Childhood risk factors and adolescent drug and alcohol abuse

Childhood risk factors for adolescent drug and alcohol abuse are reviewed. Childhood personality manifesting the difficult child syndrome and psychopathological features of hyperactivity and antisocial traits are predictive of later substance abuse, especially when these traits persist into adolescence. Key interpersonal risk factors include family mismanagement, parental substance use, low academic performance and commitment, and association with substance-using peers. A schema outlines postulated predictive paths of substance use that are comprised of various risk factors. The source of origin, time of emergence, and quantity of risk factors are proposed to account for differing levels of substance involvement.     

Prevalence and risk factors of cardiovascular diseases and psychological distress among female scientists and technicians

Journal of Zhejiang University-SCIENCE B - This study aimed to explore the prevalence and risk factors of cardiovascular disease (CVD) and psychological distress among female scientists and...     

Childhood physical and sexual abuse as risk factors for heavy drinking among African-American women: a prospective study

OBJECTIVE: This study examines the associations among characteristics of child sexual abuse. childhood physical abuse, lack of parental care, and heavy drinking in a relatively young, urban population of African-American women all of whom have documented histories of child sexual abuse. METHODOLOGY: The sample consists of 113 African American child victims who were brought to a city hospital emergency room for treatment and collection of forensic evidence in the 1970s and re-interviewed as adults in the 1990s. RESULTS: The results of this research suggest that multiple incidents of child sexual abuse, more than the characteristics of such abuse is an important predictor of adult heavy alcohol use and binge drinking. These results remain even after controlling for the effects of parental drinking behavior. CONCLUSION: Although the victim of multiple child sexual assaults is more likely to suffer force and penetration, these analyses suggest that it is the multiple victimization and not the force or penetration that drives the relationship between child sexual assault and drinking behaviors.     

Childhood emotional invalidation and adult psychological distress: the mediating role of emotional inhibition

OBJECTIVE: To evaluate a model in which chronic emotional inhibition mediates the relationship between a history of childhood emotional invalidation or abuse and adult psychological distress. METHOD: One hundred and twenty-seven participants completed a series of self-report questionnaires, and a subset of this group (n=88) completed an additional measure of current avoidant coping in response to a laboratory stressor. Structural equation modeling was used to evaluate and compare a full and partial mediational model. RESULTS: Findings strongly supported a model in which a history of childhood emotional invalidation (i.e., psychological abuse and parental punishment, minimization, and distress in response to negative emotion) was associated with chronic emotional inhibition in adulthood (i.e., ambivalence over emotional expression, thought suppression, and avoidant stress responses). In turn, emotional inhibition significantly predicted psychological distress, including depression and anxiety symptoms. CONCLUSION: This study found support for a model in which the relation between recollected negative emotion socialization in childhood and adult psychological distress was fully mediated by a style of inhibiting emotional experience and expression. Although it is likely that childhood emotional inhibition is functional (e.g., reduces parental distress and rejection), results suggest that chronic emotional inhibition may have long-term negative consequences for the inhibitor.     

Childhood emotional abuse and disordered eating among undergraduate females: mediating influence of alexithymia and distress

OBJECTIVE: Drawing from stress-vulnerability and trauma theory (e.g., Rorty & Yager, 1996), this paper presents a model of associations among child emotional abuse (CEA), alexithymia, general distress (GD), and disordered eating (DE). This study extended previous research on psychological outcomes of child physical and sexual abuse to explore those of CEA using measures of specific emotionally abusive acts. METHOD: Five hundred and eighty-eight female university students completed self-report surveys consisting of measures of CEA, alexithymia, depression, anxiety, and DE. Structural equation modeling was used to test this conceptual model. RESULTS: Comparison between measurement models suggested that bulimic behavior is a separate construct from restrictive eating behaviors and body dissatisfaction. In the structural model with the best fit, the association between CEA and DE was mediated by alexithymia and GD (i.e., a component of depression and anxiety). Specifically, CEA was associated with alexithymia, which was further related to GD. Then, restrictive eating behaviors and attitudes mediated the relation between GD and bulimic behaviors. By analyzing a second, nested model, this latter pathway was shown to be important. CONCLUSION: While the best-fitting model is only one of many possibilities, these results point to a weak-but significant-complex relation between CEA and DE. They are associated through a series of mediating relations in a multivariate model including alexithymia and GD. The current study supports research suggesting that child emotional abuse can have a negative impact on its survivors. Treatment of those survivors manifesting disordered eating should be holistic, as opposed to targeted towards specific symptoms.     

