variants. Specific IgG was present at significant levels among some men and children from each population, suggesting exposure to these variants is not exclusive to pregnancy. However, the level and prevalence of antibodies was substantially lower overall than exposed multigravidas. IgG-binding was specific and did not represent antibodies to subpopulations of non-CSA-binding IEs, and some sera inhibited IE adhesion to CSA. These findings have significant implications for understanding malaria pathogenesis and immunity and may be significant for understanding the acquisition of immunity to maternal malaria.
Leck, Pam; Difede, JoAnn; Patt, Ivy; Giosan, Cezar; Szkodny, Lauren
This study documents the prevalence of male childhood sexual abuse (CSA) and psychological sequelae in a sample of disaster workers deployed to the World Trade Center (WTC) site following the September 11, 2001 terrorist attack. There are limited data on male CSA and its psychological impact, especially on a large non-treatment seeking sample. As part of a mandatory medical screening program, workers were assessed with well-validated and widely used clinician interview and self-report measures following their involvement in the restoration of services to Ground Zero and surrounding areas of lower Manhattan. Frequency of CSA measured by the Traumatic Events Interview (TEI) was 4.3% (n = 92). Clinician interview and self-report data were analyzed using t-tests, revealing statistically significant relationships (but not clinically meaningful scores) between CSA and scores on the CAPS, PCL, BDI, STAXI, and SDS. Further analyses revealed that individuals endorsing CSA were three-times more likely to score high (vs. low) on the BDI and CAPS. Since disaster workers traditionally summon images of strength and mastery, professionals may overlook CSA and symptoms of depression and PTSD in this population.
Ensink, Karin; Bégin, Michaël; Normandin, Lina; Fonagy, Peter
The objective was to examine pathways from child sexual abuse (CSA) and maternal mentalizing to child internalizing and externalizing difficulties and to test a model of MRF as a moderator of the relationships between CSA and child difficulties. The sample was comprised of 154 mothers and children aged 2-12 where 64 children had experienced CSA. To assess parental mentalizing the Parental Development Interview was rated with the Parental Reflective Functioning Scale. Child internalizing and externalizing difficulties were assessed with the Child Behavior Checklist (CBCL). Results indicate that there were significant inverse relationships between maternal mentalizing and child internalizing and externalizing difficulties. When maternal mentalizing was considered together with CSA, only maternal mentalizing was a significant predictor of child difficulties. Furthermore, maternal mentalizing moderated the relationship between CSA and child internalizing difficulties. These findings provide evidence of the importance of the parents' mentalizing stance for psychiatric symptoms of children aged 2-12, as well as children's recovery from CSA. The clinical implications of the findings are discussed. Copyright © 2017 Elsevier B.V. All rights reserved.
Downing, Martin J; Brown, Dominique; Steen, Jeffrey; Benoit, Ellen
Childhood sexual abuse (CSA) remains a critical public health issue among black and Latino men who have sex with men (MSM), as it is associated with multiple negative outcomes including substance misuse, poor mental health, revictimization, and high-risk sexual behavior. Most CSA research with MSM relies on quantitative assessment that often precludes consideration of cultural variations in how formative sexual experiences are understood and is based on inconsistent or overly restrictive definitions of abuse, and therefore may fail to detect certain abusive experiences (eg, those involving female perpetrators), which can have harmful health consequences if they remain unrecognized. The objective of this study is to overcome existing limitations in the literature by drawing on perspectives of black and Latino MSM and men who have sex with men and women (MSMW), as well as relevant service providers to better understand the role of, and the need to include, sexual abuse histories (eg, CSA) in treatment and counseling settings, with the long-term goal of improving assessment and health outcomes. We will conduct mixed-methods interviews, framed by an intersectionality approach, with 80 black and Latino men (40 MSM and 40 MSMW) in New York City (NYC), exploring appraisals of their formative sexual experiences, including those described as consensual but meeting criteria for CSA. We will also interview 30 local service providers representing substance abuse treatment, mental health care, and HIV prevention and outreach. The study was launched in May 2017. This formative research will inform testable approaches to assessing and incorporating sexual abuse history into substance abuse treatment and other health and mental health services used by men with such histories. ©Martin J Downing Jr, Dominique Brown, Jeffrey Steen, Ellen Benoit. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 26.02.2018.
Background Childhood sexual abuse (CSA) remains a critical public health issue among black and Latino men who have sex with men (MSM), as it is associated with multiple negative outcomes including substance misuse, poor mental health, revictimization, and high-risk sexual behavior. Most CSA research with MSM relies on quantitative assessment that often precludes consideration of cultural variations in how formative sexual experiences are understood and is based on inconsistent or overly restrictive definitions of abuse, and therefore may fail to detect certain abusive experiences (eg, those involving female perpetrators), which can have harmful health consequences if they remain unrecognized. Objective The objective of this study is to overcome existing limitations in the literature by drawing on perspectives of black and Latino MSM and men who have sex with men and women (MSMW), as well as relevant service providers to better understand the role of, and the need to include, sexual abuse histories (eg, CSA) in treatment and counseling settings, with the long-term goal of improving assessment and health outcomes. Methods We will conduct mixed-methods interviews, framed by an intersectionality approach, with 80 black and Latino men (40 MSM and 40 MSMW) in New York City (NYC), exploring appraisals of their formative sexual experiences, including those described as consensual but meeting criteria for CSA. We will also interview 30 local service providers representing substance abuse treatment, mental health care, and HIV prevention and outreach. Results The study was launched in May 2017. Conclusions This formative research will inform testable approaches to assessing and incorporating sexual abuse history into substance abuse treatment and other health and mental health services used by men with such histories. PMID:29483063
Anyikwa, Victoria A
Trauma leads to deleterious effects on individuals and families causing many to seek treatment from social work practitioners across systems of care. Trauma comes in all forms, from community violence to domestic violence, including physical and sexual abuse of children and violence among intimate partners that leaves its victims devastatingly impacted. Women make up the majority of survivors of intimate partner violence (IPV) with studies revealing significant associated mental health problems. Social workers are bound to work with survivors of IPV and must be prepared to deliver effective trauma-informed services. While trauma-specific services exist for specific populations, researchers are finding that negative events in childhood and in family functioning can impact individuals' lives in negative ways thus having implications for treatment across systems. For women survivors of IPV, the traumatic stress may be cumulative with varied emotional and mental health impacts that may force them to seek services across systems, not just domestic violence specific systems. As such it is imperative that social workers increase awareness of trauma, its impact on women, and the importance of the approach and environment in which they provide services. In this article the author aims to broaden social workers knowledge of the use of a TIC approach developed by the Substance Abuse and Mental Health Services Administration that's applicable across systems of care, particularly when working with women survivors of IPV.
