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.     

Positive childhood experiences predict less psychopathology and stress in pregnant women with childhood adversity: A pilot study of the benevolent childhood experiences (BCEs) scale

This pilot study examined the psychometric properties of the Benevolent Childhood Experiences (BCEs) scale, a new instrument designed to assess positive early life experiences in adults with histories of childhood maltreatment and other adversities. A counterpart to the Adverse Childhood Experiences (ACEs) questionnaire, the BCEs was developed to be multiculturally-sensitive and applicable regardless of socioeconomic position, urban-rural background, or immigration status. Higher levels of BCEs were hypothesized to predict lower levels of psychopathology and stress beyond the effects of ACES in a sample of ethnically diverse, low-income pregnant women. BCEs were also expected to show adequate internal validity across racial/ethnic groups and test-retest stability from the prenatal to the postnatal period. Participants were 101 pregnant women (M = 29.10 years, SD = 6.56, range = 18–44; 37% Latina, 22% African-American, 20% White, 21% biracial/multiracial/other; 37% foreign-born, 26% Spanish-speaking) who completed the BCEs and ACEs scales; assessments of prenatal depression and post-traumatic stress disorder (PTSD) symptoms, perceived stress, and exposure to stressful life events (SLEs) during pregnancy; and demographic information. Higher levels of BCEs predicted less PTSD symptoms and SLEs, above and beyond ACEs. The BCEs showed excellent test-retest reliability, and mean levels were comparable across racial/ethnic and Spanish-English groups of women. Person-oriented analyses also showed that higher levels of BCEs offset the effects of ACEs on prenatal stress and psychopathology. The BCEs scale indexes promising promotive factors associated with lower trauma-related symptomatology and stress exposure during pregnancy and illuminates how favorable childhood experiences may counteract long-term effects of childhood adversity.     

Development of a prediction model for child maltreatment recurrence in Japan: A historical cohort study using data from a Child Guidance Center

To develop a prediction model for the first recurrence of child maltreatment within the first year after the initial report, we carried out a historical cohort study using administrative data from 716 incident cases of child maltreatment (physical abuse, psychological abuse, or neglect) not receiving support services, reported between April 1, 1996 through March 31, 2011 to Shiga Central Child Guidance Center, Japan. In total, 23 items related to characteristics of the child, the maltreatment, the offender, household, and other related factors were selected as predictive variables and analyzed by multivariate logistic regression model for association with first recurrence of maltreatment. According to the stepwise selection procedure six factors were identified that include 9–13 year age of child (AOR = 3.43/95%CI = 1.52−7.72), <40 year age of the offender (AOR = 1.65/95%CI = 1.09−2.51), offender’s history of maltreatment during childhood (AOR = 2.56/95%CI = 1.31−4.99), household financial instability or poverty (AOR = 1.64/95%CI = 1.10−2.45), absence of someone in the community who could watch over the child (AOR = 1.68/95%CI = 1.16−2.44), and the organization as the referral source (AOR = 2.21/95%CI = 1.24−3.93). Using these six predictors, we generated a linear prediction model with a sensitivity and specificity of 45.2% and 82.4%, respectively. The model may be useful to assess the risk of further maltreatment and help the child and family welfare administrations to develop preventive strategies for recurrence.     

A pilot study examining risk behavior in facebook posts for maltreated versus comparison youth using content analysis

BackgroundSocial Media use is highly prevalent among contemporary adolescents yet, no studies have examined the similarity in risk content (e.g., substance use, sexual behaviors) between the online posts of maltreated youth and their friends.ObjectiveThe current study examined the risk content of Facebook posts among a sample maltreated and comparison youth and compared the rates of risk content produced by the participants versus their Facebook friends.Participants and SettingData were from a sample of maltreated (n = 56) and comparison (n = 62) youth. At the time of data collection participants were in young adulthood (M = 21.78 years; SD = 1.45), but the timeframe of their Facebook profiles captured mid adolescence to young adulthood.MethodsData were downloaded from the Facebook profiles of all participants and the posts and comments were coded for references to alcohol, marijuana, hard drugs, partying, and sexual content.ResultsThe results showed that maltreated and comparison youth were similar in the amount of risky content they posted on Facebook as well as in the amount posted by their Facebook friends. Correlations between participant’s and friends’ posts showed stronger associations for posts about alcohol use for the maltreated group but stronger associations in the comparison group for posts about marijuana, hard drug, and sexual references. Gender differences were also examined, with males producing more online risky content than females.ConclusionsNext steps should incorporate a more nuanced analysis to determine which online friends are the sources of risky content.     

