Development and initial psychometric properties of the Computer Assisted Maltreatment Inventory (CAMI): a comprehensive self-report measure of child maltreatment history

Childhood exposure to domestic violence: can global estimates on the scale of exposure be obtained using existing measures?

Purpose

Childhood exposure to domestic violence and abuse (DVA) can lead to major short- and long-term effects on the victim. Despite this, there is no accepted measure for children's experiences, with most existing measures being validated only in high income countries and not in low- and middle- income countries. As a result, international statistics are not comparable. This paper seeks to critically appraise existing measures and discuss whether any are fit-for-purpose on a global scale.

Method

The COSMIN PROMs approach was followed to critically appraise and compare the appropriateness of measures. A comprehensive literature search was undertaken in seven journal databases for measures mentioned in formally peer-reviewed articles exploring childhood exposure to DVA.

Results

A literature search resulted in the identification of 10 measures and, following criteria to only keep original measures and remove modifications, four measures which have been validated cross-culturally are discussed in detail in line with the COSMIN PROMs criterion: The Child Exposure to Domestic Violence Scale, Children's Perception of Interparental Conflict Scale, Juvenile Victimization Questionnaire and The Violence Exposure Scale for Children. Strengths and limitations of each are discussed, along with any validations undertaken not in the country of origin.

Conclusion

Despite childhood exposure to DVA being an urgent research priority worldwide, the current measures to explore the extent of the issue are not validated cross-culturally, leading to concerns about comparisons across different population groups. The development and implementation of interventions to reduce the levels and effects of exposure relies heavily on cross-cultural comparisons, which may indicate different strategies are needed in different contexts. The lack of these validated comparisons is constraining advances, and the paper advocates for further efforts to be made in this regard.

The Rating of Emotional Abuse in Childhood (REACH) Questionnaire: A new self-report measure assessing history of childhood emotional abuse

BACKGROUND

A history of childhood emotional abuse (CEA) is prevalent among adults with affective disorders; therefore, a comprehensive measure of it is vital. The Rating of Emotional Abuse in Childhood Questionnaire (REACH) was developed to assess history of CEA in relation to parental behaviours of threat, ignoring, humiliation/denigration, scapegoating, antipathy, and overcontrol/conditionality in a single measure. This paper investigated the psychometric properties of REACH in a community sample and proposes values for classifying individuals as high-risk for CEA.

METHOD

A convenience sample of N = 483 adults (Female, 78.3%) was recruited to complete questionnaires that included the REACH alongside measures of mental health, insecure attachment, emotion regulation, and childhood abuse. A subset of participants (n = 198) completed the REACH 7 days later.

RESULTS

Factor analysis indicated a 2-factor model provided a good fit. Factors were named 'threatening' and 'devaluing'. A total scale score of CEA was also recommended. The threatening, devaluing, and total scales demonstrated strong psychometric properties with high internal consistency, test-retest reliability, and convergent validity, while cutoff values for identifying a high-risk CEA group demonstrated good discriminant utility.

CONCLUSIONS

The results support REACH as a valid measure and suggest a history of CEA should be measured in relation to threatening and devaluing CEA as they represent unique dimensions of CEA even though they often co-occur.

Measures of trauma exposure and trauma response: A scoping review

BACKGROUND

In contrast to the vast clinical, theoretical, and empirical literature on the impact of trauma, relatively few studies have reviewed the trauma measures that researchers and clinicians can choose to use in their work. This scoping review aimed to catalog all trauma measures (trauma exposure and its subjective responses) that have been published in the peer-reviewed literature, developed for use with adult populations.

METHOD

Through a systematic search of the literature and the screening of 19,631 abstracts, a total of 363 unique trauma measures were identified.

RESULT

Most of these measures were developed for assessment purposes rather than for clinical screening or diagnostic purposes. Most of these measures are patient-self-report measures that assess trauma exposure in the patients' lifetime, or subsequent symptoms, particularly cognitive impairments.

DISCUSSION

Complications in the trauma literature are highlighted, including the use of very similar abbreviations of measures, substantial discrepancies regarding the definition of trauma, and the general assumption that a potentially traumatic event inevitably leads to traumatic distress rather than a path of resilience.

Women's Behavioral Coping Responses During Sexual Assault: Association With Posttraumatic Stress Disorder Symptoms and the Moderating Role of Alexithymia

We examined the associations between women's behavioral coping responses during sexual assault and posttraumatic stress disorder (PTSD) symptoms, and the moderating role of alexithymia in college women (N  =  152). Immobilized responses (b  =  0.52, p < .001), childhood SA (b  =  0.18, p  =  .01), and alexithymia (b  =  0.34, p < .001) significantly predicted PTSD. The interaction between immobilized responses and alexithymia was significant (b  =  0.39, p  =  .002), indicating a stronger association for those higher in alexithymia. Immobilized responses are associated with PTSD, particularly for those with difficulty identifying and labeling emotions.

Is the Risk for Sexual Revictimization Cumulative? A Prospective Examination

INTRODUCTION

Sexual abuse during childhood is associated with risk for sexual assault as an adult, known as revictimization. Although multiple experiences of sexual assault in adulthood are also common, it is unclear how risk trajectories might continue to evolve in emerging adulthood, defined as ages 18-25. Clarifying risk trajectories is important to inform the development of targeted risk reduction interventions. To fill this gap, we examined cumulative risk for sexual assault in emerging adult women following multiple experiences of childhood sexual abuse (CSA) and adulthood sexual assault (ASA).

METHODS

Women (n = 447; aged 18-25 years at enrollment) completed behaviorally specific assessments of unwanted sexual experiences at up to 9 time points across 3 years. Logistic regression was used to predict any sexual assault during the 3-year period as a function of victimization history at baseline. A multilevel logistic regression analysis among ASA survivors was then used to determine whether each successive ASA increased risk for further victimization.

RESULTS

Extending prior research, findings revealed that the risk for sexual assault during the 3-year study was greater for women reporting more prior experiences of CSA and ASA. Unexpectedly, each ASA increased the risk for a subsequent ASA to a lesser extent among women with more experiences of CSA.

CONCLUSIONS

Findings suggest that the risk for sexual revictimization can be cumulative, but that risk does not increase indefinitely. Future research should investigate the points at which survivors of multiple assaults may begin to experience a decreased risk for later assaults, as well as the factors associated with change in risk status (e.g., removal from violent environments or relationships, changes in institutional policies). Such research could inform intervention targets.

