Search

Child sexual abuse (CSA) is a pervasive social problem that can have long-term effects on women's relationships because it makes them vulnerable to revictimization. Girls are more vulnerable than boys to be victims of CSA, and those abused by someone they trust are at higher risk of experiencing increased trauma and interpersonal problems. This quantitative research study investigated the association between CSA and interpersonal relationships. Participants completed anonymous surveys exploring these two variables. Results showed that among other vulnerabilities, women who reported sexual abuse within the family reported overall greater interpersonal problems compared with non-abused participants. Given the prevalence of intrafamilial and other types of CSA and its impact on interpersonal relationships, providing an environment where girls are safe from abuse is important. Research, education, policy, and educational programs can help prevent CSA and its consequences. Keywords: Women, Interpersonal relationships, Trinidad, Child sexual abuse, Adult survivors, Introduction Childhood sexual abuse (CSA) has been characterized by researchers as a preventable violation of the evolving child (Finkelhor et al., 2014). CSA is a global crisis of epidemic proportions [...]

Author(s): David W. Sosnowski [sup.1] , Wendy Kliewer [sup.1] , Timothy P. York [sup.2] , Ananda B. Amstadter [sup.3] , Colleen K. Jackson-Cook [sup.4] , Marcia A. Winter [sup.1] Author [...], Robust associations between adverse childhood experiences and shortened telomere length exist, but few studies have examined factors that may moderate this association, particularly with a resilience framework. The present study examined the association between exposure to childhood sexual abuse (and abuse severity) and mean telomere length, and whether social support and optimism moderated this association. The sample included 99 White monozygotic female twins, ranging in age from 35 to 70 (M.sub.age = 52.74, SD = 8.55 years), who provided a blood sample for telomere assay, and data on their childhood sexual abuse history, trait optimism, and current social support. Linear mixed effects models were employed to test study hypotheses. There were no effects of exposure to abuse or abuse severity on mean telomere length, nor were there main or moderating effects of optimism, in analyses of the full sample. However, in analyses that only included women exposed to abuse, there was an abuse type x support interaction: among women who experienced abuse in forms other than intercourse, higher levels of social support were associated with longer mean telomere length. Findings from the current study clarify the role of childhood sexual abuse in telomere attrition, and identify one factor that may protect against the negative biological effects of childhood sexual abuse.

Few studies have examined the sexual sequelae of child sexual abuse (CSA) for sexual minority women (SMW), particularly SMW in dating relationships. We examined the impact of CSA on several [...]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.chiabu.2010.02.010 Byline: Chad E. Shenk (a), Jennie G. Noll (a), Frank W. Putnam (b), Penelope K. Trickett (c) Keywords: Child sexual abuse; Physiological asymmetry; Psychopathology Abstract: Recent literature has emphasized the simultaneous assessment of multiple physiological stress response systems in an effort to identify biobehavioral risk factors of psychopathology in maltreated populations. The current study assessed whether an asymmetrical stress response, marked by activation in one system and a blunted response in another system, predicted higher levels of psychopathology over time. Author Affiliation: (a) Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA (b) Mayerson Center for Safe and Healthy Children, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA (c) School of Social Work, University of Southern California, Los Angeles, CA, USA Article History: Received 23 September 2009; Revised 11 February 2010; Accepted 11 February 2010 Article Note: (footnote) [star] This research was supported by the National Institutes of Health (R01 MH048330; R03 HD045346; T32DK063929), Department of Health and Human Services (ACYF 90CA1686l), W.T. Grant Foundation, and Smith Richardson Foundation.

Twenty-seven adult survivors of childhood sexual abuse participated in a pilot study comprising an 8-week mindfulness meditation-based stress reduction (MBSR) program and daily home practice of mindfulness skills. Three refresher classes were provided through final follow-up at 24 weeks. Assessments of depressive symptoms, post-traumatic stress disorder (PTSD), anxiety, and mindfulness, were conducted at baseline, 4, 8, and 24 weeks. At 8 weeks, depressive symptoms were reduced by 65%. Statistically significant improvements were observed in all outcomes post-MBSR, with effect sizes above 1.0. Improvements were largely sustained until 24 weeks. Of three PTSD symptom criteria, symptoms of avoidance/ numbing were most greatly reduced. Compliance to class attendance and home practice was high, with the intervention proving safe and acceptable to participants. These results warrant further investigation of the MBSR approach in a randomized, controlled trial in this patient population. Keywords: child abuse; depression; post-traumatic stress disorder; mindfulness; meditation DOI: 10.1002/jclp.20624

