Women's history of sexual abuse, their sexuality, and sexual self-schemas.

In this study, the authors assessed 48 female survivors of child sexual abuse (CSA) and 71 female control participants using measures of adult sexual function, psychological function (i.e., depression and anxiety), and sexual self-schemas. The primary purpose of this study was to examine whether differences existed between women with and without a history of CSA in the way that they viewed themselves as a sexual person and, if so, whether such differences mediated the link between early unwanted sexual experiences and later adult sexuality. CSA survivors were found to view themselves as less romantic and passionate than women who were not abused. In particular, CSA survivors showed an inverse relationship between romantic/passionate sexual self-schemas and negative sexual affect during sexual arousal. The relationship between CSA and negative sexual affect was independent from symptoms of depression and anxiety, suggesting that the impact of CSA on sexual self-schemas may be independent from the impact that the abuse may have in other areas of the survivor's life. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

When the face reveals what words do not: Facial expressions of emotion, smiling, and the willingness to disclose childhood sexual abuse.

For survivors of childhood sexual abuse (CSA), verbal disclosure is often complex and painful. The authors examined the voluntary disclosure-nondisclosure of CSA in relation to nonverbal expressions of emotion in the face. Consistent with hypotheses derived from recent theorizing about the moral nature of emotion, CSA survivors who did not voluntarily disclose CSA showed greater facial expressions of shame, whereas CSA survivors who voluntarily disclosed CSA expressed greater disgust. Expressions of disgust also signaled sexual abuse accompanied by violence. Consistent with recent theorizing about smiling behavior, CSA nondisclosers made more polite smiles, whereas nonabused participants expressed greater genuine positive emotion. Discussion addressed the implications of these findings for the study of disclosure of traumatic events, facial expression, and the links between morality and emotion. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Culture and alexithymia: Mean levels, correlates and the role of parental socialization of emotions.

Two studies examined the relationship between culture and alexithymia. In Study 1, mean levels and correlates of alexithymia were examined in 3 cultures: European American (EA), Asian American (AA), and Malaysian college students. Both Asian groups had higher alexithymia levels than the EA group. Somatization was more strongly associated with alexithymia in the Asian groups than in the EA group. Mood and life satisfaction were associated with alexithymia in similar ways across groups. In Study 2, the relations among culture, gender, retrospective reports of parental socialization of emotions, and alexithymia were examined among EA and AA college students. Cultural and gender differences were found in alexithymia and emotion socialization levels. Most important, parental emotion socialization mediated the relations among culture, gender, and alexithymia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factors associated with severity of depression and high-risk sexual behavior among persons diagnosed with human immunodeficiency virus (HIV) infection.

Whereas some people appear to cope after learning that they have HIV infection, others experience depression and suicidal ideation. In this study, 142 persons with HIV infection were administered the Center for Epidemiological Studies Depression Scale. High levels of depression were predicted by lower perceived social support, attributions that health was influenced more by chance, high-risk sexual behavior practices, and greater number of HIV illness symptoms and greater duration of time knowing of one's own positive serostatus. Ongoing high-risk sexual behavior practices were predicted by higher levels of recreational drug use and of depression. These findings highlight the need for improved mental health services for persons with HIV conditions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The pharmacokinetics and physiological effects of buprenorphine infusion in premature neonates

Whereas some people appear to cope after learning that they have human immunodeficiency virus (HIV) infection, others experience depression and suicidal ideation. In this study, 142 persons with HIV infection were administered the Center for Epidemiological Studies Depression Scale (CES-D). High levels of depression were predicted by lower perceived social support, attributions that health was influenced more by chance, high-risk sexual behavior practices, and greater number of HIV illness symptoms and greater duration of time knowing of one's own positive serostatus. Ongoing high-risk sexual behavior practices were predicted by higher levels of recreational drug use and of depression. These findings highlight the need for improved mental health services for persons with HIV conditions.     

Context matters: The benefits and costs of expressing positive emotion among survivors of childhood sexual abuse.

