Individual differences among undergraduate women in methods of coping with stressful events: the impact of cumulative childhood stressors and abuse

OBJECTIVE: The purpose of the current study was to determine if a history of greater exposure to different types of adverse and/or abusive experiences in childhood would influence coping strategies used by undergraduate women to deal with new stressful events in young adulthood. METHOD: A sample of 828 women undergraduates from a New England state university participated in this questionnaire study. Disengagement and engagement coping strategies used in response to recent stressors were compared in groups who had none, one, two, or three or more types of adverse and/or abusive childhood experiences (sexual abuse, physical abuse, witnessing domestic violence, having an alcoholic parent, and parental rejection). RESULTS: There was an increased reliance on disengagement methods of coping (wishful thinking, problem avoidance, social withdrawal, and self-criticism) as a function of more extensive child abuse histories. Engagement methods of coping (problem solving, cognitive restructuring, social support, and express-emotions), however, did not show a corresponding decrease as a function of increased exposure to different types of childhood stressors and/or abuse. CONCLUSIONS: This study demonstrates that undergraduate women with cumulative adverse and/or abusive childhood histories are particularly at-risk of relying on maladaptive disengagement coping strategies to deal with various new stressors later in life.     

Factors associated with an increased impact of child sexual abuse

Data is presented identifying factors associated with the impact of sexual abuse on children. A group of 369 sexually abused children and a comparison group of 318 children recruited from the community were compared on a parent-completed behavior rating scale. Data describing the abused children were also available from a 38-item symptom checklist completed by the child's social worker. Using a score based on the symptom checklist as the measure of the impact of sexual abuse, 15 variables were in the final regression equation explaining 42% of the variance in impact. Using a score based on parent-generated data, 5 variables were in the final equation explaining 20% of the variance. The significance of the variables in identifying factors associated with an increased impact of abuse is discussed.     

Substance abuse and behavioral correlates of sexual assault among South African adolescents

OBJECTIVE: The aim of this article is twofold: first, to examine the prevalence of being the victim of actual and attempted rape among a large representative sample of Cape Town high school students; and second, to identify the correlates of sexual assault for both boys and girls, including alcohol, tobacco and other drug use, behavioral problems, and suicidality. METHOD: Data for this study were derived from the 1997 South African Community Epidemiology Network on Drug Use (SACENDU) school survey. A stratified sampling procedure was used to select students in Grades 8 and 11 at non-private high schools in Cape Town. A total of 2,946 students completed a survey consisting of socio-demographic questions and items about substance abuse, sexual activity, and other adolescent health risk behaviors. A subsample of 939 was randomly selected to complete items about sexual violence. RESULTS: The results revealed that 8.4% of respondents were victims of attempted rape, while 5.8% were victims of actual rape. Ordinal logistic regression showed that girls were 3.9 times more likely than boys to have been victims of sexual abuse. Family structure was also significantly related to rape as persons who lived with a single parent (OR = 1.74, CI = 1.00-3.04) and those who resided with one biological parent and one step parent (OR = 2.59, CI = 1.34-5.01) were more likely to have been have been victims of sexual abuse than those living with both biological parents. Alcohol use (OR = 2.0, CI = 1.10-3.62), anti-social behavior (stolen property, caused physical damage to property, bullied others, or been in physical fights) (OR = 1.44, CI = 1.12-1.86), suicidal dialogue (OR = 2.48, CI = 1.19-5.19), and suicidal attempts (OR = 3.2, CI = 1.65-6.30) were also significant predictors of sexual abuse victimization. Racially classified social groups (RCSG), age, drug use, and cigarette smoking were not significant predictors of sexual abuse victimization, while socioeconomic status was found to be marginally significant. CONCLUSION: This study reinforces the importance of multiple factors including alcohol use, anti-social behavior, suicidal thoughts and actions, and family structure with respect to sexual assault of adolescents in South Africa. Establishing and strengthening intervention programs, school based child protective protocols, professional education of teachers and school personnel, community prevention programs, and initiatives could help prevent adolescent sexual violence and reduce the sequelae associated with this problem.     

Child sexual abuse research knowledge among child abuse professionals and laypersons

The purposes of this study were to: (1) Assess child abuse professionals’ and nonprofessionals’ knowledge of scientific research findings that are relevant to forensic child sexual abuse (CSA) evaluations and (2) describe associations between child abuse professionals’ levels of research knowledge and their education and experience. An 18-item multiple-choice test was administered to 188 child abuse professionals and 457 nonprofessionals (undergraduate college students) in Brazil and the United States. The nonprofessionals’ average percent correct, M = 44%, was not significantly different than what would be expected for random guessing (45%). The professionals’ average percent correct, M = 55%, was higher than that of nonprofessionals and random guessing (both ps < .001). The average percent correct score for the US-sample psychologists, M = 76%, was higher than the average score of the other professionals, M = 51%, p < .001. Professionals’ educational level, as measured by the highest academic degree obtained, was positively associated with percent correct scores, Spearman's ρ = .46, p < .001. Controlling for educational attainment, professional experience, as measured by the total number of CSA evaluations performed, was weakly associated with percent correct scores, partial r = .15, p = .04. Percent correct scores were low for both nonprofessionals and professionals. Most of the participants in this study were uninformed or misinformed about scientific research findings that are important for conducting optimal forensic CSA evaluations and for making accurate judgments about the validity of sexual abuse allegations.     