Friends-Based Protective Strategies and Unwanted Sexual Experiences: A Daily Diary Examination of First Year College Women

Risk for unwanted sexual experiences can emerge in social contexts-the same contexts that early college women navigate with their friends. Though friends naturally engage in prevention strategies, less is known about how capable guardianship influences risk. Using multilevel structural equation modeling, the present study examined guardianship at the person- and situation-level. First year college women (N = 132) completed eight weekends of daily surveys. We examined whether guardianship (e.g., more friends present, greater proportion of female friends, no intoxicated friends) would reduce unwanted sexual experience risk and if this relation was mediated by friends-based strategy use. An alternative model was also tested with the same predictors, but unwanted sexual experiences as the mediator and friends-based strategy use as the outcome. Over half (58%) of extended weekend nights with friends involved drinking or using drugs. Friends-based strategies were used on 29% of nights. Across models, being with one or more intoxicated friends was associated with friends-based strategy use and an unwanted sexual experience, but only at the situation-level. Parents, educators, and policy makers can encourage college women to draw on their social networks to enhance safety. Interventions could incorporate more universal strategies for responding to risk in social contexts.

Witnessing Parental Violence and Cyber IPV Perpetration in Hispanic Emerging Adults: The Mediating Role of Attitudes Toward IPV

Recent studies indicate that the perpetration of intimate partner violence via cyberspaces (cyber IPV), namely, psychological aggression, sexual aggression, and cyberstalking is high among emerging adults. However, little is known of the risk factors that lead to cyber IPV and far lesser within Hispanic adults. Based on the intergenerational transmission of violence hypothesis, the present study examined the indirect effect of witnessing parental violence during childhood on the three types of cyber IPV through attitudes condoning IPV in Hispanic men and women, separately. Participants were 1,136 Hispanic emerging adults in the age range of 18-29 years (M = 20.53 years, SD = 2.42; 72.5% women, 88% Mexican descent). Over half of the participants (54.2%) witnessed at least one instance of parental violence during childhood. In contrast to women, men were more likely to hold attitudes accepting of IPV and perpetrate cyber sexual IPV, whereas women were more likely to report cyberstalking perpetration. Men and women with exposure to mother-to-father violence held attitudes justifying IPV that was associated with perpetrating the three cyber IPV types in adulthood (women: B_range = .016-.036; men: B_range = .016-.024). No significant gender differences were found in the associations of mother-to-father WPV and father-to-mother WPV on the three types of cyber IPV perpetration. These findings are discussed in the context of Hispanic culture, which has specific implications for cyber IPV intervention strategies.

The dimensionality of adverse childhood experiences: A scoping review of ACE dimensions measurement

OBJECTIVE

Despite extensive research, the concept of adverse childhood experiences (ACEs) is not fully developed and there is low agreement on how the concept should be defined and measured. The purpose of this study was to 1) identify different conceptual dimensions associated with ACEs, such as timing or frequency; and 2) determine how these dimensions have been operationalized and analyzed to this point, in order to advance the conceptual understanding of ACEs.

METHODS

We conducted a scoping review of empirical journal articles on ACEs published after the original ACE-Study in 1998 to summarize the use of dimensions for the 10 conventional ACE domains. We used a PRISMA methodology to identify articles that assessed at least two of the 10 conventional ACE domains and at least two ACE dimensions. A standardized data extraction spreadsheet was used to record basic article information and specifics on ACE domains and dimensions.

RESULTS

Of 15,417 initial search results, 61 articles met all selection criteria. We identified four primary dimensions used for most ACE domains: frequency, timing, perception, and the role of the perpetrator. Additionally, we found several secondary and domain-specific dimensions, which relate to the intensity of the adverse event.

DISCUSSION

We identified the most commonly used ACE dimensions, but these lack standardized phrasing of items and response options. The inclusion of ACE dimensions may increase the accuracy of the association between ACEs and health outcomes and provide for more tailored treatment plans for people who have experienced ACEs. Future research should include a more comprehensive list of ACE domains and aim to develop a clearly articulated, standardized approach to assessing and analyzing ACE dimensions.

It gets better: childhood sexual abuse and trauma symptoms in female older adults

While there has been great deal of research conducted on the effects of child sexual abuse (CSA) on trauma symptoms in children and adults, there is less knowledge on the effects on trauma symptoms in female older adult CSA survivors. The aim of this study was to investigate current symptoms of trauma in adult female survivors of child sexual abuse across each successive decade, beginning with eighteen year olds. This retrospective, anonymous online study gathered a sample of 223 adult female survivors of CSA (38 of whom were aged 50-59 (17%), and 20 of whom were 60+ years of age (9%)), and surveyed their trauma history and their current symptomology. In our sample, the survivors with the most severe trauma symptoms were between 18 and 29 years old. Each subsequent decade reported fewer trauma symptoms, with respondents in the 60+ age group reporting the lowest trauma symptom severity. While a cross-sectional study does not allow us to evaluate individuals' experiences over time, these results suggest that the negative impacts of CSA may abate over the life course. Future research should consider these questions longitudinally to explore whether these results are related to survivorship (those with worse outcomes dying younger) and whether these effects endure as female older adults experience physical and mental challenges in later life.

Child maltreatment and cognitive vulnerabilities: Examining the link to posttraumatic stress symptoms

Research attempting to identify pathways from childhood maltreatment to adulthood posttraumatic stress symptoms (PTSS) implicates cognitive vulnerabilities that may increase risk for mental health concerns. The present study examined two cognitive vulnerabilities and their relation to PTSS amongst individuals with and without childhood maltreatment histories: attentional control and repetitive negative thinking (RNT). This research surveyed college students (N = 376) on constructs of interest. Results revealed that attentional control and RNT demonstrated significant indirect effects on PTSS (95% CI =.0003, .0336 and 95% CI =.0643, .1857, respectively). Findings suggest that childhood maltreatment severity was related to decreased attentional control and increased RNT, which were then both related to increased PTSS. Interventions for increasing attentional control and decreasing RNT should be implemented and evaluated for young adults with early adversity currently experiencing PTSS.

Lessons Learned: Creation and Testing of a New Instrument (Sex Offenders Grooming Assessment) for Measuring Sex Offenders' Perceptions of Their Grooming Behaviors

Grooming is a process whereby an individual who plans to commit a sexual crime uses deception with the victim as well as the people in the environment (such as the victim's family members, the offender's family, etc.) so that the crime goes undetected. Despite the overwhelming presence of grooming in sexual crimes, there is a dearth of research on sex offenders' perceptions of their own grooming behaviors. This paper describes the psychometrics and lessons learned in the pilot study of testing and revising a new instrument for measuring sex offenders' perceptions of their grooming behaviors (Sex Offenders Grooming Assessment; SOGA), with a sample (n = 50) of convicted male sex offenders in community based specialized therapy. Analyses suggest that using behaviorally-specific questions yielded more reliable results than general categorical grooming questions. Understanding how sex offenders perceive and report their grooming behavior provides valuable insight critical to treatment and assessment.