Positive emotions promote adjustment to aversive life events. However, evolutionary theory and empirical research on trauma disclosure suggest that in the context of stigmatized events, expressing positive emotions might incur social costs. To test this thesis, the authors coded genuine (Duchenne) smiling and laughter and also non-Duchenne smiling from videotapes of late-adolescent and young adult women, approximately half with documented histories of childhood sexual abuse (CSA), as they described the most distressing event of their lives. Consistent with previous studies, genuine positive emotional expression was generally associated with better social adjustment two years later. However, as anticipated, CSA survivors who expressed positive emotion in the context of describing a past CSA experience had poorer long-term social adjustment, whereas CSA survivors who expressed positive emotion while describing a nonabuse experience had improved social adjustment. These findings suggest that the benefits of positive emotional expression may often be context specific. (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)     

Longitudinal associations between emotion regulation and depression in preadolescent girls: Moderation by the caregiving environment.

Identifying childhood precursors for depression has been challenging and yet important for understanding the rapid increase in the rate of depression among adolescent girls. This study examined the prospective relations of preadolescent girls’ emotion regulation and parenting style with depressive symptoms. Participants were 225 children and their biological mothers recruited from a larger longitudinal community study. Girls’ observed positive and negative emotion during a conflict resolution task with mothers, their ability to regulate sadness and anger, and their perception of parental acceptance and psychological control were assessed at age 9. Depressive symptoms were assessed by self-report at ages 9 and 10. The results indicated interactions between child emotion characteristics and parenting in predicting later depression. Specifically, low levels of positive emotion expression predicted higher levels of depressive symptoms in the context of moderate to high parental psychological control. Low levels of sadness regulation were predictive of high levels of depressive symptoms in the context of low to moderate parental acceptance. Findings from this study support the hypothesis that the prospective association between vulnerabilities in emotion regulation and depression are moderated by the caregiving environment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relating body image to psychological and sexual functioning in child sexual abuse survivors

Cognitive-affective body image variables and their relation to long-term psychological and sexual functioning were investigated in a community sample of 57 female adult child sexual abuse (CSA) survivors and 47 comparison subjects. The Body-Self Relations Questionnaire and the Body Esteem Scale were administered to assess cognitive-affective body image. Group comparisons indicated that, after controlling for actual weight status, survivors evaluated their health more negatively and reported less body esteem regarding their sexual attractiveness than comparison subjects. Body image variables related to health and sexual attractiveness significantly explained variance on symptom measures that reflect the diverse CSA long-term sequelae. Results suggest the need for careful assessment of body image disturbances and the development of effective interventions targeting body image in the treatment of CSA survivors.     

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.     

Intrapersonal and Familial Effects of Child Sexual Abuse on Female Partners of Male Survivors.

Intrapersonal and familial effects of childhood sexual abuse (CSA) were investigated by interviewing 10 female partners of male survivors. Consensual qualitative research analysis (C. Hill, B. Thompson, & E. Nutt Williams, 1997) yielded 13 domains describing male partner, female partner, couple, and family functioning. Findings concerning emotional reactions, coping strategies, communication patterns, and sexual functioning correspond to the 3 components of C. Maltas and J. Shay's (1995) trauma contagion model (i.e., threatened beliefs, chronic stress, and reenactment of aspects of CSA). Additional findings suggest themes of recovery from trauma contagion. Whereas results concerning threatened beliefs and chronic stress may replicate to other populations (e.g., partners of war veterans), reenactment of aspects of CSA seems unique. Practice and research recommendations are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting the impact of child sexual abuse on women: The role of abuse severity, parental support, and coping strategies.

Female Navy recruits (N=5,226) completed surveys assessing history of childhood sexual abuse (CSA), childhood strategies for coping with CSA, childhood parental support, and current psychological adjustment. Both CSA and parental support independently predicted later adjustment. In analyses examining whether CSA victims' functioning was associated with CSA severity (indexed by 5 variables), parental support (indexed by 3 variables), and coping (constructive, self-destructive, and avoidant), the negative coping variables were the strongest predictors. A structural equation model revealed that the effect of abuse severity on later functioning was partially mediated by coping strategies. However, contrary to predictions, the model revealed that childhood parental support had little direct or indirect impact on adult adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A longitudinal examination of the reciprocal relations between perceived parenting and adolescents' substance use and externalizing behaviors.

Although studies have found an association between adolescent problem behavior and deficits in parental support and control, questions remain concerning the causal nature of these relations. Using longitudinal data, this study explored prospective reciprocal relations between perceived parenting and adolescents' substance use and externalizing symptoms. A community sample of adolescents and their parents (N?=?441) was studied, within which half of the adolescents were at risk for problem behavior because of parental alcoholism. Covariance structural modeling revealed full reciprocal relations between adolescent substance use and levels of parental support and control. Furthermore, although adolescent externalizing behaviors prospectively predicted parental control and support, parenting was not prospectively related to externalizing symptoms. The findings support the reciprocal effects model of socialization. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Do as I say, not as I do": Family influences on children's safety and risk behaviors.