Childhood emotional maltreatment and later psychological distress among college students: The mediating role of maladaptive schemas

ObjectiveTheoretically, exposure to experiences of emotional abuse (EA) and emotional neglect (EN) in childhood may threaten the security of attachment relationships and result in maladaptive models of self and self-in-relation to others. The purpose of this study was to explore the extent to which EA and EN treatment by parents contributed uniquely to young adult maladaptive long-term outcome with respect to symptoms of anxiety, depression, and dissociation. The extent to which the relationships between EA and EN and later symptoms were mediated by specific internalized maladaptive interpersonal schemas was also explored.MethodsQuestionnaires completed by 301 college men and women (52% female) assessed perceptions of experiences of childhood abuse and neglect, exposure to parental alcoholism, current symptoms of psychological distress, and endorsement of maladaptive interpersonal schemas.ResultsHierarchical regression analyses revealed that perceptions of childhood EA and EN each continued to exert an influence on later symptoms after controlling for gender, income, parental alcoholism, and other child abuse experiences. Both EA and EN were associated with later symptoms of anxiety and depression and were mediated by schemas of vulnerability to harm, shame, and self-sacrifice. Only EN was related to later symptoms of dissociation; this relationship was mediated by the schemas of shame and vulnerability to harm.ConclusionThe findings are discussed from an attachment perspective, focusing on how early interactions with parents contribute to the development of internal working models of self and self-in-relation to others that influence later cognitive schemas and psychological adjustment.Practice implicationsAlthough emotional abuse and emotional neglect are the least studied of all forms of child maltreatment, they may be the most prevalent. The current findings suggest that how college students have evaluated and internalized these experiences may be even more important than the events themselves in determining the extent to which these experiences exert a long-term impact. For this reason, early intervention might be particularly important in helping to modify internal working models of the self as worthless, others as abusive, or the world as threatening and dangerous as a result of past abuse experiences. This study underscores the need for counselors to actively elicit and explore experiences of emotional abuse and neglect in clients, in addition to inquiring about other abuse experiences and types of family dysfunction.The results of this study also support existing data suggesting that internalized representational models of self and others are a key mechanism underlying the relationship between emotional maltreatment and later psychopathology. Young's schema questionnaire proved to be quite sensitive in detecting specific maladaptive schemas that mediated later difficulties with depression, anxiety, and dissociation. Targeting these negative schemas in therapy may help to ameliorate such symptoms. The therapeutic relationship provides a particularly effective context for developing more positive models of self and others, as well as providing a context to explore core relationship themes across different relationship contexts (e.g., intimate partner, parent, friend, and work relationships). In particular, if the assessment of the client reveals that dissociative symptoms are present, counselors can acknowledge the adaptive function that this strategy once served, while also addressing potential limitations to over-reliance on this coping strategy.     

