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.     

Childhood sexual abuse,risky sexual behaviors and adverse reproductive health outcomes among Chinese college students

BackgroundChildhood sexual abuse (CSA) is a serious public health problem worldwide.ObjectivesWe reported the prevalence of CSA and examined its association with risky sexual behaviors and adverse reproductive health outcomes among college students in China.Participants and settingParticipants were 17,966 college students from 130 colleges in Eastern, Central, and Western China, who completed the online questionnaire in January–August 2015.MethodsData were obtained from a cluster-random Internet-based survey. Multivariate logistic regression analyses were employed: risky sexual behaviors and adverse reproductive health outcomes were outcome variables, and various types of CSA were predictor variables, while adjusting for socio-demographic and lifestyle characteristics.ResultsThe overall prevalence of any type of CSA was 27.5%. Most perpetrators were friends/acquaintances (34.6%) or intimate partners (24.7%) of the victims. Respondents who reported penetrative CSA were strongly associated with regular unprotected sex (odds ratio (OR): 3.0, 95% confidence interval (CI): 2.2–4.0), early sexual debut (OR: 5.5, 95% CI: 3.3–9.1), having genital tract symptoms in the last 12 months (OR: 5.0, 95% CI: 4.1–6.0), unintended pregnancy (OR: 6.2, 95% CI: 4.2–9.0), and induced abortion (OR: 5.5, 95% CI: 3.7–8.2) (for boys, the survey asked about history of unintended pregnancy and induced abortion of their sexual partners). A dose-response relationship was found across non-contact, contact, and penetrative CSA.ConclusionsCSA experience may increase the likelihood of risky sexual behaviors and adverse reproductive health outcomes in victims’ early adulthood.     

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 precipitating maternal hospitalization

CHILD ABUSE often occurs in families with multiple and frequent stresses [1]. Disclosure of the abuse and the resulting therapeutic interventions may increase the stresses on family members and the family structure [2, 3], Some parents express greater concern about the disruption of their own lives caused by sexual abuse than they express for the victimized child [4, 5,]. Under such circumstances, the child may be deprived of the support needed to cope with the traumatic experience.This paper provides three case reports of unusual examples of family disruption following childhood sexual abuse. In each case the mother's hospitalization was precipitated by the disclosure and investigation of the child's sexual assault complaint.     

Child on child sexual abuse: psychological perspectives

OBJECTIVE: This study describes the emotional and behavioral responses of children who have been sexually victimized by juveniles (CC) 17 years of age and younger compared to child victims of adults (CA) 18 years of age and older. METHOD: A total sample of N = 194 children and adolescents participated in the study, with 26% (n = 51) comprising CC and 74% (n = 143) encompassing CA. The mother/caretaker was administered a demographic form, Achenbach's Child Behavior Checklist (CBCL), and the Family Assessment Measure (FAM-P). The child was given the Family Assessment Measure (FAM-C) and the Trauma Symptom Checklist for Children (TSCC). The clinician completed the Parental Reaction to Incest Disclosure Scale (PRIDS). RESULTS: No differences were found between the two groups for the type of sexual abuse, penetration, or the use of force. CC were younger and more likely to be males who were abused in a school setting, home, or a relative's home by a sibling or a non-related male. CC endorsed clinically significant sexual preoccupations and manifested borderline clinically significant symptomatology. CONCLUSIONS: Children victimized by other children manifested elevated levels of emotional and behavioral problems and were not significantly different from those who had been sexually abused by adults.     

