Child sexual abuse consequences in community samples of Latino and European American adolescents

Older immigrant Latino gay men and childhood sexual abuse: Findings from the Palabras Fuertes project

Childhood Sexual Abuse (CSA) and maltreatment have long-term negative impacts on survivors, including older adults. Yet, limited qualitative examinations of how these experiences impact the lives of older adults exists and even fewer among older Latino gay men. We drew data from life-history narratives the first author conducted with five Spanish speaking older Latino gay men in New York City. Our analyses were guided by an Ecological Model, a Suffering lens, and our clinical social work experience with older adults, sexual minorities and people of color. All participants reported sexual experiences prior to the age of 15 and possible emotional and physical maltreatment. Yet, not all participants perceived these experiences as abuse. Our findings indicate how cultural, linguistic and contextual factors may affect disclosure and coping. Despite the fact that CSA and maltreatment occurred decades ago, these early experiences affected long-term psychosocial functioning. Our findings support a need for future research and clinical practice that considers the subjective perceptions of childhood sexual experiences and maltreatment and how these relate to psychosocial functioning in Latino gay men during older adulthood.

Hiding under the Color of Authority: Eric Wess Uller and his Decades-Long Rampage of Child Sexual Abuse

There are uniform characteristics of perpetrators of child sexual abuse; two of which stand out. Perpetrators generally put themselves in positions that provide easy access to children or adolescents, and they exploit the power or authority of those positions to sexually coerce their victims. There are nonetheless characteristics of perpetrators that are assuredly unique. Effectively posing as a police officer, while also claiming to be a medically trained practitioner capable of performing physical examinations, is an example of such. Relying on both of these misrepresentations, Eric Wess Uller grievously sexually abused over ninety underprivileged adolescent boys who were participants in a youth serving organization (YSO). Arrested after a twenty-year rampage, Mr. Uller then killed himself following his release on bail. Though anomalous in some respects, this case is best understood as a vital underscoring of the vulnerability of underprivileged teenage boys. Where the shortcomings of YSO's are concerned, the commitment to vigilance must be sustained irrespective of the hierarchical status of the personnel involved. Policy recommendations, informed by the limitations of diagnostic predictions, are included.

"Is there anything else you would like me to know?": Applying a trauma-informed approach to the administration of the adverse childhood experiences questionnaire

Nearly ubiquitous agreement exists regarding the potentially negative impact of adverse childhood experiences (ACEs) on health and well-being across the lifespan. This has propelled a movement across the nation for consistent screening of ACEs. Despite agreement regarding the consequences of ACEs, little research related specifically to the administration of the ACE questionnaire exists. Using data from a mixed-methods study of first-time mothers as means of illustration, this paper examines shortcomings of the ACE questionnaire. Participant responses revealed ambiguity with item structure, limited breadth of included events, and failure to capture the gravity of the experience. These shortcomings underscore inadequacies of the measure in accurately understanding individuals' lived experiences and call for the application of trauma-informed (TI) values, both in its content and administration. We apply the main tenets of a TI framework to the ACE questionnaire and make recommendations for its administration, translating theoretical underpinnings of a TI approach into action.

Differences in Visual Attention Patterns to Sexually Mature and Immature Stimuli Between Heterosexual Sexual Offenders, Nonsexual Offenders, and Nonoffending Men

Men, whether gynephilic or androphilic, show both early and late attention toward adults and not toward children. We examined early and late visual attention to sexually mature versus immature stimuli in four groups of heterosexual men: sexual offenders against children (SOAC = 18), sexual offenders against adults (SOAA = 16), nonsexual offenders (NSO = 18), and nonoffending men (NOM = 19). We simultaneously presented adult and child stimuli and measured time to first fixation, number of first fixations, total duration of fixation, and fixation count to four areas of interest: entire body, then face, chest, and pelvis. We found a significant interaction where only SOAC tended to fixate more first times to child than to adult stimuli. Conversely, we found longer total duration of fixations for the bodies of adults compared to the bodies of children in all groups; however, in both the total duration of fixations and the fixation count for the whole body, but especially in the chest, SOAC tended to fixate longer and more often on child stimuli than the other two groups of offenders, but not longer or more often than NOM. This study adds to the limited research using eye-tracking techniques in samples of SOAC.