Women's Perceived Likelihood to Engage in Sexual Risk Taking: Posttraumatic Stress Symptoms and Poor Behavioral Regulation

Sexual abuse prior to age 18 may put some women at risk for engaging in sexual risk taking. This association could exist, in part, as a result of the impact of posttraumatic stress symptoms on behavioral regulation. The current study utilized a path analysis to investigate the association between severity of sexual abuse before age 18, posttraumatic stress symptoms, poor behavioral regulation, and expected engagement in sexual risk taking among college women. The sample consisted of 88 college women with experiences of sexual abuse prior to the age of 18. Severity of sexual abuse predicted posttraumatic stress symptoms. In addition, posttraumatic stress symptoms predicted poor behavioral regulation, which in turn predicted expected engagement in sexual risk taking. These findings indicate functional mechanisms involved in sexual decision making of women who have had past sexual abuse and experience posttraumatic stress symptoms.

Through the Eyes of a Child: Witnessing Childhood Trauma Is as Impactful as Experiencing Trauma for Polyvictimized Survivors of Child Sexual Abuse

In this retrospective study of 244 adult survivors of child sexual abuse (CSA), their experiences of childhood polyvictimization were analyzed as to their cumulative effect on trauma symptoms, education, and income levels. The data were gathered by anonymously sampling adult survivors of CSA from websites that were specific to this population (such as online peer support groups). Their experiences of victimization were examined as to Cumulative Polyvictimization, Witnessing Traumas (such as witnessing intimate partner violence), and Experiencing Traumas (such as child physical abuse). The majority of the sample (87%) experienced polyvictimization in childhood (in combination with CSA), with the largest part of the sample (83%) experiencing emotional abuse by someone close to them, and the smallest part of the sample (22%) experiencing child physical abuse by someone with whom they were not close. The results of the linear regressions showed that both experiencing and witnessing trauma were significantly associated with trauma symptoms for CSA survivors. These results suggest that both types of victimization (experiencing and witnessing) need to be treated as direct traumas, and a more holistic approach toward survivors of CSA is needed toward assessment and treatment.

Negative mood regulation expectancies moderate the effect of childhood maltreatment on compulsive buying

OBJECTIVE

Two studies investigated childhood maltreatment, alexithymia-the inability to identify one's mood-and negative mood regulation expectancies (NMRE)-confidence that one can alleviate one's negative moods-as predictors of compulsive buying (CB).

METHOD

Participants were recruited from internet CB forums and undergraduate psychology classes. Online, they completed questionnaires and a behavioral task that assessed impulsive spending.

RESULTS

In Study 1 (N = 646), analyses indicated that NMRE, alexithymia, and childhood maltreatment were significant independent predictors of CB. For Study 2, a subset of participants from the Study 1 pool (N = 295) who met the criterion for clinical levels of CB were selected, based on their self-report. Analyses revealed that NMRE buffered the effect of maltreatment: among participants with high NMRE-higher levels of maltreatment were associated with minimal increases in CB and impulsive spending behavior.

CONCLUSION

Being confident that one can control one's unpleasant moods was a protective factor from the maladaptive consequences of childhood maltreatment. Increasing NMRE early in psychotherapy for CB may result in clients' using more adaptive coping strategies.

Systematic Review of Risk and Protective Factors for Revictimization After Child Sexual Abuse

Child sexual abuse (CSA) is a widespread public health problem in the United States. It has been associated with multiple long-term deleterious outcomes including revictimization in adulthood. This systematic review of 25 studies synthesizes research examining possible risk and protective factors that might explain the established link between CSA and future victimizations. Specific risk factors identified included co-occurring maltreatment in the home, risky sexual behavior (particularly in adolescence), post-traumatic stress disorder, emotion dysregulation, and other maladaptive coping strategies. Only one protective factor was identified: perceived parental care. The review also revealed considerable variability in definitions and measurement of both CSA and adult victimization, particularly in terms of how researchers conceptualized age. Many of the studies were limited in generalizability by including only college-age women. These findings have clinical and research implications. Public health interventions working to prevent revictimization among CSA survivors can utilize these findings when designing programs. For researchers, the results highlight the need for standardized definitions of both CSA and revictimization, for well-validated and consistent measurement, and for inclusion of additional population groups in future research.

Preliminary Cross-Sectional Validation of the CROPS 14-Item for Juvenile Offenders

The Child Report of Posttraumatic Symptoms (CROPS) is an effective 26-item trauma assessment tool. Research has indicated a 14-item version of the CROPS for juvenile offenders with improved predictive accuracy for detecting trauma exposure among male offenders and commensurate accuracy for female offenders. However, the 14-item scale has yet to be validated for juvenile offenders with an established trauma measure. Cross-sectional retrospective data of 74 adjudicated youth (59.5% male) from the original CROPS 14-item psychometric study sample were used to examine the factor structure, internal consistency, and convergent and divergent validity of the 14-item scale. Findings indicated strong internal consistency and significant correlations with all scales of an established and more extensive trauma measure for children and adolescents. Findings also revealed a CROPS 12-item model explaining 36.9% of variance. Results supported both convergent and divergent validity, suggesting both the CROPS 14-item and 12-item may be used as valid trauma symptom screeners for juvenile offenders.

Effect of child abuse and neglect on risk behaviors in inner-city minority female adolescents and young adults

BACKGROUND

Over six million children each year are referred to child protective services for child abuse (sexual, physical and emotional) and neglect (physical and emotional).

OBJECTIVE

While the relationship between child sexual abuse and sexually transmitted infections has been documented, there has been little research regarding the effects of other forms of maltreatment.

PARTICIPANTS AND SETTING

882 inner-city females aged 12-20 years of age seen at a large adolescent and young adult (AYA) health center in New York City between 2012-2017.

METHODS

History of maltreatment was assessed using the Childhood Trauma Questionnaire. Associations with depressive symptoms, antisocial behavior, peer deviancy, drug/alcohol use, and risky sexual behaviors were assessed.

RESULTS

History of maltreatment was common in our cohort of inner-city AYA females, with 59.6 % reporting any type of maltreatment, including sexual abuse (17.5 %), physical abuse (19.5 %) or neglect (26.2 %), and emotional abuse (30.7 %) or neglect (40.4 %). We observed significant associations between all forms of maltreatment and risk of depression, drug/alcohol use, antisocial behaviors, peer deviancy, and risky sexual risk behaviors (including having a higher number of sexual partners, having a sexual partner 5+ years older, and anal sex). Physical and emotional abuse were associated with having unprotected sex while under the influence of drugs/alcohol.

