Experience of sexual abuse in childhood and abortion in adolescence and early adulthood

ObjectiveThe present study examined the associations between the experience of sexual abuse in childhood (CSA) and the number of abortions in adolescence and early adulthood.MethodA 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 assessments of experience of CSA using retrospective data gathered at ages 18 and 21, self-reported abortions from ages 15 to 25, measures of childhood socio-economic disadvantage, family stability, family functioning, experience of childhood physical abuse, and pregnancy in adolescence and early adulthood.ResultsSeverity of CSA experience was significantly (p < .01) associated with an increasing rate of abortions during ages 15–25. Adjustment of the association for potentially confounding factors from childhood reduced the magnitude of the association, but it remained marginally statistically significant (p < .10). However, controlling for the mediating effects of pregnancy risk in adolescence and early adulthood reduced the association between experience of CSA and abortion to statistical non-significance (p > .70).ConclusionsThe current study suggested that the association between experience of CSA and increased rates of abortion was mediated by the increased rates of pregnancy associated with CSA experiences. The results suggest a causal chain in which experience of CSA leads to increased rates of pregnancy, which in turn leads to increased rates of abortion.     

Resilience to adult psychopathology following childhood maltreatment: evidence from a community sample

OBJECTIVE: Child abuse is an important risk for adult psychiatric morbidity. However, not all maltreated children experience mental health problems as adults. The aims of the present study were to address the extent of resilience to adult psychopathology in a representative community sample, and to explore predictors of a good prognosis. METHODS: Data are drawn from a follow-up of the Isle of Wight study, an epidemiological sample assessed in adolescence and at midlife. Ratings of psychiatric disorder, peer relationships and family functioning were made in adolescence; adult assessments included a lifetime psychiatric history, personality and social functioning assessments, and retrospective reports of childhood sexual and physical abuse. RESULTS: Ten percent of individuals reported repeated or severe physical or sexual abuse in childhood. Prospective measures revealed increased rates of adolescent psychiatric disorders in this group. Rates of adult psychopathology were also high. A substantial minority of abused individuals reported no mental health problems in adult life. Resilience of this kind was related to perceived parental care, adolescent peer relationships, the quality of adult love relationships, and personality style. CONCLUSION: Good quality relationships across childhood, adolescence and adulthood appear especially important for adult psychological well being in the context of childhood abuse.     

Temperamental sensitivity to early maltreatment and later family cohesion for externalizing behaviors in youth adopted from foster care

Children in foster care frequently have histories of physical/sexual abuse and neglect, increasing their risk for externalizing behaviors (EB; e.g., aggression). According to the differential susceptibility theory, children with reactive temperaments (e.g., negative emotionality) may be particularly vulnerable to early maltreatment, but may also benefit the most from environmental enrichment such as family cohesion. In a high-risk longitudinal sample of 82 children adopted from foster care in Los Angeles County from 1996 and 2001, we examined predictions of EB from childhood to adolescence/young adulthood from temperament, preadoption maltreatment, and adoptive family cohesion. Overall, results from generalized linear models and generalized estimating equations (GEE) did not support differential susceptibility theory – specifically, youth with early reactive temperament did not exhibit heightened sensitivity to maltreatment nor to later adoptive family cohesion. Instead, reactive temperament was associated with higher EB at initial adoptive placement and escalating EB across childhood, controlling for age, gender, race-ethnicity, preadoption maltreatment, and adoptive family cohesion. Preadoption maltreatment history was unrelated to baseline EB, although sexual abuse history predicted escalating childhood EB post-adoption, whereas exposure to family violence (e.g., domestic violence) inversely predicted EB over time. By late adolescence/young adulthood 11–15 years post-adoption, rates of arrest and substance use in this sample were relatively comparable to normative populations of youth, although older age of adoption predicted more substance use in late adolescence/young adulthood. Findings highlight early reactive temperament and preadoption maltreatment as important risk factors to target for ameliorating patterns of EB growth in the first few years of adoption.     

