What are we teaching our students by not asking about abuse?

Comments on the article by K. Becker-Blease and J. Freyd (see record 2006-03947-003), which addressed the ethics of asking and not asking research subjects about abuse. Their article encourages researchers to more openly consider the risks and benefits of not asking research participants about abuse. They also point out that the alleged risks are not supported by evidence, and there are costs associated with avoiding the questions. On the basis of some of the current authors' own work, they briefly comment on additional benefits of asking about abuse as well as an additional alleged risk involved in asking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A public health perspective on "The ethics of asking and not asking about abuse."

Comments on the article by K. Becker-Blease and J. Freyd (see record 2006-03947-003), which provides a thought-provoking and important perspective regarding the ethics of researchers asking or not asking adults about abuse they experienced as children. Many of these authors' concerns with research on abuse during childhood apply equally to abuse and violence experienced at all life stages. Focusing on intimate partner violence (IPV), we wish to amplify upon and respond to their observations from the perspective of public health scientists involved in large-scale telephone survey research on violence (including family violence, IPV, sexual violence, and suicide). We strongly agree with Becker-Blease and Freyd that decisions not to ask about abuse play directly into the social forces that perpetuate IPV and other forms of violence as pervasive and pernicious social and public health problems. From a public health perspective, the question is not whether to ask but how to ask about participants' experiences with violence and abuse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

It's OK to ask about past abuse.

Comments on the article by K. Becker-Blease and J. Freyd (see record 2006-03947-003), which addressed the ethics of asking and not asking research subjects about abuse. In their article, they systematically reviewed often-voiced concerns about and objections to asking questions about child maltreatment in survey research. They concluded that by failing to ask about a history of child maltreatment, an important predictor of later-life problems may be overlooked. The current authors discuss the Adverse Childhood Experiences (ACE) study, which provides strong evidence of the association between early traumatic experiences and some of the major public health problems facing our nation. Results from the ACE study have shown an association between traumatic childhood experiences and a broad range of health outcomes, including liver disease, ischemic heart disease, reproductive health, and mental illness, as well as a variety of health risks such as obesity, smoking, and alcoholism. The associations that these studies showed demonstrate that researchers studying health outcomes who do not ask study subjects about traumatic childhood experiences are overlooking an important risk factor for many of the major health issues of our day. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

To ask, or not to ask, about abuse--New Zealand research.

Comments on the article by K. Becker-Blease and J. Freyd (see record 2006-03947-003), which addressed the ethics of asking and not asking research subjects about abuse. J. Read reviews some clinical research in New Zealand in which there was a low level of inquiry about abuse by mental health staff, and notes that this is consistent with the results of similar studies elsewhere. He agrees with Becker-Blease and Freyd that there are many consequences to researchers and clinicians of not asking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Asking research participants about trauma and abuse.

Comments on the article by K. Becker-Blease and J. Freyd (see record 2006-03947-003), which presented a timely, persuasive, and well-documented argument to psychologists about why it is important to consider asking about a history of abuse and/or trauma in research studies. As a social psychologist studying victims' disclosures of sexual assault, social reactions received from others following disclosure, and the effects of these reactions on victims, S. E. Ullman expands on just a few of the 10 concerns discussed in their article regarding risks associated with trauma and abuse disclosure that may help researchers decide about whether to ask such questions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison between the effects of medial septal lesions and entorhinal cortex lesions on performance of nonspatial working memory tasks and reversal learning

Two studies explored the relationship between cognitions and long-term symptoms in adult child sexual abuse (CSA) survivors. In Study 1, an American sample of 43 survivors completed questionnaires assessing attributional style and dysfunctional beliefs in cognitive themes affected by victimization, as well as measures of posttraumatic symptoms. Survivors' attributions of negative events were more internal, stable, and global than those of 29 comparison subjects without a history of CSA. However, only the globality scale was significantly related with severity of long-term symptoms. High correlations between dysfunctional beliefs concerning safety, trust, esteem, or intimacy, and posttrauma symptoms were found. The latter finding was replicated in Study 2 with a German sample of 35 CSA survivors, even when controlling for frequency of abuse.     

Impact of child sexual abuse on developing sexuality.

This article reviews theoretical and empirical literature on sexual abuse and focuses on the effects of child sexual abuse on developing sexuality. The issues addressed include (a) prominent family qualities associated with sexual socialization, (b) theoretical formulations that account for the effects of sexual abuse on developing sexuality, and (c) research findings on the impact of child sexual abuse on the sexuality development of child victims and adult survivors. Directions for future research and implications for practitioners are also discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluating and overcoming barriers to taking abuse histories.

Psychologists are frequently faced with issues of whether, when, and how to ask clients if they have been abused. Despite the demonstrated relationship between child abuse and adult psychopathology, researchers report that many clinicians still do not routinely inquire about abuse. A questionnaire completed by 63 psychologists and 51 psychiatrists in New Zealand revealed that factors related to reluctance to ask about abuse include the following: more pressing issues, fear of disturbing clients, a diagnosis of schizophrenia, biological etiology beliefs, and fear of inducing "false memories." Significant differences were found between psychologists and psychiatrists on some of these factors. Practice guidelines for enhancing the frequency and efficacy of abuse inquiry are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Researching the effects of confidentiality law on patients' self-disclosures.