CONCLUSIONS AND RELEVANCE

Reporting a history of maltreatment was associated with an increased likelihood of engaging in risky sexual and antisocial behaviors, as well as depression in inner-city female youth. These data highlight the broad, lingering repercussions of all types of child maltreatment.

Self-deception, emotional neglect and workplace victimization

Purpose

The purpose of this paper is to define workplace victimization as any behavior that impairs employees’ basic psychological needs and explores the mutually interactive association between trait self-deception; emotional neglect, especially by supervisors, and workplace victimization.

Design/methodology/approach

Workplace victimization is identified as a pervasive problem in organization. This paper zeroes in on self-deception and emotional neglect as two possible antecedents of workplace victimization, explores the genesis of the two concepts and analyzes their conceptual relationship with each other and with workplace victimization. Based on the conceptual analysis, it identifies the lack of intentionality as a common element in both constructs and identifies a set of possible frameworks linking self-deception, emotional neglect and workplace victimization for future research.

Findings

This paper explores four possible frameworks to model the expected association while advocating for investigation of these given models to check whether one has considerable expository success than other by either connecting or disassociating these two constructs.

Research limitations/implications

The amount of linkage between self-deception and emotional neglect at workplace is worth investigating, and this research paper presents several possible models that might help to focus and organize the future workplace investigations.

Practical implications

The current paper postulates that supervisors’ and subordinates’ ability to display appropriate leadership and follower behavior and interaction will be impaired if they are high in trait self-deception and have been the victim or perpetrators of emotional neglect.

Originality/value

In the workplace, self-deceptive individuals display behaviors such as conscientiousness, resilience, optimism and competitiveness that are considered characteristics of good employees and, hence, are more likely to be promoted to supervisory positions, where emotional neglect of others such as subordinates becomes more pertinent.

Observing Alcohol Myopia in the Context of a Trauma Film Paradigm: Differential Recall of Central and Peripheral Details

BACKGROUND

A major tenet of the alcohol myopia model is that intoxication results in a narrowing of attention to the most central environmental cues, at the cost of more peripheral information. Though long hypothesized, no known study of alcohol myopia has demonstrated differential immediate recall of central and peripheral cues using a standardized task. To address this gap, we conducted an alcohol administration study with a clear, standardized focus-a trauma film.

METHODS

Ninety-eight female social drinkers completed self-report measures, and then were randomized to consume a placebo beverage, a low dose of alcohol (mean breath alcohol concentration [BrAC] = 0.04%), or a high dose of alcohol (mean BrAC = 0.11%). Participants then moved to a staged room where they viewed a film clip depicting a sexual assault. After leaving the room, participants completed a written free recall task of the film and the room.

RESULTS

The distinction between recall of central and peripheral details was supported by confirmatory factor analysis. Consistent with the alcohol myopia model, relative to placebo, a high dose of alcohol led to impaired recall of peripheral (but not central) details. Although the interaction between BrAC and information type (central vs. peripheral) was not statistically significant, simple effects revealed a strong association between BrAC and peripheral information, and no association between BrAC and central information. Bolstering myopia as an explanation for our findings, neither central nor peripheral information correlated with self-reported tendencies to dissociate or distract oneself, or typical alcohol consumption or expectancies.

CONCLUSIONS

Alcohol myopia can be observed through an immediate free recall task following a stressful film. Additional research is needed to continue evaluating dose-dependent differential recall in larger samples. This task may be useful for clarifying the role of alcohol myopia in clinical phenomena, such as aggressive behavior and processing traumatic events.

Effects of individual risk and state housing factors on adverse outcomes in a national sample of youth transitioning out of foster care

INTRODUCTION

Compared to their peers, youth who leave the foster care system without permanency experience greater risks for adverse young adult outcomes, including homelessness, incarceration, substance abuse, and early child birth. Extant literature focuses on individual-level factors related to adversity. In this study, we estimated the impact of state and individual-level risk and protective factors on adverse 19-year-old outcomes among a cohort of U.S. transition age youth.

METHODS

We used multilevel modeling to analyze prospective, longitudinal data from two waves of the National Youth in Transitions Database (N = 7449). These data were linked to the Adoption and Foster Care Reporting System, the Administration for Children and Families budget expenditures, and the American Community Survey for the period from 2011 to 2013.

RESULTS

Approximately 30% of the variation in each of the 19-year-old outcomes could be attributed to state-level effects. Residence in a state that spent above average of CFCIP budget on housing supports reduced the risk of homelessness and incarceration. Living in a state with a higher proportion of housing-burdened low-income renters significantly increased the risk of substance abuse and child birth. Individual-level risks were significant: racial/ethnic minority, male gender, past risk history, placement instability, child behavioral problems, residence in group home or runaway. Remaining in foster care at age 19 reduced the odds of homelessness, incarceration, and substance abuse.

CONCLUSION

Macro factors, including financial support for transition-age youth, and broader housing market characteristics, have a bearing on young adult outcomes, and raise policy questions across social and human service sectors.

Grooming Hurts Too: The Effects of Types of Perpetrator Grooming on Trauma Symptoms in Adult Survivors of Child Sexual Abuse

There are a multitude of behaviors that child sexual abusers use to 'groom' children into becoming vulnerable to abuse. In this study of 277 adult survivors of child sexual abuse, participants advised the many ways they were groomed into being abused by up to three perpetrators. The effects of three categories of grooming (Verbal Coercion, Grooming that used Drugs/Alcohol, and Threatening/Violent Grooming) were examined for their effects on trauma symptom severity. Using Linear Regressions, each grooming category had a significant predictive effect on trauma symptom severity. Multiple Linear Regressions revealed that for most trauma symptoms, Threatening/Violent Grooming was a significant predictor of trauma symptom severity, even when other more well-known variables were controlled for (including age at onset of abuse, relationship to perpetrator, and severity of abuse), with a notable exception of verbal coercion as a significant predictor of sexual problems in adulthood (i.e. not satisfied, low drive, overactivity, confusion, bad thoughts or feelings).

The effects of Toxic Early Childhood Experiences on Depression according to Young Schema Model: A Scoping Review

BACKGROUND

Young Schema Model (YSM) emphasizes Toxic Early Childhood Experiences (TECE) as vulnerability factors to depression. However, the lack of consensus on how to define and measure TECE is likely to have led to inconsistent findings in current literature. This review maps supported and unsupported pathways to depression and measures used.