Staples, Jennifer M.; George, William H.; Stappenbeck, Cynthia A.; Davis, Kelly Cue; Norris, Jeanette; Heiman, Julia
HIV and other STIs are major public health concerns for women, and risky sexual behaviors increase the risk of transmission. Risky sexual behaviors include sexual abdication, that is, willingness to let a partner decide how far to go sexually. Alcohol intoxication is a risk factor for risky sexual behavior, and the Inhibition Conflict Model of Alcohol Myopia may help explain this relationship (Steele et al., 1985). This model suggests that in order for intoxication to influence behavior there must be high conflict, meaning the strength of the instigatory cues and inhibitory cues are both high. Recent research indicates that the degree to which cues are experienced as high in instigation or inhibition is subject to individual difference factors. One individual difference factor associated with alcohol-related sexual risk taking is child sexual abuse (CSA) history. The current study examined the influence of acute alcohol intoxication, CSA, and inhibition conflict on sexual abdication with 131 women (mean age 25) randomized into a 2 (alcohol, control) x 2 (high conflict, low conflict) experimental design. Regression analyses yielded a significant 3-way interaction, F (1,122) = 8.15, R2 = .14, p <.01. When there was high conflict, intoxicated CSA women were more likely to abdicate than sober CSA women, however, sober CSA women were less likely to abdicate than sober NSA women. When there was low conflict, CSA history and alcohol intoxication had no influence on abdication. These results may help explain the association between alcohol and risky sexual decision making among women with CSA. PMID:25310825
Staples, Jennifer M; George, William H; Stappenbeck, Cynthia A; Davis, Kelly Cue; Norris, Jeanette; Heiman, Julia R
HIV and other STIs are major public health concerns for women, and risky sexual behaviors increase the risk of transmission. Risky sexual behaviors include sexual abdication, that is, willingness to let a partner decide how far to go sexually. Alcohol intoxication is a risk factor for risky sexual behavior, and the Inhibition Conflict Model of Alcohol Myopia may help explain this relationship. This model suggests that in order for intoxication to influence behavior there must be high conflict, meaning the strength of the instigatory cues and inhibitory cues are both high. Recent research indicates that the degree to which cues are experienced as high in instigation or inhibition is subject to individual difference factors. One individual difference factor associated with alcohol-related sexual risk taking is child sexual abuse (CSA) history. The current study examined the influence of acute alcohol intoxication, CSA, and inhibition conflict on sexual abdication with 131 women (mean age 25) randomized into a 2 (alcohol, control)×2 (high conflict, low conflict) experimental design. Regression analyses yielded a significant 3-way interaction, F (1,122)=8.15, R(2)=.14, p<.01. When there was high conflict, intoxicated CSA women were more likely to abdicate than sober CSA women, however, sober CSA women were less likely to abdicate than sober NSA women, when there was low conflict, CSA history and alcohol intoxication had no influence on abdication. These results may help explain the association between alcohol and risky sexual decision making among women with CSA. Copyright © 2014 Elsevier Ltd. All rights reserved.
Li, Nan; Ahmed, Saifuddin; Zabin, Laurie S
The objective of this study was to examine the relationship between a history of childhood sexual abuse (CSA) and negative psychological consequences in adulthood, controlling for family environments and Confucian values. The data used in this study were collected from Taipei. The final analysis sample comprised 4,084 participants aged 15-24 years. Three sets of logistic regression models were fitted to verify the association between CSA and negative psychological outcomes. Sociodemographic variables, household instability, and parenting variables, as well as Confucian value variables were controlled in models step by step. The overall prevalence of CSA in our analysis sample was 5.2%. The overall prevalence of depression, anxiety, and suicidal ideation among Taipei respondents was 11.8%, 16.4%, and 16.7%, respectively, but young people who experienced CSA had significantly higher rates of all three than young adults who had not experienced CSA. After controlling for other covariates, the odds ratios of depression, anxiety, and suicidal ideation associated with a history of CSA were 1.78 (95% confidence intervals [CI]: 1.25-2.54), 1.77 (95% CI: 1.28-2.44), and 2.56 (95% CI: 1.56-4.29), respectively. Our findings suggested that CSA was an independent predictor of negative psychological consequences in adulthood. In our analysis, we controlled for household, parenting, and Confucian culture factors, which provides a better understanding of how they work together to affect adult psychological status. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Leeners, Brigitte; Görres, Gisela; Block, Emina; Hengartner, Michael Pascal
Although childhood sexual abuse (CSA) may seriously impair childbirth experiences, few systematic evaluations on associations, mediating influences, risk and protective factors are available. As such information is mandatory to improve obstetric care, the present study aimed to provide such data. The study compared childbirth experiences from 85 women after CSA and at least one pregnancy resulting in a life birth with those from 170 control women matched for nationality, personal age and children's age. Trained specialists from support centers investigated CSA. Obstetrical data were collected from the official personal clinical record of each pregnancy (Mutterpass) and data on CSA as well as childbirth experiences were examined by questionnaires. Childbirth was more often highly frightening (24.7 vs. 5.3%; p<0.01) and a negative experience (40.7 vs. 19.6%, p<0.01) in women with a history of CSA than in controls. Multivariate regression models support the hypothesis that at least part of this association was mediated by covariates (specifically, birth preparation classes, presence of a trusted person, participation in medical decision-making, pain relief, emergency during labor and extreme duration of labor), which represent important resources in improving obstetric care. In 41% of women with CSA, memories of traumatic experiences intruded during childbirth, whereas about 58% experienced dissociation. While dissociation may result in loss of contact with obstetric staff, it was also used to reduce labor pain. Childbirth following a history of CSA is associated with particular challenges. Creating a trusting environment by evaluating and integrating individual needs could ameliorate birth experiences. Copyright © 2016 Elsevier Inc. All rights reserved.