Insomnia symptom trajectories among adult survivors of childhood sexual abuse: A longitudinal study

BackgroundChildhood sexual abuse (CSA) is associated with sleep disturbances in adulthood. However, longitudinal studies have yet to identify among CSA-survivors subgroups distinguished by the trajectory of their insomnia severity, or predictors of subgroup membership.ObjectiveThe objective of this study was to examine longitudinal insomnia symptom trajectories, as well as predictors and correlates of the identified trajectories, over a 4 year study period in a sample of adult, mainly female CSA-survivors.Participants and settingThe sample comprised 533 adult survivors of CSA (94.9% women, mean age 39.2 years, mean age of abuse onset 6.5 years), recruited from support centers for sexual abuse survivors in Norway.MethodsLatent class growth analyses were used to identify insomnia symptom trajectories.ResultsThree distinct trajectories of insomnia symptoms were identified; one characterized by high insomnia symptom scores minimally decreasing over the study period (‘high and decreasing’, 30.6%), one characterized by stable intermediate insomnia symptom scores (‘intermediate and stable’, 41.5%), and one characterized by stable low insomnia symptom scores (‘low and stable’, 27.9%). Predictors of belonging to the high and decreasing trajectory (using the low and stable trajectory as a reference), was lower age of abuse onset (expotentiated coefficient (EC): 0.93, p = 0.026), abuse involving penetration (EC: 2.36, p = 0.005), threats (EC: 3.06, p < 0.001) or physical violence (EC: 3.29 p < 0.001), a higher score on a composite variable comprising multiple other abuse and perpetrator aspects (EC: 2.55, p < 0.001), as well as scoring above a clinical cut-off on a measure of posttraumatic stress symptoms (EC: 12.17, p < 0.001). Those belonging to the high and decreasing trajectory also reported lower levels of perceived social support and higher levels of subjectively experienced relational difficulties compared to those belonging to the two other trajectories.ConclusionsWe conclude that different longitudinal insomnia trajectories exist among adult CSA survivors. The overall results, as well as the significant predictors, are discussed alongside their potential clinical implications.     

The impact of maltreatment characteristics and revicitimization on functioning trajectories in children and adolescents: A growth mixture model analysis

Person-centered approaches are considered promising methods for a deeper understanding of the causes and consequences of maltreatment. So far, only few studies have employed such approaches in the study of maltreatment. The aim of the present study was to examine the impact of maltreatment-related variables on trajectories after maltreatment. Growth mixture modelling (GMM) was used to examine different trajectories of functioning in 206 children and adolescents (M = 9.8 years) with a history of child maltreatment. Trajectories were analyzed in regards to maltreatment characteristics and revictimization using multinomial logistic regression. The participants were followed up over a 12 months period including three assessments. Four trajectories were identified: resilient (22.9%), worsening (15.1%), recovering (32.2%), chronic (29.8%). Revictimization (OR: 2.6–5.5), a longer period between first and last reported incident of maltreatment (OR: 0.033 – 0.038) and consequently the age at first (OR: 0.039 – 0.054) and age at last reported incident (OR: 20.3–26.9) were significant predictors of a worsening functioning trajectory. Having experienced neglect predicted a worsening trajectory in contrast to a chronic and resilient trajectory (OR = 4.8–5.2). Findings suggest that a clinical follow-up of children with a history of maltreatment is crucial as this population represents a high risk sample. A worsening trajectory was closely associated with revictimization. Functioning trajectories seem to be directly linked to chronicity and timing of maltreatment. Implications are discussed.     

