Sexually and physically abused foster care children and posttraumatic stress disorder.

Considerable debate exists regarding the possible relationship between child abuse and posttraumatic stress disorder (PTSD). In this study, 3 groups of foster care children were compared. The groups included 50 sexually abused, 50 physically abused, and 50 nonabused foster care children. Participants completed the Child Post-Traumatic Stress Reaction Index, the Childhood PTSD Interview, and the Modified Stroop Procedure (MSP), which included sexual abuse and nonsexual abuse stimuli. The MSP has not been previously used in child abuse research. Results indicated that sexually and physically abused children demonstrated PTSD at a high level. The MSP discriminated between the sexually abused children with PTSD and those without PTSD. Responses to the MSP sexual abuse stimuli resulted in significantly longer color-naming times than responses to nonsexual abuse stimuli. Preadolescents demonstrated more severe PTSD than early adolescent children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Childhood abuse, body image disturbance, and eating disorders

Studies have suggested that women who experience child sexual abuse are at risk for developing symptoms related to anorexia nervosa and bulimia. The purpose of the present study was to examine the relationships among childhood sexual and physical abuse, body image disturbance, and eating disorder symptomatology. Of 670 female college students screened for childhood abuse, 29 sexually abused, 32 physically abused, and 29 nonabused women completed measures of eating disorder symptoms, psychological factors thought to be related to eating disorders, and body image distortion. Contrary to previous reports, there was no evidence that child sexual or physical abuse was associated with the development of body image disturbance. Furthermore, the results did not support the hypothesis that child sexual and physical abuse are related to eating disorder symptomatology. It is suggested that subjects who are victims of child sexual abuse and who are receiving psychotherapy manifest higher rates of a number of different types of psychopathology, including eating disorders.     

Child sexual and physical abuse and alcoholism: a review

OBJECTIVE: To examine possible relations between child sexual or physical abuse and adult alcoholism. METHOD: Studies reviewed included prospective studies, retrospective studies on the prevalence of child sexual or physical abuse in alcoholics and nonalcoholics, and retrospective studies in mental health clients and in population samples comparing the prevalence of alcohol use disorders in abused and nonabused subjects. RESULTS: Prospective studies do not indicate a significant association between child sexual or physical abuse and alcoholism. In contrast, studies among alcoholic women do suggest a relationship. Also, a significantly higher prevalence of alcohol problems in abused women than in nonabused women is found in population samples. The results of studies among mental health clients are inconclusive. In addition, several methodological limitations should be taken into consideration when evaluating results of the available studies. CONCLUSIONS: Current evidence is insufficient to draw conclusions about relationships between child sexual or physical abuse and alcoholism among men. Among females, however, there is a higher likelihood of alcohol problems if they were sexually or physically abused as children.     

The impact of childhood sexual abuse and family functioning on four dimensions of women's later parenting

OBJECTIVE: While child sexual abuse and its negative effects have been of increasing interest to researchers and practitioners, more empirical focus has been given to measuring mental health consequences rather than other areas of life functioning such as parenting. Furthermore, recent questions have been raised about whether documented negative effects of abuse stem from the abuse itself or the more general negative family environment which often accompanies it. The aim of the current study was to examine the impact of a history of child sexual abuse and more general family relationship quality on the parenting of a sample of low-income mothers. METHOD: The current study was a secondary analysis of archived data collected by Zuravin (1996) on 518 low-income mothers. Parenting was assessed using measures such as frequency of worry about child problems, views of self as a parent, and how child discipline problems were handled. RESULTS: Child sexual abuse was associated with more negative views of self as a parent and the greater use of physical punishment strategies even after accounting for differences in family-of-origin relationship quality. CONCLUSIONS: The findings indicate that sexual abuse may be a risk factor for more negative views of self as a parent beyond differences between abused and nonabused samples in more general assessments of family-of-origin quality. Implications for future research and intervention are discussed.     