Childhood physical abuse, early social support, and risk for maltreatment: current social support as a mediator of risk for child physical abuse

OBJECTIVE: The study investigated whether perceptions of social support in adulthood partially mediated the associations between childhood experiences (i.e., receipt of physical abuse and levels of early social support) and adult risk for child physical abuse. METHOD: Participants included 598 general population adults who completed self-report measures designed to assess childhood physical abuse, perceptions of early and current social support, and risk factors for child physical abuse. Structural equation modeling was used to test and cross validate a model that included the direct effects of child physical abuse and early social support on child physical abuse risk, as well as mediated effects through an influence on adult perceptions of social support. RESULTS: Childhood physical abuse and early social support covaried, such that receipt of physical abuse was associated with lower levels of perceived early social support. Early support, but not child physical abuse, had an indirect effect (i.e., through current support) on child physical abuse risk. More specifically, levels of early support were directly related to adult perceptions of support, and adult perceptions of support were inversely associated with child physical abuse risk. Childhood physical abuse was directly related to child physical abuse risk. CONCLUSIONS: Low levels of early support may impact risk for child physical abuse by affecting perceptions of others as supportive in adulthood. The receipt of physical abuse in childhood, however, does not appear to impact perceptions of support in adulthood. Research is needed to identify additional factors that may explain the association between receipt of physical abuse in childhood and increased risk of child physical abuse in adulthood.     

Gender differences in the effects of childhood maltreatment on adult depression and anxiety: A systematic review and meta-analysis

Child maltreatment has well-documented long-term, adverse effects on mental health, but it is not clear whether there are gender differences in these effects. We conducted a systematic review to investigate whether there are gender differences in the effects of maltreatment on adult depression and anxiety. Medline, PsycINFO, Web of Science, and Lilacs were searched for relevant studies published up to May 2016. Eligible studies included population-based studies (with a cohort, case-control or cross-sectional design) which assessed maltreatment during childhood or adolescence (≤18 years) and its association with major depression or generalized anxiety disorder (DSM/ICD diagnostic criteria) in adulthood (>18 years) separately for females and males. Meta-analysis was performed to estimate the association between each exposure and outcome using fixed and random effects models. Pooled odds ratios (OR) were estimated separately for women and men and compared. Five studies of physical and sexual abuse were included in the meta-analyses. These provided twenty-two effects sizes estimates (11 for men, 11 for women) for associations between physical/sexual abuse and depression/anxiety. Exposure to each kind of abuse increased the odds of depression/anxiety. Associations were larger for women than for men, however, these gender differences were not statistically significant. Physical and sexual abuse in childhood/adolescence are risk factors for depression/anxiety in adulthood and the effect could be larger for women; however, currently there is insufficient evidence to definitively identify gender differences in the effects of maltreatment.     

Dietary Guidelines for Chinese Residents (2016): comments and comparisons

A high quality diet is believed to play a functional role in promoting the healthy growth of mankind and preventing many kinds of chronic degenerative diseases, including cancer, cardiovascular disease, diabetes, and obesity. Adherence to a high quality diet has been strongly associated with a lower risk of mortality. To help promote healthy lifestyles and physical strength, the Chinese government has produced a new revised version of the Dietary Guidelines for Chinese Residents (2016) and the Chinese Food Pagoda, as guidance for dietary intake among its population. Similarly, the Japanese government has produced the Japanese Food Guide Spinning Top Model, and the US government has recently published revised dietary recommendations in its 2015–2020 eighth edition of Dietary Guidelines for Americans. The evidence from all respective cohort studies involved in producing these guidelines shows a reduced risk of many chronic diseases and mortality if the guidelines are followed. All scientific findings support encouraging the general population to consume a broad variety of food on the basis of nutrient and food intakes in order to prevent deficiency diseases and a surplus of energy and nutrients, and recommend daily physical activity for health promotion.     