A longitudinal study of kindergarten children at risk for reading disabilities: the poor really are getting poorer

Over the past decade, educators and researchers concerned about children with reading disabilities have called for widespread adoption of early identification tools and early effective programming. This call may be the result of, in part, what Stanovich calls "Matthew effects in reading." That is, when stakeholders delay identification and support for young children struggling to read, the variance of individual differences in reading will inevitably increase, creating a widening of the gap between strong and struggling readers. In this longitudinal study, reading achievement data from 382 children were collected as they progressed from kindergarten through Grade 3. In kindergarten, children were screened with a battery of phonological awareness measures. Percentile rank scores were collected, and children were identified as having poor, average, or strong phonological awareness. As children moved through Grades 1, 2, and 3, reading-based data were collected in the spring of each year. Results indicated that, in general, as children progressed from kindergarten to Grade 3, those in lower ranks of reading achievement were likely to remain in the lower ranks, and furthermore, at each progressing data collection point struggling readers fell further behind their grade-level reading peers. In other words, as each year passed the variance between strong and struggling readers increased significantly. The authors hypothesized that this finding is consistent with the "Matthew effect"-the rich were getting richer while the poor were getting poorer.     

The distal consequences of physical and emotional neglect in emerging adults: A person-centered,multi-wave,longitudinal study

Despite being the most prevalent form of child maltreatment, the correlates and consequences of neglect are poorly understood, particularly during early adulthood. The present multi-wave, longitudinal study sought to address this gap in this literature by examining physical and emotional neglect in emerging adults in a diverse community sample. 580 adolescents (Age_Mean = 18.25; Age_SD = 0.59; 58.3% female; 31% Hispanic, 28.9% Caucasian; 26.2% African-American; 13.9% other) completed self-report measures for child maltreatment at baseline, and measures for depression, posttraumatic stress disorder, generalized anxiety disorder, and substance use every year for three years. For our analyses, we used both variable-centered (mixed-level modeling) and person-centered (latent profile analysis) analyses to best understand a) how physical and emotional neglect relate to other forms of maltreatment and b) to determine physical and emotional neglect’s unique impact on prospective mental health functioning. Our person-centered analyses revealed that a three-profile model provided the best solution for our data (“No Trauma,” “Abuse”, and “Neglect”). In longitudinal analyses, the “the neglect” group had significantly elevated scores compared to the “no trauma” group on all outcomes except alcohol use (p < 0.01). Results from our variable-centered analyses showed comparable findings between physical and emotional neglect, with higher scores corresponding to elevated symptoms of depression, PTSD, illicit substance use, and cigarette use over time (p < 0.01). In conclusion, our results suggest that early neglect-exposure poses a risk for the subsequent development of internalizing symptoms and substance use behaviors among emerging adults.     

Early life adversities and polyvictimization in young persons with sexual behavior problems: A longitudinal study of child protective service referrals

There is scarce research on children and youth with sexual behavior problems (SBP) and their developmental antecedents and the research that does exist is mostly retrospective and correlational. While prior research focused on the central role of sexual victimization, recent research suggests that young persons with SBP are exposed to a series of adversities not limited to child sexual victimization and require multifaceted assessment and intervention using a developmental life course perspective. The current study includes an examination of the complete longitudinal sequence of child protective service (CPS) investigations involving young persons with SBP. The study is based on a sample of 957 youth referred to the CPS in Quebec, Canada. The data include their longitudinal sequence of referrals from birth to age 18. Semi-parametric analyses identified four trajectories of referrals with significant differences in terms of onset, frequency, types of life adversity, and polyvictimization. The trajectories suggest that a range of developmental profiles characterize young persons with SBP, with SBP often occurring after CPS contacts for compromising issues other than sexual victimization, especially parental neglect and serious behavior problems. Of importance, polyvictimization was relatively common for this group throughout childhood and adolescence, which highlights the multiintervention needs of this population.     

A longitudinal study of the development of oral reading fluency in young children at risk for reading failure

The purpose of this study was to examine the development of oral reading fluency in a sample of first-grade children. Using growth curve analysis, models of growth were identified for a combined sample of at-risk (AR) and not-at-risk (NAR) children, and predictors of growth were identified for the longitudinal AR sample in first and second grade. Large and serious differences in reading fluency growth between the AR and NAR samples were apparent early, replicating other reports. Theories of sight-word learning and reading fluency were supported, in that letter-sound fluency was a uniquely significant predictor of first-grade reading fluency. The effects of phonological awareness and rapid automatized naming were mediated by the other variables in the model. Growth in first-grade oral reading fluency accounted for the most unique variance in second-grade growth and end-of-year performance. The results suggest that word reading fluency should be regarded as developing concomitantly with early word recognition rather than as a later-developing skill.     