Childhood sexual abuse is a traumatic life event that may cause psychiatric disorders such as posttraumatic stress disorder and depression. During 2003-2004, 20 sexually abused children were referred to the Child and Adolescent Psychiatry Clinic of Ege University in Izmir, Turkey. Two years later, the psychological adjustment of these children (M age = 9.4 years, SD = 3.63 years, range = 5 to 16 years) is evaluated. Semistructured interviews, a form for the sociodemographic characteristics, are used for evaluations by a child psychiatrist who is blind to the first evaluation. It is determined that sexually abused children have more psychiatric disorders within the first year than 2 years later. However, some behavior problems occur at both short-term and long-term follow-ups. Keywords: childhood; sexual abuse; social outcomes; emotional outcomes; posttraumatic stress disorder

Emotional intelligence is found to be a protective factor for suicidal behavior after examining the relations between childhood sexual abuse and suicidal ideation and attempts to emotional intelligence. Childhood sexual abuse is found to be a strong predictive of the results.

Childhood sexual abuse (CSA) is common and is associated with both mental and physical health problems in adulthood. Using data from an age- and sex-stratified population survey of 600 Olmsted County, Minnesota, residents, a Sexual Abuse Severity Score was developed. The abuse characteristics of 156 CSA respondents were associated with self-reported trauma, somatization, and alcohol use. Characteristics included age of first sexual abuse, more than one perpetrator, degree of coercion, severity of abuse (i.e., attempted intercourse is more severe than fondling), and the number of occurrences. This is one of the few reports to develop a risk summary that quantifies the severity of CSA. Keywords: sexual abuse; child abuse, Hx of child abuse; PTSD, adolescent victims; sexual assault, male victims; sexual assault, situational factors

Posttraumatic stress disorder (PTSD) is 1 of several possible outcomes of child sexual victimization. There is a growing body of literature regarding the prevalence of PTSD among children who have been sexually victimized. Using specific case examples, this article looks at the nature and scope of the problem, diagnostic criteria according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000) symptomatology of children presenting with this disorder, assessment and diagnosis, treatment interventions, and implications for counselors treating this population., A child awakens in the middle of the night, the nightmare still fresh in her mind of "him" on top of her. Her breath comes in short, quick gasps as [...]

Gay and bisexual men carry the burden of HIV infections in the United States and have high rates of childhood sexual abuse that predict HIV and other health outcomes. This study examined differential effects of forced, consensual, and no childhood sexual experiences (CSE) on health outcomes among a probability sample of adult men who have sex with men (MSM). The forced sex group had the highest levels of psychological distress, substance use, and HIV risk. There were no differences in rates of depression and suicidal ideation between the consensual- and no-sex groups. The consensual- and forced-sex groups had higher rates of substance use and transmission risk than the no-sex group. The forced-sex group, however, had significantly higher rates of frequent drug use and high-risk sex than the consensual group. Findings suggest that forced CSEs result in a higher-risk profile than consensual or no childhood sexual experiences, the kind of risk pattern differs between forced and consensual childhood sexual experiences, and the underlying mechanisms that maintain risk patterns may vary. It is important to clarify risk patterns and mechanisms that maintain them differentially for forced and consensual sex groups so that interventions may be tailored to the specific trajectories related to each experience., In the United States, gay and bisexual men continue to carry the burden of new HIV infections (Centers for Disease Control and Prevention [CDC], 2003). Studies using opportunistic samples have [...]

Objective: The present study evaluated the association between women's health and physical and sexual abuse suffered before age 18. Methods: A total of 3,568 randomly sampled insured women ages 18-64 completed a telephone interview to assess history of physical only, sexual only, or both physical and sexual abuse before age 18 (Behavioral Risk Factor Surveillance System); and current health (Short Form-36, Center for Epidemiologic Studies-Depression, Presence of Symptoms surveys). Adjusted analyses compared the health of women with physical abuse only, sexual abuse only, or physical and sexual abuse to the health of women without these abuse histories. Results: Poorest health status was observed in women with a history of both physical and sexual child abuse compared to women without these abuse histories. In models that adjusted for age and income, women with both abuse types had increased prevalence of depression (prevalence ratio, 2.16), severe depression (PR, 2.84), physical symptoms (PR range, 1.33 for joint pain to 2.78 for nausea/vomiting), fair/poor health (PR, 1.84), and lower SF-36 scores (3.15-5.40 points lower). Women with physical abuse only or sexual abuse only also had higher prevalence of symptoms and lower SF-36 scores but the associations were not as strong. Conclusions: This study adds to the literature showing a graded association between multiple adverse events in childhood and adult health. Keywords: Child abuse Physical abuse Sexual abuse Health status Intimate partner violence