METHODS

A scoping review was conducted in accordance with the Joanna Briggs Institute protocol to identify primary research studies that examined developmental and maintenance pathways to depression within the YSM framework. 2463 articles were identified with 49 primary research studies selected for inclusion. As a subset of the overall review, this paper focuses on the 14 studies that examined effects of TECE on depression in context of YSM.

RESULTS

The studies used 11 different measures to examine the role of TECE in depression. Effects of maltreatment (i.e., physical abuse, emotional abuse, emotional neglect,) and perceived parenting (i.e., low care, high rejection, high overprotection and/or control, maladaptive parenting styles) on depression are well supported. Effects of sexual abuse and physical neglect on depression are currently inconclusive.

CONCLUSION

In conclusion, findings revealed the inconsistent definition and measurement of TECE (with 11 different measures) in current literature. Findings support the effects of physical abuse, emotional abuse, emotional neglect, low care, high rejection, high overprotection and/or control, and maladaptive parenting styles on depression. Limitations of existing studies include researchers' inconsistent definition and measurement of TECE, under-examined TECE sub-constructs, possible moderating relationships, predominant cross-sectional design, and homogeneous sampling. Limitations of the scoping review include its small number of studies and the absence of evaluation of the measures used. Nevertheless, this review represents the first step in the systematic examination of the empirical basis of YSM and is an important contribution to depression treatment and innovation.

Sexual Victimization and Sex-Related Drinking Motives: How Protective is Emotion Regulation?

One in five college women experience sexual victimization (SV), and SV severity is associated with subsequent psychological distress, including sex-related distress. SV severity may also be associated with drinking motives to cope with sex-related distress and to enhance sex (sex-related drinking motives [SRDMs]), particularly if individuals suffer from emotion regulation (ER) difficulties. College women (N = 151) completed a survey assessment of ER, SV history, childhood sexual abuse (CSA), and SRDMs. Twelve regression models assessed six facets of ER as moderators between SV severity and SRDMs. Among women with no or low levels of prior SV severity, women with greater access to ER strategies were less likely to endorse drinking to cope SRDMs. At higher levels of SV severity, women at all levels of access to ER strategies were equally likely to endorse drinking to cope SRDMs, suggesting that access to ER strategies did not mitigate motivations to drink to cope with sex-related distress for these women. Women with severe SV histories may benefit from interventions that build on existing ER strengths or address other factors. However, greater access to ER strategies may serve as a protective factor against SRDMs when SV severity is low.

Examining the relationship between higher educational attainment, trauma symptoms, and internalizing behaviors in child sexual abuse survivors

The trauma symptoms of child sexual abuse (CSA) survivors don't end with the abuse, or even with the advent of adulthood. Instead, these symptoms can persist into all the realms of a survivor's life, including education, which sets the foundation for career advancement. This retrospective study of adult survivors of childhood sexual abuse (n=260) examined the relationships between trauma symptoms, dissociation, dissociative amnesia, anxiety, depression, sleep problems and higher education attainment. The purpose of this study was to determine if these factors are associated with higher education completion for childhood sexual abuse (CSA) survivors. Linear regressions and ANOVAs suggest that many of these variables are significantly associated with survivors' educational trajectory, and multiple linear regressions show that trauma symptoms (as measured by the Trauma Symptom Checklist-40), caregivers' education levels, and age at onset of abuse are significant predictors of decreased education levels. This information can provide insight into additional risk and protective factors for CSA survivors in order to enhance acute and long-term management of trauma symptoms to increase levels ofattainment of higher education.

Administration of Childhood Physical and Childhood Sexual Abuse Screens in Adolescents and Young Adults: a Literature Review

BACKGROUND

Childhood physical and sexual abuse can have a negative impact on adolescents and young adults. Although effective interventions that can ameliorate both the short- and long-term negative impacts are available, many adolescent and young adult victims remain without help: They rarely self-identify as victims, and health care providers generally fail to inquire about a history of childhood abuse, especially in the absence of physical signs. The health care field lacks an understanding of effective methods for the identification of childhood abuse.

OBJECTIVES

To address this knowledge gap, this paper focuses on a systematic review of the literature for studies comparing modes of administration of measures to identify a history of childhood physical and sexual abuse in adolescents and young adults.

METHODS

A systematic review of the literature published in English in peer-reviewed journals between January 1, 1994, and December 31, 2014 was conducted to identify studies that compared 2 or more modes of administration using the same measure to identify a history of childhood physical and sexual abuse in adolescent and young adult populations. Studies that compared 2 or more different measures for identifying abuse were not included in this review because the focus of the review was to isolate the effects of the mode of administration.

FINDINGS

Only 1 study that met review criteria was found. It was conducted among female college students in a university setting. No studies were identified that compared modes of administration used to elicit disclosure of a history of childhood abuse among adolescents.

CONCLUSIONS

There remains an urgent need to conduct evaluations of methods to identify childhood physical and sexual abuse including the mode of administration of screens in young people. It is recommended that future studies include diverse populations and randomized and quasi-experimental approaches.

Comparison of Modes of Administration of Screens to Identify a History of Childhood Physical Abuse in an Adolescent and Young Adult Population

BACKGROUND

Childhood physical abuse is a major public health issue with negative consequences to health and well-being manifested in childhood and adolescence, and persisting into adulthood. Yet much childhood physical abuse is not identified when it occurs and little is known about how to screen for it.

METHODS

To address this gap, the effectiveness of 4 modes of administration of screens to identify childhood physical abuse were compared in a sample of 506 adolescents and young adults aged 12-24 years seeking general health services at a primary care clinic. Comparisons were made between paper and pencil screen, audio computer-assisted self-interview screen, face-to-face structured screen (all 3 using the same measure), and face-to-face unstructured interview.

FINDINGS

Overall, 44.5% of the sample disclosed that they had been physically abused. Compared to paper and pencil screen, the odds of reporting physical abuse were 1.5 (95% confidence interval [CI]: 0.92, 2.58) and 4.3 (95% CI: 2.49, 7.43) higher among participants using face-to-face structured screen and face-to-face unstructured interview methods, respectively. The face-to-face unstructured interview identified significantly more reports than the paper and pencil screen.

CONCLUSIONS

Although the unstructured interview was the most effective mode for screening for childhood physical abuse, additional research is needed to confirm whether this holds true in other health care settings. Further research should examine how a health provider's training, experience, and comfort level might influence the identification of physical abuse disclosure in primary care settings using face-to-face unstructured interview.