Disclosure of Child Sexual Abuse: What Does the Research Tell Us About the Ways That Children Tell?

The empirical basis for the child sexual abuse accommodation syndrome (CSAAS), a theoretical model that posits that sexually abused children frequently display secrecy, tentative disclosures, and retractions of abuse statements was reviewed. Two data sources were evaluated: retrospective studies of adults' reports of having been abused as children and concurrent or chart-review studies of children undergoing evaluation or treatment for sexual abuse. The evidence indicates that the majority of abused children do not reveal abuse during childhood. However, the evidence fails to support the notion that denials, tentative disclosures, and recantations characterize the disclosure patterns of children with validated histories of sexual abuse. These results are discussed in terms of their implications governing the admissibility of expert testimony on CSAAS. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intellectual stability in children with unilateral brain lesions

Developmental differences in behavior and self-perception were examined in a group of 44 preschool and school-age children referred for evaluation of sexual abuse and 41 comparison children with no history of sexual abuse, matched on age and gender, and from a similar socioeconomic background. Children suspected of having been sexually abused were rated by their parents as having more internalizing and externalizing problems than comparison children. When children rated their self-competence and social acceptance, there were no group differences between children based on their abuse status; however, there was significant within-group variation among the children suspected of having been sexually abused. Preschool children had elevated scores of perceived competence and social acceptance, and school-age children had depressed scores. There were no age differences among the children in the comparison group. The results suggest that among children suspected of abuse, not only does their self-perception vary by their developmental level, but preschool children may respond with elevated perceptions of themselves. Focusing on individual differences in children's response to suspicions of sexual abuse enables us to identify risk and protective factors that contribute to the psychological outcomes of child sexual abuse.     

The use of anatomical dolls to assess child sexual abuse: A critical review.

Reviews the empirical literature to investigate the following 2 aspects of the controversial use of anatomical dolls to assess for child sexual abuse: (1) Are anatomical dolls valid tools to assess child sexual abuse? (2) What progress has been made toward the development of an anatomical doll interview that is objective and standardized? 16 empirical studies were located which have assessed children's reactions to anatomical dolls. Criteria used to evaluate the studies are listed. In regard to validity, the empirical data suggest that children who have been referred for sexual abuse respond differently to anatomical dolls than nonabused children. Furthermore, considerable progress has been made toward the development of an objective assessment protocol and reliable scoring criteria. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pediatric acquired immunodeficiency syndrome. Barriers to recognizing the role of child sexual abuse

The only reportable exposure categories for human immunodeficiency virus (HIV) infection of children are vertical transmission from an HIV-infected mother or receipt of infected blood or blood products. Although sexual transmission of HIV among adults is the subject of intense concern, sexual transmission of HIV to children during child sexual abuse has received almost no investigative attention. This review discusses factors contributing to the exclusion of sexual transmission of HIV to children from studies of the epidemiology of HIV infection. Difficulties occur in screening and confirming abuse in nonselected populations of children, perceived and real barriers exist to the evaluation for HIV of sexually abused children, and problems occur in the assessment for child sexual abuse of HIV-infected children. Impediments to the understanding of the relationship between sexual abuse and HIV infection in sexually abused, HIV-infected children are considered, and measures that can allow these barriers to be overcome are discussed.     

Depressive symptoms among physically abused and psychiatrically disturbed children.

Examined the relation of physical abuse and depressive symptoms among 79 6–13 yr old child psychiatric inpatients. Childhood depression, hopelessness, and self-esteem were assessed through questionnaire or interview measures administered to the children. 79 25–52 yr old mothers or maternal guardians also completed measures to evaluate their children's dysfunction. As predicted, the 33 physically abused children, compared with the 46 nonphysically abused patient controls, evinced significantly lower self-esteem and greater depression and negative expectations toward their futures. Among abused children, those with both past and current abuse showed more severe symptoms of depression that did those with either past or current abuse only. The differences in depressive symptoms between abused and nonabused children could not be accounted for by differences in child psychiatric diagnosis, age, race, gender, IQ, or severity of psychopathology or parent psychiatric diagnoses, marital, or SES. Results suggest that physical abuse, at least for a psychiatric patient sample, is related to symptoms of depression. The possible basis for this relation and the treatment implications are discussed. (36 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impact of sexual abuse on children: A review and synthesis of recent empirical studies.