Childhood Abuse and Adulthood IPV, Depression, and High-Risk Drinking in Latinas

Little is known about relationships between child maltreatment and adulthood intimate partner violence (IPV), depression, and risky drinking in Latinas. 548 Latinas in a sexual health randomized control trial (RCT) self-reported childhood physical, sexual, and emotional abuse, IPV, depression, and risky drinking. Childhood abuse was related to adulthood IPV, OR = 1.27, depression, OR = 2.02, and high-risk drinking, OR = 2.16. Childhood emotional abuse was linked to depression, OR = 2.19; childhood physical abuse to risky drinking, OR = 2.62; and childhood sexual abuse to depression, OR = 2.78 and risky drinking, OR = 2.38. Results may inform prevention/intervention efforts for mental health nurses.

Prevalence of potential sexual abuse in adolescents and young adults and feasibility of an assessment and management plan used in three research projects

The aims of this study were to examine the feasibility of a protocol to assess for assessment and response to potential sexual abuse (defined as self-report of sexual initiation before age 13) among adolescent and young adult research participants in human papillomavirus (HPV) vaccination screening; determine the proportion of participants whose survey responses indicated potential sexual abuse and assess whether age, gender, race, and recruitment site were associated with potential abuse. We pooled data from three cross-sectional studies of 13-26 year-old women and men (N = 1541) recruited at a Teen Health Center (THC) and Health Department (HD). Using written and electronic documentation, we demonstrated feasibility by the following outcomes: 100% of participants who indicated early sexual initiation were interviewed by the research staff, 100% of assessments were disclosed to participants' primary care clinicians, and no adverse consequences of the interviews or referrals occurred. Potential sexual abuse was identified in 95 participants (6.2%). In multivariable logistic regression, the following factors were independently associated with potential abuse: race (Black vs. White, odds ratio [OR] = 3.0, 95% confidence interval [CI] = 1.6-5.7; other race vs. White, OR = 2.6, 95%CI = 1.0-6.5); and recruitment site (HD vs. THC, OR = 2.1, 95%CI = 1.4-3.3). The standardized protocol to identify, assess and refer youth who may have been sexually abused was feasible and can enable researchers to ensure the safety of study participants.

Increased amygdala reactivity following early life stress: a potential resilience enhancer role

BACKGROUND

Amygdala hyper-reactivity is sometimes assumed to be a vulnerability factor that predates depression; however, in healthy people, who experience early life stress but do not become depressed, it may represent a resilience mechanism. We aimed to test these hypothesis examining whether increased amygdala activity in association with a history of early life stress (ELS) was negatively or positively associated with depressive symptoms and impact of negative life event stress in never-depressed adults.

METHODS

Twenty-four healthy participants completed an individually tailored negative mood induction task during functional magnetic resonance imaging (fMRI) assessment along with evaluation of ELS.

RESULTS

Mood change and amygdala reactivity were increased in never-depressed participants who reported ELS compared to participants who reported no ELS. Yet, increased amygdala reactivity lowered effects of ELS on depressive symptoms and negative life events stress. Amygdala reactivity also had positive functional connectivity with the bilateral DLPFC, motor cortex and striatum in people with ELS during sad memory recall.

CONCLUSIONS

Increased amygdala activity in those with ELS was associated with decreased symptoms and increased neural features, consistent with emotion regulation, suggesting that preservation of robust amygdala reactions may reflect a stress buffering or resilience enhancing factor against depression and negative stressful events.

Child maltreatment and pediatric asthma: a review of the literature

BACKGROUND

Child maltreatment is a common problem with known adverse consequences, yet its contributions to the development and course of pediatric asthma are only poorly understood.