Childhood abuse and community violence: Risk factors for youth violence

ObjectiveTo investigate the joint effect of child abuse and neglect (CAN) and community violence (CV) on adolescents with peers that commit youth violence (YV).MethodsThis is a school-based cross-sectional study of 699 students enrolled in four public and nine private schools in the municipality of Rio de Janeiro, Brazil. Participants were selected through a complex cluster sampling procedure. CAN was identified using the Childhood Trauma Questionnaire (CTQ). Exposure to CV was assessed by asking students if they have witnessed cases of lethal violence in the community. YV was measured indirectly through questions about having friends who have committed acts of crime. Multivariate logistic models were used to study the effects of emotional, physical, and sexual abuse and emotional and physical neglect in childhood on YV, controlled for confounders, according to different levels of CV.ResultsEmotional abuse OR = 3.32 (CI 95%: 1.79–6.17), sexual abuse OR = 2.33 (CI 95%: 1.20–4.54), and physical neglect OR = 1.81 (CI 95%: 1.02–3.20) increased the odds of YV in adolescents, whether cooccurring with CV or not. Physical abuse OR = 3.95 (CI 95%: 2.29 - 6.80) and emotional neglect OR = 2.93 (CI 95%: 1.83–4.72) are only risk factors for YV involvement when associated with CV.ConclusionsThese findings highlight the relevance of CAN and CV as risk factors for YV and the potential increase in adolescents’ vulnerability when exposed to both. Policies aiming at preventing and dealing with CAN are essential strategies to reduce YV, especially in areas with high levels of CV.     

Childhood abuse,adult interpersonal abuse,and depression in individuals with extreme obesity

This study sought to examine (a) a mediational model of childhood abuse, adult interpersonal abuse, and depressive symptoms and (b) the impact of weight-related teasing on rates and correlates of childhood abuse. Charts of 187 extremely obese individuals seeking psychological clearance for bariatric (weight-loss) surgery were retrospectively examined. Among the participants, 61% reported a history of childhood abuse, 30.5% reported adult interpersonal abuse, and 15% reported clinically significant depressive symptoms. Initially, the relationship between childhood abuse and current depressive symptoms was significant (p < .001). However, the introduction of adult interpersonal abuse as a mediator in the model reduced the magnitude of its significance (Sobel's test p = .01). The associations between childhood abuse and adult interpersonal abuse and between adult interpersonal abuse and depressive symptoms were significant (p < .001 and p = .002, respectively), and the model showed a good fit across multiple indices. Finally, weight-related teasing was a significant moderator in the relationship between childhood and adult interpersonal abuse. Bariatric surgery patients report elevated rates of childhood abuse that are comparable to rates in psychiatric populations (e.g., eating disorders, depression), and higher than those in community samples and other medical populations. The relationship between child abuse and depressive symptomatology may be partially explained by the presence of adult interpersonal abuse; additionally, the relationship between childhood and adult interpersonal abuse was stronger for those who did not endure weight-related teasing than for those who did.     

Childhood sexual abuse: Long-term effects on psychological and sexual functioning in a nonclinical and nonstudent sample of adult women

The purpose of this study was to explore how the experience of childhood sexual abuse is related to long-term psychological and sexual functioning in a nonclinical and nonstudent community sample of women. Questionnaires were distributed to 1,500 nurses and returned anonymously. Fifty-four women who had been sexually abused as children (age 15 or younger) responded. These subjects were then matched with 54 nonabused control subjects. Although there was no difference on a measure of self-esteem, the abused group reported more symptoms of distress on the Global Severity Index and on seven out of nine subscales of the Derogatis Brief Symptom Inventory. They also reported more disturbance on a scale which examined psychological symptoms that have been commonly reported in the literature to be particularly associated with sexual abuse. These differences between the abused and nonabused groups were evident even after controlling for differences in subjects' perceptions of parental emotional support. Unlike the results for psychological adjustment, however, the abused subjects did not differ from the control subjects on self-reported levels of sexual satisfaction or sexual dysfunction.     

Childhood sexual abuse among university students in Tanzania

OBJECTIVES: There are no prevalence data for childhood sexual abuse among Tanzanian university students. This investigation addressed this paucity. The nature of sexual abuse was also investigated. METHOD: Participants (N=487) from a university in Tanzania completed a questionnaire which assessed abusive childhood sexual experiences, gathering information about age of victim, duration of abuse, perpetrators, amount of force or persuasion involved, and potential causes of child sexual abuse. A number of individuals were also interviewed about their experiences. RESULTS: The overall prevalence rate for child sexual abuse was 27.7%, with rates being higher for females than for males. The average age of the victim when abuse occurred was 13.8 years. Perpetrators were generally unidentified by respondents; nonetheless, a surprisingly high proportion of female perpetrators was noted. There was a considerable amount of force or persuasion involved in the abusive behavior: betrayal of trust, bribes and physical force were cited frequently. Poverty and superstition were the primary explanations given for child sexual abuse. CONCLUSION: The study provides evidence for the existence of child sexual abuse in Tanzania. Poverty feeds the "sugar daddy/mammy" phenomenon and combined with various forms of superstition is an important factor in child sexual abuse in Tanzania.     