Wilton, Leo; Magnus, Manya; Wang, Lei; Wang, Jing; Dyer, Typhanye Penniman; Koblin, Beryl A.; Hucks-Ortiz, Christopher; Fields, Sheldon D.; Shoptaw, Steve; Stephenson, Rob; O’Cleirigh, Conall; Cummings, Vanessa
Objectives. We assessed the relation of childhood sexual abuse (CSA), intimate partner violence (IPV), and depression to HIV sexual risk behaviors among Black men who have sex with men (MSM). Methods. Participants were 1522 Black MSM recruited from 6 US cities between July 2009 and December 2011. Univariate and multivariable logistic regression models were used. Results. Participants reported sex before age 12 years with someone at least 5 years older (31.1%), unwanted sex when aged 12 to 16 years (30%), IPV (51.8%), and depression (43.8%). Experiencing CSA when aged 12 to 16 years was inversely associated with any receptive condomless anal sex with a male partner (adjusted odds ratio [AOR] = 0.50; 95% confidence interval [CI] = 0.29, 0.86). Pressured or forced sex was positively associated with any receptive anal sex (AOR = 2.24; 95% CI = 1.57, 3.20). Experiencing CSA when younger than 12 years, physical abuse, emotional abuse, having been stalked, and pressured or forced sex were positively associated with having more than 3 male partners in the past 6 months. Among HIV-positive MSM (n = 337), CSA between ages 12 and 16 years was positively associated with having more than 3 male partners in the past 6 months. Conclusions. Rates of CSA, IPV, and depression were high, but associations with HIV sexual risk outcomes were modest. PMID:26469666
... advice. loveisrespect.org : 1-866-331-9474 National Domestic Violence Hotline : 1-800-799-SAFE (7233) National Sexual ... Rape National Latino Alliance for the Elimination of Domestic Violence If you’re concerned about abusive relationships, here’s ...
Munro-Kramer, Michelle L.; Dulin, Alexandra C.; Gaither, Caroline
Objective: Sexual assault is a pervasive crime on our college campuses and many survivors do not seek post-assault resources. This study will explore components of alternative interventions to consider in the development of campus-based interventions for sexual assault survivors. Participants: Three stakeholder groups including survivors (n = 8),…
Joshua, Opeyemi; Olusola, Kolapo O; Busari, Ayobami A; Omuh, Ignatius O; Ogunde, Ayodeji O; Amusan, Lekan M; Ezenduka, Chidiogo J
The data presented herein are results of the research summary of the investigation for pozzolanic activity in coconut shell ash (CSA) towards a sustainable construction. The data article provides information on the properties of Coconut Shell Ash that are indicative of pozzolanic activity as stated in ASTM C618-15 (2015) , BS EN 197-1 (2011)  and Joshua et al. (2018) . The data are the physical property of the sand used in determining the binder strengths and the chemical and physical properties (oxide composition and Strength Activity Indices respectively) of the pulverized, calcined and sieved Coconut Shell Ash.
Bland, R C; Orn, H
The results of 2000 standardized psychiatric diagnostic interviews of randomly selected adult household residents of Edmonton showed that having had any psychiatric diagnosis increased the risk for being involved in spouse and child abuse, particularly for those with alcohol abuse/dependence plus anti-social personality or depression. Altogether 56% of spouse abusers and 69% of child abusers had a lifetime psychiatric diagnosis.
Butler, Ebony; Jacquin, Kristine
This study investigated whether a defendant's history of childhood sexual abuse (CSA) and/or personality disorder (PD) diagnosis affected juror decision making in a child sexual abuse trial. The PDs in the study were borderline PD and antisocial PD. Participants were 385 college students, 121 men and 264 women, who read a summary of a mock criminal trial and then made various juror decisions. Trial summaries were prepared by the principal investigator and were all uniform in content, length and detail. For the trial, both the defendant's gender and victim's gender were specified. The defendant was male, and the alleged victim was female. When the verdict was assessed, the results yielded that when the defendant's CSA history was presented, juror guilt ratings were higher than when there was no history of CSA. Similarly, when the defendant had a PD diagnosis, there were higher guilt ratings than when there was no PD diagnosis. CSA history and PD diagnosis were significant predictors of guilt ratings, suggesting that jurors perceive defendants more negatively if they have either been sexually abused as a child or have borderline or antisocial PD. Copyright © 2014 John Wiley & Sons, Ltd.
Ige, Olusimbo K; Fawole, Olufunmilayo I
This study examined parents' perceptions of child sexual abuse as well as prevention practices in an urban community in southwest Nigeria. Questionnaires were collected from 387 parents and caregivers of children younger than 15 years of age. Results showed that many parents felt CSA was a common problem in the community, and most parents disagreed with common child sexual abuse myths. In addition, almost all parents ( >90%) reported communicating with their child(ren) about stranger danger. However, about 47% felt their children could not be abused, and over a quarter (27.1%) often left their children alone and unsupervised. There were no significant variations in the perceptions of child sexual abuse and communication practices. The implications of findings for child sexual abuse prevention are discussed.
Willie, Tiara C; Overstreet, Nicole M; Peasant, Courtney; Kershaw, Trace; Sikkema, Kathleen J; Hansen, Nathan B
There is a critical need to examine protective and risk factors of anxiety and depressive symptoms among people living with HIV in order to improve quality of life. Structural equation modeling was used to examine the associations between HIV-related shame, sexual abuse-related shame, posttraumatic growth, and anxiety and depressive symptoms among a cohort of 225 heterosexual women and men who have sex with men (MSM) living with HIV who have experienced childhood sexual abuse (CSA). Higher sexual abuse-related shame was related to more anxiety and depressive symptoms for heterosexual women. Higher posttraumatic growth predicted less anxiety symptoms for only heterosexual women. Higher posttraumatic growth predicted less depressive symptoms for heterosexual women and MSM, but the magnitude of this effect was stronger for heterosexual women than MSM. Psychosocial interventions may need to be tailored to meet the specific needs of heterosexual women and MSM living with HIV and CSA.