MAIN

This review first describes possible pathways connecting child maltreatment to pediatric asthma, including aspects of the physical home environment, health behaviors and disease management, and psychological consequences of child maltreatment. We subsequently review existing studies, which generally report an association between maltreatment experiences and asthma outcomes in childhood. However, this literature is in its early stages; there are only a handful studies, most of them rely on self-reports of both child maltreatment and asthma history, and none have investigated the physiological underpinnings of this association. Taken together, however, the studies are suggestive of child maltreatment playing a role in pediatric asthma incidence and expression that should be explored further.

CONCLUSION

Existing data are sparse and do not allow for specific conclusions. However, the data are suggestive of child maltreatment influencing asthma risk and morbidity long before the adult years. Future research should focus on understanding how child maltreatment contributes to asthma disease risk and progression in this highly vulnerable population.

Posttraumatic Stress among Victimized Latino Women: Evaluating the Role of Cultural Factors

Research examining victimization and posttraumatic symptomatology among Latinos is lacking in the extant literature. This analysis used the victimized subsample (N = 752) of the Sexual Assault Among Latinas Study. The aim was to evaluate victimization prevalence and test the following hypotheses: (a) that victimization would be associated with higher levels of posttraumatic symptoms, (b) that cultural factors that move away from traditional Latino culture would be associated with higher levels of posttraumatic symptomatology, and (c) that cultural factors associated with traditional Latino culture would be related to lower posttraumatic symptomatology. Average age of the sample was 44.57 years, with three fourths having a high school education or higher, and two thirds having a household income below $30,000. Of exposure types, adulthood threats were most likely to result in Criterion A traumatic events (23.4%). Using the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000) based PTSD Checklist, between 8.8% and 45.5% of individuals met presumed PTSD diagnosis based on various PCL cut scores or algorithm criteria. Regression analyses indicated that the combined different types of adult and childhood victimizations, masculine gender role, and negative religious coping were associated with increased symptoms (βs ranging from .16 to .27). The results suggested a role of culture in posttraumatic symptoms for Latinas.

Prevalence of different forms of child maltreatment among Taiwanese adolescents: a population-based study

Reported cases of child maltreatment are increasing in Taiwan. Yet, comprehensive epidemiological characteristics of adolescents' exposure over the wide spectrum of violence are still lacking. The purpose of this study was to estimate the prevalence and magnitude of child maltreatment among Taiwanese adolescents. A population-based study was conducted with 5,276 adolescents aged 12-18 from 35 schools in 17 cities and townships to determine the prevalence of five forms of child maltreatment in Taiwan. A total of 5,236 adolescents completed anonymous, self-report, structured questionnaires. Most adolescents (91%, n=4,788) experienced at least one form of maltreatment with 83% (n=4,347) exposed during the previous year. Violence exposure was the most common type of child maltreatment experienced, followed by psychological abuse, physical abuse, neglect, and sexual abuse. Adolescents reported an average of 7.4 (SD=5.87) victimizations over their lifetime and 4.8 (SD=4.82) victimizations during the past year. Females reported a higher rate of neglect, while males reported a higher rate of sexual abuse. Most of the sexual abuse perpetrators were known by their victims. Adolescents' victimization and polyvictimization from child maltreatment in Taiwan deserves a review and modification of national control and prevention policies.

Security in Father-child Relationship and Behavior Problems in Sexually Abused Children

While the influence of mother-child relationships on children's recovery following sexual abuse has been documented, less is known about the possible contribution of father-child relationships on outcomes. The present study explored the contribution of children's perception of security in their relationship to the father on internalizing and externalizing behavior problems, while controlling for sociodemographic variables and variables associated with the mother-child relationship. Participants were 142 children who disclosed sexual abuse involving a perpetrator other than the biological father. Regression analyses indicated that children's perception of security to fathers contributed to the prediction of parental reports of children's behavior problems, even after controlling for maternal psychological distress and perception of security to mothers.