Disclosure is a prominent variable in child sexual abuse research, but little research has examined male disclosure experiences. Sixteen male survivors of childhood sexual abuse were interviewed regarding experiences of disclosure. Analytic techniques included a grounded theory approach to coding and the use of conceptually clustered matrices. Participants described distinct personal (e.g., lack of cognitive awareness, intentional avoidance, emotional readiness, and shame), relational (e.g., fears about negative repercussions, isolation), and sociocultural (e.g., lack of acceptance for men to experience or acknowledge victimization) reasons for their struggles with disclosure. These results highlight that barriers to disclosure exist in multiple domains of experience and are encountered across the lifespan. Implications for future research and clinical interventions are discussed. Keywords: sexual abuse, male survivors, narrative analysis, disclosure

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1471-6402.2008.00418.x Byline: Suzanne R. Lemieux (1), E. Sandra Byers (1) Abstract: The present study examined the association between child sexual abuse (CSA) and a range of positive and negative aspects of women's sexual well-being. We also investigated the extent to which women's cognitive-affective sexual appraisals mediated these relationships. Participants were 272 female community college and university students. CSA involving fondling only was generally not associated with adverse sexual outcomes. However, the women who had experienced CSA involving sexual penetration or attempted sexual penetration were (a) more likely to be sexually revictimized in adulthood; (b) more likely to have engaged in casual sex, unprotected sex, and voluntary sexual abstinence; and (c) reported fewer sexual rewards, more sexual costs, and lower sexual self-esteem. These findings held over and above the effects of nonsexual abuse in childhood, and as predicted, sexual self-esteem partially or fully mediated most of these relationships. Nonsexual abuse in childhood and adult sexual victimization were also uniquely associated with a number of adverse sexual outcomes. However, outcomes were not worse for women who had experienced CSA involving actual or attempted sexual penetration and sexual assault in adulthood. The results highlight the fact that CSA is a serious and widespread problem with significant implications for adult women's sexual functioning. Author Affiliation: (1)Calgary Health Region (2)University of New Brunswick Article History: Initial submission: August 4, 2006Initial acceptance: October 5, 2007Final acceptance: January 8, 2008 Article note: Address correspondence and reprint requests to: E. Sandra Byers, Department of Psychology, University of New Brunswick, Fredericton, New Brunswick, Canada E3B 6E4. E-mail: byers@unb.ca

Objectives: Since the late 1980s, there has been a strong theoretical focus on psychological and social influences or perpetration of child sexual abuse. This paper presents the results of a review and meta-analysis of studies examining risk factors for perpetration of child sexual abuse published since 1990. Method: Eighty-nine studies published between 1990 and April of 2003 were reviewed. Risk factors were classified into one of the following six broad categories: family factors, externalizing behaviors, internalizing behaviors, social deficits, sexual problems, and attitudes/beliefs. Sex offenders against children (SOC) were compared to three comparison groups identified within the 89 studies: sex offenders who perpetrated against adults (SOA), non-sex offenders, and non-offenders with no history of criminal or sexual behavior problems. Results: Results for the six major categories showed that SOC were not different from SOA (all d between--.02 and .14) other than showing lower externalizing behaviors (d = -.25). Sex offenders against children were somewhat different from non-sex offenders, especially with regard to sexual problems and attitudes (d =.83 and .51). Sex offenders against children showed substantial differences from non-offenders with medium sized effects in all six major categories (d's range from .39 to .58). Conclusion: Child sex offenders are different from non-sex offenders and non-offenders but not from sex offenders against adults. Practice implications: This study suggests that the presence of general risk factors may lead to a variety of negative behavioral outcomes, including the perpetration of child sexual offending. Family factors were strongly related to the perpetration of child sex offending (vs. non-sexual offending or non-offending) and may be valuable intervention points for interrupting the development of child sex offending, as well as other negative behaviors. Other potential points for intervention may focus on the development of appropriate social and emotional skills that contribute to sexual offending. Keywords: Child sexual abuse Child molester Perpetration Risk factors

This study examined the co-occurrence of childhood sexual abuse, adult sexual assault, intimate partner violence, and sexual harassment in a predominantly African American sample of 268 female veterans, randomly sampled from an urban Veterans Affairs hospital women's clinic. A combination of hierarchical and iterative cluster analysis was used to identify 4 patterns of women's lifetime experiences of violence co-occurrence. The 1st cluster experienced relatively low levels of all 4 forms of violence; the 2nd group, high levels of all 4 forms: the 3rd, sexual revictimization across the lifespan with adult sexual-harassment; and the 4th, high intimate partner violence with sexual harassment. This cluster solution was validated in a theoretically driven model that examined the role of posttraumatic stress disorder (PTSD) as a mediator of physical health symptomatology. Structural equation modeling analyses revealed that PTSD fully mediated the relationship between violence and physical health symptomatology. Consistent with a bio-psycho-immunologic theoretical model, PTSD levels more strongly predicted pain-related physical health symptoms compared to nonpain health problems. Implications for clinical interventions to prevent PTSD and to screen women for histories of violence in health care settings are discussed. Keywords: sexual violence, childhood sexual abuse, intimate partner violence, PTSD, physical health

