Child sexual abuse

Evaluation of Bikers Against Child Abuse (BACA) program: A community intervention for child abuse victims

Children who have experienced physical abuse benefit from a multitude of community interventions including support programs to address emotional and behavioral stability. This pilot study evaluated the services of Bikers Against Child Abuse (BACA), a community of bikers lending intervention to abused children, using a pre/post exploratory design. Participants (N=154) were children who had been referred by parents/guardians for current or past physical and/or sexual abuse. Parents/guardians of children were interviewed four times over a course of one year. Results indicated children demonstrated substantial improvements in their overall levels of emotional distress, conduct concerns, hyperactivity, and behavioral and emotional functioning. Overall, results support the premise that services provided by BACA may serve as a unique intervention for children who have experienced abuse.

Gender-based differences in injecting drug use by young adults who experienced maltreatment in childhood: Findings from an Australian birth cohort study

BACKGROUND

Childhood maltreatment has been associated with a range of adverse mental and psychosocial outcomes, but its association with subsequent injecting drug use (IDU) is less clear. This study investigates the associations between specific and multiple forms of substantiated childhood maltreatment and IDU reported at 21 years.

METHOD

The Mater-University of Queensland Study of Pregnancy is a prospective birth cohort study. It recruited pregnant women at their first antenatal clinic visit and collected data on their children at 21 years. Data from 3750 participants (1769 males and 1981 females) were analysed using agency substantiated childhood maltreatment from birth to 14 years of age and self-reports of ever IDU at 21 years. We used multivariable logistic regression analyses to control for possible confounders.

RESULTS

The sample's mean age was 20.6 years. Some 4.1% (n=72) of males and 4.6% (n=91) of females had experienced substantiated childhood maltreatment. The prevalence of IDU was 6.6% (n=118) and 4.6% (n=91) for males and females, respectively. In adjusted models, all forms of substantiated childhood maltreatment, with the exception of sexual abuse, were associated with IDU in females (adjusted odds ratios (AORs)=2.69-3.02) but only emotional abuse (AOR=2.51) was associated with IDU in males. Multiply occurring forms of childhood maltreatment were also associated with IDU in females (AORs=2.36-3.41) but not in males.

CONCLUSIONS

Injecting drug use appears to be an adverse outcome of childhood maltreatment particularly in females. Additional research is needed to better understand why females appear to be more affected than males.

Cultural considerations in the treatment of mental illness among sexually abused children and adolescents: the case of Bali, Indonesia

Childhood and adolescence sexual abuse can have long-lasting and devastating effects on personal and interpersonal growth and development. Sexually abused children tend to exhibit higher rates of poor school performance, aggressive behavior, PTSD (posttraumatic stress disorder), or depressive symptomatology, as well as social and relational deficits (e.g., age-inappropriate sexual behaviors). The trauma following such abuse can further affect neurodevelopment and physiology, aggravating mental or physical problems in adulthood. Early symptom recognition and appropriate interventional applications are important factors in successfully treating or even preventing the development of mental disorders in such cohorts. A central element of effective treatment is the selection of treatment targets. Cultural considerations are rarely or peripherally considered in sexual abuse treatment strategies. Western-trained psychiatrists and clinical psychologists tend to overlook or underestimate such factors in cross-cultural settings, resulting in interventional efforts that may interfere with traditional approaches to healing, and potentially contributing to a transgenerational cycle of trauma. By using Bali (Indonesia) as a focal culture, in this article we discuss the effects of cultural elements and showcase their potential contribution and systematic implementation into a holistic and sensitive interventional model for the treatment of mental illness in childhood and adolescence sexual traumatization.

Emotional and Sexual Correlates of Child Sexual Abuse as a Function of Self-Definition Status

Among individuals defined as having been sexually abused based on legal criteria, some will self-report having been abused and some will not. Yet, the empirical correlates of self-definition status are not well studied. Different definitions of abuse may lead to varying prevalence rates and contradictory findings regarding psychological outcomes. The present study examined whether, among legally defined sexual abuse survivors, identifying oneself as having experienced childhood sexual abuse (CSA) was associated with more severe abuse, negative emotional reactions toward the abuse, and current sexual reactions. A convenience sample of 1,021 French-speaking Canadians completed self-report questionnaires online. The prevalence of legally defined CSA was 21.3% in women and 19.6% in men, as compared to 7.1% in women and 3.8% in men for self-defined CSA. Among legally defined sexual abuse survivors, those who identified themselves as CSA survivors had been abused more frequently, were more likely to report a male aggressor, and more often described abuse by a parental figure than those who did not self-identify as abused. Further, self-defined CSA was associated with more negative postabuse reactions and sexual avoidance, whereas those not identifying as sexually abused were more likely to report sexual compulsion.