Victim Alcohol Intoxication During a Sexual Assault: Relations With Subsequent PTSD Symptoms

This study examines associations between women's alcohol intoxication at the time of sexual assault and posttraumatic stress disorder (PTSD) symptoms. Drawing on the dual representation theory (Brewin, Gregory, Lipton, & Burgess, 2010), we hypothesized that intoxication at the time of assault would be positively associated with both overall symptoms of PTSD and PTSD reexperiencing symptoms in particular. A total of 143 community women (ages 18-26 years; 71.3% European American) reporting sexual victimization completed questionnaires assessing severity of coercion involved in the assault, perceived level of intoxication at the time of assault, and current PTSD symptoms. Overall, results suggested that greater alcohol intoxication (but not alcohol use alone) was associated with more severe PTSD symptoms when controlling for severity of coercion. Furthermore, higher levels of victim intoxication at the time of the assault were most predictive of reexperiencing symptoms relative to the other symptom clusters.

Cumulative Childhood Trauma and Adult Sexual Satisfaction: Mediation by Affect Dysregulation and Sexual Anxiety in Men and Women

Childhood cumulative trauma (CCT) refers to an amalgam of childhood maltreatment experiences that can lead to a range of symptoms and problems in adulthood. The current study examined an integrative model of CCT for its relevance to psychosexual adjustment in adult survivors. A total of 620 participants aged 18 years and over completed a questionnaire assessing early life experiences, affect dysregulation, sexual anxiety, and sexual satisfaction. Path analyses confirmed the hypothesis that CCT is associated with affect dysregulation and sexual anxiety that, in turn, predict lower levels of sexual satisfaction. The validity of this mediational model was demonstrated for different operationalizations of CCT. The results suggested that sex therapists, who are likely to encounter CCT survivors in their practice, should consider targeting affect dysregulation in their efforts to decrease sexual anxiety and increase sexual satisfaction.

Childhood abuse and later marital outcomes: Do partner characteristics moderate the association?

Although people with a history of child abuse are known to be at elevated risk for later difficulties in relationships, there is debate over whether these effects are enduring and relatively immutable or are moderated by characteristics and behaviors of the partner. To reconcile these competing perspectives, we conducted a longitudinal study of 414 newlywed couples living in low-income neighborhoods, testing whether the association between abuse history and relationship satisfaction is dependent on the partners' aggression, depression, substance abuse, observed communication, and other demographic risk factors. Spouses who had been abused as children (25% of husbands, 31% of wives) reported more symptoms of depression and substance abuse and, among husbands, displayed more negative communication. Spouses with a history of child abuse were also less satisfied with their marriage, even as newlyweds; abused wives also declined in satisfaction over time compared to those without this history. However, interactions between abuse history and all of the proposed moderators were not significant, indicating that partner and relationship characteristics failed to strengthen or weaken the association between abuse history and relationship satisfaction. Childhood experiences of abuse appear to have lasting and broad effects on individual and relational outcomes, and these effects are neither heightened nor mitigated by the partner's characteristics or behaviors. (PsycINFO Database Record

Maltreatment, family environment, and social risk factors: Determinants of the child welfare to juvenile justice transition among maltreated children and adolescents

This study prospectively examines the transition from the child welfare system into the juvenile justice system among 10,850 maltreated children and adolescents and explores how patterns of risks, including severity and chronicity of maltreatment, adverse family environment, and social risk factors, affect service systems transition. Almost three percent of maltreated children and adolescents had their first juvenile justice adjudication within an average of approximately six years of their initial child protective services investigation (CPS). Social risk factors, including a child's age at index CPS investigation (older), gender (boys), and race/ethnicity (Black and Hispanic) significantly predicted the risk of transition into the juvenile justice system. Recurrence of maltreatment and experiencing at least one incident of neglect over the course of the study period also increased the risk of transition into the juvenile justice system. However, subtypes of maltreatment, including physical, sexual, and other types of abuse did not significantly predict the risk of juvenile justice system transition. Finally, family environment characterized by poverty also significantly increased the risk of juvenile justice system transition. These findings have important implications for developing and tailoring services for maltreated children, particularly those at-risk for transitioning into the juvenile justice system.

The Occurrence and Traumatic Impact of Sexual Revictimization in Newlywed Couples

The present study examines whether individuals with a history of child sexual abuse are at risk of sexual revictimization in marriage and, if so, whether these experiences are associated with increased trauma symptomatology. Two hundred heterosexual newlywed couples were recruited from marriage license records and completed self-report assessments of past sexual victimization and sexual coercion within the marital dyad. Actor-Partner Interdependence Models revealed that, compared to non-victims, women with a history of child sexual abuse (CSA) experienced more acts of sexual coercion by their husbands during the past year. Moreover, there was a significant interaction between CSA and sexual coercion such that, among women who experienced CSA, the relationship between marital revictimization and trauma symptoms was stronger. Findings suggest that, for women but not men, sexual revictimization may occur in the context of a new marriage, and these experiences are associated with increased trauma symptoms. These findings have implications for understanding female survivors' perceptions of risk, and are particularly concerning given the high degree of personal and legal commitment involved in marriage.

Women's Behavioral Responses to Sexual Aggression: The Role of Secondary Cognitive Appraisals and Self-Regulation

Sexual assault history, secondary cognitive appraisals, and a dual-process model of self-regulation were examined as predictors of women's intended behavioral responses to hypothetical sexual aggression. College women ( N = 435) read a sexually aggressive scenario and rated their intentions to engage in assertive, polite, and passive behavioral responses. Results indicated secondary cognitive appraisals predicted less assertive, more polite, and more passive responses. Good self-control predicted assertive and polite responses, while sexual assault history and poor regulation predicted passive responses. Poor regulation significantly moderated the relationship between secondary cognitive appraisals and passive behavioral responses. Implications for the prevention of sexual assault are discussed.

Unique versus cumulative effects of physical and sexual assault on patterns of adolescent substance use

The present study assessed the unique versus cumulative effects of physical and sexual assault, on patterns of substance-use in adolescents. It was hypothesized that experiencing a single assault (physical or sexual) when compared with exposure to both physical and sexual assault would be more strongly related to membership of polysubstance use classes. From the National Survey of Adolescents-1995 (N= 4023) 918 adolescents (age range=12-17 years, M=14.92, 49.6% female) with reports of physical assault and/or sexual assault were selected. Using information on alcohol-use, cigarette-smoking, chewing tobacco, non-prescribed use of medicines, and drug-use, latent class analysis indicated a three class solution for substance-use, namely, Experimental use, Light polysubstance-use, and Polysubstance-use. Multinomial logistic regression analyses indicated that as compared to adolescents exposed to a single type of assault those exposed to both physical and sexual assault were two-to-three times more likely to be in the heavier polysubstance-use class. Females were more likely to be members of the polysubstance-use class than of the experimental use class. Gender did not emerge as a significant moderator. It was concluded that assessing for single type or co-occurring assault can facilitate identification of adolescents at elevated risk for polysubstance-use.