The publicity about online 'predators' who prey on naive children using trickery and violence is largely inaccurate. Internet sex crimes involving adults and juveniles more often fit a model of statutory rape--adult offenders who meet, develop relationships with, and openly seduce under-age teenagers--than a model of forcible sexual assault or pedophilic child molesting. This is a serious problem, but one that requires approaches different from those in current prevention messages emphasizing parental control and the dangers of divulging personal information. Developmentally appropriate prevention strategies that target youths directly and acknowledge normal adolescent interests in romance and sex are needed. These should provide younger adolescents with awareness and avoidance skills while educating older youths about the pitfalls of sexual relationships with adults and their criminal nature. Particular attention should be paid to higher risk youths, including those with histories of sexual abuse, sexual orientation concerns, and patterns of off- and online risk taking. Mental health practitioners need information about the dynamics of this problem and the characteristics of victims and offenders because they are likely to encounter related issues in a variety of contexts. Keywords: Internet, adolescents, child sexual abuse, statutory rape, sexual offending

Prior research consistently has shown a strong relation between childhood abuse and nonsuicidal self-injury (NSSI), yet it is unclear why this relation exists. The authors examined 2 specific posttraumatic stress disorder (PTSD) symptom clusters as potential mechanisms through which childhood abuse may be related to NSSI. Participants were 86 adolescents (78% female, 22% male; 73% Caucasian, 27% other races/ethnicities; mean age = 17.03 years, range = 12-19 years) who completed measures of childhood abuse, Diagnostic and Statistical Manual of Mental Disorders (4th ed.) PTSD symptoms, and NSSI. Analyses revealed a significant relation between childhood sexual abuse in particular and the presence and frequency of NSSI. Moreover, data supported a theoretical model in which PTSD reexperiencing and avoidance/numbing symptoms independently mediate this relation. Future research must test the temporal relation between childhood sexual abuse, PTSD symptoms, and NSSI and identify additional pathways to engagement in NSSI. Keywords: self-injury, child abuse, trauma, posttraumatic stress disorder, self-harm

Objectives: Although a wealth of literature suggests that childhood physical, emotional, and sexual abuse are related to later-life HIV-related risk behaviors, few studies have explored disinhibition (e.g., impulsivity, risk-taking propensity, and sensation-seeking) as a risk factor in this relationship. Method: This cross-sectional study examined impulsivity, risk-taking propensity, and sensation seeking as mediators in the relationship between abuse history and engagement in HIV-related risk behaviors among a sample of 96 inner-city African American adolescents. Results: Findings indicated that abuse history was positively related to self-reported engagement in HIV-related risk behaviors (B=.027, SE .008, [beta]=.32, [sr.sup.2]=.105, p=.001), as well as risk-taking propensity (B=.35, SE .11, [beta]=.30, [sr.sup.2]=.090, p=.003) and sensation seeking (B=.17, SE.05, [beta]=.35, [sr.sup.2]=. 124, p=.0004). Abuse history was not related to impulsivity. Further, while sensation-seeking and risk-taking propensity (to a lesser extent) mediated this relationship, impulsivity did not. Conclusions: These findings provide an initial step in the examination of the mechanisms underlying the relationship between childhood abuse and engagement in HIV-related risk behaviors. Keywords: HIV risk behavior; Child abuse; Sensation seeking; Risk-taking propensity; Assessment; Adolescents