Childhood emotional abuse characteristics moderate associations with adult psychopathology and caregiving

As the consequences of childhood maltreatment for adult adjustment become increasingly established in the literature, investigations of individual differences in these effects must evolve to examine more nuanced components of the maltreatment experience. This is particularly true for studies of childhood emotional abuse (CEA), which represents an umbrella label for numerous qualitatively different experiences. The present study examined the distinct contributions and potential interactive effects of CEA frequency and intensity on adult psychopathology, caregiving behaviors, and caregivers’ representations of the caregiver-child relationship in a diverse sample of 62 female caregivers of 4-year-old children, all of whom had experienced CEA. Frequency and intensity emerged as orthogonal characteristics of CEA with differential effects on adult adaptation. Higher CEA frequency predicted increased adult psychopathology, whereas higher CEA intensity predicted increased boundary dissolution in caregivers’ representations. Further, an interaction between frequency and intensity predicted negativity in caregivers’ representations, such that higher frequency of high intensity, but not low intensity, CEA predicted decreased negativity. Neither frequency nor intensity of CEA predicted observed caregiving behaviors. These results provide evidence that characteristics of CEA signal important differences in its experience, with differential implications for later adjustment. The specific differences in caregiving representations associated with high vs. low intensity CEA suggest that diverging mechanisms by which these experiences eventuate in adult outcomes should also be investigated. Above all, this study suggests that the measurement of CEA, and childhood maltreatment broadly, will benefit from enhanced attention to specific characteristics of individuals' experiences.     

Childhood abuse and neglect and adult intimate relationships: a prospective study

OBJECTIVE: The present study extends prior research on childhood maltreatment and social functioning by examining the impact of early childhood physical abuse, sexual abuse, and neglect on rates of involvement in adult intimate relationships and relationship functioning. METHOD: Substantiated cases of child abuse and neglect from 1967 to 1971 were matched on gender, age, race, and approximate family class with non-abused and non-neglected children and followed prospectively into adulthood. Between 1989 and 1995, 1,196 participants (676 abused and neglected and 520 controls) were administered a 2-hour in-person interview, including a psychiatric assessment and a variety of standardized rating scales. RESULTS: Male and female abuse and neglect victims reported higher rates of cohabitation, walking out, and divorce than controls. Abused and neglected females were also less likely than female controls to have positive perceptions of current romantic partners and to be sexually faithful. CONCLUSIONS: Although previous research on childhood maltreatment and adult intimate relationships has emphasized outcomes for female victims of childhood sexual abuse, present findings suggest that other forms of early maltreatment (physical abuse and neglect) also have a negative effect on both males' and females' ability to establish and maintain healthy intimate relationships in adulthood.     

Childhood and adult sexual abuse, rumination on sadness, and dysphoria

OBJECTIVE: The study addressed the hypothesis that adults reporting sexual abuse are more likely to exhibit a general tendency to ruminate on sadness. The relations between reported abuse, rumination on sadness, and dysphoria were also examined. METHOD: Undergraduate students (101 women and 100 men) reported on childhood and adult sexual abuse and instances of intimidation, as well as completing the Rumination on Sadness Scale [Journal of Personality Assessment 75 (2000) 404] and the Beck Depression Inventory [Depression: Clinical, Experimental, and Theoretical Aspects, Harper & Row, New York]. RESULTS: Participants who reported more abuse were more likely to report rumination on sadness. Both reports of abuse and of rumination were linked to dysphoria. Overall, causal modeling indicated that two models were equally effective in accounting for the data: (a) victimization leads to dysphoria, with this relation being partly mediated by rumination and (b) victimization leads to dysphoria, which in turn leads to rumination. Both models are consistent with prior research. For men considered separately, both models were equally effective. For women, model a best accounted for the data. CONCLUSION: One of the pathways by which victimization may lead to depression in adulthood is by encouraging the development of a tendency to ruminate on sadness. Alternatively, victimization may lead to depression by other means, and the experienced depression or dysphoria may foster rumination.     