Severity of maltreatment and personality pathology in adolescents of Jammu, India: A latent class approach

The aims of the present study were to identify discrete classes of adolescents based on their reporting of emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect of several levels of severity using a person-centered analytic approach (i.e., latent class analysis), and to compare the latent classes on 17 dimensions of personality pathology. It was hypothesized that based on types of maltreatment and severity levels within each type there would be discrete latent classes, and that classes of adolescents exposed to a larger number of maltreatment types with higher severity (i.e., moderate-severe) would report higher levels of personality pathology than adolescents in classes exposed to less types with less severity, after controlling for age and gender. Participants were 702 adolescents from Jammu, India (13-17 years, 41.5% females). The latent classes were based on three levels of severity for each type of maltreatment assessed via the Childhood Trauma Questionnaire (Bernstein et al., 2003). Four distinct classes of adolescents, namely, Moderate-severe abuse and physical neglect (Class 1), Low to moderate-severe abuse (Class 2), Moderate-severe neglect (Class 3), and Minimal abuse or neglect (Class 4) were found. Classes with higher percentages of adolescents reporting abuse and neglect with higher severity (Classes 1 and 2) reported higher levels of personality pathology than the other classes. There are distinct classes of adolescents' identifiable based on levels of severity and types of abuse and neglect, which are differentially associated with specific dimensions of personality pathology. Implications for research and practice are discussed.

The Complex Trauma Questionnaire (ComplexTQ): development and preliminary psychometric properties of an instrument for measuring early relational trauma

Research on the etiology of adult psychopathology and its relationship with childhood trauma has focused primarily on specific forms of maltreatment. This study developed an instrument for the assessment of childhood and adolescence trauma that would aid in identifying the role of co-occurring childhood stressors and chronic adverse conditions. The Complex Trauma Questionnaire (ComplexTQ), in both clinician and self-report versions, is a measure for the assessment of multi-type maltreatment: physical, psychological, and sexual abuse; physical and emotional neglect as well as other traumatic experiences, such rejection, role reversal, witnessing domestic violence, separations, and losses. The four-point Likert scale allows to specifically indicate with which caregiver the traumatic experience has occurred. A total of 229 participants, a sample of 79 nonclinical and that of 150 high-risk and clinical participants, were assessed with the ComplexTQ clinician version applied to Adult Attachment Interview (AAI) transcripts. Initial analyses indicate acceptable inter-rater reliability. A good fit to a 6-factor model regarding the experience with the mother and to a 5-factor model with the experience with the father was obtained; the internal consistency of factors derived was good. Convergent validity was provided with the AAI scales. ComplexTQ factors discriminated normative from high-risk and clinical samples. The findings suggest a promising, reliable, and valid measurement of early relational trauma that is reported; furthermore, it is easy to complete and is useful for both research and clinical practice.

Initial Validation of a Brief Pictorial Measure of Caregiver Aggression: The Family Aggression Screening Tool

In the present study, we report on the development and initial psychometric properties of the Family Aggression Screening Tool (FAST). The FAST is a brief, self-report tool that makes use of pictorial representations to assess experiences of caregiver aggression, including direct victimization and exposure to intimate partner violence. It is freely available on request and takes under 5 minutes to complete. Psychometric properties of the FAST were investigated in a sample of 168 high-risk youth aged 16 to 24 years. For validation purposes, maltreatment history was assessed using the Childhood Trauma Questionnaire; levels of current psychiatric symptoms were also assessed. Internal consistency of the FAST was good. Convergent validity was supported by strong and discriminative associations with corresponding Childhood Trauma Questionnaire subscales. The FAST also correlated significantly with multi-informant reports of psychiatric symptomatology. Initial findings provide support for the reliability and validity of the FAST as a brief, pictorial screening tool of caregiver aggression.

A Child Self-Report Exemplar: Adapting Administration Procedures of the Self-Perception Profile for Children to Reduce Measurement Error

Background and Purpose: Child self-reports can provide unique information to researchers. When the 2-step structured format of a frequently used self-concept measure resulted in unusable data during a pilot of inner-city school children, the framework of attention and executive control was used to analyze the task and adapt administration format. Methods: A card system was substituted for the paper format and Cronbach’s alphas calculated on data obtained from 233 3rd–6th graders. Results: Complete data; alphas ranged from .58 (social competence) to .75 (behavioral conduct). Conclusions: The use of cards to facilitate choices effectively reduced error by removing one option from view prior to completing second step. Two competence subscales (social and athletic) had alphas less than .70 suggesting further exploration with this population.

Childhood Exposure to Family Violence and Adult Trauma Symptoms: The Importance of Social Support from a Spouse

This study examines the roles of both positive and negative social support from a spouse as potential moderators of associations between experiences of physical abuse and exposure to intimate partner violence (IPV) as a child and adult trauma symptoms. We hypothesized that positive social support received from a spouse would have a buffering effect on trauma symptoms, while negative social support from a spouse would have a potentiating effect. Participants were 193 newlywed couples (total N = 386) randomly recruited from a marriage license database. Participants completed self-report questionnaires measuring the nature and severity of child maltreatment and trauma symptoms, and engaged in a brief video-taped task in which they discussed a personal problem with their partner. Positive and negative support behaviors exhibited during the recorded task were then coded. Results of a dyadic data analysis (actor partner interdependence model) indicated that positive social support from a spouse buffered against trauma symptoms among men who were exposed to IPV during childhood, while negative social support from a spouse potentiated trauma symptoms among men who were exposed either to IPV or child physical abuse (CPA). The buffering and potentiating effects of spousal support were reduced among men who were exposed to increasingly severe levels of both IPV and CPA. By contrast, women's trauma symptoms were unrelated to either positive or negative support from a spouse. These findings extend prior research by suggesting that, for men, day-to-day provisions of support from a spouse may play a key role in posttraumatic recovery.

Development of a Childhood Attachment and Relational Trauma Screen (CARTS): a relational-socioecological framework for surveying attachment security and childhood trauma history

BACKGROUND

Current psychometric measures of childhood trauma history generally fail to assess the relational-socioecological context within which childhood maltreatment occurs, including the relationship of abusers to abused persons, the emotional availability of caregivers, and the respondent's own thoughts, feelings, and actions in response to maltreatment.