Objective: The purpose of this study was to examine patterns of change in attributions for childhood sexual abuse (CSA) over a 6-year period and whether such patterns were related to abuse severity, age, gender, and subsequent symptoms of depression and PTSD. Methodology: One-hundred and sixty children, 8-15 years old, were interviewed within 8 weeks of the time the CSA was reported to child protective services (i.e., the time of abuse discovery). Follow-up interviews were conducted 1-year later on 147, and 6 years later on 121 of the original participants. Abuse-specific attributions were obtained using two methods. Participants first responded to an open-ended interview question about why they believed the CSA had happened to them and then completed a rating scale about the extent to which possible attributions for the CSA applied to them (e.g., 'Because I was not smart enough'). Results: Over time, perpetrator-blame attributions were consistently more common than self-blame attributions for CSA (using both interview and rating measures). Youth were more likely to report self-blame attributions on the rating measure than the open-ended interview question. The interview method indicated that youth often felt confused about why the abuse happened up to a year following discovery but this response diminished by the third assessment. On average, ratings of perpetrator-blame attribution remained high over time (p < .05), whereas ratings of self-blame decreased (p < .01). Penetration was related to more self-blame (p < .05) and less perpetrator-blame (p < .05), and the use of force was related to more perpetrator-blame. The initial level of self-blame attribution ratings predicted subsequent symptoms of depression (p < .05) and intrusive experiences (p < .05) after controlling for age at abuse discovery, gender, and self-blame attributions for common events. Perpetrator-blame attributions were not related to symptoms. Conclusions: The findings of this study suggest that assessing responses to open-ended interview questions about the perceived reasons for the abuse and ratings of attributions are important for understanding how youth make sense of their abuse. Abuse-specific self-blame attributions at abuse discovery have a persistent effect on internalizing symptoms and should be assessed and the target of treatment as soon as possible after CSA has been reported to the authorities. Keywords: Child sexual abuse; Self-blame; Perpetrator blame

The study explored types of memory for childhood sexual abuse (CSA) in a clinical sample of 30 women and identified factors that led some women (n = 24) to report recovered memories. Questionnaires produced three types of memory: always (n = 6), recovered (n = 14), both (n = 10); however, analysis of narrative data also revealed the use of language that could not be categorized into discrete types. Recovered memories were linked to three categories of experience (cumulative reactions, atypical reactions, and atypical experiences). Subcategories identified specific contexts associated with those experiences. Findings suggest that further research is needed on the phenomenology of memory experiences using language derived from CSA survivors and a better understanding of the long-term process of interpretations of key experiences that result in reports of recovered memories. Keywords: childhood sexual abuse; types of memory

Objective: An anogenital examination is usually part of the standard medical assessment in children evaluated for suspected sexual abuse, and the emotional impact on the child has been studied. The primary aim of this study was to assess non-abused preschool children's responses to an anogenital examination. Method: One hundred and fifty-eight children (119 girls), aged 5-6 years old, were recruited by self-selection from a town community in Norway. After a full medical 'top-to-toe' examination, including an anogenital examination with use of a colposcope, the children were asked for their reactions to different parts of the examination. The instrument used was a Faces Rating Scale with five faces, ranging from smiling to crying. Parents and nurses also completed questionnaires regarding their perceptions of the children's reactions. Results: The results from the self-report scales showed that only 7.7% of the children rated the anogenital examination as somewhat negative, but the children rated the anogenital part of the examination as significantly more distressing than the examination of their ears and mouth. Microbiological swabbing from the anogenital area was most frequently mentioned as something the children disliked. Complementary data from the parents supported the children's responses regarding the anogenital part, but also emphasized the importance of good preparation and a 'child-friendly' atmosphere when performing the examination. Conclusions: Most preschool children, who have no history of sexual abuse do not find an anogenital examination traumatic if the examination is well planned and performed by experienced professionals in a supportive atmosphere. Keywords: Child sexual abuse; Anogenital examiniation; Children's perception; Non-abused children

Research has shown both childhood physical and sexual abuse to be associated with later suicide attempts, although some studies have not supported these findings. However, few studies have investigated differences in physical and sexual abuse histories among single and multiple suicide attempters. The goals of the current study were two-fold: (a) to replicate previous findings of associations between childhood sexual and physical abuse and suicide attempts, and (b) to explore differences in reports of childhood physical and sexual abuse among single and multiple suicide attempters. While our results supported the findings that individuals with a history of suicide attempts are more likely to report histories of childhood physical and sexual abuse, we did not find a difference in reported abuse between single and multiple suicide attempters. Implications of these findings, as well as implications for future research, are discussed.

Objective: The potential path from sexual abuse as a child to the current risk of physical abuse by mothers was assessed. Ontogenic variables including the experience of the parent's sexual abuse as a child and current depression or substance abuse were expected to have a greater impact on the risk of child abuse than microsystem and exosystem variables such as family functioning, domestic violence, income, community safety, and social support. Method: A path analysis using secondary data was conducted to examine these systemic impacts. The sample consisted of 265 women, the majority of whom were African-American with a high school education or GED. The majority of these women were employed, lower socio-economic status, and over 50% of the sample had never been married. Results: Sexual abuse as a child was found to impact maternal depression. Maternal depression and locus of control impacted risk of physical abuse. These two variables accounted for 22% of the variance in the dependent variable. Conclusion: These findings indicate that it may not be the experience of sexual abuse itself that has an impact on a mother's risk of physical abuse, but rather whether she is able to resolve that trauma. Her locus of control appears to be important in this resolution. The majority of these women were low-income, urban African-American women; it may be important to focus on locus of control for this population. Keywords: Sexual abuse; Physical abuse; Child abuse; Systems theory