Emotional abuse and neglect (psychological maltreatment): a conceptual framework

OBJECTIVE: Emotional abuse and neglect is an under-recognized, but actually common, form of child abuse. Professionals in the field continue to find difficulty in recognizing and operationally defining it, and experience uncertainty about proving it legally. There are also questions about intervention and therapy to protect the child in the least detrimental manner. These difficulties have led to delays in recognition and protective intervention. Emotional abuse and neglect are defined as a carer-child relationship that is characterized by patterns of harmful interactions, requiring no physical contact with the child. Motivation to harm the child is not necessary for the definition. Unlike sexual abuse that is a secret activity, these forms of ill treatment are easily observable. The child's development is impaired in all domains of functioning but, not being specific to emotional abuse and neglect, cannot be regarded as diagnostic. METHOD: Research, clinical experience and theoretical considerations have led to a conceptual framework and operational definitions of five categories of harmful interactions between parent and child. This framework is contrasted with the APSAC categories. RESULTS: It is postulated that the different categories of ill treatment respectively require different therapeutic interventions. CONCLUSION: Concerns about the presence of emotional abuse need to trigger an assessment process that includes identifying the nature of the abusive or neglectful interactions and a time-limited trial of specific interventions. The family's response to this process and its outcome will determine the need for statutory involvement, as well as providing a basis for litigation if this is required.     

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.     

Childhood maltreatment experiences and problematic sexual outcomes in adult males who have sexually offended: Further evidence of the potency of male caregiver psychological abuse

BackgroundAlthough research on the developmental antecedents of sexual offending has tended to focus on sexual abuse, recent research in juveniles and adults who have sexually offended suggests that psychological abuse perpetrated by a male caregiver may be a particularly important factor in the development of problematic sexual interests and behaviors.ObjectiveThis study aimed to extend previous findings by investigating the association between psychological abuse by a male caregiver and problematic sexual outcomes in a sample of adult males who had sexually offended.ParticipantsParticipants were 529 adult males incarcerated for sexual offenses, 21% of whom were civilly committed.MethodsChildhood maltreatment and problematic sexual outcomes were assessed using the Multidimensional Assessment of Sex and Aggression, a contingency-based inventory that assesses domains related to sexual aggression. Hierarchical regressions were calculated examining the association between childhood abuse types and sexual outcomes.ResultsChildhood sexual abuse was associated with child sexual (β = .247, p < .001) and other paraphilic interests (β = .189, p < .001). Male caregiver psychological abuse also emerged as marginally associated with child sexual interest (β = .100, p = .059), even after controlling for other abuse types.ConclusionsThese results partially replicate recent findings in a juvenile sample and challenge conventional developmental theories of sexual offending, by suggesting that male caregiver psychological abuse may play a role in the etiology of child sexual interest among males who have sexually offended. This study also suggests a possible gender symmetry effect moderating the developmental consequences of abuse.     

Childhood sexual abuse and revictimization in adolescence.

OBJECTIVE: The aim of this study was to examine the link between childhood experiences of sexual abuse and subsequent revictimization in adolescence. METHOD: A sample of 281 female adolescents between 17-20 years of age, who participated in a prevalence survey of unwanted sexual contacts, completed the Sexual Experiences Survey as a measure of unwanted sexual contacts in adolescence and indicated whether or not they had experienced childhood sexual abuse. RESULTS: Childhood experiences of sexual abuse were reported by 8.9% of the respondents, a further 8.5% indicated they were not sure if they had been sexually abused as children. Both abused women and women uncertain about their victimization status were significantly more likely to report unwanted sexual contacts as adolescents than women who did not state abuse. The link between childhood abuse and subsequent victimization was mediated by a higher level of sexual activity among the abuse victims. CONCLUSIONS: The results support existing evidence on the impact of childhood sexual abuse on sexual relationships in subsequent developmental stages and underline the need to consider childhood sexual abuse as a risk factor of adolescent sexual victimization.     

Childhood sexual abuse: impact on a community's mental health status.

Epidemiologists have used impact fractions (e.g., attributable fractions) to study the influence of various risk factors on the rates of physical diseases within the community. In this study, impact fractions are applied to a psychiatric epidemiologic problem in order to examine the impact of childhood sexual abuse (CSA) on the mental health status of a community. Analysis of the Los Angeles Epidemiologic Catchment Area (LAECA) data indicate that a history of CSA significantly increases an individual's odds of developing eight psychiatric disorders in adulthood. On the community level, however, it is estimated that 74% of the exposed psychiatric cases (i.e., those with a history of CSA), and 3.9% of all psychiatric cases within the population can be attributed to childhood sexual abuse. Intervention implications are discussed.     