Risk Reduction: Recontexualizing Health As a Physical Education Curriculum

While there is sufficient evidence to suggest that physical activity is inversely related to lifestyle diseases, researchers are far from being certain that this evidence extends to children. Nevertheless, the school physical education curriculum has been targeted as an institutional agency that could have a significant impact on health during childhood and later during adulthood if individuals could be habituated to assume a physically active lifestyle. The purpose of this article is to examine the recontextualization of biomedical knowledge into an ideology of healthism in which health is conceived as a controllable certainty and used as a pedagogical construction to transform school physical education. Using a Foucauldian perspective, we explore how the atomized biomedical model of chemical and physical relationships is constructed, reproduced, and perpetuated to service and empower the discourse and the practices of researchers and scholars. In this process the sociological or cultural aspects of public health are marginalized or ignored. As a result of this examination, alternative approaches are proposed that engage the limitations of the biomedical model and openly consider the insights that are available from the social sciences regarding what participation in physical activity means to individuals.     

Predictors of resilience in abused and neglected children grown-up: the role of individual and neighborhood characteristics

PURPOSE: This paper examines individual, family, and neighborhood level predictors of resilience in adolescence and young adulthood and describes changes in resilience over time from adolescence to young adulthood in abused and neglected children grown up. METHOD: We use documented cases of childhood physical and sexual abuse and neglect (n=676) from a Midwestern county area during the years 1967-1971 and information from official records, census data, psychiatric assessments, and self-reports obtained through 1995. Analyses involve logistic regressions, replicated with Mplus to test for possible contextual effects. RESULTS: Almost half (48%) of the abused and neglected children in adolescence and nearly one-third in young adulthood were resilient. Over half of those who were resilient in adolescence remained resilient in young adulthood, whereas 11% of the non-resilient adolescents were resilient in young adulthood. Females were more likely to be resilient during both time periods. Being white, non-Hispanic decreased and growing up in a stable living situation increased the likelihood of resilience in adolescence, but not in young adulthood. Stressful life events and a supportive partner promoted resilience in young adulthood. Neighborhood advantage did not exert a direct effect on resilience, but moderated the relationship between household stability and resilience in adolescence and between cognitive ability and resilience in young adulthood. CONCLUSIONS: Ecological factors appear to promote or interfere with the emergence and stability of resilience following childhood maltreatment.     

Adolescent exposure to violence and adult physical and mental health problems

Evidence on the relationship of adolescent exposure to violence (AEV) with adult physical and mental health problems is limited, with studies often focusing on earlier childhood rather than adolescence, and also on short term rather than long term outcomes. Information specifically on the relationship of AEV to seeking help for mental health problems in adulthood from either formal sources such as mental health professionals or informal sources such as friends and clergy is even more difficult to find. The present study investigates how adolescent exposure to violence (AEV), in the form of parental physical abuse, witnessing parental violence, and exposure to violence in the neighborhood, are related to self-reported adult physical problems and seeking formal or informal assistance with mental health, controlling for more general adolescent violent victimization and for self-reports and parent reports of mental health problems in adolescence. This study adds to the literature on AEV and adult physical problems, and provides a rare look at the relationship of AEV to adult help-seeking for mental health problems. The results suggest that AEV is associated with mental health problems in adolescence for both females and males, that for females AEV is related to physical problems and to seeking help for mental health problems in adulthood, but for males the only significant relationship involves inconsistent reports of witnessing parental violence and adult physical problems.     

The influence of context,timing, and duration of risk experiences for the passage from childhood to midadulthood

This study investigated the long-term effects of social disadvantage on academic achievement and on subsequent attainments in adulthood. The study drew on data collected for over 30,000 individuals born 12 years apart, following their development from birth to adulthood. The pathways that link social disadvantage to individual development across the life course were analyzed in a developmental-contextual systems model. The results showed that the influence of risk factors associated with socioeconomic disadvantage depended on the developmental stage of the individual, the experience of long-term or continuous disadvantage, and the overall sociohistorical context. Early risk had a moderate influence on the formation of individual competences. The greatest risk was associated with persisting and accumulating experiences of socioeconomic disadvantage throughout childhood and adolescence. Material conditions improved for the later-born cohort, yet pervasive social inequalities existed that affected outcomes during childhood and were consequently reflected in adult attainment.     