Sexually abused children may have poor mental health because of their victimization as well as preexisting or co-occurring family problems. However, few studies consider psychopathology in relation to both abuse and other family experiences. This study uses data from the National Survey of Child and Adolescent Well-Being (NSCAW) to create latent subgroups of 553 children investigated for sexual abuse. The study investigates children's psychological symptoms and child welfare service (CWS) patterns to understand how children's needs relate to mental health services. Analyses were conducted by child age: 3-7, 8-11, and 12-14. Factor mixture modeling and regression analyses were used. Results show meaningful subgroups of children that relate to different symptom patterns. Among 3- to 7-year-olds, behavioral symptoms are associated with caregiver domestic violence and mental illness. Among 8- to 11-year-olds, depressive symptoms are associated with severe abuse and multiple family problems, whereas posttraumatic stress is associated with chronic, unresolved abuse. Although many children received mental health services, services are not well matched to children's needs--the substantiation status of the abuse explains services. Implications for CWS and mental health services are discussed. Keywords: sexual abuse, NSCAW, latent profile analysis, child welfare services

This in-depth qualitative study explores how 16 resilient male survivors of serious childhood sexual abuse, representing a range of racial, ethnic, and socioeconomic backgrounds, made meaning from their abuse experiences. Three main types of meaning making styles were identified in the narratives: meaning making through action, using cognitive strategies, and engaging spirituality. Meaning making through action included helping others and using creative expression to describe and process the abuse. Reasoning systems that helped survivors to understand why the abuse happened included developing a psychological framework for understanding the abuser or the role of the self in the abuse, using a sociocultural explanation, or developing a philosophical view. A few men made meaning through their spirituality. Meaning making styles seem to be related to experiences with therapy; the more experience these men had had with specialized trauma therapy, the more likely they were to make meaning by attempting to understand their perpetrators. In this study, men of color, regardless of socioeconomic class, were less likely than Caucasian men to have received specialized trauma therapy. Keywords: male survivors, childhood sexual abuse, resiliency, meaning making, narratives

Several authors have argued that survivors of childhood sexual abuse (CSA) who report to have repressed their traumatic memories are more skilled in forgetting emotional stimuli than survivors who have always remembered the abuse. The current experiment employed a list-wise directed forgetting task to investigate whether women reporting repressed (n = 16) or recovered (n = 23) memories of CSA are better at forgetting disturbing material, relative to women reporting having always remembered their abuse (n = 55) or reporting no history of abuse (n = 20). We found no support for the hypothesis that women reporting repressed or recovered memories of CSA are especially versed in inhibiting retrieval of trauma-related words. Additional analyses revealed that participants characterized by a repressive coping style did not display a superior retrieval inhibition mechanism for negative material. Keywords: Childhood sexual abuse; Repression; Directed forgetting

This study examines the interrelationships between childhood abuse, exposure to maternal domestic violence, and posttraumatic stress disorder (PTSD) symptomatology in a multiethnic sample of 111 adult female residents of a domestic violence (DV) shelter. Participants completed structured interviews about the DV and their prior violence exposure, as well as the Impact of Event Scale-Revised. As hypothesized, there was high co-occurrence between exposure to maternal DV and childhood physical and sexual abuse, and the frequency of lifetime violence exposure predicted PTSD symptomatology. A series of multiple regressions indicated a more complex pattern of relationships, in which specific forms of prior violence exposure predicted different PTSD symptom dimensions. A history of witnessing maternal DV predicted intrusion symptoms, and a history of childhood sexual abuse predicted hyperarousal symptoms. Ethnicity was not related to levels of violence exposure or to PTSD symptoms. Clinical implications of the findings are discussed. Keywords: interpersonal violence; PTSD; childhood abuse; trauma

