Review of Child sexual abuse: Critical perspectives on prevention, intervention, and treatment.

Reviews the book, Child sexual abuse: Critical perspectives on prevention, intervention, and treatment edited by Christopher R. Bagley and Ray J. Thomlison (1991). This book is a compilation of a series of literature reviews originally commissioned by Health and Welfare Canada in 1987 and completed in 1988. The individual papers included in this edited version represent a cross section of Canadian academicians, clinicians, and case workers who are integrally involved in the policies and practices regarding child sexual abuse in Canada. The work provides a comprehensive perspective on prevention at the primary, secondary, and tertiary levels. The list of authors is impressive in terms of their expertise and experience. At a time when numerous books on child sexual abuse are appearing on the market, it is nice to see a book that has some unusual aspects. Aside from its distinctly Canadian perspective, the book addresses several important, yet frequently ignored, topics. The book provides an up-to-date review of several core issues: conceptualization of the problem, prevention strategies, impact of sexual abuse, investigative interviewing, treatment outcome studies, and treatment issues for child molesters. The more unique topics include a review of the strategies used to evaluate prevention programs, prevalence rates among a number of special populations, the role of medical practitioners in preventing and intervening in child sexual abuse, and sexual abuse and exploitation among disabled individuals. Overall, I can recommend this book for clinicians and researchers in Canada and elsewhere who are interested in child sexual abuse. This compilation of literature reviews highlights the leading role that Canadian social service agencies have taken in developing programs for sexually abused children and their families. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Healing voices.

Reviews the book, Healing voices by Toni Ann Laidlaw, Charyl Malmo, and Associates (see record 1990-97463-000). This book is a rich collection of a particular type of feminist therapy aimed primarily at adult female victims of sexual abuse. Readers who are interested in feminist therapies, psychodynamic approaches to the treatment of women, or the deleterious effects of sexual abuse on women will find this book interesting reading. The authors, therapists, and clients provide much detail and personal reflection which give this book depth. Unfortunately they do not address the important issues of systematically validating the effectiveness of these strategies, nor frequently, the need for serious consideration of what therapy to use with whom. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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)     

Review of Come here: A man overcomes the tragic aftermath of childhood sexual abuse.

Reviews the book, Come here: A man overcomes the tragic aftermath of childhood sexual abuse by Richard Berendzen, with Laura Palmer. Berendzen, former president of American University in Washington, D.C. was both the perpetrator and the victim of a psychosexual tragedy. This autobiography, however, focuses only on his own tragedy: his mother's sexual abuse of him. It completely ignores the tragic consequences of his own frightening, obscene phone calls which he admits making to 10-15 women who had placed ads in newspapers to provide child care. Although Berendzen states in his book that the fact that he was a victim of childhood sexual abuse does not excuse his crimes, he nonetheless repeatedly describes the terroristic phone calls as the result of a "compulsion" and "impulse." One of the women to whom Berendzen made repeated calls cooperated with the police to catch him, and his world fell apart. The rest of the book describes his resultant trials, humiliation, and grief as he faced his family, members of the American University community, the press and, briefly noted, the criminal justice system. Berendzen agonizes throughout much of this book with self-pitying, but moving, pathos over the consequences of his detection to his own life and career, as well as his family's and university's well-being. But nowhere does he agonize about the effect that terrorizing phone calls detailing child sexual abuse could have on women charged with watching children, women who may have vulnerable children themselves. This book may have been therapeutic for Berendzen, but it has left one of his victims, who says she "was doing pretty well until this came up," shaken again. Still, the book is significant and valuable, for therapists and the general public, for the lessons learned between the lines. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of The colors within: One rainbow reclaimed.