A prospective,longitudinal cohort study: The impact of child maltreatment on delinquency among South Korean youth in middle and high school

BackgroundCultural groups vary in how they understand child maltreatment and children's misbehavior and these cultural variations may impact the relationship between maltreatment and delinquency.ObjectiveThis study investigated the impact of maltreatment on delinquency among South Korean youth. Participants and Setting: Using Korean Children and Youth Panel Survey data, this study followed two cohorts of middle (n = 2,275) and high (n = 2,272) school youth for their first self-reported delinquency over 4 years.MethodDiscrete-time hazard model was used for the analyses.ResultsApproximately 19% of middle and 11% of high school youth engaged in delinquency for 4 years. Maltreatment is associated with delinquency only for high school youth (HR = 1.42). In both cohorts, male youth with high levels of aggression were more likely to engage in delinquency. Additional risk factors included high levels of depression (HR = 1.36) and negative attitudes toward school rules (HR = 0.68), father's education less than high school (HR = 0.63), low levels of self-control (HR = 0.63). Findings also identified culturally unique factors that place Korean youth at heightened risk of delinquency: mother's education more than high school (HR = 1.49) and higher family income (HR = 1.93).ConclusionPreventive interventions need to identify culturally specific risk factors for youth at increased risk of delinquency and thus these preventive interventions should be culturally tailored.     

Educational and emotional health outcomes in adolescence following maltreatment in early childhood: A population-based study of protective factors

Although childhood maltreatment is associated with long-term impairment, some children function well despite this adversity. This study aimed to identify the key protective factors for good educational attainment and positive emotional health in adolescents who experienced maltreatment in early childhood. Data were analyzed from the Avon Longitudinal Study of Parents and Children, a large UK prospective cohort study. The sample was defined by maternally reported exposure to physical or emotional maltreatment by a parent prior to 5 years. 1118 (8.0%) children were emotionally maltreated and 375 (2.7%) were physically maltreated before the age of 5. There were too few cases of sexual abuse to be considered. Positive outcomes were operationalized as achieving 5 or more grade A*-C GCSE exam grades at 16 years and scores above the cohort median on the self-report Warwick-Edinburgh Mental Wellbeing Scale and Bachmann Self-Esteem Scale at 17.5 years. The associations of individual, family and community covariates with successful adaptation to the adversity of maltreatment were investigated using logistic regression.School related factors, including engagement in extracurricular activities, satisfaction with school and not being bullied were the most important in facilitating resilience in educational attainment, self-esteem and wellbeing. Good communication and social skills was the most protective individual trait. There was insufficient evidence to suggest that family factors were associated with resilience to maltreatment. School-based interventions are recommended to promote positive adaptation following parental maltreatment. Future research should evaluate outcomes across the life-course to understand whether the protective influences of school persist into adulthood.     

Adverse childhood experiences and adjustment: A longitudinal study of street-involved youth in Brazil

Most research on adverse childhood experiences (ACEs) has been conducted in high-income countries in the global North. The current longitudinal study examined the prevalence, overlap, and impact of ACEs in a sample of Brazilian children and adolescents who use city streets as spaces for socialization and survival (i.e., street-involved youth). Participants (N = 113; M age = 14.18 years) were recruited in three cities following standardized procedures. Most youth were male (80.5%) and non-White (91%). Lifetime exposure to ACEs was assessed at the first study time point; six indicators of psychological, behavioral, and physical adjustment were assessed 6 months later. Analyses addressed three research goals. First, the prevalence of seven ACEs was examined. Youth reported an average of 4.8 ACEs (SD = 1.25); no significant age or gender differences were found in ACEs exposure (all ps > .05). Second, the overlap between different ACEs was explored. Family dysfunction was correlated with family disruption and physical abuse; poverty and physical abuse were related (ps < .05). Third, prospective associations between ACEs and adjustment were tested. Total number of ACEs was not significantly correlated with any outcome, but several associations emerged for specific ACEs. For example, death of a close friend or family member was prospectively associated with negative affect; sexual abuse was associated with illicit drug use and physical health symptoms (ps < .05). Findings highlight the prevalence of ACEs in this vulnerable population and underscore the value of extending research on ACEs into novel populations and contexts.     

