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At least 19 recordsLinked to original sources

The ecology of adolescent maltreatment: a multilevel examination of adolescent physical abuse, sexual abuse, and neglect.

This study examined the individual characteristics, family relations, and stress/social support of 50 maltreated adolescents and their mothers. Dyads were divided into 4 demographically similar groups: neglect, physical abuse, sexual abuse, and nonmaltreatment control. Results show that adolescent neglect was primarily associated with extrafamilial difficulties and social isolation. Adolescent physical abuse was linked more with rigidity in family relations, poorer maternal understanding of child developmental skills, and adolescent externalizing behaviors. In contrast, adolescent sexual abuse was related to maternal emotional problems and adolescent internalizing behaviors. In general, each group of maltreated adolescents experienced lower levels of family cohesion, more attention problems, and more daily stress than did their nonmaltreated counterparts. Findings are consistent with an ecological model of adolescent maltreatment.

Adaptation, Psychological↗

An exploration of child sexual abusers' sexual fantasies before and after treatment.

Although there is a substantial literature looking at the relationship between deviant sexual fantasies and child sexual abuse, there is scant previous work that focuses upon the actual content of such fantasies. The present study looks at child sexual abusers' deviant fantasies both pre- and postintervention. Using both qualitative and quantitative methodologies, a description of the frequency and content of, and triggers for, child sexual abusers' deviant fantasies is reported both pre- and postintervention. The implications of this information for subsequent intervention programs is explored.

Adult↗

The antecedents of women's crack cocaine abuse: family substance abuse, sexual abuse, depression and illicit drug use.

Young African-American women are the fastest growing group of crack cocaine users in the United States. Despite this increase, relatively little is known about women who use crack cocaine and the possible reasons for their drug use. This descriptive, exploratory study focused on data from a sample of 105, predominantly African-American women who use(d) crack cocaine, of whom 60 were in drug treatment and 45 were still using crack cocaine. Significant correlations were found between variables such as family drug use, first age of sexual abuse, age of first depressive symptoms and age of first illicit drug use. These data are consistent with other studies which have noted high rates of depression and sexual abuse in samples of predominantly Euro-American, alcoholic women. Implications for the treatment of women are discussed.

Adolescent↗

Update on child physical abuse, sexual abuse, and prevention.

PURPOSE OF REVIEW: The most recent literature regarding assessment and management of child maltreatment will be considered. The current status of abuse prevention activity will also be reviewed. RECENT FINDINGS: Clinical practice continues to be burdened by the general lack of training and knowledge of the presenting signs and symptoms of child maltreatment by general practitioners. The need for better training is emphasized. Physician engagement in child protection is further inhibited by imprecise reporting obligations and an inadequate child protective services response by the state. Several randomized, controlled trials of home-visiting programs by professionals have demonstrated modest effects in the primary prevention of child abuse and neglect; however, the prevention of recurrent maltreatment of children who remain in the home has proved elusive. SUMMARY: Current clinician training in child maltreatment is inadequate. Research into effective education of clinicians and program effectiveness is plainly needed, and should be supported by increased funding.

Child↗

Child sexual abuse, peer sexual abuse, and sexual assault in adulthood: a multi-risk model of revictimization.

This study explored the predictors and consequences of sexual assault occurring after the age of 16 years in a nonclinical sample of women. Child sexual abuse occurring before the age of 16 years was the only predictor of later sexual assault among comorbid risk factors. Peer sexual abuse, number of perpetrators, age at time of sexual abuse, and severity of sexual abuse did not increase the risk for later sexual assault. Adult sexual assault victims showed lower levels of mental health functioning than did survivors of child or peer sexual abuse. We discuss a specificity model of revictimization and the differential effects of child, peer, and adult sexual trauma on the developmental trajectory of sexual violence and psychosocial functioning.

Adolescent↗

Sexual abuse and sexual risk behaviors of minority women with sexually transmitted diseases.

The relationship between sexual abuse and sexually transmitted disease (STD) represents an important and underinvestigated context of domestic violence. This study examined the association between sexual abuse, sexual risk behaviors, and risk for reinfection and HIV among minority women with STD. Mexican American and African American women (n = 617) with active STD entered a randomized study of behavioral intervention to reduce STD recurrence. Each underwent questioning at entry regarding sexual abuse and sexual risk behaviors. Comparisons of these behaviors using chi-square, t tests, and logistic regression were made by history of sexual abuse. Sexually abused women were more likely to have lower incomes, earlier coitus, STD history, currently abusive partners, new sex partners, anal sex, and bleeding with sex, placing them at increased risk for STD reinfection and HIV. Due to this association with sexual risk behavior, assessment for sexual abuse is essential in programs focusing on STD/HIV prevention.