Willie, Tiara C.; Overstreet, Nicole M.; Peasant, Courtney; Kershaw, Trace; Sikkema, Kathleen J.
There is a critical need to examine protective and risk factors of anxiety and depressive symptoms among people living with HIV in order to improve quality of life. Structural equation modeling was used to examine the associations between HIV-related shame, sexual abuse-related shame, posttraumatic growth, and anxiety and depressive symptoms among a cohort of 225 heterosexual women and men who have sex with men (MSM) living with HIV who have experienced childhood sexual abuse (CSA). Higher sexual abuse-related shame was related to more anxiety and depressive symptoms for heterosexual women. Higher posttraumatic growth predicted less anxiety symptoms for only heterosexual women. Higher posttraumatic growth predicted less depressive symptoms for heterosexual women and MSM, but the magnitude of this effect was stronger for heterosexual women than MSM. Psychosocial interventions may need to be tailored to meet the specific needs of heterosexual women and MSM living with HIV and CSA. PMID:26837633
Olley, B O
In Nigeria, freshmen constitute a risk group of adolescents and young adults capable of engaging in unsafe sexual practices. This study documents the associated factors to sexual risk behaviours practices of University of Ibadan, Nigeria freshmen. Eight hundred and forty one (841), freshmen who attended a routine orientation program were asked to respond to a questionnaire. Results showed that 30.8% were sexually active and 47% did not use condom in their last sexual episode. Associated with sexual risk behaviours include: being a male freshman increasing age; lower tendency for violence; increase sexual compulsivity; alcohol abuse; history of rape and a history of Child Sexual Abuse (CSA). Three variables: alcohol abuse; history of CSA and increasing age remained significant in a multiple regression analysis. The paper presents the first evidence of vulnerability of freshmen to sexual risk practices in a Nigerian University.
Everson, Mark D; Sandoval, Jose Miguel
Evaluators examining the same evidence often arrive at substantially different conclusions in forensic assessments of child sexual abuse (CSA). This study attempts to identify and quantify subjective factors that contribute to such disagreements so that interventions can be devised to improve the reliability of case decisions. Participants included 1106 professionals in the field of child maltreatment representing a range of professional positions or job titles and years of experience. Each completed the Child Forensic Attitude Scale (CFAS), a 28-item survey assessing 3 forensic attitudes believed to influence professional judgments about CSA allegations: emphasis-on-sensitivity (i.e., a focus on minimizing false negatives or errors of undercalling abuse); emphasis-on-specificity (i.e., a focus on minimizing false positives or errors of overcalling abuse); and skepticism toward child and adolescent reports of CSA. A subset of 605 professionals also participated in 1 of 3 diverse decision exercises to assess the influence of the 3 forensic attitudes on ratings of case credibility. Exploratory factor analysis identified 4 factors or attitude subscales that corresponded closely with the original CFAS scales: 2 subscales for emphasis-on-sensitivity and 1 each for emphasis-on-specificity and skepticism. Attitude subscale scores differed significantly by sample source (in-state trainings vs. national conferences), gender, years of experience, and professional position, with Child Protective Service workers unexpectedly more concerned about overcalling abuse and more skeptical of child disclosures than other professionals-a pattern of scores associated with an increased probability of disbelieving CSA allegations. The 3 decision exercises offered validation of the attitude subscales as predictors of professional ratings of case credibility, with adjusted R(2)s for the three exercises ranging from .06 to .24, suggesting highly variable effect sizes. Evaluator disagreements
Peterson, Zoё D; Janssen, Erick; Goodrich, David; Fortenberry, J Dennis; Hensel, Devon J; Heiman, Julia R
Previous research has suggested that sexually aggressive behavior and sexual HIV risk behavior are associated. Childhood sexual abuse (CSA) is a well-established risk factor for both types of problematic sexual behavior. Negative affect (i.e., anxiety, depression, and anger) is a less well-studied risk factor, but it has been theorized to relate to both sexual aggression and HIV risk behavior. Thus, this study sought to (1) confirm the relationship between sexual aggression and HIV risk behavior, (2) establish CSA and negative affect as shared risk factors for sexual aggression and HIV risk behavior, and (3) evaluate whether negative affect mediates the relationship between CSA and sexual aggression and between CSA and HIV sexual risk in a sample of heterosexual men. We recruited 18- to 30-year-old heterosexual men (N = 377) from urban sexually transmitted infection clinics. Men completed measures of sexual HIV risk history (number of partners and condom use), sexual aggression history, CSA history, and trait negative affect (anger, anxiety, and depression). Structural equation modeling was used to examine hypothesized direct and indirect relationships. In the final SEM model, sexual aggression history and sexual HIV risk behavior were correlated. CSA was associated with both types of problematic sexual behavior. Anxiety significantly mediated the relationship between CSA and sexual aggression and between CSA and sexual HIV risk behavior (χ 2  = 2121.79, p < .001; CFI = 0.905; RMSEA [90% CI] = .044 [.041-.047]). Sexual aggression appears to be part of a constellation of sexual risk behaviors; thus, it may be possible to develop prevention programs that target both sexual HIV risk and sexual aggression. CSA is a shared risk factor for sexual aggression and HIV risk behavior through the pathway of anxiety. Thus, anxiety might be one promising target for intervention.