Prevalence and spectrum of sexual abuse among adolescents in Kerala, South India

OBJECTIVE

To study the prevalence and spectrum of sexual abuse among adolescents in Kerala, South India.

METHODS

A self- report survey was conducted among adolescents in the 15-19 y age group, studying in the plus one and plus two classes in selected schools.

RESULTS

Of the 1614 respondents (688 boys and 926 girls), 36 % of boys and 35 % of girls had experienced sexual abuse at some point during their lifetime. Most instances were sexual advances while using public transport. Feelings of insecurity and isolation at home, of being disliked by parents and of being depressed were significantly more in adolescents who had experienced sexual abuse, compared to those who had not.

CONCLUSIONS

Sexual abuse is widely prevalent and both boys and girls are equally susceptible. There is a need to evolve strategies to protect children from sexual abuse and the programmes should address both boys and girls.

State of the science: group therapy interventions for sexually abused children

Research investigating the use of group therapy treatment for sexually abused children is limited. This paper aims to review the current state of the science of group therapy and its outcomes with children and adolescents under age 18 who have experienced sexual abuse. A literature review was conducted which located eight articles meeting the inclusion criteria of this paper. These outcome studies utilized a wide array of theoretical orientations and intervention delivery, as well as an assortment of outcomes measurement. While the studies lacked consistency, there is some support that group therapy formats to treat sexually abused children and adolescents may be effective across a range of symptoms. Implications for practice, policy, and future research are discussed.

Childhood sexual experiences with an older partner among men who have sex with men in Buenos Aires, Argentina

This study sought to describe childhood sexual experiences with older partners (CSEOP) among men who have sex with men (MSM) in Buenos Aires, Argentina. MSM were recruited through respondent driven sampling. They responded to a computer administered self-interview with questions on CSEOP, operationalized as manual, oral, genital, or anal contact prior to age 13 with a partner at least 4 years older. Of the 500 respondents, only 25% identified as gay. Eighteen percent of the respondents reported CSEOP, the majority of whom did not feel they were hurt by the experience and did not consider it to be childhood sexual abuse (CSA). Over two-thirds of MSM who reported CSEOP said that their older partner was a female. Only 4% of those with a female partner felt their experience was CSA compared to 44% of those who had a male partner. Among all men reporting CSEOP, those who felt sexually abused were more likely to have been physically forced or threatened, physically hurt, and emotionally hurt than those who did not feel sexually abused. Having CSEOP, being hurt by the experiences, and perceiving the experiences as sexual abuse were not associated with current HIV sexual risk or substance use behavior. In this sample of MSM in Argentina, a substantial minority reported CSEOP. Those who felt they had been sexually abused were much more likely to have had an older male partner than an older female partner, and were more likely to report having been physically forced and threatened by their older partner.

The relationship between knowledge and child and caregiver distress during the medical examination for child sexual abuse

When child sexual abuse is suspected, a child sexual abuse-related medical examination is recommended to ensure the child's well-being. While the extant research has sought to identify factors influencing child distress during this examination, only recently have studies began examining variables that may be directly associated with the child or with the medical setting. Knowledge of the child sexual abuse-related medical examination is one medical-related variable that has been implicated in child and caregiver distress during the examination. The current study contributes to the existing literature by investigating associations among examination knowledge in relation to caregiver and child anxiety at the time of a child sexual abuse-related medical examination, taking into account ethnicity, past child abuse, injury to child as result of abuse, and caregiver response to disclosure. Sixty-eight children and their nonoffending caregiver were assessed. Results indicated that understanding of the examination and caregiver response to disclosure were significantly associated with caregiver and child anxiety.

Intimate partner violence and incident depressive symptoms and suicide attempts: a systematic review of longitudinal studies

BACKGROUND

Depression and suicide are responsible for a substantial burden of disease globally. Evidence suggests that intimate partner violence (IPV) experience is associated with increased risk of depression, but also that people with mental disorders are at increased risk of violence. We aimed to investigate the extent to which IPV experience is associated with incident depression and suicide attempts, and vice versa, in both women and men.