Extradyadic Sexual Involvement and Sexual Compulsivity in Male and Female Sexual Abuse Survivors

We tested a mediation model in which the relationship between child sexual abuse (CSA) severity and extradyadic sexual involvement (ESI) is explained through sexual compulsivity. Participants were 669 adults currently involved in an intimate relationship who completed self-report questionnaires. Prevalence of ESI was 32% in women and 57% in men survivors, more than twice the rates among participants with no CSA history. Sexual compulsivity was significantly higher in participants with multiple extradyadic partners as compared to participants reporting only one extradyadic relationship, who nevertheless scored higher than participants reporting no extradyadic partner. The hypothesized structural equation model (SEM) was invariant across men and women and indicated CSA severity was positively and significantly associated with sexual compulsivity, which, in turn, predicted ESI. However, there was also a direct association between CSA and ESI. High CSA severity, directly and through high sexual compulsivity, led to the highest probability of ESI.

Severity of mental illness as a result of multiple childhood adversities: US National Epidemiologic Survey

PURPOSE

To examine patterns of childhood adversity, their long-term consequences and the combined effect of different childhood adversity patterns as predictors of subsequent psychopathology.

METHODS

Secondary analysis of data from the US National Epidemiologic Survey on alcohol and related conditions. Using latent class analysis to identify childhood adversity profiles; and using multinomial logistic regression to validate and further explore these profiles with a range of associated demographic and household characteristics. Finally, confirmatory factor analysis substantiated initial latent class analysis findings by investigating a range of mental health diagnoses.

RESULTS

Latent class analysis generated a three-class model of childhood adversity in which 60 % of participants were allocated to a low adversity class; 14 % to a global adversities class (reporting exposures for all the derived latent classes); and 26 % to a domestic emotional and physical abuse class (exposed to a range of childhood adversities). Confirmatory Factor analysis defined an internalising-externalising spectrum to represent lifetime reporting patterns of mental health disorders. Using logistic regression, both adversity groups showed specific gender and race/ethnicity differences, related family discord and increased psychopathology.

CONCLUSIONS

We identified underlying patterns in the exposure to childhood adversity and associated mental health. These findings are informative in their description of the configuration of adversities, rather than focusing solely on the cumulative aspect of experience. Amelioration of longer-term negative consequences requires early identification of psychopathology risk factors that can inform protective and preventive interventions. This study highlights the utility of screening for childhood adversities when individuals present with symptoms of psychiatric disorders.

Effects of perpetrator identity on suicidality and nonsuicidal self-injury in sexually victimized female adolescents

PURPOSE

Child sexual abuse and sexual dating violence victimization are common problems that are known to have long-term negative consequences. This study aimed to compare the sociodemographic, abuse-related, and clinical features of female adolescents who were sexually abused by different perpetrators, and identify the factors associated with suicidality and nonsuicidal self-injury (NSSI) in these cases.

PATIENTS AND METHODS

Data of 254 sexually abused female adolescents between the ages of 12-18 years were evaluated. The cases were classified into three groups, namely "sexual dating violence", "incest", and "other child sexual abuse", according to the identity of the perpetrator. The three groups were compared in terms of sociodemographic, abuse-related, and clinical features.

RESULTS

Major depressive disorder was the most common psychiatric diagnosis, which was present in 44.9% of the cases. Among all victims, 25.6% had attempted suicide, 52.0% had suicidal ideation, and 23.6% had NSSI during the postabuse period. A logistic regression analysis revealed that attempted suicide was predicted by dating violence victimization (adjusted odds ratio [AOR] =3.053; 95% confidence interval [CI] =1.473, 6.330) and depression (AOR =2.238; 95% CI =1.226, 4.086). Dating violence victimization was also the strongest predictor of subsequent suicidal ideation (AOR =3.500; 95% CI =1.817, 6.741). In addition, revictimization was determined to be an important risk factor for both suicidal ideation (AOR =2.897; 95% CI =1.276, 6.574) and NSSI (AOR =3.847; 95% CI =1.899, 7.794).

CONCLUSION

Perpetrator identity and revictimization are associated with negative mental health outcomes in sexually victimized female adolescents. Increased risk of suicidality and NSSI should be borne in mind while assessing cases with dating violence and revictimization histories, in particular.

Neurological changes in brain structure and functions among individuals with a history of childhood sexual abuse: A review

OBJECTIVE

Review literature focused on neurological associations in brain structure among individuals with a history of childhood sexual abuse (CSA).

METHODOLOGY

A review of literature examining physiological irregularities in brain structures of individuals with a history of CSA was conducted.

RESULTS

Results revealed that a history of CSA was associated with irregularities in the cortical and subcortical regions of the brain. These irregularities have been recognized to contribute to various cognitive, behavioral, and psychological health outcomes later in life. Age of CSA onset was associated with differential neurological brain structures.

CONCLUSION

Mental and behavioral health problems such as anxiety, depression, substance abuse, dissociative disorders, and sexual dysfunction are associated with CSA and may persist into adulthood. Research depicting the associations of CSA on neurological outcomes emphasizes the need to examine the biological and subsequent psychological outcomes associated with CSA. Early intervention is imperative for CSA survivors.