OBJECTIVE

To evaluate a computerized approach to measuring the relational-socioecological context within which childhood maltreatment occurs.

METHOD

The psychometric properties of a Childhood Attachment and Relational Trauma Screen (CARTS) were evaluated as a retrospective survey of childhood maltreatment history designed to be appropriate for completion by adults. Participants were undergraduates (n=222), an internet sample (n=123), and psychiatric outpatients (n=30).

RESULTS

The internal reliability, convergent, and concurrent validity of the CARTS were supported across samples. Paired differences in means and correlations between rated item-descriptiveness to self, mothers, and fathers also accorded with findings of prior attachment and maltreatment research, illustrating the utility of assessing the occurrence and effects of maltreatment within a relational-socioecological framework.

CONCLUSIONS

Results preliminarily support a new survey methodology for assessing childhood maltreatment within a relational-socioecological framework. Further psychometric evaluation of the CARTS is warranted.

Posttraumatic stress disorder symptoms: a mechanism in the relationship between early sexual victimization and incapacitated/drug-or-alcohol-facilitated and forcible rape

Sexual assault occurring when the victim is unable to consent or resist due to the use or administration of alcohol or drugs (i.e., incapacitated/drug-or-alcohol facilitated rape; IR/DAFR) is a particularly prevalent form of victimization experienced by college women. By definition, substance use precedes IR/DAFR; however, few studies have examined other potential risk factors for IR/DAFR that may be unique from those associated with forcible rape (FR; i.e., sexual assault occurring due to threats or physical restraint). The present investigation tested a model of risk for IR/DAFR and FR suggesting that child or adolescent sexual abuse (CASA) leads to posttraumatic stress disorder (PTSD) symptoms, which in turn increase the likelihood of IR/DAFR, but not FR. Results revealed full mediation for PTSD hyperarousal symptoms in the pathway between CASA and IR/DAFR, and partial mediation for hyperarousal symptoms in the pathway between CASA and FR. Theoretical and clinical implications are discussed.

Serotonin system gene polymorphisms are associated with impulsivity in a context dependent manner

Impulsivity is a risk factor for adverse outcomes and characterizes several psychiatric disorders and risk for suicide. There is strong evidence that genetic variation influences individual differences in impulsivity, but the details are not yet understood. There is growing interest in better understanding the context dependency of genetic effects that is reflected in studies examining gender specificity, gene×environment interaction and epistasis (gene-gene interaction). In a cross-sectional study we examined whether polymorphisms in six serotonin system candidate genes and the experience of early life trauma (age 0-12) were associated with individual differences in impulsivity in a non-clinical sample of Caucasian university students (N=424). We specifically tested potential gender specific, gene-gene, and gene×environment (early life trauma) effects. In our main analyses with Barratt Impulsiveness Scale (BIS-11) total score, there were significant (i.e. p<.01 and False Discovery Rate <.10) interactions between (1) gender and TPH2 (rs1386483) genotype; (2) gender and HTR2A (rs6313) genotype; and epistatic interactions among (3) 5-HTTLPR and MAOA uVNTR; (4) 5-HTTLPR and rs6313 and (5) HTR1B (rs6296) and rs6313 genotypes. Our results strongly support the explicit investigation of context dependent genetic effects on impulsivity and may help to resolve some of the conflicting reports in the literature.

Lifetime sexual victimization and poor risk perception: does emotion dysregulation account for the links?

The present study examined whether and which facets of emotion dysregulation serve an intervening role in the association between prior victimization and risk perception in an analogue sexual assault vignette. Participants were 714 university women who completed self-report measures of sexual victimization, emotion dysregulation, and a computer-administered written vignette of a college party scene that culminates in acquaintance rape. Approximately 42% of the sample reported lifetime sexual victimization during childhood, adolescence, or adulthood. Two individual aspects of emotion dysregulation, limited access to emotion regulation strategies and impulse control difficulties, mediated the association between lifetime victimization and leaving the scenario later. Findings suggest the importance of emotion dysregulation in predicting risk perception among victims and of improving victims' emotion regulation skills in revictimization risk reduction interventions.

Child abuse, early maladaptive schemas, and risky sexual behavior in college women

Previous research suggests that individuals abused as children are more likely to engage in risky sexual behavior during adulthood. The present study examined early maladaptive schemas as mediators of the child abuse-risky sexual behavior relationship among 653 college women. Self-report surveys assessed three forms of child abuse: Sexual, physical, and emotional, and assessed early maladaptive schemas within two domains: Disconnection/rejection and Other-Directedness. Disconnection/rejection schemas fully mediated the relation between child emotional abuse and number of sexual partners and partially mediated the relationship for sexual and physical abuse. However, when frequency of specific risky sexual acts (e.g., sex without contraception) was examined in the previous six months, only abandonment was a partial mediator. Implications for intervention and future research are discussed.

Emotion dysregulation and risky sexual behavior in revictimization

OBJECTIVE

The current study examined emotion dysregulation as a mechanism underlying risky sexual behavior and sexual revictimization among adult victims of child sexual abuse (CSA) and child physical abuse (CPA).

METHODS

Participants were 752 college women. Victimization history, emotion dysregulation, and risky sexual behavior were assessed with anonymous, self-report surveys utilizing a cross-sectional design.

RESULTS

Approximately 6.3% of participants reported CSA, 25.5% reported CPA, and 17.8% reported rape during adolescence or adulthood. CSA and CPA were associated with increased risk for adolescent/adult rape; 29.8% of CSA victims and 24.3% of CPA victims were revictimized. Path analytic models tested hypothesized relationships among child abuse, emotion dysregulation, adolescent/adult rape and three forms of risky sexual behavior (e.g., failure to use condoms, contraception, or having sex with someone under the influence of alcohol/drugs), including frequency of risky sexual behavior with a regular dating partner, with a stranger, and lifetime number of intercourse partners. Emotion dysregulation mediated revictimization for both CSA and CPA. Emotion dysregulation also predicted lifetime number of sexual partners and frequency of risky sex with a stranger, but not frequency of risky sex with a regular dating partner.

CONCLUSIONS

Findings suggest that emotion dysregulation is a distal predictor, and risky sex, particularly with lesser known partners, is a proximal predictor of sexual revictimization. Because emotion dysregulation also maintained a significant direct path to revictimization, risky sexual behavior appears to be one of several proximal risk factors for revictimization.

PRACTICE IMPLICATIONS

Findings confirm that emotion dysregulation is a critical pathway to more proximal risk factors such as risky sexual behavior, and suggest that clinical interventions aimed at improving emotion dysregulation may help reduce risky sexual behavior and risk for revictimization.