METHODS AND FINDINGS

We conducted a systematic review and meta-analysis of longitudinal studies published before February 1, 2013. More than 22,000 records from 20 databases were searched for studies examining physical and/or sexual intimate partner or dating violence and symptoms of depression, diagnosed major depressive disorder, dysthymia, mild depression, or suicide attempts. Random effects meta-analyses were used to generate pooled odds ratios (ORs). Sixteen studies with 36,163 participants met our inclusion criteria. All studies included female participants; four studies also included male participants. Few controlled for key potential confounders other than demographics. All but one depression study measured only depressive symptoms. For women, there was clear evidence of an association between IPV and incident depressive symptoms, with 12 of 13 studies showing a positive direction of association and 11 reaching statistical significance; pooled OR from six studies = 1.97 (95% CI 1.56-2.48, I²  =  50.4%, p(heterogeneity = 0.073). There was also evidence of an association in the reverse direction between depressive symptoms and incident IPV (pooled OR from four studies = 1.93, 95% CI 1.51-2.48, I²  =  0%, p = 0.481). IPV was also associated with incident suicide attempts. For men, evidence suggested that IPV was associated with incident depressive symptoms, but there was no clear evidence of an association between IPV and suicide attempts or depression and incident IPV.

CONCLUSIONS

In women, IPV was associated with incident depressive symptoms, and depressive symptoms with incident IPV. IPV was associated with incident suicide attempts. In men, few studies were conducted, but evidence suggested IPV was associated with incident depressive symptoms. There was no clear evidence of association with suicide attempts.

The effect of acculturation and immigration on the victimization and psychological distress link in a national sample of Latino women

Distinct bodies of research have examined the link between victimization and psychological distress and cultural variables and psychological health, but little is known about how cultural variables affect psychological distress among Latino victims. Substantial research has concluded that Latino women are more likely than non-Latino women to experience trauma-related symptoms following victimization. In addition, examination of different types of cultural adaptation has found results supporting the idea that maintaining ties with one's culture of origin may be protective against negative mental health outcomes. The present study evaluates the effect of victimization, immigrant status, and both Anglo and Latino orientation on psychological distress in a national sample of Latino women. Results indicate that along with the total count of victimization experiences, Anglo and/or Latino orientation were strong predictors of all forms of psychological distress. Anglo orientation also functioned as a moderator between victimization and psychological distress measures for anger, dissociation, and anxiety. The results suggest a more nuanced and complex interaction between cultural factors, victimization, and psychological distress.

Evaluation of a personal safety program with Latino preschoolers

This study evaluated a personal safety educational program designed for Latino families attending preschools in a large metropolis. Seventy-eight children who participated in the Kids Learning About Safety program were compared to 45 control children. Compared with controls, participating children demonstrated enhanced ability to recognize inappropriate touches, learned correct genital terminology, were able to recognize the inappropriateness of touch requests made by "good" people, demonstrated higher levels of personal safety skills, and learned general safety rules. Gains in knowledge were maintained at three-month follow-up testing for all content areas except genital terminology. Although feedback provided by participating families was positive, recruiting participants and maintaining attendance at sessions was difficult. Discussion includes recommendations for future research and engagement of this population.

Childhood and adolescent violent victimization and the risk of young adult intimate partner violence victimization

Using a nationally representative sample of participants, this study investigates childhood victimization in the home and adolescent violent victimization in the community on the risk of being a victim of intimate partner violence (IPV), general violence, or both during early adulthood. The study findings indicate being left home alone and being physically abused during childhood, and adolescent violent victimization in the community had strong independent effects on an individual's likelihood of becoming a victim of IPV, general violence, or both in early adulthood. The study findings suggest a consistent pattern of victimization across the life course, and intervention programs need to be developed that address the specific needs of children and adolescents at high risk for home and community violent victimization.