Comparison of programs for teaching personal safety skills to preschoolers.

We compared the relative effectiveness of two educational approaches for teaching personal safety skills with 100 preschoolers. A behavioral skills training program was compared with a feelings-based program, which instructs children to trust their feelings when making safety decisions. Children's abilities to discriminate between appropriate- and inappropriate-touch requests, their prevention skills, and levels of emotional distress were assessed before, immediately, and one month after program participation. Parents and teachers were surveyed regarding children's reactions. Compared with a control presentation, both programs were effective in enhancing children's knowledge and prevention skills without making them fearful, suggesting that preschool children can benefit from such programs. However, children in the feelings-based program had difficulty recognizing the appropriateness of certain touch requests, suggesting that this approach may have limited utility with preschool-age children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison of trauma-focused and present-focused group therapy for survivors of childhood sexual abuse: A randomized controlled trial.

This randomized controlled trial compared trauma-focused group psychotherapy (TFGT) with present-focused group psychotherapy (PFGT) and a waitlist condition for 166 survivors of childhood sexual abuse who were at risk for HIV infection. Primary outcomes included risk for HIV infection (based on sexual revictimization, drug and alcohol use, and risky sex) and posttraumatic stress disorder (PTSD) symptoms. It was hypothesized that TFGT would be superior to the PFGT and waitlist conditions and that receiving either treatment (combining both TFGT and PFGT) would be superior to no treatment (waitlist condition). Intention-to-treat analyses for HIV risk found that all conditions reduced risk; however, there was no effect for condition on HIV risk. Intention-to-treat analyses for PTSD symptoms found a reduction for all conditions. There was no advantage for either TFGT or PFGT in reducing PTSD symptoms; however, there was an effect for treatment compared with the waitlist condition. On secondary outcomes, there was a greater reduction in anger for TFGT compared with PFGT, and when comparing treatment with the waitlist condition, there was a greater reduction in hyperarousal, reexperiencing, anger, and impaired self-reference for the treatment condition. Adequate dose analyses generally confirmed the intention-to-treat findings and additionally found that treatment led to reductions in depression, dissociation, and sexual concerns. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Teaching personal safety skills to young children: an investigation of age and gender across five studies

OBJECTIVE: To determine the extent to which preschool-aged boys and girls can benefit from instruction in personal safety. METHOD: Data compiled from five previous studies were employed. Four hundred and six preschoolers were pretested and participated in either the Behavioral Skills Training program (BST; Wurtele, 1986) or a control program. Children were posttested on skill and knowledge gains. RESULTS: Preschoolers who had participated in the BST program demonstrated greater knowledge and higher levels of personal safety skills compared with controls. Boys and girls reacted similarly to the program, as did children from younger and older age groups. CONCLUSIONS: These results provide support for the assertion that most preschool-aged children can benefit from participating in a developmentally appropriate personal safety program. Suggestions for expanding the efforts to prevent child sexual abuse are offered, so that children do not shoulder the full responsibility for prevention.     

Posttraumatic stress disorder in adult female survivors of child sexual abuse: A comparison study.

This study compared symptoms of posttraumatic stress disorder (PTSD) in a group of 45 adult women in outpatient treatment for childhood sexual abuse (CSA) and a group of 31 women who reported no CSA. The comparison group consisted of women in outpatient treatment for problems in their committed relationships with male living partners. This research also investigated the traumatic impact of dual abuse (both childhood sexual and physical abuse). Standardized assessment instruments were used to measure PTSD, CSA, and childhood physical abuse (CPA). Results indicated that 86.7% of the CSA group met criteria for current PTSD in accordance with the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., revised; American Psychiatric Association, 1987), compared with 19.4% of the relationship distress group, providing support for CSA as an etiological agent for PTSD. In addition, 89% of the CSA survivors reported CPA. Multivariate analysis revealed that both CSA and CPA exposure variables accounted for a significant portion of the variance in PTSD symptoms in the CSA group. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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)     

Evaluation of a sexual abuse prevention program for adults with mental retardation

We have measured the Fourier transform spectrum of natural OCS from 3700 to 4800 cm-1 with a near Doppler resolution and a line-position accuracy between 4 and 8 x 10(-5) cm-1. For the normal isotopic species, 37 vibrational transitions have been analyzed for both frequencies and intensities. We also report 15 bands of OC34S, eight bands of O13CS, nine bands of OC33S, and two bands of 18OCS. Important effective Herman-Wallis terms are explained on the basis of eigenvectors. A comparison of different line-pointing programs is also presented. Copyright 1998 Academic Press.     

A relationship between childhood sexual abuse and professional sexual misconduct.