Reviews the book, The colors within: One rainbow reclaimed by Jana Adams (2006). In this book, the author uses an illustrated fairy tale to depict the recovery process of one abused child as she navigates the complex journey into adulthood. Vivid metaphors, compelling language, and powerful images that capture both the fundamental loss experienced by an abused child and her gradual restoration of an integrated sense of self comprise this beautifully written book. Touching on the many challenges faced by survivors of childhood abuse, Adams provides a picture that trauma clinicians will recognize as an accurate characterization of the issues often confronted by the patients they treat. The unique value of this book lies in its potential as a therapeutic tool to help patients process traumatic experiences related to abuse. It will be of interest to any clinician who seeks to understand trauma from a nonacademic perspective and aspires to utilize a creative form of treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of The link between childhood trauma and mental illness.

Reviews the book, The link between childhood trauma and mental illness by Barbara Everett and Ruth Gallop (see record 2000-16130-000). This is a very useful book, particularly for novice practitioners and front-line workers who may not have had a supervised experience dealing with abused individuals. The authors set out to provide a practical guide to the care of individuals who have experienced abuse (both sexual and physical) as children, and who present themselves as adults to mental health practitioners, in particular to those who are not practicing in specialized trauma clinics. I believe they have succeeded in their goal. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Assessing dangerousness: Violence by sexual offenders, batterers and child abusers.

Reviews the book, Assessing dangerousness: Violence by sexual offenders, batterers and child abusers by Jacqueline C. Campbell (see record 1995-98215-000). This is a valuable volume of consistently well written chapters by authors of diverse backgrounds. The book's chapters identify research on clusters of risk factors for child abuse, wife assault, homicide by battered women and sexual offending. The identification of risk factors is the prevalent concept in contemporary violence prediction research. Risk factors are determined by researching actual circumstances of violence and statistically identifying antecedent events that appear to be pertinent. The current text is a readable and well referenced overview of the contemporary state of research efforts to address the notion of dangerousness potential. Dangerousness is reviewed in several key interpersonal areas. We anticipate that the text will be attractive to many average readers who unfortunately may be mislead not only by the series editor's stated aspiration, but also by the misguided illusion that the field is slowly progressing towards actual empirical prediction of dangerousness. For the professional reader who has practical experience with violent behavior, we anticipate that the text will be a valuable concise resource for at least the next several years. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preventing violence in relationships: Psychological science addressing complex social issues.

This paper traces the development of a universal violence prevention initiative from its early roots in the dynamics of child abuse developmental psychopathology. My research has been devoted to preventing violence in relationships, including physical and sexual abuse of children, children who witness domestic violence, woman abuse, and dating violence in adolescence. A central theme throughout this work has been to integrate psychological knowledge about healthy, non-violent relationships with knowledge of risk factors for abuse and violence. As laws and public sentiment have challenged the generations- old status quo of family privacy and personal rights, psychology has risen to this challenge by studying aspects of abuse and violence in the lab, in analog situations, in the home, and in the clinic. This paper reflects how knowledge about the causes and consequences of violence in relationships is leading to promising educational and prevention initiatives such as the Fourth R, a universal school-based initiative aimed at early adolescence to reduce relationship violence and related risk behaviours. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of childhood abuse on relapse in a recently homeless substance-dependent veteran population.

The impact of childhood abuse, both childhood sexual abuse (CSA) and childhood physical abuse (CPA), is well documented. Both CSA and CPA have been associated with a number of mental health difficulties, including substance dependence. Though the association between abuse and mental health problems is well documented, what has received little attention is the impact that abuse histories may have on the ability to complete treatment for these problems. This study evaluates the association between abuse and failure to complete treatment due to substance relapse in 70 substance-dependent homeless men served by a Veterans Affairs Domiciliary Residential Rehabilitation and Treatment Program. Demographic and mental health variables were compared with incident rates of sexual and physical abuse as well as with rates of relapse prior to program completion. Contrary to predictions, results found that physical abuse, not sexual abuse, was associated with higher relapse rates. Limitations, implications, and future directions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factors associated with sexual behavior problems in young sexually abused children