Childhood disclosure of sexual abuse and mental health outcomes in adulthood: Assessing merits of early disclosure and discussion

BackgroundEmpirical research on the impact of early disclosure of child sexual abuse (CSA) on survivor health is limited and mixed. One recent study found that early disclosure may actually be detrimental for abuse cessation and adult symptomatology (Swingle et al., 2016). The current study re-examined the effects of early disclosure and related variables on long-term mental health for men with histories of CSA.ObjectiveThe primary aims of this study were to: a) investigate whether early disclosure and response to early disclosure were related to mental distress in adulthood, and b) examine whether having an in-depth discussion and timing of that discussion were related to mental distress in adulthood.Participants and settingData were collected from a large, non-clinical sample of male survivors (N = 487), ranging in age from 19 to 84 years, through an online, anonymous survey.MethodsHierarchical regression analyses were conducted by entering groups of variables in four steps: control variables, CSA severity, disclosure, and discussion.ResultsOverall, models explained between 24–28% of the variance in mental distress. None of the CSA severity variables reached significance. Both early disclosure (β = −0.126, p = 0.003) and response to first disclosure (β = −0.119, p = 0.006) were significant protective factors in Model 3. In the final model, having an in-depth discussion (β = −0.085, p = <0.036) and years until discussion (β = 0.102, p = 0.029) were also related to mental distress.ConclusionsResults support the merits of early disclosure and discussion on long-term mental health. Implications for future research and practice are presented.     

Childhood sexual abuse,mental health,and religion across the Jewish community

Current estimates of childhood sexual abuse among Jews in the United States are only available for females and do not include a spectrum of religiosity. We examined sexual abuse, mental health, and religion, in a religiously diverse sample of male and female Jewish adults from North America, using a novel methodology to minimize sampling/response biases. A total of 372 diversely religious Jews participated. Prevalence of any form of childhood sexual abuse was statistically equivalent to national rates, except that females reported less involuntary penetration (OR = 0.53). All Jewish religious groups reported equivalent levels of sexual abuse, except that history of involuntary penetration was greater among formerly (but not presently) Orthodox Jews (OR = 3.00). Across our sample, sexual abuse was associated with increased likelihood of psychiatric diagnosis (OR = 1.34), greater mental distress (F ranging from 2.99 to 9.08, p < .05 for all analyses), lower religious observance (F = 4.53, p = .03), and lower intrinsic religiosity (F = 4.85, p = .03). Further, across our sample we observed a moderate buffering effect of spiritual/religious factors against mental distress (ΔR² values ranging from 0.028 to 0.045, p <.01 for all analyses). Thus, we found childhood sexual abuse to occur across the spectrum of Jewish religious affiliation and greater prevalence among formerly Orthodox individuals. Furthermore, history of childhood sexual abuse was associated with greater risk for psychiatric distress and less religious involvement, however spiritual/religious engagement and belief appeared to facilitate resilience in the context of abuse.     

Childhood sexual abuse history and role reversal in parenting

OBJECTIVE: This study explored the main and interactive effects of sexual abuse history and relationship satisfaction on self-reported parenting, controlling for histories of physical abuse and parental alcoholism. METHOD: The community sample consisted of 90 mothers of 5- to 8-year-old children. The sample was limited to those mothers currently in an intimate relationship, 19 of whom reported a history of childhood sexual abuse. Participants completed the Child Behavior Checklist, the Parenting Stress Inventory, the Family Cohesion Index, and questions assessing parent-child role reversal, history of abuse and parental alcoholism, and current relationship satisfaction. RESULTS: Results of analyses and multivariate analyses of covariance suggested that sexual abuse survivors with an unsatisfactory intimate relationship were more likely than either sexual abuse survivors with a satisfactory relationship or nonabused women to endorse items on a questionnaire of role reversal (defined as emotional overdependence upon one's child). Role reversal was not significantly predicted by histories of physical abuse or parental alcoholism or child's gender. While parenting stress was inversely predicted by the significant main effect of relationship satisfaction, neither parenting stress nor child behavior problems were predicted by the main effect of sexual abuse history or by the interaction between sexual abuse history and relationship satisfaction. CONCLUSIONS: These results suggest the unique relevance of sexual abuse history and relationship satisfaction in the prediction of a specific type of parent-child role reversal--namely, a mother's emotional overdependence upon her child.     