Objective: Although there is considerable speculation that family-based socialization processes influence children's safety and risk behaviors, few studies have addressed this important issue. The present study compared the impact of parent practices and teaching about safety on children's current behaviors and their intended future behaviors when they reach adulthood. Design and Measures: Children 7 to 12 years of age were interviewed and asked to report on their parents' practices and teachings (discussions, expectations for children's behavior) regarding five common safety behaviors. As well, the children reported on their own current practices and how they intended to behave when an adult. When appropriate, they provided explanations about why their parents engage in fewer safety behaviors than they required of their children. Results: Children's current behavior was best predicted by parental teaching, however, how children planned to behave when they were adults was best predicted by parents' practices. Children attributed less frequent safety behaviors by their parents than themselves to general attributes of adults and their parent having special skills that made the safety practices less necessary than was true for children. Conclusion: These results highlight family influences on children's adoption of safety and risk practices and support the notion of intergenerational transmission of risk behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Co-occurrence of eating disorders and incest: The role of attachment, family environment, and social competencies.

Childhood attachment, family environment, and adult social competencies were examined to explain the association between sexual abuse and eating disorders (EDs). Female college students (n?=?102) and female clients sexually abused in childhood (n?=?52) completed surveys retrospectively that assessed parental bonds, family environment, and sexual abuse, as well as current self-efficacy, social support, intimacy, adult attachment style, and ED symptoms. Client incest survivors had a higher ED rate (47%) than did sexually abused clients (22%), student incest survivors (24%), or nonabused students (17%). Significant associations were found between family environment, incest, social competencies, and eating disorders. Incest survivors had more dysfunctional families and lower social competencies than did nonabused women. Among incest survivors, those with the lowest levels of social competencies and poorest bonds with their mothers had more ED symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Childhood Sexual Abuse, Disordered Eating, Alexithymia, and General Distress: A Mediation Model.

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. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Childhood Sexual Abuse, Relationship Satisfaction, and Sexual Risk Taking in a Community Sample of Women.

Childhood sexual abuse (CSA) has been proposed to influence both women's adult sexual risk behaviors and the quality of their intimate relationships. Among a household sample of women (n = 732), good fit was obtained for a model in which CSA predicted Wave 1 male partner sexual risk and aggression characteristics, resulting in lower relationship satisfaction, and ultimately in higher numbers of Wave 2 sexual partners. The model was generally replicated among women who entered new relationships at Waves 2 and 3. Partner sexual risk characteristics also were associated with women's risk of sexually transmitted infection from current partner. Elevated sexual risk behaviors among CSA survivors reflect difficulty in establishing stable and safe relationships and may be reduced by interventions aimed at improving intimate relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parental bonding and current psychological functioning among childhood sexual abuse survivors.

The relation between perceived parental bonding to maternal and paternal primary caregivers and current psychological functioning was examined among an adult female sample (n?=?78) of child sexual abuse survivors (CSASs). Although CSASs revealed significantly poorer psychological adjustment than non-CSASs, high paternal care was significantly associated with better psychological functioning among CSASs. These data are discussed in the context of attachment theory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Vulnerability to depression as a function of parental rejection and control.

Investigated the relationship between depression proneness in 46 male and 49 female undergraduates and the amount of care and overprotection they perceived from their parents during childhood. Ss completed a test battery that included the Parental Bonding Instrument, the Beck Depression Inventory, and the Fear Survey Schedule. For sons, depression proneness was associated with perceptions of a cold, rejecting father. For daughters, depression proneness was associated with perceptions of an intrusive and controlling mother. The pattern of correlations between parenting practices and depression proneness differed substantially from that observed between parenting practices and fearfulness, suggesting that perceptions of parental rejection and control are not characteristic of psychopathology in general, but can lead to the development of a depression-prone personality. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The co-occurrence of childhood sexual abuse, adult sexual assault, intimate partner violence, and sexual harassment: A mediational model of posttraumatic stress disorder and physical health outcomes.

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. (PsycINFO Database Record (c) 2010 APA, all rights reserved)