Objective: To explore the relationships between psychological symptoms and thyroid hormone levels in adolescent girls who had experienced the traumatic stress of sexual abuse. Method: The study design was cross-sectional/correlational. Subjects (N = 22; age range = 12-18 years) had their blood drawn, and they completed 2 psychological tests (depression and general distress/posttraumatic stress disorder [PTSD]). A pediatrician completed a sexual abuse questionnaire after reviewing law enforcement and Child Protective Services reports and conducting forensic interviews and medical examinations. Results: Girls' average free [T.sub.4], total [T.sub.4], free [T.sub.3], total [T.sub.3], and TSH levels were within age-specific laboratory reference range limits, as were most individual concentrations. The strongest correlations (p < .05) were between free [T.sub.3] and PTSD total score (-.50), PTSD--avoidance/numbing (-.49), and general distress (-.48); and between total [T.sub.3] and depression (-.46), general distress (-.45), and PTSD--arousal (-.44). Conclusions: Our findings support one of the two contemporary models of the relationships between thyroid hormones (i.e., free and total [T.sub.3]) and psychological symptoms (i.e., depression, general distress, and PTSD)--one of 'shutting down' (vs. 'activation') in the face of trauma. Keywords: Child sexual abuse; Thyroid hormones; Posttraumatic stress disorder

Objective: The aim of this study was to examine the impact of childhood sexual abuse (CSA) on clinical characteristics and premature termination of treatment in anorexia nervosa (AN). Method: The participants were 77 consecutive patients with AN admitted to an inpatient eating disorders unit. The patients were assessed in terms of eating disorder symptoms, general psychopathology, and CSA history at admission to hospital. Results: Thirty-seven patients (48%) reported a history of CSA before the onset of the eating disorder. Individuals with a history of CSA reported significantly greater psychiatric comorbidity, including higher levels of depression and anxiety, lower self-esteem, more interpersonal problems, and more severe obsessive-compulsive symptoms. Patients with the binge-purge subtype of AN (AN-BP) were significantly more likely to report a history of CSA prior to the onset of the eating disorder as compared with patients with the restricting subtype (AN-R) of the illness (65% of the AN-BP patients vs. 37% of the AN-R patients; p < .02). Contrary to our predictions, abused patients were not significantly more likely to dropout of treatment overall. However, patients of the binge-purge subtype (AN-BP) with a history of CSA were significantly more likely to terminate treatment prematurely as compared with the other patients. Conclusions: Consistent with previous findings, the present results indicate that the prevalence of CSA is high among individuals seeking inpatient treatment for AN. A history of CSA was associated with greater psychiatric disturbance overall and a higher rate of dropout for patients of the binge-purge subtype. Keywords: Anorexia nervosa: Sexual abuse: Treatment dropout

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.chiabu.2005.08.015 Byline: David A. Wolfe (a), Karen J. Francis (b), Anna-Lee Straatman (b) Keywords: Child abuse; Religious institutions; Sexual abuse Abstract: To describe the long-term impact of physical and sexual abuse of boys by someone in a trusting, non-familial relationship. This clinical study reports on the psychological functioning of men (N =76) with substantiated claims against a residential religiously-affiliated institution for multiple and severe incidents of sexual, physical, and/or emotional abuse during childhood. The abuse was perpetrated by several adults in positions of authority and trust at the institution. Author Affiliation: (a) Centre for Addiction and Mental Health, University of Toronto, Toronto, Ont., Canada (b) Department of Psychology, University of Western Ontario, London, Ont., Canada Article History: Received 11 November 2004; Revised 19 July 2005; Accepted 12 August 2005

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

Objective: The present study explores the link between reported sexual and/or physical abuse and psychological defense styles, as well as the association of both with psychological distress in adulthood. In two patient samples that differ in psychological distress and somatization, we examine whether the adversities reported and immature defense styles are associated with psychopathological symptoms. Method: We examined 266 consecutive inpatients in the psychosomatic department and 109 consecutive inpatients who had been treated for low-back pain in the orthopedic department of a German university hospital. Psychological defense styles were assessed by a two-factor solution of the German modified adaptation of the Defense Mechanism Inventory (DMI), childhood adversities by a structured interview, psychological distress by the SCL-90-R, and somatization by the Screening for Somatoform Disorders (SOMS). Results: Both samples demonstrated a significant link between immature defense styles and the extent of overall psychological distress as well as somatization. Reported sexual and/or physical abuse of patients in both patient samples was directly associated with somatization. Conclusion: Recollections of sexual and/or physical abuse in childhood and immature defense styles have an association with psychopathology in adulthood. This finding suggests that immature defense styles may act, in part, as mediators between the adversities investigated and adult psychopathology. Keywords: Defense style; Physical maltreatment; Psychological distress; Sexual abuse; Somatization

Experiences of women sexually abused by professionals in adulthood are examined, comparing those sexually abused in childhood with those not so abused. The goal is to inform subsequent therapists about the needs of this clinical population. Those sexually abused in childhood appear to have a more difficult time following the abuse by the professional and to present a wider array of emotional turmoil and life difficulties. They also present particular strengths. Both groups seem to benefit from a boundaried, competent subsequent therapist versed in the effects of malpractice and in the specific needs of this client population related to such issues as mistrust of professionals, legal concerns, etc. KEYWORDS. Revictimization, sexual abuse, professional ethics, patient abuse, professional client sexual relations, survivors, treatment