OBJECTIVE: To identify variables associated with the presence of sexual behavior problems in young sexually abused children. METHOD: Data were gathered from the clinical records of 100 sexually abused boys and girls ages 3-7 years enrolled in two treatment programs. Information was coded systematically on approximately 350 areas related to the child and family's history and functioning, the sexual abuse experience, and treatment outcome. The children were grouped and compared according to their presenting sexual behavior into three categories: (1) developmentally "expected"; (2) "sexualized/self-focused"; and (3) problematic "interpersonal" sexual behavior. RESULTS: Bivariate and multivariate analyses highlighted five variables which were predictive of sexual behavior problems among sexually abused children. Sexual arousal of the child during his/her sexual abuse, the perpetrator's use of sadism, and a history of physical and emotional abuse differentiated between those children with and without "interpersonal" sexual behavior problems. Who the child blamed for his/her sexual abuse further contributed to the distinction between children whose sexual behavior was exclusively "self-focused" (sexualized) versus "interpersonal." CONCLUSIONS: The five major predictor variables, as well as other variables identified in this study, have potential utility in assessing child risk for negative outcomes and determining referral priorities for sexual abuse treatment. Given that sexual arousal and who the child blames for the abuse are prominent variables associated with sexual problems and self-blame, clinicians will need to ensure that sexually abused children and their caregivers are given specific opportunities to deal with these areas in the supportive context of treatment. Children with sexual behavior problems differ not only in the type and level of sexual behavior they exhibit but in most other areas as well, suggesting a need for differential assessment and individualized treatment approaches.     

Addressing religious and spiritual issues in trauma-focused cognitive behavior therapy for children and adolescents.

Psychologists have become increasingly concerned with the role of religion and spirituality in resolving childhood physical and sexual abuse, particularly religion-related abuse. In treating victims of child abuse, trauma-focused cognitive behavior therapy has emerged as a leading treatment for recovery. In this article, we discuss the relevance of religious and spiritual issues in trauma-focused cognitive behavior therapy for children and teens. Using three case studies, we then present a model for assessing and treating religion and spirituality in trauma-focused cognitive behavior therapy. This model focuses on the client’s pre-existing religious and spiritual functioning as well as changes in religion/spirituality after abuse. We suggest that this approach will assist clients from various religious and spiritual affiliations to process childhood abuse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Treating substance abuse: Theory and technique.

Reviews the book, Treating substance abuse: Theory and technique edited by Frederick Rotgers, Daniel S. Keller, and Jon Morgenstern (see record 1995-99052-000). The authors initially postulate the question of "why we produced this book": They indicated that it is "a response to forces of change." Their answers are a reflection of "the increasing uneasiness among substance abuse treatment providers, the unstable, and often poor outcomes that result from mainstream treatments." Those who suffer from psychoactive substance use disorders, (PSUD's) constitute a staggering population; and many fail to benefit from treatment over a period of time. The authors organized the book into five major approaches to treatment theory and techniques. (1) 12-step, (2) Psychodynamic, (3) Marital-Family therapy, (4) Behavioral, and (5) Motivational enhancement. This book is essential for the beginning practitioner in the field of substance abuse, but it also serves as a valuable adjunct for those of us who have been in the field for a period of time. The authors were thorough, organized, and clear in their presentations. The text is well written and certainly a valued, up-to-date, adjunct to the field of substance abuse theory and treatments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pathways from childhood abuse and neglect to HIV-risk sexual behavior in middle adulthood.

Objective: This study examines the relationship between childhood abuse and neglect and sexual risk behavior in middle adulthood and whether psychosocial factors (risky romantic relationships, affective symptoms, drug and alcohol use, and delinquent and criminal behavior) mediate this relationship. Method: Children with documented cases of physical abuse, sexual abuse, and neglect (ages 0–11) processed during 1967–1971 were matched with nonmaltreated children and followed into middle adulthood (approximate age 41). Mediators were assessed in young adulthood (approximate age 29) through in-person interviews between 1989 and 1995 and official arrest records through 1994 (N = 1,196). Past year HIV-risk sexual behavior was assessed via self-reports during 2003–2004 (N = 800). Logistic regression was used to examine differences in sexual risk behavior between the abuse and neglect and control groups, and latent variable structural equation modeling was used to test mediator models. Results: Child abuse and neglect was associated with increased likelihood of risky sexual behavior in middle adulthood, odds ratio = 2.84, 95% CI [1.74, 4.64], p ≤ .001, and this relationship was mediated by risky romantic relationships in young adulthood. Conclusions: Results of this study draw attention to the potential long-term consequences of child abuse and neglect for physical health, in particular sexual risk, and point to romantic relationships as an important focus of intervention and prevention efforts. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Co-occurrence of avoidant personality disorder and child sexual abuse predicts poor outcome in long-standing eating disorder.