We hypothesized that conflicting research findings on the effects that confidentiality laws have on patients' self-disclosures reflect the fact that privacy is important only to some patients in some circumstances. Instead of asking whether privacy is always important, we posed the following question: What factors determine whether privacy is important? With 42 outpatients we found that self-disclosures about sensitive issues (e.g., child abuse, drug abuse) during intake were determined partly by how legally informed patients were and partly by how relevant and consequential the law was to their cases. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Methodological issues in the study of sexual abuse effects.

Despite its relative infancy, child abuse research has provided a substantial literature on the psychological sequelae of sexual molestation. These findings have been helpful in informing social policy and guiding mental health practice. Because of the recency of interest in this area, however, as well as the costs and time investment associated with more rigorous longitudinal research, many of these studies have used correlational designs and retrospective reports of abuse. The implications of this methodology are outlined, and remedies are suggested where possible. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychologists' knowledge, opinions, and decision-making processes regarding child abuse and neglect reporting laws.

Mandated child abuse reporting laws have been in effect in the United States for more than 20 years, yet practitioners vary in their understanding and opinions of these laws. A sample of licensed psychologists were surveyed and reported being relatively well-informed. However, their performance on a knowledge measure suggests knowledge deficits and a tendency to overreport. Legal considerations encourage reporting, whereas beliefs that one can provide client treatment deter reporting. Opinions of the laws were generally favorable, with some concerns about child protection systems and the impact of reporting on the therapeutic alliance. Practice and policy implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Femoral and lateral femoral cutaneous nerve block for muscle biopsies in children

OBJECTIVE: Unintentional injuries are the number one cause of death for infants. Many of these injuries could be prevented if parents took additional safety precautions. In this study physicians' and parents' perspectives regarding the part that physicians play in educating first time parents about child safety issues were compared. METHODS: All pediatricians and family physicians in London, Ontario were surveyed by mail (68% return rate) regarding their practices, attitudes, and beliefs related to parent education about child safety issues. A sample of 114 first time mothers, including 38 each with 6, 12, and 18 month old infants, completed a telephone interview. All parents had physicians who had returned questionnaires. RESULTS: There was good correspondence between parents' and physicians' judgments about the safety issues most often covered, and what role physicians should adopt regarding parent education about child safety issues. In addition, they both agreed that parents seldom seek out safety information by asking questions. Relative to parent reports, however, physicians significantly overestimated the time they spent on safety issues and the degree of their direct involvement in communicating this information. The best predictor of time spent by physicians on safety issues was their rating of the importance of assuming the role of parent educator. The best predictor of parents asking questions about child safety was their rating of the adequacy of physicians' responses to previously asked questions. CONCLUSIONS: The results suggest that both physicians and parents contribute to undermine communication about child safety during well-baby visits.     

Review of Healing the incest wound: Adult survivors in therapy, 2nd edition.

Reviews the book, Healing the incest wound: Adult survivors in therapy, 2nd edition by Christine A. Courtois (see record 2010-06160-000). Similar to the first edition, the second edition is divided into three main sections: Section I gives a broad but in-depth overview of the characteristics and dynamics of incest; Section II provides a breadth of information on the long-term effects, assessment, and diagnosis; and Section III details current evidence-informed best practice in working with survivors of prolonged child sexual abuse. The book presents a wide range of treatment modalities that represent a bevy of both empirically supported and supplemental techniques, from cognitive–behavioral to expressive therapies, such as art or poetry. The second edition of Healing the incest wound is an important read for any practitioner, novice or experienced, working with child sexual abuse survivors. Courtois both provides a solid basis for those beginning work with child sexual abuse survivors and adds to the knowledge of seasoned practitioners by bringing together the most current empirical evidence and clinical wisdom regarding child sexual abuse treatment. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Child maltreatment research: Federal support and policy issues.

The recent history of federal support for child maltreatment research paints a mixed picture of inadequate funding and uncertain administrative guidance against a backdrop of growing public concern about the prevalence of child abuse and neglect. This article describes some of the problems that have been identified in federal research funding, administration, and support of research initiatives and training concerning child abuse and neglect. Remedies for these difficulties are outlined, priorities for new research in this area are identified, and ways in which to rejuvenate the federal government's role in this area, in league with a concerted commitment to policy-relevant research by behavioral scientists, are suggested. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Treatment Beliefs Questionnaire (TBQ): An instrument to assess beliefs about children's mood disorders and concomitant treatment needs.