Childhood maltreatment and the persistence of smoking: A longitudinal study among adults in the US

The current study examined the relationship between childhood maltreatment—emotional, physical, and severe physical maltreatment—and the initiation and persistence of smoking. Data were drawn from the Midlife Development in the United States (MIDUS) Survey Waves 1 and 2. Frequency of childhood emotional, physical, and severe physical maltreatment (never, rare, intermittent, frequent) reported at Wave 1 was examined in relation to ever smoking, smoking daily, and persistent daily smoking at Waves 1 and 2. Logistic regression analyses were used to calculate odds ratios (with 95% confidence intervals), which were then adjusted for potential confounders. Childhood emotional, physical, and severe physical maltreatment were associated with increased odds of ever smoking, smoking daily, and persistent smoking at Waves 1 and 2. The majority of these associations remained significant after adjusting for confounding variables. These results suggest a history of trauma may play a prominent role in recalcitrant cigarette smoking and suggest that the success rates of treatments for smoking cessation may be improved by integrating trauma treatment where appropriate.     

Families at risk of poor parenting: A descriptive study of sixty at risk families in a model prevention program

Sixty families assessed to be at risk of poor parenting were the subject of this study. These families were participants in a model multidisciplinary program designed for the secondary prevention of poor parenting and the extremes of child abuse and neglect. The model program consists of special medical, psychological, social and developmental services to families on an inpatient, outpatient, and in-home basis. Demographic information on these 60 families was tabulated. Each family was given a monthly rating on a simple measure of family function. Ratings over lime were observed, and families were characterized in terms of a family rating vector (up. up-plateau, plateau, fluctuating, and down). Families were also described in terms of the constellation of problems brought to the therapy situation. Problem lists for each family were subjected to factor analysis. Five factor constructs which made clinical sense emerged from the analysis. Each factor could be labeled as a “family type.” These types were: (I) Abusive Family. (II) Neglectful or Antisocial Family. (III) Family with an Emotionally Unstable Parent, (IV) Family with Cultural or intellectual Limitation, and (V) Family with Child-Rearing Difficulties. Approximately 20% of these families did not fit the typology. Families were then divided into two groups—those who were relatively long-term, ongoing recipients of services, and those who left the program in the observation interval. Families were categorized according to family function rating vector and “family type.” It was noted among long-term families, measured improvement in family function was most evident in families with transient situational crisis (who did not fit the typology) and those with intellectual and cultural deficits (Type IV). Among the families who dropped from the program. 15% were no longer at risk. Sixty-three percent of the remaining families were not improving. These techniques may be useful in determining which at risk families are more successful candidates for prevention efforts.     

Disentangling the mental health impact of childhood abuse and neglect: A replication and extension study in a Brazilian sample of high-risk youth

Childhood maltreatment is a key predictor of mental health problems across the life span. Yet, how maltreatment types independently and jointly influence the risk for psychiatric problems remains unclear. The aim of the study was two-fold: first, to replicate recent findings regarding the impact of maltreatment types on youth psychiatric symptoms, based on a Brazilian sample of high-risk adolescents (n = 347; age range = 11–17 yrs), and second, to extend existing findings by examining whether this relationship is mediated by bullying victimization and/or perpetration. Measures included self-report ratings of childhood maltreatment and peer victimization, as well as multi-informant reports of internalizing and externalizing symptoms. Consistent with prior research, we found that: (i) maltreatment types often co-occurred; (ii) there was a linear association between number of maltreatment types experienced and symptom severity (i.e. cumulative effect); and (iii) emotional abuse emerged as the most consistent independent predictor of poor mental health across domains, raters, and gender. Additionally, this study extends previous findings by showing that the influence of maltreatment on psychiatric outcomes is partially mediated by peer victimization, but not by bullying perpetration. In conclusion, these findings expand our understanding of the heterogeneity in individual responses to maltreatment as well as highlighting emotional abuse as an important predictor of poor mental health.     