This article identifies specific factors that place therapists at risk for engaging in sexual activity with clients and provides guidelines to minimize the likelihood of such behavior. In a national, randomly drawn sample of 323 mental health practitioners, 3 of 5 men who reported severe childhood sexual abuse and whose psychological symptoms met the criteria for a high degree of psychological distress reported sexual boundary violations with clients. High-risk clinicians should avoid the isolation of private practice, closely monitor their boundaries with clients, obtain ongoing professional supervision, and seek personal psychotherapy to address any remaining abuse-related issues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Group treatment for child sexual abuse.

Describes a 12-wk group therapy program used with more than 50 preadolescent children (aged 7–12 yrs) who have experienced intrafamilial sexual abuse. A cotherapy model is used. 90-min group sessions consist of 4 parts: circle time, focused activities, diary time, and snack. Activities are designed to highlight (1) development of trust, cohesiveness, and safety; (2) identification and labeling of feelings; (3) discussion of family relationships and family changes; and (4) exploration of issues associated with the offender. Sessions also examine legal issues and concerns and focus on self-esteem enhancement, social skills development, sex education, prevention of future abuse, and termination issues. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Conceptually derived treatments for sexual aggressors.

The relative absence of theoretical models has interfered with progress in the assessment and treatment of sexual aggressors. G. C. Hall and R. Hirschman (see record 1992-05851-001) have proposed a conceptual model of sexual aggression that has treatment implications. Physiological, cognitive, affective, and developmentally related personality precursors correspond to subtypes of sexual aggressors. Each subtype, the associated primary motivational precursor, a case example, and treatment methods that could be used for treating each subtype are presented here. There is some evidence of effective interventions for each of the motivational precursors. However, additional research is needed on the effectiveness of treatments in reducing recidivism. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive-relaxation and social skills treatments of anger: A year later.

The present study provides a 12-month follow-up of a study by Deffenbacher, Story, Stark, Hogg, and Brandon (1987) that compared cognitive-relaxation and social skills training interventions for general anger reduction in college students. After 1 year both cognitive-relaxation and social skills subjects reported less general anger, personal-situational anger, anger-related psychophysiological reactivity, and trait anxiety than untreated controls. These findings suggested longterm maintenance of anger reduction and a generalization to anxiety that was not found posttreatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impact of child sexual abuse: A review of the research.

Reviews studies that have tried to empirically confirm the effects of child sexual abuse cited in the clinical literature. In regard to initial effects, empirical studies have indicated reactions—in at least some portion of the victim population—of fear, anxiety, depression, anger and hostility, aggression, and sexually inappropriate behavior. Frequently reported long-term effects include depression and self-destructive behavior, anxiety, feelings of isolation and stigma, poor self-esteem, difficulty in trusting others, a tendency toward revictimization, substance abuse, and sexual maladjustment. The kinds of abuse that appear to be most damaging are experiences involving father figures, genital contact, and force. The effects of duration and frequency of abuse, age at onset, the child's reporting of the offense, parental reaction, and institutional response are also considered. The controversy over the impact of child sexual abuse is discussed. (49 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preventing substance abuse among American-Indian adolescents: A bicultural competence skills approach.

Tobacco, alcohol, and drug use are problems for American-Indian people. We reviewed these problems and the explanations for them and described a bicultural competence skills approach for preventing substance abuse with American-Indian adolescents. Data from a study of that approach suggest its efficacy with American-Indian youth. At posttest and a 6-month follow-up, American-Indian subjects who received preventive intervention based on bicultural competence skills concepts improved more than did American-Indian subjects in a no-intervention control condition on measures of substance-use knowledge, attitudes, and interactive skills, and on self-reported rates of tobacco, alcohol, and drug use. Our findings have implications for future substance-abuse prevention research with American-Indian people. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A cognitive approach to child abuse prevention.

This investigation tested the incremental utility of cognitive retraining as a component within a program designed to prevent child maltreatment. High-risk families (N=96) were randomly assigned to a control condition, home visitation modeled after the Healthy Start program (unenhanced home visitation), or home visitation that included a cognitive component (enhanced home visitation). Mothers were identified late during pregnancy or soon after birth, and their participation continued for 1 year. Lower levels of harsh parenting were found among mothers in the enhanced home visitation condition than among those in the unenhanced home visitation or control conditions. Prevalence of physical abuse (percentage of mothers who were abusive) during the first year was 26% in the control condition, 23% in the unenhanced home visitation condition, and 4% in the enhanced home visitation condition. Benefits were greatest in families that included a medically at-risk child. A linear pattern of benefits was found for child health; as program features were added, benefits for child health increased. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Practice makes perfect? The role of participant modeling in sexual abuse prevention programs.