Emotional abuse in childhood and suicidality: The mediating roles of re-victimization and depressive symptoms in adulthood

This study examined the effects of emotional abuse in childhood, along with physical and sexual abuse, on suicidality in adulthood, and whether and how emotional abuse and depressive symptoms in adulthood mediate the association between the childhood emotional abuse and suicidality. The data were drawn from the 2012 Korean General Social Survey, a nationally representative survey with a multistage area proportional probability sampling method. Random effects regression and the Sobel test were used to analyze the relationships between childhood emotional abuse and suicidality and the mediating effects. Random effects models showed that emotional abuse in childhood was positively associated with suicidality in adulthood, even after controlling for physical and sexual abuse in childhood. Emotional abuse and depressive symptoms in adulthood mediated the association between emotional abuse in childhood and suicidality. Depressive symptoms also mediated between emotional abuse in adulthood and suicidality. These findings suggest that emotional abuse in childhood has indirect harmful effects on suicidality in adulthood. It increases suicidality through higher occurrences of re-victimization and depressive symptoms in adulthood. Practitioners and policy makers should recognize that experiences of emotional abuse in childhood may result in re-victimization in adulthood, which, in turn, lead to suicidality. Early intervention programs to reduce the likelihood of experiencing re-victimization may be critical for people exposed to emotional abuse in childhood.     

Patterns of victimization: A person-centered approach to physical and sexual violence in a representative sample of Danish youth

Professionals and policy makers have only recently begun to recognize the extent to which different types of victimization are interconnected. To enhance our knowledge of the co-occurrence of physical and sexual violence across childhood and adolescence/early adulthood, the present study investigated distinct typologies of victimization in a sample of adolescents and young adults and explored the relationship between victimization typologies and gender, age, and mental health. Data from the Danish 2013 National Health Survey (“How are you?”) were used. Latent class analysis (i.e., a person-centered approach) was used to identify typologies of physical and sexual victimization in a representative sample of 3812 adolescents and young adults aged 16–24 years. Five distinct victimization typologies emerged: a normative, non-victimization group (76%), a physical victimization in adolescence/early adulthood group (13%), a physical revictimization group (5%), a poly-victimization group (4%), and a physical victimization in childhood group (2%). Physical revictimization, poly-victimization, and physical victimization in childhood were highly associated with poor mental health status. Using a latent variable modeling approach, we identified meaningful subgroups of the victimized population. Two subgroups (i.e., physical revictimization and poly-victimization), which comprised a third of all individuals in the victimization subgroups, had a high probability of exposure to multiple traumatic events and poor mental health. These study findings underscore the need to promote interventions addressing the co-occurrence of physical and sexual victimization and the persistence of victimization over time.     

Association between early sexual abuse and adult HIV-risky sexual behaviors among community-recruited women.

OBJECTIVE: The first purpose was to determine whether sexual abuse involving penetration that occurred in childhood only, adolescence only, or both childhood and adolescence differently impacted whether community-recruited women had ever traded sex for money or drugs, their number of recent sex partners, and the number of times they had engaged in recent unprotected sex. The second purpose was to assess the mediating effects of adulthood rape, recent drug use, and recent sex with an injection drug user on these three HIV-risky sexual behaviors. METHOD: Women (n = 1,490) recruited from three US sites were questioned about their childhood and/or adolescent sexual abuse histories, adulthood rape experiences, recent drug use, and adult HIV-risky sexual behaviors via structured interviews. RESULTS: One-third of the women reported having experienced sexual abuse involving penetration in childhood and/or adolescence. Overall, regression analyses indicated a significant relationship between early sexual abuse and adult risky behaviors; rape in adulthood mediated this relationship for all three HIV-risky behaviors. Abuse that occurred in childhood only and abuse that occurred in both childhood and adolescence had a stronger impact on later risky behaviors than did abuse that occurred in adolescence only. CONCLUSIONS: Because childhood constitutes a critical period in individuals' sexual, social, and personal development, sexual abuse precipitated during this time may distort women's constructions of sex and sexuality. Women abused in childhood may therefore engage in HIV-risky sexual behaviors to a greater extent than women abused in adolescence as a result of these disruptions to their development. Rape in adulthood appears to intensify the effects of early sexual abuse,     