The long-term impact of childhood sexual abuse in Australian women

OBJECTIVE: The aim of this study was to examine the association between childhood sexual abuse (CSA) and a range of adverse adult outcomes in a community sample of women using multivariate analysis which accounted for a number of potential confounding effects. METHOD: Retrospective study of cross-sectional data on the long-term impact 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. RESULTS: Significant associations were found between reporting CSA and experiencing domestic violence, rape, sexual problems, mental health problems, low self-esteem, and problems with intimate relationships even after taking into account a range of family background factors. Women who had experienced abuse involving intercourse were the most vulnerable to these negative outcomes. CONCLUSIONS: The findings indicate that the influence of CSA on adverse long-term effects is mediated and influenced both by the severity of the abuse experiences and by a range of family and social background factors.     

Pregnancy and delivery for women with a history of child sexual abuse

OBJECTIVE: To study whether women with a history of child sexual abuse are at increased risk of delivering low birth weight infants. Secondary aims were to study smoking habits, obstetric complications, health care use, and health complaints during pregnancy among women with a history of child sexual abuse. METHOD: In a case control study, 82 women with birth of a low birth weight infant (< 2500 g) (cases) and 91 women with birth of a normal birth weight infant (controls) were interviewed about experiences of child sexual abuse. RESULTS: Fourteen percent of the women disclosed a history of child sexual abuse involving at least genital touch. Birth of a low birth weight infant was not associated with a history of child sexual abuse (OR 1.03, 95% CI .44-2.40). More women with a history of child sexual abuse were smokers during pregnancy (56% vs. 31%) compared with nonabused women. Abused women reported lower age at menarche and sexual debut. Nonscheduled contacts with the antenatal care clinic and discomfort during pregnancy were more frequent among abused women when controlled for low birth weight. CONCLUSIONS: Women who delivered low birth weight infants were not more likely to have experienced child sexual abuse than women who delivered nonlow birth weight infants. Abused women were unemployed and daily smokers more often than nonabused women. Some of the abused women reported more health complaints, and more use of health care services during pregnancy, but did not have more obstetric complications during pregnancy and delivery.     

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,     

A meta-analysis of the relationship of child sexual abuse to HIV risk behavior among women

OBJECTIVE: This study is a meta-analysis of the literature exploring the relationship between child sexual abuse (CSA) and HIV risk behavior among women. Four outcome variables were tested: unprotected sex; sex with multiple partners; sex trading; and adult sexual revictimization. METHOD: Forty-six studies met the inclusion criteria and were included in the analysis, and separate meta-analyses were performed for each of the four dependent variables described above. RESULTS: Using the correlation coefficient r as an effect size estimate, results indicate an average effect size of .05 for the unprotected sex meta-analysis (N = 16 studies), .13 for the sex with multiple partners meta-analysis (N = 23 studies), .12 for the sex trading meta-analysis (N = 23 studies), and .17 for the adult sexual revictimization meta-analysis (N = 21 studies). We conducted a test of three potential moderator variables (source of sample, definition of CSA based on type of contact, and definition of CSA based on maximum age of victim). Results did not support the hypothesis that these three variables explain a significant amount of variability in effect sizes with one exception: Studies that define CSA more broadly to include adolescent victims (e.g., victims up to 17 years of age) had larger and more homogenous effect sizes for the sex trading meta-analysis than those that defined CSA as having occurred at younger ages. CONCLUSIONS: These findings suggest a small positive relationship between CSA and subsequent HIV risk behavior among women that varies as a function of how CSA and HIV risk behavior are operationalized.     

Juror and expert knowledge of child sexual abuse.

Mental health professionals with expertise in child sexual abuse (CSA) often testify as expert witnesses in court. There is significant controversy over the admissibility of this type of evidence. To be admissible, the testimony of an expert must be beyond the common knowledge of the jury and based on information generally considered to be reliable within the professional community in which it is used. To date, no empirical data have existed to allow courts to make an informed judgement as to the extent of either juror knowledge or professional acceptance of CSA data. The present study addresses this issue. Jurors and experts completed a questionnaire designed to reveal their understanding of CSA. Results indicate that experts demonstrated strong consensus on 29 of 40 items included in the questionnaire, and that relative to experts, jurors have limited knowledge of these issues. These results suggest that many of the scientific findings concerning CSA are reliable and that the information is often beyond the common knowledge of the jury. These findings argue for the use of expert testimony in select cases of child sexual abuse.     

The impact of case characteristics on child abuse reporting decisions.