A review of 45 studies clearly demonstrates that sexually abused children have more symptoms than nonabused children, with abuse accounting for 15–45% of the variance. Fears, posttraumatic stress disorder (PTSD), behavior problems, sexualized behaviors, and poor self-esteem occurred most frequently among a long list of symptoms noted, but no one symptom characterized a majority of sexually abused children. Some symptoms were specific to certain ages, and approximately one-third of victims had no symptoms. Penetration, the duration and frequency of the abuse, force, the relationship of the perpetrator to the child, and maternal support affected the degree of symptomatology. About two-thirds of the victimized children showed recovery during the 1st 12–28 mo. The findings suggest the absence of any specific syndrome in children who have been sexually abused and no single traumatizing process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differences among sexually abused and nonabused women from functional and dysfunctional families.

This study identified a previously unexamined group of sexual abuse survivors (those from functional families) and addressed methodological flaws in previous research by examining differences among abused women from functional families, abused women from dysfunctional families, nonabused women from dysfunctional families, and nonabused women from functional families. Measures of depression, anxiety, and interpersonal problems were completed by participants along with a measure of overall distress across a cluster of symptoms associated with childhood sexual abuse. On all four measures, the abused-dysfunctional group reported the highest level of psychological distress. Conversely, the level of psychological distress reported by the abused-functional group did not differ from that of the nonabused-functional or nonabused-dysfunctional groups. Research and counseling implications 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.     

A function in apoptosis other than transactivation inherent in the NH2-terminal domain of p53

This study used a cluster analysis to examine the clinical profiles of female survivors of child sexual abuse. Eighty-five participants who presented for group therapy to deal specifically with issues related to sexual abuse completed the revised version of the Minnesota Multiphasic Personality Inventory (MMPI-2; J. N. Butcher, W. G. Dahlstrom, J. R. Graham, A. Tellegen, & B. Kaemmer, 1989) as part of an extensive assessment procedure. The cluster-analytic procedure used in this study allowed 5 subgroups within the population to emerge, supporting the idea that women who report having been sexually abused as children are not a homogeneous group. Additional analyses indicated differences on the basis of cluster membership on the MMPI-2 content scales, as well other measures of psychological distress. The treatment implications of these findings are discussed.     

Treatment of sexually abused children and adolescents.

The authors review research demonstrating the variable effects of childhood sexual abuse, the need for intervention, and the effectiveness of available treatment models. The well-controlled treatment-outcome studies reviewed do not focus on sensationalistic fringe treatments that treat sexually abused children as a special class of patients. Instead, studies demonstrate empirical evidence for extending and modifying treatment models from mainstream clinical child psychology to sexually abused children. The authors propose a continuum of interventions to meet the needs of this heterogeneous group. Interventions range from psychoeducation, prevention, and screening, to short-term, abuse focused cognitive-behavioral therapy with family involvement, to more comprehensive long-term plans for multiproblem cases. Last discussed are gaps in the research and suggestions for future research to address the pressing dilemmas faced by clinicians and policymakers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relation between methods of coping during adulthood with a history of childhood sexual abuse and current psychological adjustment.