Yu, Zeng-Zhao; Zhang, Bei-Chuan; Li, Xiu-Fang; Wang, Ning; Shi, Tong-Xin; Chu, Quan-Sheng
To study the AIDS related high risk behaviors and psychological appearances among men who have sex with men (MSM) who ever experienced childhood sexual abuse (CSA). Target sampling for a cross-sectional study was developed and valid anonymous questionnaires were adopted to compare the differences of high risk behaviors related to AIDS and psychological appearances between those with or without CSA experiences among 2147 MSM from nine cities. Compared to corresponding ones without CSA experience, CSA group had a significant larger numbers in the following events: total sexual partners, anal sex episodes with same sex, female sexual partners and anal sex in the previous six months, with the figures of median as 20.0, 10.0, 3.0, 3.0 respectively. In the previous year, 30.8% of them had ever participated in 'group sex', 19.2% ever exchanged money for sex, 36.7% bled while having sexual intercourse, 37.3% had sex with male partners away from his own region. All the above said figures were higher than non-CSA group, with significant differences. It also appeared that CSA experience had an impact on significant lower rate of condom use (67.3%) in the last anal sex. Those with CSA experience had more psychological problems which appeared as: 75.6% considered they would suffer from serious discrimination if their sexual orientation ever disclosed, 34.7% had a strong intention of suicide and 24.3% ever having had suicidal attempts. The differences of the two groups showed statistical significance. CSA experience not only increased the number of AIDS related high risk behaviors in adulthood, but also had negative impact on their psychological appearances. It is of urgent need to carry out psychological intervention approaches to target on MSM with CSA experiences while childhood sexual education and rights assurance towards juvenile population should also not be neglected.
Freeman, Sally Ann; Rosenbluth, Barri; Cotton, Laura
Teen dating abuse, also known as teen dating violence, is a significant public health issue. Adolescents with a history of dating abuse may struggle academically and experience increased risk for serious injury or even death. They may engage in risky sexual behavior, substance abuse, and unhealthy dieting and exhibit suicidal behaviors. School nurses may be the first adults that teens confide in when experiencing dating abuse and may lack the knowledge and skills to intervene with teens involved in unhealthy dating relationships. Beginning in 2008, Dell Children s Medical Center in Austin, Texas, partnered with SafePlace (a local nonprofit that serves survivors of sexual and domestic violence) to address dating abuse. This collaboration is part of Start Strong Austin, one of 11 communities nationwide participating in the Start Strong: Building Healthy Teen Relationships Initiative funded by the Robert Wood Johnson Foundation. The Start Strong model employs innovative strategies in education, community engagement, policy change, and social marketing to prevent dating abuse before it starts.
Langevin, Rachel; Hébert, Martine; Allard-Dansereau, Claire; Bernard-Bonnin, Anne-Claude
Child sexual abuse (CSA) is associated with emotion regulation deficits in childhood. Parents play a crucial role in the development of emotion regulation in their children, especially at younger ages. Close to 50% of mothers of sexually abused children report having been sexually victimized themselves as children. They are consequently at risk of experiencing significant distress following the disclosure of sexual abuse of their child. Parents' distress could interfere with their ability to provide support and to foster development of emotion regulation in their children. The aim of the present study was to explore the relationship of parental factors (history of sexual victimization in childhood and the current level of distress) to sexually abused preschoolers' emotion regulation competencies. Emotion regulation was assessed in 153 preschoolers by their parents with the Emotion Regulation Checklist; 75 of these children were abused (14 boys); 78 were not abused (21 boys) and were part of a comparison group. Parents reported their level of distress using the Psychiatric Symptom Index. Results indicated that parental factors contributed to some dimensions of preschoolers' emotion regulation (namely displays of underregulation of emotion) above and beyond children's victimization status and gender (Cohen's ƒ(2) = .15). Identifying parental distress and history of sexual victimization as positively associated with emotional dysregulation in preschool children victims of CSA has important research and clinical implications. Copyright © 2016 International Society for Traumatic Stress Studies.
Mimiaga, Matthew J.; Noonan, Elizabeth; Donnell, Deborah; Safren, Steven A.; Koenen, Karestan C.; Gortmaker, Steven; O’Cleirigh, Conall; Chesney, Margaret A.; Coates, Thomas J.; Koblin, Beryl A.; Mayer, Kenneth H.
Background Previous studies have found high rates of childhood sexual abuse (CSA) among US men who have sex with men (MSM). CSA history has been associated with a variety of negative effects later in life including behaviors that place MSM at greater risk for HIV acquisition and transmission. The present analysis is the first to examine the longitudinal association between CSA and HIV infection, unprotected anal sex, and serodiscordant unprotected anal sex, as well as mediators of these relationships among a large sample of HIV-uninfected MSM. Methods The EXPLORE Study was a behavioral intervention trial conducted in 6 US cities over 48 months with HIV infection as the primary efficacy outcome. Behavioral assessments were done every 6 months via confidential computerized assessments. Longitudinal regression models were constructed, adjusting for randomization arm, geographical location of study site, age at enrollment, education, and race/ethnicity. Results Of the 4295 participants enrolled, 39.7% had a history of CSA. Participants with a history of CSA [adjusted hazards ratio = 1.30, 95% confidence interval (CI): 1.02 to 1.69] were at increased risk for HIV infection over study follow-up. A significant association was seen between history of CSA and unprotected anal sex (adjusted odds ratio = 1.24, 95% CI: 1.12 to 1.36) and serodiscordant unprotected anal sex (adjusted odds ratio = 1.30, 95% CI: 1.18 to 1.43). Among participants reporting CSA, the EXPLORE intervention had no effect in reducing HIV infection rates. Participants reporting CSA were significantly more likely to have symptoms of depression and use nonprescription drugs. Conclusions A predictive relationship between a history of CSA and subsequent HIV infection was observed among this large sample of HIV-uninfected MSM. Findings indicate that HIV-uninfected MSM with CSA histories are at greater risk for HIV infection, report higher rates of HIV sexual risk behavior, and may derive less benefit from
Elder abuse is a prevalent phenomenon resulting in physical, emotional, and social costs to individuals, families, and society. Timely and effective intervention is crucial because victims are often involved in relationships where re-victimization is common. Most elder abuse victims, however, are reluctant to seek help from outside their families. The aim of the present study is to explore factors associated with help-seeking behaviors among mistreated elders in Hong Kong. In-depth interviews were conducted with 40 elder abuse survivors. Although almost all of the participants could provide some examples of elder abuse, most denied that their own experience was abusive. Personal and professional social networks were important determinants of help seeking. Social isolation, cultural barriers, self-blame, and lack of knowledge were major barriers to help seeking. © The Author(s) 2014.