Childhood sexual abuse, parenting and postpartum depression--a 3-year follow-up study

OBJECTIVE: This study is the second and final phase of a 3-year follow-up study of women who had been admitted with a major depressive episode in the postpartum period, along with their children and partners where present. The effect of a maternal sexual abuse history on the women's well-being and child outcome compared to those women without such a history is highlighted. METHOD: Forty-five of an original cohort of 56 women were seen with their child where possible, when the child was an average of 36.8 months old. Twenty-two women had no history of sexual abuse, and 23 gave a history of childhood sexual abuse. Women were assessed with respect to well-being, relationships, parenting stress and psychiatric history since recruitment. The child's behavior and cognitive development was also assessed. RESULTS: Women with a history of sexual abuse rated higher depression and anxiety scores (p < .05), and had greater life stresses (p < .05). Their partners rated themselves as more comforting and their children as more disturbed (p < .05). Over time, this group had failed to improve as much as the nonabuse group on these measures. There was no difference in child cognitive scores between groups. CONCLUSIONS: A history of sexual abuse in women who become depressed postpartum may have long term implications for the woman's mental health, her relationship with her child, as well as the emotional development of her child. It is critical to offer women in this high-risk group supports in an attempt to minimize these difficulties and any long-term adverse effects.     

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.     

Coping strategies and social support as mediators of consequences in child sexual abuse victims.

OBJECTIVE: The main objective of this study was to evaluate the mediator role of coping strategies and social support on the adaptation of children following CSA. Empirical studies indicate that short-term consequences of child sexual abuse (CSA) are multiple and varied (Kendall-Tackett, Williams, & Finkelhor, 1993; Wolfe & Birt, 1995). While abuse-related characteristics were first studied to explain the variability of CSA outcome, more recently, the influence of other variables such as coping strategies and social support have been considered. METHOD: Fifty sexually abused children aged between 7 and 12 participated in this study. The Child Behavior Checklist (Achenbach, 1991) and the Perceived Competence Scale for Children (Harter, 1985) were used to measure victims' adjustment. Coping strategies were evaluated by the Self-Report Coping Scale (Causey & Dubow, 1992) and the children completed the Perceived Social Support (Harter, 1985). A French version of the History of Victimization (Wolfe, Gentile, & Bourdeau, 1987) was used to gather abuse-related characteristics from medical records. RESULTS: Results indicate that sexually abused children exhibit internalizing and externalizing behavior problems following CSA. Coping strategies and social support exert direct effects on victims' adjustment instead of the mediator influences originally expected. Among abuse-related variables, only the perpetrator's identity is directly related to internalizing symptoms. CONCLUSIONS: The absence of mediational effects of coping and social support is discussed in light of the measures used and the cross-sectional nature of the study. Results highlight the importance of parental implication and the consideration of coping strategies in designing therapeutic interventions with this population.     

Childhood sexual abuse, adolescent sexual coercion and sexually transmitted infection acquisition among homeless female adolescents

OBJECTIVE: To examine the relationship between childhood experiences of sexual abuse, sexual coercion during adolescence, and the acquisition of sexually transmitted infections (STIs) in a population of homeless adolescents. METHOD: Homeless adolescent females (N = 216) from a northwestern United States city were recruited by street outreach workers for a longitudinal study of STI epidemiology. Baseline data on childhood abuse and recent history of sexual coercion were used to predict physiologically confirmed STI acquisition over the subsequent 6 months. RESULTS: About 38% of all girls reported a history of childhood sexual abuse (CSA). Girls with a history of CSA were more likely to report recent sexual coercion. In turn, sexual coercion in the last three months was significantly associated with a higher number of sexual partners (but not with a greater frequency of intercourse or with lower rates of condom use). Number of sexual partners significantly predicted the future acquisition of an STI within 6 months. CONCLUSIONS: Interventions to reduce risky sexual behaviors in homeless adolescent females may need to consider the impact of CSA, particularly on the number of sexual partners during adolescence. However, it also should be noted that engagement in intercourse often results from coercion and is not voluntary in this population.