A study on the inclusion of deafblind young people in mainstream schools: key findings and implications for research and practice

This article, written by Leda Kamenopoulou of Roehampton University, reports a research project on deafblindness and inclusion in education. Deafblindness is a rare and therefore significantly under‐explored disability. Even less systematic research has focused on deafblind young people enrolled in mainstream schools. The study presented here used a multiple case study and mixed methods design to explore the social inclusion and participation of four deafblind pupils in mainstream placements. Interviews were conducted with the pupils, their parents and selected teachers regarding their peer interactions and relationships. Semi‐structured observations of peer interactions during school breaks were also conducted to complement interview data, but due to space constraints, these are not discussed here. Findings from the interviews suggest that the young people were socially present in their schools, but all faced certain issues in terms of being fully included. Both barriers to and facilitators of social inclusion and participation are discussed with reference to implications for research and practice.     

Maternal history of child maltreatment and maternal depression risk in the perinatal period: A longitudinal study

Existing research is limited, with only a few studies considering each single type and multiple types of child maltreatment (CM) as well as multiple assessments of maternal depression throughout the perinatal period. The purpose of the study was to assess each type and accumulative types of CM in relation to the risk of maternal depression throughout the perinatal period. In total, 276 pregnant women were recruited from the prenatal clinic at a general hospital in China. Maternal CM history and depression risk were assessed at late pregnancy, postpartum week 1, and postpartum week 4 using the Childhood Trauma Questionnaire (CTQ) and Edinburgh Postnatal Depression Scale (EPDS). The GEE showed that physical and emotional neglect and multiple types of CM were associated with higher overall depression risk across the perinatal period. The multinomial regression models showed physical neglect and multiple types of CM predicted higher risk of both antepartum and postpartum depression. Emotional and sexual abuse and emotional neglect predicted antepartum depression risk, while none of the three types of CM predicted postpartum depression risk. Physical abuse did not predict antepartum and postpartum depression risk. The findings suggest that maternal history of child physical and emotional neglect play significant roles in perinatal depression risk with physical neglect as the most important predictor. Routine screening for maternal CM history and depression risk in prenatal clinics is needed to aid in the early detection and treatment of depression.     

Development of an item bank for assessing generic competences in a higher-education institute: a Rasch modelling approach

This paper describes the development and validation of an item bank designed for students to assess their own achievements across an undergraduate-degree programme in seven generic competences (i.e., problem-solving skills, critical-thinking skills, creative-thinking skills, ethical decision-making skills, effective communication skills, social interaction skills and global perspective). The Rasch modelling approach was adopted for instrument development and validation. A total of 425 items were developed. The content validity of these items was examined via six focus group interviews with target students, and the construct validity was verified against data collected from a large student sample (N?=?1151). A matrix design was adopted to assemble the items in 26 test forms, which were distributed at random in each administration session. The results demonstrated that the item bank had high reliability and good construct validity. Cross-sectional comparisons of Years 1–4 students revealed patterns of changes over the years. Correlation analyses shed light on the relationships between the constructs. Implications are drawn to inform future efforts to develop the instrument, and suggestions are made regarding ways to use the instrument to enhance the teaching and learning of generic skills.     

A longitudinal perspective on boys as victims of childhood sexual abuse in South Africa: Consequences for adult mental health

Childhood sexual abuse of boys was examined in a longitudinal cohort in South Africa, with data on abuse collected at six age points between 11 and 18 years. Potential personal and social vulnerability of male sexual abuse victims was explored and mental health outcomes of sexually abused boys were examined at age 22–23 years. Reports of all sexual activity – touching, oral and penetrative sex – increased with age and sexual coercion decreased with age. Almost all sexual activity at 11 years of age was coerced, with the highest rates of coercion occurring between 13 and14 years of age; 45% of reports of coerced touching were reported at age 14, 41 percent of coerced oral sex at age 13, and 31% of coerced penetrative sex at age 14. Sexual coercion was perpetrated most frequently by similar aged peers, and although gender of the assailant was less often reported, it can be presumed that perpetration is by males. Boys who experienced childhood sexual abuse tended to be smaller (shorter) and from poorer families. No relationships to measured childhood intelligence, pubertal stage, marital status of mother or presence of the father were found. There was no significant association between reports of childhood sexual abuse and mental health in adulthood and when personal and social vulnerabilities were taken into account.