Adult↗

Preventing female-perpetrated sexual abuse.

Sexual abuse and sexual assault are serious public health concerns. Although almost all of the research shows that the majority of sexual perpetrators are males, there is growing evidence that female-perpetrated sexual abuse is not rare and that the consequences of female-perpetrated sexual abuse can be just as traumatic as male-perpetrated sexual abuse. Despite this, there has been very little research published that has focused on female sex offending. Furthermore, although there have been some efforts in the past decade to stop sexual offenses by targeting potential perpetrators, few efforts have specifically focused on preventing females from becoming sex offenders. In an attempt to fill this gap, this article describes common characteristics of female sex offenders; and, based on these characteristics, suggestions are given of possible ways to intervene in the lives of at-risk females before they offend.

Dangerous Behavior↗

Developmental issues in the assessment and treatment of adolescent perpetrators of sexual abuse.

Sexual abuse perpetrated by adolescents is not recognized as a major problem. While there may be similarities between adults and adolescents who perpetrate sexual abuse, adolescent sexual abusers face developmental issues which are different from those of adults. It is argued that the specific needs of the adolescent sexual abuser cannot be fully understood by simply extrapolating knowledge derived from work with adult perpetrators. The purpose of the present paper is to discuss the importance of the developmental issues facing the adolescent perpetrator of sexual abuse and their implications for the assessment and treatment of this group of sexual abusers.

Adolescent↗

[Venereal diseases in children and sexual abuse].

Sexual abuse in children is reported increasingly frequently. The abuse frequently comes to the attention of the authorities when the children present symptoms which raise the suspicion of sexual abuse. One of these symptoms may be sexually transmitted disease in the child. Previously, there was a tendency to accept the possibility that sexually transmitted disease in children could be transmitted by other means than sexual contact, eg indirectly by infected bedclothes and toilet articles. Where gonorrhoea is concerned, no documentation exists in the literature for non-sexual infection in children. Condylomata acuminata are caused by infection with the human papilloma virus and may possibly infect children by non-sexual contact in rare instances but, in the majority of cases, meticulous investigation of the surroundings of the children will raise the suspicion of sexual abuse as the cause of the infection. The case history of gonococcal vulvo-vaginitis in a girl aged 23 months were the source of infection could not be successfully proved is mentioned. Two case histories are reported concerning anal condylomata acuminata in a girl aged nine years who had been sexually abused and a girl aged 25 months where there was a strong suspicion of sexual abuse but where the source of infection remained unknown. On the basis of literature from recent years and the case histories reported here, it is concluded that all gonococcal infections in children must be regarded as being sexually transmitted and these should, therefore, be reported to the social authorities. In addition, all children with ano-genital condylomata acuminata should be investigated meticulously for sexual abuse and be reported to the social authorities, if the suspicion is well founded.

Anus Neoplasms↗

Psychiatric aspects of sexual abuse.

Sexual abuse of children and adolescents has become an increasingly publicized phenomenon. Psychiatrists and other mental health professionals are often called upon to evaluate and treat children and adolescents who may have been sexually abused, to provide counseling or treatment to the families of such children, and to provide reports and testimony for proceedings about such cases in the child protection system, the criminal justice system, and in custody disputes. Clarity regarding the medical, psychiatric, and legal aspects of sexual abuse is essential in carrying out such professional activities and in evaluating and formulating research on sexual abuse. In this paper current knowledge regarding these aspects of sexual abuse is summarized, and the role of psychiatrists in clinical and forensic work involving allegations of sexual abuse is discussed.

Adolescent↗

Representations of self and other in the narratives of neglected, physically abused, and sexually abused preschoolers.