Associations between abuse/neglect and ADHD from childhood to young adulthood: A prospective nationally-representative twin study

Child maltreatment has consistently been found to be associated with attention deficit/hyperactivity disorder (ADHD). However, the robustness of this association and the direction of the link between maltreatment and ADHD remain unclear. We used data from the Environmental Risk (E-Risk) Longitudinal Twin Study, a cohort of 2232 British twins, to investigate the associations between exposure to abuse/neglect and ADHD in childhood and in young adulthood, and to test their robustness and specificity. We also aimed to test longitudinal associations between abuse/neglect and ADHD from childhood to young adulthood, controlling for confounders. Results indicated strong associations between abuse/neglect and ADHD in childhood and also in young adulthood. In childhood, the association was concentrated among children with comorbid conduct disorder. Longitudinal analyses showed that childhood ADHD predicted abuse/neglect in later years. This association was again concentrated among individuals with comorbid conduct disorder. Abuse/neglect in childhood was not associated with later ADHD in young adulthood after adjusting for childhood ADHD. Our study does not provide support of a causal link between child abuse/neglect and adult ADHD but highlights the possibility of a long-term effect of disruptive behaviors on the risk for experiencing abuse/neglect. These findings emphasize the need for clinicians treating people with ADHD, especially those with comorbid conduct disorder, to be aware of their increased risk for experiencing abuse/neglect. Interventions aimed at reducing risks of abuse/neglect should also focus on the environment of individuals with disruptive behaviors.     

Height deficit in early adulthood following substantiated childhood maltreatment: A birth cohort study

Early life stress including childhood maltreatment has been associated with reduced head circumference and/or brain size, cognitive, and academic deficits in children and adolescents. However, little is known about the effect of childhood maltreatment on height, especially in early adulthood. This study was designed to examine the association between confirmed cases of multiple or subtypes of childhood maltreatment and stunted growth in young adulthood controlling for perinatal and familial confounding factors. A total of 2661 (48.4% female) young adults from the Mater Hospital-University Study of Pregnancy (MUSP) had data on standardised height-for-age score measurement as part of physical assessment at the 21-year follow-up. Prospectively substantiated cases of childhood maltreatment, 0–14 years of age, were linked to the MUSP dataset. Ethical approval was obtained from the Human Ethics Review Committee of The University of Queensland and the Mater Hospital. Multiple regression analyses were performed to determine the effects of childhood maltreatment on height in young adults. Childhood physical or emotional abuse and neglect were significantly associated with a deficit in height in young adulthood after controlling for perinatal and familial confounders. Multiple incidents of childhood maltreatment also were associated with a deficit in height.     

The association between childhood maltreatment experiences and the onset of maltreatment perpetration in young adulthood controlling for proximal and distal risk factors

The evidence for association between child maltreatment victimization and later maltreatment perpetration is both scant and mixed. The objective of the present study was to assess the association between childhood maltreatment experiences and later perpetration of maltreatment in young adulthood controlling for proximal young adult functioning, prior youth risk behaviors, and childhood poverty. The study included 6,935 low-income children with (n = 4,470) or without (n = 2,465) maltreatment reports prior to age 18 followed from ages 1.5 through 11 years through early adulthood (ages 18–26). Administrative data from multiple regional and statewide agencies captured reports of maltreatment, family poverty and characteristics, system contact for health, behavioral risks and mental health in adolescence, and concurrent adult functioning (crime, mental health and poverty). After controlling for proximal adult functioning, repeated instances of neglect or mixed type maltreatment remained associated with young adult perpetration. Females and subjects with adolescent history of runaway, violent behaviors or non-violent delinquency also had higher risk. Greater caregiver education remained associated with reduced risk. The study concludes that prevention of recurrent neglect and mixed forms of maltreatment may reduce risk of maltreatment for future generations. Intervening to increase parental education and decrease adolescent risk behaviors may offer additional benefit.     