Doritchamou, Justin; Arango, Eliana M.; Cabrera, Ana; Arroyo, Maria Isabel; Kain, Kevin C.; Ndam, Nicaise Tuikue; Maestre, Amanda
In pregnancy, parity-dependent immunity is observed in response to placental infection with Plasmodium falciparum. Antibodies recognize the surface antigen, VAR2CSA, expressed on infected red blood cells and inhibit cytoadherence to the placental tissue. In most settings of malaria endemicity, antibodies against VAR2CSA are predominantly observed in multigravid women and infrequently in men, children, and nulligravid women. However, in Colombia, we detected antibodies against multiple constructs of VAR2CSA among men and children with acute P. falciparum and Plasmodium vivax infection. The majority of men and children (>60%) had high levels of IgGs against three recombinant domains of VAR2CSA: DBL5ε, DBL3X, and ID1-ID2. Surprisingly, these antibodies were observed only in pregnant women, men, and children exposed either to P. falciparum or to P. vivax. Moreover, the anti-VAR2CSA antibodies are of high avidity and efficiently inhibit adherence of infected red blood cells to chondroitin sulfate A in vitro, suggesting that they are specific and functional. These unexpected results suggest that there may be genotypic or phenotypic differences in the parasites of this region or in the host response to either P. falciparum or P. vivax infection outside pregnancy. These findings may hold significant clinical relevance to the pathophysiology and outcome of malaria infections in this region. PMID:24686068
Doritchamou, Justin; Sabbagh, Audrey; Jespersen, Jakob S.; Renard, Emmanuelle; Salanti, Ali; Nielsen, Morten A.; Deloron, Philippe; Tuikue Ndam, Nicaise
The VAR2CSA protein of Plasmodium falciparum is transported to and expressed on the infected erythrocyte surface where it plays a key role in placental malaria (PM). It is the current leading candidate for a vaccine to prevent PM. However, the antigenic polymorphism integral to VAR2CSA poses a challenge for vaccine development. Based on detailed analysis of polymorphisms in the sequence of its ligand-binding N-terminal region, currently the main focus for vaccine development, we assessed var2csa from parasite isolates infecting pregnant women. The results reveal for the first time the presence of a major dimorphic region in the functionally critical N-terminal ID1 domain. Parasite isolates expressing VAR2CSA with particular motifs present within this domain are associated with gravidity- and parasite density-related effects. These observations are of particular interest in guiding efforts with respect to optimization of the VAR2CSA-based vaccines currently under development. PMID:26393516
Segal, Shirley Ann
As a result of the Holocaust, many survivors developed long term psychosocial impairment known as the Post-traumatic Stress Disorder (PTSD), which is characterized by depression, anxiety, hypocondriasis, inability to concentrate or to express anger, nightmares, insomnia, obsessive thoughts, guilt, mistrust, and alienation. The literature in this…
Sikkema, Kathleen J.; Ranby, Krista W.; Meade, Christina S.; Hansen, Nathan B.; Wilson, Patrick A.; Kochman, Arlene
Objective: To examine whether (a) Living in the Face of Trauma (LIFT), a group intervention to address coping with HIV and childhood sexual abuse (CSA), significantly reduced traumatic stress over a 1-year follow-up period more than an attention-matched support group comparison intervention; and (b) reductions in avoidant coping over time mediated…
... drug abuse. And it's illegal, just like taking street drugs. Why Do People Abuse Prescription Drugs? Some people abuse prescription drugs ... common risk of prescription drug abuse is addiction . People who abuse ... as if they were taking street drugs. That's one reason most doctors won't ...
Battaglia, Tracy A; Finley, Erin; Liebschutz, Jane M
To identify characteristics that facilitate trust in the patient-provider relationship among survivors of intimate partner violence (IPV). Semistructured, open-ended interviews were conducted to elicit participants' beliefs and attitudes about trust in interactions with health care providers. Using grounded theory methods, the transcripts were analyzed for common themes. A community advisory group, composed of advocates, counselors and IPV survivors, helped interpret themes and interview excerpts. Together, key components of trust were identified. Eastern Massachusetts. Twenty-seven female survivors of IPV recruited from community-based IPV organizations. Participants' ages ranged from 18 to 56 years, 36% were African American, 32% Hispanic, and 18% white. We identified 5 dimensions of provider behavior that were uniquely important to the development of trust for these IPV survivors: 1) communication about abuse: provider was willing to openly discuss abuse; 2) professional competency: provider asked about abuse when appropriate and was familiar with medical and social histories; 3) practice style: provider was consistently accessible, respected confidentiality, and shared decision making; 4) caring: provider demonstrated personal concern beyond biomedical role through nonjudgmental and compassionate gestures, empowering statements, and persistent, committed behaviors; 5) emotional equality: provider shared personal information and feelings and was perceived by the participant as a friend. These IPV survivors identified dimensions of provider behavior that facilitate trust in their clinical relationship. Strengthening these provider behaviors may increase trust with patients and thus improve disclosure of and referral for IPV.