We tested the prediction that a sexual abuse prevention program that included participant modeling (PM) would result in superior skill acquisition compared with a symbolic modeling (SM) program. Twenty-six kindergarten children were assigned to one of the two programs after being matched for initial skill level. The PM program taught self-protective skills through modeling and active rehearsal; the SM program taught the same skills, but the children watched as skills were modeled by the experimenter. Results provided evidence for the greater efficacy of PM relative to SM for the learning of personal safety skills and, thus, support the inclusion of active rehearsal in prevention programs for young children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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)     

Abuse characteristics among childhood sexual abuse survivors in therapy: a gender comparison

OBJECTIVE: The goal of this investigation was to examine similarities and differences in childhood sexual abuse (CSA) characteristics between men and women survivors in outpatient psychotherapy utilizing a substantial sample size of men, while examining an extensive range of abuse characteristics. METHOD: Abuse characteristics of 48 men from an outpatient treatment program for adult survivors of CSA in a university-based community mental health center were compared with those of 257 women from the same program. Data on abuse history were collected at admission or as soon thereafter as possible using a structured clinical interview with established reliability. RESULTS: Women were significantly more likely to have been sexually abused by a family member. Men were significantly more likely to report having oral sex performed upon them. Otherwise, no significant gender differences not attributable to anatomical differences (e.g., vaginal vs. anal intercourse) were found. CONCLUSIONS: The findings suggest that very few differences exist in the nature and extent of CSA reported by men and women. Thus CSA perpetrated on boys appears largely comparable in nature and extent to that committed against girls.     

Twelve-step and cognitive-behavioral treatment for substance abuse: A comparison of treatment effectiveness.

The comparative effectiveness of 12-step and cognitive-behavioral (C-B) models of substance abuse treatment was examined among 3,018 patients from 15 programs at the US Department of Veterans Affairs Medical Centers. Across program types, participants showed significant improvements in functioning from treatment admission to a 1-year follow-up. Although 12-step patients were somewhat more likely to be abstinent at the 1-year follow-up, 12-step, C-B, and combined 12-Step–C-B treatment programs were equally effective in reducing substance use and improving most other areas of functioning. The finding of equal effectiveness was consistency over several treatment subgroups: Patients attending the "purest" 12-step and C-B treatment programs, and patients who had received the "full dose" of treatment. Also, patients with only substance abuse diagnoses, those with concomitant psychiatric diagnoses, and patients who were mandated to treatment showed similar improvement at the 1-year follow-up, regardless of type of treatment received. These data provide important new evidence supporting the effectiveness of 12-step treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Support Network: Crisis intervention for extrafamilial child sexual abuse.

Describes the establishment of the Support Network, a community-based treatment program for children and families facing crises due to extrafamilial child sexual abuse. The components necessary to establish a Support Network are discussed. A crisis intervention model of treatment is proposed that provides these children and families with immediate contact with a therapist, emotional support, education, and problem-solving strategies, thus enabling some resolution of the crisis and a return to precrisis routines and adaptation. Termination and follow-up issues are also addressed, and a case example of 4-yr-old sexually abused girl is presented to illustrate the usefulness of the Support Network. It is contended that, by providing services to these children and their families, Support Network therapists also help to sensitize and educate other community professionals to the needs of the sexually abused child and his/her family. A list of selected references for use with children and families is appended. (48 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Implications of traumatic brain injury for survivors of sexual abuse: A preliminary report of findings.

The authors' purpose for presenting these cases is to report on some clinical observations that may have relevance for a subgroup of individuals recovering from a traumatic brain injury. Specifically, the authors observe that a group of patients who reported histories of childhood sexual trauma and then sustained a TBI as adults are experiencing a reemergence of intrusive recollections and other symptoms related to the abuse. Further, the appearance of these posttraumatic stress-type symptoms—sometimes after years of nonoccurrence—frequently proves disruptive to the patient's rehabilitation process. Possible structural, chemical, and phenomenological factors are discussed. The authors' observations raise the possibility that individuals who have made the best recoveries from childhood sexual trauma are the most vulnerable to the reemergence of posttraumatic stress disorder symptoms subsequent to the TBI. These provisory observations would suggest that sensitive inquiry regarding abuse history should be considered as part of any clinical interview with patients who have sustained neurological trauma. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prevention of child sexual abuse: Myth or reality.

Programs to prevent child sexual abuse have proliferated as a result of increased public awareness and professional documentation of its incidence. We describe the content and format of these prevention programs in general and examine selected programs for effectiveness. Although there is limited evidence for an increase in knowledge for program participants, most evaluations suffer from basic design problems and present few results indicative of either primary prevention or detection. Overall, we argue that self-protection against sexual abuse is a very complex process for any child and that few, if any, prevention programs are comprehensive enough to have a meaningful impact on this process. Finally, we discuss several untested assumptions that guide these programs. We conclude that it is unclear whether prevention programs are working or even that they are more beneficial than harmful. (PsycINFO Database Record (c) 2010 APA, all rights reserved)