The MacArthur Story Stem Battery was used to examine maternal and self-representations in neglected, physically abused, sexually abused, and nonmaltreated comparison preschool children. The narratives of maltreated children contained more negative maternal representations and more negative self-representations than did the narratives of nonmaltreated children. Maltreated children also were more controlling with and less responsive to the examiner. In examining the differential impact of maltreatment subtype differences on maternal and self-representations, physically abused children evidenced the most negative maternal representations; they also had more negative self-representations than nonmaltreated children. Sexually abused children manifested more positive self-representations than neglected children. Despite these differences in the nature of maternal and self-representations, physically and sexually abused children both were more controlling and less responsive to the examiner. The investigation adds to the corpus of knowledge regarding disturbances in the self-system functioning of maltreated children and provides support for relations between representational models of self and other and the self-organizing function that these models exert on children's lives.

Child Abuse↗

Comparing child victims and adult survivors: clues to the pathogenesis of child sexual abuse.

Sexual abuse consists of two discrete traumatic elements; the repeated infliction of sexual assault that is superimposed on a chronic background of pathological family interaction, including betrayal, stigmatization, role reversal, and violation of personal boundaries. The acute episodes of sexual assault may be overwhelming to the child and result in anxiety-related symptoms, including PTSD. The long-standing family dysfunction leads to a pathological defensive organization that becomes woven into the victim's personality structure, resulting in long-term characterological changes. As the sexually abused child progresses through adolescence into adulthood, and the immediacy of his or her victimization recedes to the background, the acute posttraumatic anxiety symptoms are gradually replaced by more enduring symptoms and characterological defenses. Traumatic memories of the abuse become repressed or dissociated from consciousness. Identifications, attitudes, and affects derived from the abusive environment are usually organized around victimization experiences, leading to identifications with the aggressor or victim, which contribute to sadomasochistic object relationships and problems with the regulation of sexual behavior. The repressed or dissociated traumatic memories of sexual abuse carry the potential for producing future psychopathology through displacement in the form of conversion symptoms or somatization, and by generating delayed PTSD when these memories are elicited by current experiences. Anxiety and depression triggered by the emergence of these traumatic memories often lead to alcohol and drug abuse. These substances may be used for their anxiolytic and antidepressant effects.

Adaptation, Psychological↗

Further abuse of sexually abused children.

OBJECTIVE: To determine the incidence of re-abuse in children known to have been sexually abused and to find factors that increase the risk of re-abuse. METHOD: The study group consisted of 183 children with substantiated sexual abuse who presented to two children's hospitals' Child Protection Units in Sydney, Australia during 1988 through 1990. At intake, when the children were aged between 5 years and 15 years, data about the child, the family, and the nature of the index sexual abuse were collected. Six years after presentation for the abuse, records of the Department of Community Services were checked to see if any of the young people had been the subject of substantiated notifications for abuse/neglect before and after intake to the study. Predictors of notifications for abuse/neglect after presentation for the index sexual abuse were identified. RESULTS: Of the sexually abused young people, nearly one in three were the subject of subsequent substantiated notifications to the Department of Community Services for some form of child abuse and neglect or behavior which placed them at risk of harm. Later notifications for abuse/neglect were predicted by notifications for emotional abuse before the index sexual abuse (adjusted RR = 4.88, CI: 1.43 to 16.65), severity of the index sexual abuse (p = .03), and the number of changes in the child's primary caregivers before intake (p = .03). Approximately one in six of the sexually abused young people were notified for sexual abuse after intake to the study. One in 10 also had prior notifications for sexual abuse. Sexual abuse notifications after study intake were predicted by caregiver changes before intake (p = .01) and whether or not there were notifications for emotional abuse before the index sexual abuse (adjusted RR = 3.40, CI: 1.05 to 11.02). CONCLUSIONS: Revictimization of children appears to be a marker of ongoing family dysfunction. Intervention in child sexual abuse needs to consider a range of risk factors associated with re-abuse and, in particular, should focus on family functioning if further abuse is to be prevented.

Adolescent↗

The relationship between sexual abuse and sexual risk among high school students: findings from the 1997 Massachusetts Youth Risk Behavior Survey.