In the present study, attachment-related differences in long-term memory for a highly emotional life event, child sexual abuse (CSA), were investigated. Participants were 102 documented CSA victims whose cases were referred for prosecution approximately 14 years earlier. Consistent with the proposal that avoidant individuals defensively regulate the processing of potentially distressing information (Bowlby, 1980), attachment avoidance was negatively associated with memory for particularly severe CSA incidents. This finding was not mediated by the extent to which participants reported talking about the abuse after it occurred, although postabuse discussion did enhance long-term memory. In addition, accuracy was positively associated with maternal support following the abuse and extent of CSA-related legal involvement. Attachment anxiety was unrelated to memory accuracy, regardless of abuse severity. Implications of the findings for theories of avoidant defensive strategies and emotional memory are discussed. Keywords: attachment; emotion; memory; individual differences; child sexual abuse

This study compared the effectiveness of cognitive processing therapy for sexual abuse survivors (CPT-SA) with that of the minimal attention (MA) given to a wait-listed control group. Seventy-one women were randomly assigned to 1 of the 2 groups. Participants were assessed at pretreatment and 3 times during posttreatment: immediately after treatment and at 3-month and 1-year follow-up, using the Clinician-Administered Posttraumatic Stress Disorder (PTSD) Scale (D. Blake et al., 1995), the Beck Depression Inventory (A. T. Beck, R. A. Steer, & G. K. Brown, 1996), the Structured Clinical Interview for the DSM-IV (R. L. Spitzer, J. B. W. Williams, & M. Gibbon, 1995; M. B. First et al., 1995), the Dissociative Experiences Scale-II (E. M. Bernstein & F. W. Putnam, 1986), and the Modified PTSD Symptom Scale (S. A. Falsetti, H. S. Resnick, P. A. Resick, & D. G. Kilpatrick, 1993). Analyses suggested that CPT-SA is more effective for reducing trauma-related symptoms than is MA, and the results were maintained for at least 1 year. Keywords: PTSD, child sexual abuse, cognitive therapy, trauma, treatment

Drawing from trauma-related theory (e.g., M. F. Schwartz & P. Gay, 1996), this article presents a model of associations among child sexual abuse (CSA), psychological distress, alexithymia, and disordered eating (DE). Structural equation modeling was used to test this conceptual model with a sample of female college students (N = 589). Results indicate that CSA is not directly associated with DE. Instead, CSA is associated with psychological distress, which is further related to alexithymia. Additionally, bootstrapping analyses were used to show that distress and alexithymia mediate the relationship between CSA and DE. Finally, restrictive eating behaviors and attitudes mediate between alexithymia and bulimic behaviors. This latter pathway was shown to be important to the model by the analysis of a 2nd, nested model. Although this model is only one of many possible, these results point to a weak but significant complex relation between CSA and DE. Keywords: child sexual abuse, eating disorders, alexithymia, structural equation modeling, college students

The present study examined tonic immobility (TI) in victims of childhood sexual abuse (CSA). Female undergraduates (n = 39) and female psychiatric inpatients (n = 41) who experienced CSA completed a series of questionnaires assessing aspects of their victimization history, psychological functioning, and TI symptoms. Over fifty-two percent of all participants reported TI in response to CSA. Episodes of CSA involving attempted or completed penile/vaginal penetration were more likely to be associated with an increased likelihood of experiencing TI, and report of TI was associated with greater current psychological impairment. The implications of these findings are discussed, and suggestions for future research are offered. [c] 2004 Elsevier Ltd. All rights reserved. Keywords. Childhood sexual abuse; Trauma; Rape-induced paralysis; Posttraumatic stress

The purpose of this study was to examine the relationships among negative affect, childhood sexual abuse (CSA), thought suppression, and diagnostic symptoms of borderline personality disorder (BPD) in a community sample (n = 127). Findings suggest that the temperamental variable negative affect intensity/ reactivity was a stronger predictor of BPD symptoms than CSA. In addition, results indicated that higher thought suppression mediated the relationship between negative affective intensity/reactivity and BPD symptoms, after controlling for a history of CSA. Overall, findings suggest that (a) negative affectivity may be a better predictor of BPD symptoms than CSA, and (b) chronic efforts to suppress unpleasant thoughts may be a regulation strategy underlying the relationship between intense negative emotions and BPD symptoms. [c] 2004 Elsevier Ltd. All rights reserved. Keywords: Borderline personality; Emotion; Regulation; Childhood sexual abuse; Suppression