Risk factors and protective factors in relation to subjective health among adult female victims of child sexual abuse

OBJECTIVE: To investigate the relationships between risk and protective factors and health outcome in a sample of adult females who had been victims of child sexual abuse. METHOD: Both person- and variable-oriented analyses were applied to questionnaire data from a non-clinical group of women (n = 152) reporting sexual abuse during childhood. RESULTS: Six groups with different patterns of risk and protective factors were found by cluster analysis. Two groups (Good Coping and Support Compensation) had significantly better health than expected in spite of severe abuse. Self-esteem and social support were strong predictors of health in the regression models. CONCLUSION: The relationships between risk and protective factors and health may be different in different groups of victims of child sexual abuse. Self-esteem was closely related to health outcome displaying the importance of this concept in clinical practice. Availability of resources seems to be more important for health outcomes than the amount of risk factors.     

Maternal perinatal risk factors and child abuse

A retrospective matched pair study was designed to compare maternal perinatal factors such as abnormal pregnancy history and labor and delivery experience in families who subsequently were reported as physically abusive to one or more of their children as compared to non-abusive families. The study population consisted of the mothers of 532 children reported to the Baltimore (Maryland) Department of Social Services as physically abused during the years 1975-77. The comparison group was handmatched to the study group from State of Maryland birth certificates on the basis of the abused child's birth year and sex, maternal race, education and hospital of delivery. The study population was 67% black with a mean maternal education of 10.5 completed years. The abused children were 59% male with 48% less than 2 years of age. Results indicated that selected medical definitions of abnormal pregnancy, labor and delivery did not identify families at differential risk of maltreatment. However, mothers in maltreating families were younger, had shorter birth intervals, less prenatal care and were significantly more likely to have had a stillbirth or reported abortion or a prior child death. Study limitations are addressed as are suggestions for future research.     

Trauma and psychological distress among ethnically diverse community college students

An association has been found between traumatic experiences and psychological distress; however, the impact of ethnicity on psychological distress is less clear. The present study examined the relationship between traumatic experiences and measures of psychological distress among a multiethnic sample of community college students. A total of 389 male and 848 female students completed a questionnaire that included the Distressing Events Questionnaire (DEQ), the Traumatic Life Events Questionnaire (TLEQ), the Center for Epidemiologic Studies-Depression Scale (CES-D), the Bulimia (BUL), and the Drive for Thinness (DT) subscales of the Eating Disorders Inventory. As predicted, Blacks and Latinos reported higher levels of interpersonal trauma than White students. There was a positive association between trauma exposure and symptoms of depression, eating disorders, and posttraumatic stress disorder (PTSD), and no ethnic differences were observed in depression and PTSD scores among students exposed to interpersonal trauma. The high levels of trauma among Blacks and Latinos should be of concern to academic institutions because trauma is linked to poor academic performance.     

Stress and psychological distress among trainee secondary teachers in England

The relationships between stress and psychological distress were investigated among a cohort of trainee secondary school teachers in England. Specifically, the study examined the structure of a Teacher Stress Scale and its relationship to mental health as measured by the 12‐item General Health Questionnaire. Three factors were identified: behaviour management, workload, and lack of support. Differences were identified between men and women in respect of stressors and psychological distress. Stress attributed to pupils’ disruptive behaviour and stress attributed to perceived occupational stress were found to be significant predictors of psychological distress. The findings are discussed in relation to the degree to which trainees are prepared for the challenges they are likely to experience as teachers.