This article applies dream work to the case of an addicted survivor of sexual abuse trauma using models of C. G. Jung (1974) and L. S. Leonard (1989). It then relates the dreams of the fictional client to St. Teresa of Avila's (1577/1989) classic model for spiritual growth, The Interior Castle. The goal of working with dreams in the context of…
Salazar, Carmen F.; Casto, Challon
The authors propose the Moving From Victim to Survivor of Cultural Violence model, using the stages of D. W. Sue and D. Sue's (1999) Racial/Cultural Identity Development model. This conceptual model describes the process of first overcoming internalized sexism, domestic abuse, sexual harassment, rape, and other forms of oppression and then healing…
Beeble, Marisa L; Sullivan, Cris M; Bybee, Deborah
Intimate partner violence (IPV) is a pervasive social problem impacting the psychological well-being of millions of US women annually. The extant literature draws our attention to the devastating mental health effects of IPV, but largely overlooks how ecological factors may further explain survivors' well-being. This study examined how neighborhood disadvantage may contribute to survivors' compromised well-being, in addition to the abuse women experienced. Neighborhood disorder and fear of victimization significantly impacted survivors' well-being, over and above abuse. Although between-women effects of neighborhood disorder and fear were unrelated to change in women's depression or quality of life (QOL), significant within-woman effects were detected. Change in neighborhood disorder was negatively associated with change in QOL, and this relationship was fully mediated by fear. While no direct relationship between change in neighborhood disorder and depression was detected, an indirect effect through survivors' fear was revealed. Implications for future research and practice are discussed.
López-Mongay, Daniel; Ahuir, Maribel; Crosas, Josep Mª; Navarro, J Blas; Monreal, José Antonio; Obiols, Jordi E; Palao, Diego
The objective of this study was to explore social functioning in schizophrenic patients who have suffered child sexual abuse (CSA) in comparison with those who have not suffered from it in a Spanish sample of 50 patients with schizophrenia or schizoaffective disorder. The Quality of Life (QOL) Scale, the Childhood Trauma Questionnaire (CTQ-SF), and the NEO Five Factor Inventory (NEO-FFI) were administered in this study. We found a CSA prevalence of 22% in our sample. Results showed that QOL global scores reduced by 9.34% at a statistically significant level ( p = .037) in sexually abused patients in comparison with those who did not report experiencing sexual abuse. Regression analysis in the QOL scales showed no differences in intrapsychic foundation scores or in the social relations scale. Scores in the instrumental role scale were reduced by 4.42 points in patients with CSA ( p = .009). Neither neuroticism nor extraversion results differ between the trauma group and those who did not suffer trauma. Clinical implications of these results are discussed.
Brabant, Marie-Eve; Hebert, Martine; Chagnon, Francois
This study explored the clinical profiles of 77 female teenager survivors of sexual abuse and examined the association of abuse-related and personal variables with suicidal ideations. Analyses revealed that 64% of participants experienced suicidal ideations. Findings from classification and regression tree analysis indicated that depression,…
Sexual abuse is one form of child abuse. It includes a wide range of actions between a child ... to children or pressuring them for sex is sexual abuse. Using a child for pornography is also sexual ...
... No child is prepared to cope with repeated sexual stimulation. Even a two or three year old, who ... abuse. Some signs can only be detected on physical exam by a physician. Sexual abuse can also include noncontact abuse, such as ...
Three conceptual approaches to estimating local child abuse rates using the National Incidence Study of Child Abuse and Neglect data set are evaluated. All three approaches yield estimates of actual abuse cases that exceed the number of reported cases. (SLD)
Sugiura, Nobuo; Clausen, Thomas Mandel; Shioiri, Tatsumasa; Gustavsson, Tobias; Watanabe, Hideto; Salanti, Ali
Placental malaria, a serious infection caused by the parasite Plasmodium falciparum, is characterized by the selective accumulation of infected erythrocytes (IEs) in the placentas of the pregnant women. Placental adherence is mediated by the malarial VAR2CSA protein, which interacts with chondroitin sulfate (CS) proteoglycans present in the placental tissue. CS is a linear acidic polysaccharide composed of repeating disaccharide units of D-glucuronic acid and N-acetyl-D-galactosamine that are modified by sulfate groups at different positions. Previous reports have shown that placental-adhering IEs were associated with an unusually low sulfated form of chondroitin sulfate A (CSA) and that a partially sulfated dodecasaccharide is the minimal motif for the interaction. However, the fine molecular structure of this CS chain remains unclear. In this study, we have characterized the CS chain that interacts with a recombinant minimal CS-binding region of VAR2CSA (rVAR2) using a CS library of various defined lengths and sulfate compositions. The CS library was chemo-enzymatically synthesized with bacterial chondroitin polymerase and recombinant CS sulfotransferases. We found that C-4 sulfation of the N-acetyl-D-galactosamine residue is critical for supporting rVAR2 binding, whereas no other sulfate modifications showed effects. Interaction of rVAR2 with CS is highly correlated with the degree of C-4 sulfation and CS chain length. We confirmed that the minimum structure binding to rVAR2 is a tri-sulfated CSA dodecasaccharide, and found that a highly sulfated CSA eicosasaccharide is a more potent inhibitor of rVAR2 binding than the dodecasaccharides. These results suggest that CSA derivatives may potentially serve as targets in therapeutic strategies against placental malaria.
Lewis, Carla S; Griffing, Sascha; Chu, Melissa; Jospitre, Tania; Sage, Robert E; Madry, Lorraine; Primm, Beny J
This study examines the differential effects of adult and childhood physical and psychological abuse, abuse-specific coping, and psychological adjustment in battered women seeking emergency shelter. Multivariate regression analyses confirmed the devastating impact of psychological abuse (childhood and concurrent) on battered women's adjustment. The results corroborated prior research suggesting a cumulative vulnerability to psychological victimization in a substantial proportion of residents. Unexpectedly, frequency of physical violence was unrelated to women's distress. The study argues that modes of coping traditionally considered adaptive (e.g., engaged, proactive) may be unsafe for battered women and children. The multifaceted nature of survivors' coping choices is discussed.
Austin, L S; Godleski, L S
Common psychiatric responses to disasters include depression, PTSD, generalized anxiety disorder, substance-abuse disorder, and somatization disorder. These symptom complexes may arise because of the various types of trauma experienced, including terror or horror, bereavement, and disruption of lifestyle. Because different types of disaster produce different patterns of trauma, clinical response should address the special characteristics of those affected. Traumatized individuals are typically resistant to seeking treatment, so treatment must be taken to the survivors, at locations within their communities. Most helpful is to train and support mental health workers from the affected communities. Interventions in groups have been found to be effective to promote catharsis, support, and a sense of identification with the group. Special groups to be considered include children, injured victims, people with pre-existing psychiatric histories, and relief workers.