Few consistent predictive factors for eating disorder have been identified across studies. In the current 5-year prospective study, the objective was to examine whether (a) personality disorder and child sexual abuse predict the course of severity of eating disorder symptoms after inpatient treatment and (b) how the predictors interact. A total of 74 patients with long-standing eating disorder and mean age of 30 years were assessed at the beginning and end of inpatient therapy and at 1-, 2-, and 5-year follow-up. A mixed model was used to examine the predictors. Avoidant personality disorder and child sexual abuse interacted in predicting high levels of eating disorder over a long-term course. These results suggest that eating disorder, avoidant personality disorder, and sequelae after child sexual abuse are potential targets for treatment that need further investigation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Health consequences of abuse in the family: A clinical guide for evidence-based practice.

Reviews the book, Health consequences of abuse in the family: A clinical guide for evidence-based practice, edited by Kathleen A. Kendall-Tackett (see record 2003-88342-000). This book is a comprehensive clinical guide that stresses the necessity of assessing and understanding the effects of abuse on physical health. Each chapter succinctly captures unique issues relevant to the assessment and treatment of abuse with at-risk populations (e.g., children with disabilities, battered women, those with traumatic brain injuries, elderly individuals, and minority women). The book gives thoughtful consideration to the barriers in assessing abuse and provides insightful suggestions on how to overcome those obstacles. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessing suicidality in adults: Integrating childhood trauma as a major risk factor.

Can knowing whether an adult client was abused as a child assist psychologists when assessing suicidality? Reviewing the files of 200 outpatients revealed, in keeping with previous studies, that child abuse was related not only to previous psychiatric admissions and younger age at first treatment and first admission, but also to past and present suicidality. Current suicidality was predicted better by child sexual abuse (experienced on average 20 years previously) than by a current diagnosis of depression. Evidence that abuse histories are not routinely taken, and recommendations for why, and how, taking abuse histories should be integrated into suicide assessment and treatment, are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Childhood Sexual and Physical Abuse and the 1-Year Prevalence of Medical Problems in the National Comorbidity Survey.

In a population sample (N = 5,877; ages 15 to 54), the authors found childhood sexual and physical abuse to be associated with the 1-year prevalence of serious health problems for both men and women. The authors also found that participants' psychiatric disorders partially mediated the effects of physical and sexual abuse on adult health. However, childhood abuse continued to independently influence health status after the authors controlled for psychiatric disorders. Contrary to expectations, individuals who experienced a combination of sexual and physical abuse did not have a higher frequency of health problems than those who experienced either type of abuse alone. Implications for these findings are discussed, including possible mechanisms that may account for the association between childhood abuse and adult health problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Wethinks the author doth protest too much: A reply to Esterson (2002).

A. Esterson (see record 2002-10275-005) responded to the authors' (see record 1999-01068-004) analysis of recent reformulations of Freud's seduction theory and alleged sexual abuse discoveries. Esterson gave several additional examples of the same type of problematic writing the authors discussed in their original article. His commentary is largely a repetition of several already-published arguments, and his numerous criticisms of the article are, in the authors' opinion, without merit. The authors address confusion over inferring abuse from symptoms, treatment of symptoms versus resolution of cases, and fathers as perpetrators of abuse. It is clear that, as long as the topic of child sexual abuse elicits heated debate, so will Freud's seduction theory, but there may be times when one needs to step back to allow a debate to move forward. (PsycINFO Database Record (c) 2010 APA, all rights reserved)