Drawing distinctions on the basis of at least some case characteristics in making reporting decisions makes considerable sense. Using data from a national survey of mandated reporters that included vignettes in which case and personal characteristics were systematically varied, this paper examines the impact of selected characteristics while controlling for others. The data reveal that respondents noticed and responded to case characteristics. Abuse-relevant judgments and reporting intentions varied, often substantially, as a function of case characteristics. Three case characteristics--previous abuse, severity of abuse, and recantation--were powerful predictors of vignette outcomes. A history of previous abuse led to judgments of greater seriousness, a more salutary impact of a report, and greater likelihood of reporting. More severe abuse was more likely to be labelled as abuse, and was more likely to be reported. When the alleged victim retracted her accusation upon questioning by an authority figure, respondents were significantly less likely to intend a report. Child age, perpetrator intent and family socioeconomic status also influenced abuse-relevant judgments and reporting intentions. Respondents were more likely to intend a report when younger children, lazy or angry perpetrators and children from poorer families were portrayed.     

Gender differences in social reactions to abuse disclosures, post-abuse coping, and PTSD of child sexual abuse survivors

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 characteristics, sexual abuse experiences, disclosure characteristics, post-abuse coping, and social reactions from others. RESULTS:Female students reported greater prevalence and severity of CSA, more distress and self-blame immediately post-assault, and greater reliance on coping strategies of withdrawal and trying to forget than male students. Women were more likely to have disclosed their abuse to others, to have received positive reactions, and to report greater PTSD symptom severity, but were no more likely to receive negative reactions upon disclosure than men. Women delaying disclosure had greater PTSD symptom severity, whereas men's symptoms did not vary by timing of disclosure. Additional regression analyses examined predictors of PTSD symptom severity and negative and positive social reactions to abuse disclosures. CONCLUSIONS:Several gender differences were observed in this sample of college students in terms of sexual abuse experiences, psychological symptoms, coping, PTSD, and some aspects of disclosure and social reactions from others.     

Ego development in women with histories of sexual abuse.

As many as a third of the women in this culture experience sexual abuse prior to reaching age 18. Recent literature and research have presented divergent views related to the impact of early abuse on ego development, with arguments supporting both ego fragmentation and ego acceleration. This preliminary study compared the level of ego development, as measured by Loevinger's Washington University Sentence Completion Test (SCT), of 30 women with histories of childhood sexual victimization, and 30 women with no history of abuse. Results indicated no significant difference between the ego levels of the sexually abused and nonabused groups, with a slight trend toward higher ego development in the abused group. Factors contributing to these findings are discussed and recommendations for future research are suggested.     

Assessing the relationship between child sexual abuse and marginal living conditions on HIV/AIDS-related risk behavior among women prisoners

OBJECTIVE: There were two aims in this research. First, to examine the relationships between childhood sexual abuse and HIV drug and sexual risk taking behaviors among female prisoners, and second, to examine the relationship between a marginal adult living context and HIV drug and sexual risk taking behavior among female prisoners. METHOD: The data were collected through face-to-face interviews with a random sample of 500 women at admission to prison in 1994. Differences between women who were sexually abused while growing up (n = 130) were compared to women who reported no sexual abuse (n = 370) along various demographic, and HIV drug and sexual risk taking dimensions. RESULTS: A history of sexual abuse while growing up was associated with increased sexual risk taking behaviors in adulthood. A marginal adult living situation also emerged as an important factor increasing the risk for HIV infection. Examining the co-occurrence of both childhood sexual abuse and adult marginal living context revealed a strong relationship between these two factors and HIV risk taking activities. CONCLUSIONS: The findings indicate that childhood sexual abuse may be a predictor for HIV sexual risk taking behaviors among incarcerated women. The marginal and chaotic adult living style of these women was also associated the extent of their HIV drug and sexual risk taking behaviors. Our research suggests that the co-occurrence of sexual victimization and marginality is a stronger predictor of HIV risk than each variable alone.     

Testifying in criminal court: emotional effects on child sexual assault victims.

Child victims must cope not only with the emotional consequences of criminal acts but also with the potentially traumatizing effects of legal involvement. Dramatic increases in the reporting of child sexual abuse are bringing greater numbers of children into contact with the criminal justice system, raising fears that child victims of sex crimes will be further harmed by the courts. In the present study, the effects of criminal court testimony on child sexual assault victims were examined in a sample of 218 children. From this sample, the behavioral disturbance of a group of "testifiers" was compared to that of a matched control group of "nontestifiers" at three points following testimony: 3 months, 7 months, and after prosecution ended. At 7 months, testifiers evinced greater behavioral disturbance than nontestifiers, especially if the testifiers took the stand multiple times, were deprived of maternal support, and lacked corroboration of their claims. Once prosecution ended, adverse effects of testifying diminished. In courthouse interviews before and after testifying, the main fear expressed by children concerned having to face the defendant. Children who appeared more frightened of the defendant while testifying were less able to answer the prosecutors' questions; and later, after the cases were closed, they were more likely to say that testifying had affected them adversely. The two most pervasive predictors of children's experiences in the courtroom, however, were age and severity of abuse. Despite relevant laws, few innovative techniques were used to help the children testify. The results are discussed in relation to children's ability to cope with stressful situations, the interaction of the legal system with the child/family system, and debates about the need to protect child victims who testify in criminal court.