Moscoso, Miriam; Esteban-Torres, María; Menéndez, Margarita; García, Ernesto
Ceragenin CSA-13, a cationic steroid, is here reported to show a concentration-dependent bactericidal/bacteriolytic activity against pathogenic streptococci, including multidrug-resistant Streptococcus pneumoniae. The autolysis promoted by CSA-13 in pneumococcal cultures appears to be due to the triggering of the major S. pneumoniae autolysin LytA, an N-acetylmuramoyl-L-alanine amidase. CSA-13 also disintegrated pneumococcal biofilms in a very efficient manner, although at concentrations slightly higher than those required for bactericidal activity on planktonic bacteria. CSA-13 has little hemolytic activity which should allow testing its antibacterial efficacy in animal models.
Martens, C. S.; Mendlovitz, H. P.; White, B. L.; Hoer, D.; Sleeper, K.; Chanton, J.; Wilson, R.; Lapham, L.
The Chimney Sampler Array (CSA) was designed to measure in situ chemical and physical parameters within the benthic boundary layer plus methane and oxygen sediment-water chemical fluxes at upper slope sites in the northern Gulf of Mexico. The CSA can monitor temporal changes plus help to evaluate oceanographic and sub-seafloor processes that can influence the formation and stability of gas hydrates in underlying sediments. The CSA consists of vertical cylinders (chimneys) equipped with internal chemical sensors and with laboratory flume-calibrated washout rates. Chimney washout rates multiplied by chimney mean versus ambient concentrations allow calculation of net O2 and methane sediment-water fluxes. The CSA is emplaced on the seafloor by a ROVARD lander using a ROV for chimney deployments. The CSA presently includes two 30 cm diameter by 90 cm length cylinders that seal against the sediment with lead pellet beanbags; within each chimney cylinder are optode, conductivity and methane sensors. The CSA's data logger platform also includes pressure and turbidity sensors external to the chimneys along with an acoustic Doppler current meter to measure temporal variation in ambient current velocity and direction. The CSA was deployed aboard a ROVARD lander on 9/13/2010 in the northern Gulf of Mexico (Lat. 28 51.28440, Long. 088 29.39421) on biogeochemically active sediments within Block MC-118. A ROV was utilized for chimney deployment away from the ROVARD lander. The CSA monitored temporal changes in water column physical parameters, obtained near-bottom chemical data to compare with pore fluid and sediment core measurements and measured temporal variability in oxygen and methane sediment-water fluxes at two closely spaced stations at MC-118. A continuous, three-week data set was obtained that revealed daily cycles in chemical parameters and episodic flux events. Lower than ambient chimney dissolved O2 concentrations controlled by temporal variability in washout rates
Fergusson, David M; McLeod, Geraldine F H; Horwood, L John
Childhood sexual abuse (CSA) has been associated with many adverse medical, psychological, behavioral and socioeconomic outcomes in adulthood. This study aims to examine the linkages between CSA and a wide range of developmental outcomes over a protracted time period to age 30. Data from over 900 members of the New Zealand birth cohort the Christchurch Health and Development Study were examined. CSA prior to age 16 was assessed at ages 18 and 21 years, in addition to: mental health, psychological wellbeing, sexual risk-taking behaviors, physical health and socioeconomic outcomes to age 30. After statistical adjustment for confounding by 10 covariates spanning socio-demographic, family functioning and child factors, extent of exposure to CSA was associated with increased rates of (B, SE, p): major depression (0.426, 0.094, <.001); anxiety disorder (0.364, 0.089, <.001); suicidal ideation (0.395, 0.089, <.001); suicide attempt (1.863, 0.403, <.001); alcohol dependence (0.374, 0.118, <.002); and illicit drug dependence (0.425, 0.113, <.001). In addition, at age 30 CSA was associated with higher rates of PTSD symptoms (0.120, 0.051, .017); decreased self-esteem (-0.371, 0.181, .041); and decreased life satisfaction (-0.510, 0.189, .007). Childhood sexual abuse was also associated with decreased age of onset of sexual activity (-0.381, 0.091, <.001), increased number of sexual partners (0.175, 0.035, <.001); increased medical contacts for physical health problems (0.105, 0.023, <.001); and welfare dependence (0.310, 0.099, .002). Effect sizes (Cohen's d) for the significant outcomes from all domains ranged from .14 to .53, while the attributable risks for the mental health outcomes ranged from 5.7% to 16.6%. CSA is a traumatic childhood life event in which the negative consequences increase with increasing severity of abuse. CSA adversely influences a number of adult developmental outcomes that span: mental disorders, psychological wellbeing, sexual risk
Homma, Yuko; Wang, Naren; Saewyc, Elizabeth; Kishor, Nand
Childhood and adolescent sexual abuse has been shown to lead to increased odds of sexual behaviors that lead to sexually transmitted infections and early pregnancy involvement. Research, meta-analyses, and interventions, however, have focused primarily on girls and young women who have experienced abuse, yet some adolescent boys are also sexually abused. We performed a meta-analysis of the existing studies to assess the magnitudes of the link between a history of sexual abuse and each of the three risky sexual behaviors among adolescent boys in North America. The three outcomes were (a) unprotected sexual intercourse, (b) multiple sexual partners, and (c) pregnancy involvement. Weighted mean effect sizes were computed from ten independent samples, from nine studies published between 1990 and 2011. Sexually abused boys were significantly more likely than nonabused boys to report all three risky sexual behaviors. Weighted mean odds ratios were 1.91 for unprotected intercourse, 2.91 for multiple sexual partners, and 4.81 for pregnancy involvement. Our results indicate that childhood and adolescent sexual abuse can substantially influence sexual behavior in adolescence among male survivors. To improve sexual health for all adolescents, even young men, we should strengthen sexual abuse prevention initiatives, raise awareness about male sexual abuse survivors' existence and sexual health issues, improve sexual health promotion for abused young men, and screen all people, regardless of gender, for a history of sexual abuse. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.