With a community sample of 192 women who had been sexually abused during childhood, the investigators determined if methods of coping in adulthood with the aftermath of child sexual abuse were associated with current symptoms of psychological distress. Multiple regression analyses indicated that disengagement methods of coping with the sexual abuse accounted for unique variance in general psychological distress even after controlling for characteristics of the abuse and methods of coping with other stressors. Disengagement methods of coping were also used more often to deal with the stressful aspects of having been sexually abused than to deal with other stressful events. In contrast, engagement methods of coping were used more often to deal with the other stressors than with sexual abuse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexual abuse and bulimia: response to inpatient treatment and preliminary outcome

The purpose of this study was to explore the clinical impact of child sex abuse on bulimic patients. Specifically, differences in treatment response and preliminary treatment outcome between hospitalized bulimic patients with and without a reported history of sexual abuse were examined. The patients were evaluated for past history of alleged sexual abuse by investigator-based interview and ratings of severity of sexual abuse were made. Assessments of mood, eating disordered-related attitudes, and eating behaviors were conducted at the start of treatment, weekly during treatment, and three months post discharge. Sixty-one per cent (45) of the 74 patients enrolled in the study reported a history of child sexual abuse. The majority of such events constituted serious and very serious abuse by this study's criteria. The abused subjects exhibited higher levels of depression, anxiety, and eating disordered attitudes at each assessment point relative to nonabused subjects. In addition, abused subjects were more likely to be re-hospitalized in the 3 month post-discharge period. Significant differences in the extent of actual bulimic behaviors were not detected. Both the abused and nonabused bulimic patients demonstrated significant reductions in psychiatric symptomatology from pretreatment to posttreatment, and from posttreatment to follow-up. Contrary to prediction, differences in symptomatology between the very serious, serious, and least serious abused groups were not detected. Results suggest that bulimic patients with reported histories of sexual abuse can be effectively engaged in a conventional eating disorder treatment program, but that such abuse may place patients at a disadvantage owing to higher levels of pretreatment symptom severity. Findings suggest that extended and/or more specific intervention may be warranted for the abused bulimic patient.     

Early and long-term effects of child sexual abuse: An update.

New research on the impact of child sexual abuse generally confirms the conclusions of an earlier review article by A. Browne and D. Finkelhor (see record 1986-14683-001) and extends findings into a few new areas. For example, more studies are now available concerning the impact of abuse on boys, but they have not found consistent gender differences. Some longitudinal studies have also been completed; they show a decline in symptomatology in the months following disclosure. Two areas of controversy are also prominent. One concerns how to explain the relatively substantial percentages of sexually abused children in most studies who have no symptoms on current diagnostic measures. The second concerns whether posttraumatic stress disorder is a useful conceptual framework for understanding the findings on the impact of sexual abuse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

MMPI-2 profiles of adult women with child sexual abuse histories: Cluster-analytic findings.

This study used a cluster analysis to examine the clinical profiles of female survivors of child sexual abuse. Eighty-five participants who presented for group therapy to deal specifically with issues related to sexual abuse completed the revised version of the Minnesota Multiphasic Personality Inventory (MMPI-2; J. N. Butcher, W. G. Dahlstrom, J. R. Graham, A. Tellegen, & B. Kaemmer, 1989) as part of an extensive assessment procedure. The cluster-analytic procedure used in this study allowed 5 subgroups within the population to emerge, supporting the idea that women who report having been sexually abused as children are not a homogeneous group. Additional analyses indicated differences on the basis of cluster membership on the MMPI-2 content scales, as well as other measures of psychological distress. The treatment implications of these findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Accuracy of adult recollections of childhood victimization, Part 2: Childhood sexual abuse.

Questions have been raised about the accuracy of retrospective self-reported information about childhood sexual abuse. Using data from a prospective-cohorts-design study, a large group of children who were sexually and physically abused or neglected approximately 20 years ago were followed up and compared with a matched control group. Accuracy of adult recollections of childhood sexual abuse was assessed using 4 different measures, completed in the context of a 2-hr in-person interview in young adulthood (N = 1,196). Results indicate gender differences in reporting and accuracy, substantial underreporting by sexually abused respondents in general, good discriminant validity and predictive efficiency of self-report measures for women, and some support for the construct validity of the measures. Implications for researchers and practitioners are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)