OBJECTIVE: To assess whether adolescents with a history of sexual abuse were more likely than those with no such history to engage in sexual risk behaviors. METHODS: Data for this study were obtained through the 1997 Massachusetts Youth Risk Behavior Survey, a self-report questionnaire administered to a representative sample of 9th through 12th graders (N = 4,014) to assess a variety of adolescent risk behaviors. Only sexually experienced adolescents (n = 1,610; female = 779, male = 831) were included in the present study. Logistic regression models were constructed to examine the relationship of sexual abuse history to sexual risk behaviors. Adolescents were considered as having a history of sexual abuse if they reported ever having had sexual contact against their will. RESULTS: Almost one-third of sexually experienced adolescent girls (30.2%) and one-tenth (9.3%) of adolescent boys reported a history of sexual abuse. After controlling for related demographics and risk behaviors, sexually abused female students were significantly more likely than those without such a history to have had earlier first coitus (OR = 2.2, 95%CI = 1.46-3.47), to have had three or more sex partners ever (OR = 2.5, 95%CI = 1.71-3.68), and to have been pregnant (OR = 1.9, 95%CI = 1.21-2.92). Sexually abused male students were significantly more likely than those without such a history to have ever had multiple partners (OR = 3.2, 95%CI = 1.56-6.57), to have had multiple sex partners in the past 3 months (OR = 2.9, 95%CI = 1.71-3.68), and to have engaged in sex resulting in pregnancy (OR = 3.4, 95%CI = 1.53-7.34). CONCLUSION: Both adolescent girls and boys with a history of sexual abuse report greater sexual risk-taking than those without such a history. However, although sexual abuse is more prevalent among girls than boys, the impact of sexual abuse on sexual risk appears to be even greater for boys. Programs addressing both sexual abuse and sexual risk must be made available to all adolescents.

Adolescent↗

Sexual abuse and sexual functioning in a chronic pelvic pain sample.

Sexual abuse, particularly childhood sexual abuse, has been linked to chronic pelvic pain and to sexual dysfunction, though the sexual functioning of survivors of sexual abuse has not been studied in a chronic pain population. Sixty-three women with chronic pelvic pain completed measures of sexual function, sexual abuse, and pain. Using an index of the extent of sexual abuse experiences in childhood and adolescence/adulthood, higher scores were related to lower rates of sexual activity, less satisfaction with orgasm and feelings of closeness with sexual partners, and greater severity of and interference from pain. Findings point to the importance of controlling for relationship status in analyses of long-term effects of sexual abuse and of assessing chronic pelvic pain patients for histories of sexual abuse using measures that address the extent or severity of abuse.

Adult↗

Childhood sexual abuse, adolescent sexual coercion and sexually transmitted infection acquisition among homeless female adolescents.

OBJECTIVE: To examine the relationship between childhood experiences of sexual abuse, sexual coercion during adolescence, and the acquisition of sexually transmitted infections (STIs) in a population of homeless adolescents. METHOD: Homeless adolescent females (N = 216) from a northwestern United States city were recruited by street outreach workers for a longitudinal study of STI epidemiology. Baseline data on childhood abuse and recent history of sexual coercion were used to predict physiologically confirmed STI acquisition over the subsequent 6 months. RESULTS: About 38% of all girls reported a history of childhood sexual abuse (CSA). Girls with a history of CSA were more likely to report recent sexual coercion. In turn, sexual coercion in the last three months was significantly associated with a higher number of sexual partners (but not with a greater frequency of intercourse or with lower rates of condom use). Number of sexual partners significantly predicted the future acquisition of an STI within 6 months. CONCLUSIONS: Interventions to reduce risky sexual behaviors in homeless adolescent females may need to consider the impact of CSA, particularly on the number of sexual partners during adolescence. However, it also should be noted that engagement in intercourse often results from coercion and is not voluntary in this population.

Adolescent↗

Core data elements tracking elder sexual abuse.

Sexual abuse in the older adult population is an understudied vector of violent crimes with significant physical and psychological consequences for victims and families. Research requires a theoretical framework that delineates core elements using a standardized instrument. To develop a conceptual framework and identify core data elements specific to the older adult population, clinical, administrative, and criminal experts were consulted using a nominal group method to revise an existing sexual assault instrument. The revised instrument could be used to establish a national database of elder sexual abuse. The database could become a standard reference to guide the detection, assessment, and prosecution of elder sexual abuse crimes as well as build a base from which policy makers could plan and evaluate interventions that targeted risk factors.

Age Factors↗

Introduction to the special section on adult survivors of childhood sexual abuse.

Sexual abuse researchers need to use more complex models of abuse and more sophisticated research designs for studying long-term effects and for evaluating treatment programs. The articles that comprise this special section integrate the study of sexual abuse with perspectives on adult victimization, developmental psychopathology, and attachment theory and also offer specific methodological suggestions for improving research on long-term effects and therapy with the abuse survivor.

Adolescent↗