Parent and child beliefs about the child's mood disorder and need for treatment may affect the willingness of the patient and his or her family to participate in and adhere to treatment recommendations. Such beliefs may also affect mental health treatment outcomes. However, there is a paucity of research in this area, which is further reflected in a lack of assessment instruments. The present study describes the creation and initial psychometric evaluation of parent and child versions of the Treatment Beliefs Questionnaire (TBQ) in a sample of 8- to 11-year-old children with a primary mood disorder and comorbid psychiatric conditions. Preliminary results support the reliability and validity of these scales in this population. The role of health beliefs in mental health treatment adherence and treatment outcome is addressed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Symptoms of female survivors of child sexual abuse

Women who suffered sexual abuse as children often experience a variety of physical and psychosocial symptoms as adults. Identifying this pattern of symptoms might assist health professionals in recognizing and treating nonreporting survivors of child sexual abuse. In this study, the Adult Survivors of Incest (ASI) Questionnaire (Brown & Garrison, 1990) was used to determine the symptoms and contributing factors for 22 adult survivors of child sexual abuse. Six physical symptoms were experienced by 50% of the subjects, and over 75% of the subjects experienced 11 psychosocial symptoms. The number of physical symptoms correlated significantly with other victimizations (r = .59) and number of psychosocial symptoms (r = .56). The findings suggest that the ASI Questionnaire was effective in identifying patterns of symptoms and contributing factors of adult survivors of child abuse. Additional study is needed to determine the usefulness of this questionnaire in identifying nonreporting survivors in clinical situations.     

Child abuse and psychosis: A literature review and implications for professional practice.

This review summarizes the research demonstrating the relationships of childhood abuse to psychosis and schizophrenia and raises the possibility that the relationships may be causal. Six ways in which the relationship between child abuse and psychosis can be minimized are identified: (a) excluding psychotic individuals from studies; (b) relying on records of childhood abuse rather than asking patients; (c) ignoring relevant studies; (d) reinterpreting psychotic symptoms as nonpsychotic where abuse is identified, thereby avoiding diagnoses such as schizophrenia; (e) positing spurious intervening variables; and (f) adhering rigidly to a biomedical model. Implications for professional practice, at the policy and clinical levels, are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measuring adolescent smoking expectancies by incorporating judgments about the expected time of occurrence of smoking outcomes.

French and English Canadian adolescents completed a smoking expectancy questionnaire and 2 measures of current smoking status. Multiple regression revealed that beliefs about the expected time of occurrence of smoking outcomes explained unique variance in current smoking after controlling for judgments about the probability and desirability of these outcomes. In addition, the relationship between the perceived probability of the general costs of smoking and current smoking was moderated by beliefs about the expected time of occurrence of these costs. There was no relationship between perceived probability of general costs and smoking for adolescents who expected the costs to occur far in the future, whereas there was a significant negative relationship between these 2 variables for adolescents who expected the costs to occur soon after smoking. The authors' results suggest that it may be possible to increase the concurrent validity of traditional smoking expectancy measures by incorporating expected-time-of-occurrence judgments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Exploring the nature of the relationship between child sexual abuse and substance use among women

AIMS: This study investigated whether child abuse (CSA) was associated with earlier substance use and greater severity of substance dependence and what aspects of CSA might predict substance abuse. DESIGN: The study compared (a) drug and alcohol treatment clients with and without a history of CSA and (b) CSA survivors outside drug and alcohol treatment who did or did not have current substance abuse. SETTINGS: Semi-structured interviews took place at participants' homes, treatment agencies or the research centre. PARTICIPANTS: Volunteer participants included 100 women recruited from drug and alcohol treatment programmes and 80 CSA survivors recruited through CSA counseling services and medial advertising. MEASUREMENTS: The results focus on data from the Opiate Treatment Index, Severity of Alcohol Dependence Questionnaire, Substance Dependence Scale, Self-Esteem Inventory and self-reported histories of CSA. FINDINGS: There were no differences between CSA survivors and other drug and alcohol treatment clients in their severity of dependence. Women with a history of CSA more frequently identified stimulants as their main problem drug and reported an earlier age of first intoxication and earlier use of inhalants. Among abused CSA survivors outside drug and alcohol treatment, women with current substance abuse had typically been abused during adolescence by someone outside the family, whereas those without current substance abuse were typically abused by family members before adolescence. CONCLUSIONS: The results suggest that adolescence is a crucial time for the influence of CSA experiences on substance abuse.     

Remembering childhood sexual abuse: A national survey of psychologists' clinical practices, beliefs, and personal experiences.

A national survey of 1,000 psychologists, to which 223 responded, assessed professionals' clinical practices and beliefs about the treatment of adult survivors of childhood sexual abuse (CSA), personal CSA history, and the phenomenon of clients remembering CSA in therapy. Results indicated that over 25% of therapists reported using guided imagery, dream interpretation, bibliotherapy regarding sexual abuse, referral to sexual abuse survivors' group, and free association of childhood memories as memory retrieval techniques with clients who had no specific memory of CSA. However, the majority of therapists reported that they had not seen any cases of adult clients entering therapy with no memory of CSA and subsequently recalling abuse in the course of therapy. A personal history of CSA was not associated with most clinical practices related to treating sexual abuse survivors. The implications for training and establishing scientific standards of psychological practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)