Development of Adjustment Problems in Girls: What Syndromes Emerge?

The development of a broad spectrum of adjustment problems in girls was studied longitudinally from late childhood to early adulthood. A specific interest concerned how well the externalizing-internalizing distinction could explain the data. The sample consisted of about 500 Swedish girls, reasonably representative of the general population. Variable-oriented methods were complemented with person-oriented methods to study syndrome formation at the level of the individual. The results suggested a rather diversified pattern of multi-problem syndromes in late childhood, whereas the syndrome structure in early adolescence was organized around a differentiation between girls with externalizing adjustment problems and girls with peer problems. An externalizing syndrome was found to be stable between late childhood and early adolescence, increasing the risk of severe maladjustment in adulthood. Internalizing problems showed no clear-cut continuity with adult maladjustment. Results are discussed in relation to the externalizing-internalizing distinction, which to some extent is called in question.     

Girls in residential care: From child maltreatment to trauma-related symptoms in emerging adulthood

The current study examined the association between child maltreatment and trauma-related symptoms in emerging adulthood – over and above the incidence of such symptoms and conduct problems during adolescence – among a sample of female adolescents in residential care. This study used data from a longitudinal study. The sample was composed of 89 adolescent females who were first interviewed at time of admission in a residential center (M_age = 15.33 years, SD = 1.31) and later in young adulthood (M_age = 19.27, SD = 1.55). At time 1, trauma-related symptoms were assessed with the Trauma Symptom Checklist for Children and conduct problems with a composite measure. At time 2, child maltreatment was assessed retrospectively with the Childhood Trauma Questionnaire, and trauma-related symptoms were reassessed with the Trauma Symptom Inventory-2. Results indicated that child maltreatment, especially emotional abuse and neglect, was related to anxious arousal, depression, and anger in emerging adulthood. This study showed that females from our sample often reported different types of maltreatment during childhood and that these traumatic experiences were significantly associated with poor adult psychological functioning.     

Opportunities for Neurodevelopmental Plasticity From Infancy Through Early Adulthood

Multiple and rapid changes in brain development occur in infancy and early childhood that undergird behavioral development in core domains. The period of adolescence also carries a second influx of growth and change in the brain to support the unique developmental tasks of adolescence. This special section documents two core conclusions from multiple studies. First, evidence for change in brain‐based metrics that underlie cognitive and behavioral functions are not limited to narrow windows in development, but are evident from infancy into early adulthood. Second, the specific evident changes are unique to challenges and goals that are salient for a respective developmental period. These brain‐based changes interface with environmental inputs, whether from the child's broader ecology or at an individual level.     

A history of abuse and negative life events in patients with a sexually transmitted disease and in a community sample

OBJECTIVE: Our aim was to investigate the psychological impact of abuse and negative life events during childhood, adolescence and adulthood in patients recruited from a sexual health clinic. METHOD: Sixty-two patients with a sexually transmitted disease (STD) were matched on age and gender with a community sample. Forty-two patients without an STD formed another control group. Subjects self-reported their trauma histories and current psychological distress. RESULTS: Compared to controls, categories of abuse and negative life events were more prevalent in STD patients, particularly Physical/Sexual Abuse in adolescence and adulthood. Both within the STD and community samples, a negative life event category that measured illness/death of loved ones during childhood and adolescence predicted current psychological distress. In addition, Control Abuse (a subtype of psychological abuse involving selfish manipulation and deprivation) in childhood and adolescence strongly predicted current psychological distress in STD patients. In general, effects were stronger in females than in males. Psychological/Verbal Abuse did not independently predict current psychological distress, but accompanied other abuse types and possibly amplified their adverse effects. CONCLUSIONS: Our findings suggest that multiple types of abuse and negative life events increase the risk of STD infection, perhaps by increasing the likelihood of multiple sexual partners. These patients may ignore social conventions of sexual behaviour because they are bitter about past life experiences. Alternatively, they may persistently search for affection to compensate for a lack of affection in the past.