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

Sexual education and development after early childhood sexual abuse: A qualitative study of experiences of parents and children

BACKGROUND

In the Amsterdam Sexual Abuse Case (ASAC), infants and toddlers experienced childhood sexual abuse (CSA). The perpetrator was convicted, and psychosocial care was offered to children and families. A research project was established to investigate the impact of CSA at an early age, with this study specifically focusing on sexual education and development.

OBJECTIVE

To investigate parents' and children's experiences with sexual education and development following CSA.

PARTICIPANTS AND SETTING

We conducted interviews with 18 parents of 20 children, and with 6 children themselves. On average, the children were 16 months old at the time of the CSA and 16 years old during the interviews.

METHODS

Qualitative open interviews using an interview guide, followed by thematic analysis.

RESULTS

In general, parents and children reported common experiences with sexual education and development. However, some distinctive concerns related to past CSA were mentioned by parents such as added weight to talking about sex, being more cautious, and additional conversations about boundaries and possible influence on sexual experiences. Also, both parents and children expressed uncertainty about the impact of the past sexual abuse on sexual development.

CONCLUSIONS

Our findings generally align with existing literature on sexual education in a non-abused population. Impact on sexual development as perceived by parents and children was mostly absent, indicating resilience. Nonetheless, distinctive concerns and uncertainties about the impact of early CSA persist. Future research should delve deeper into the long-term consequences of early CSA and the factors contributing to resilience over time.

Empowering Young People with Special Educational Needs to Recognize and Report Child Sexual Exploitation and Abuse: A Mixed-Methods Review

Young people with special educational needs (SEN), such as intellectual disability and/or autism, are particularly vulnerable to child sexual exploitation and abuse (CSEA). This mixed-methods systematic literature review consolidates findings in respect to how young people with SEN are currently being taught about CSEA in the UK, incorporating empirical and practice-based findings to counteract publication bias. Key databases were searched, and relevant organizations were contacted regarding studies published between 2015 and 2022 (inclusive). Thirteen articles met the inclusion criteria. Of these, 10 adopted a qualitative methodology, and three a mixed-methods approach. The thematic synthesis of the qualitative studies identified the following themes: (a) beliefs and stereotypes about CSEA, vulnerability. and risk have led to young people with SEN being misinformed and misunderstood, and (b) anxiety about the topic of sex and abuse creates polarized views regarding CSEA education in adult guardians of young people with SEN. Themes are discussed in the context of societal biases in respect to vulnerability and risk, and these biases are considered to have a negative effect on how young people with SEN are supported. The findings of this review encourage providers of CSEA awareness education to be mindful of not endorsing harmful stereotypes, and to involve parent-carers as much as possible. This review additionally encourages services and organizations to increase focus on practitioner reflexivity and regular training to counteract potential biases in respect to gender, vulnerability, and risk.

Role of psychopathology on children credibility of sexual abuse testimony

When an alleged victim has a pre-existing psychopathological diagnosis, this can affect the rating of their version of the abuse in terms of credibility. The objective of this work is to analyze the relationship between the assessment of the credibility of the testimony of a CSA victim, the psychological problems that the child may have presented prior to sexual abuse and the possible psychological sequelae that she may present as a result of the abuse. 109 cases were selected in which the credibility of the testimony could be determined. Through forensic interviews and the study of the corresponding professional reports, the following were obtained: sociodemographic data, data on their previous psychological state and data on their psychological state after the reported events. The psychological state of the child after the reported events shows no relation to the forensic evaluation of the credibility of her testimony. The existence of a relationship between the absence of previous psychopathology and the fact that the victim's testimony is valued as a credible account is confirmed. This study reveals that children who presented psychological manifestations prior to their experience of abuse receive a lower credibility rating than those without previous psychopathological symptoms or diagnoses.

Impacts of child sexual abuse: The mediating role of future orientation on academic outcomes

BACKGROUND

Child Sexual Abuse (CSA) has significant impacts on an individual's physical and mental well-being including substance use, depression, anxiety, post-traumatic stress disorder, relationship issues, as well as sexual revictimization in adulthood. Positive future orientation is associated with higher educational outcomes and successful goal attainment, but CSA survivors have lower educational attainment and less employment opportunities leading to less financial security in adulthood.

OBJECTIVE

Our study seeks to examine whether future orientation mediates the relationship between CSA and academic outcomes using data from the Kaplan Longitudinal and Multigenerational Study (KLAMS).

PARTICIPANTS & SETTING

KLAMS is a U.S. based panel study which captures information about the mental health, relationships, academic outcomes, and deviant behavior of two generations of family members at multiple points in time. In the present study, we use data from two separate interviews with the children (N = 2084) of the original respondents.

METHODS

We estimated a series of regressions using generalized structural equation modeling to examine the relationship between child sexual abuse, future orientation, and three different types of academic outcomes.

RESULTS

Youth who experienced sexual abuse had lower grades in school, were more likely to drop out, and had lower levels of education than children with no history of sexual abuse. Negative future orientation mediated the relationship between child sexual abuse and all three outcomes.

CONCLUSIONS

In support of existing research, we found child sexual abuse has a negative impact on positive future orientation, and positive future orientation contributes to better academic outcomes.

Early adversity and emotional awareness: A partial confirmation and extension of their relationship

Early adversity has been consistently linked to mental health outcomes, but the underlying pathways remain unclear. One previous study found an association between early adversity and trait emotional awareness (EA), which has itself been linked to health outcomes, but links to mental health were not explicitly examined. The aim of the current study was to test the hypothesis that the association between early adversity and health can be partially accounted for by differences in EA within a large student sample (n = 196). Participants completed measures of early adversity, EA, and current emotional functioning (i.e., depression, anxiety, somatization, positive/negative affect). Bayesian analyses found the most evidence for models with an interaction between sex and early adversity in predicting emotional functioning - revealing the expected negative relationship between early adversity and EA in females, but a positive relationship in males. Early adversity, but not EA, was associated with depression, anxiety, and implicit negative affect. Only explicit positive affect was associated with both early adversity and EA, and EA partially mediated the negative association between early adversity and positive affect. These results provide limited support for EA as a mediating pathway for the effects of early adversity on mental health.

The relationship between interpersonal violence in adulthood and mental health: a longitudinal study based on the Northern Swedish Cohort

BACKGROUND

Longitudinal studies evaluating the negative effects of exposure to interpersonal violence in the adulthood on the mental health of both women and men are scarce. Using longitudinal data, we evaluated the relationship between the last year experience of violence and functional somatic and depressive symptoms at the ages of 30 and 43 among participants (n = 1006; 483 women and 523 men) in the Northern Swedish Cohort. Further, the relationship between cumulative exposure to violence over a decade and mental health symptoms among participants was evaluated.

METHODS

Participants' experience of interpersonal violence and symptoms of functional somatic and depressive symptoms were evaluated with standard questionnaires at the ages of 30 and 43. General linear models were used to evaluate the relationship between the experience of interpersonal violence and mental health symptoms among the participants. The interactions between gender and violence on functional somatic and depressive symptoms were evaluated separately, and models in which the interaction was significant, were split by gender.

RESULTS

We found that the last year experience of violence at the age of 30 was related to current functional somatic symptoms among all participants and depressive symptoms only among men, (β _Adj for the experience of any violence among men: 0.21; CI: 0.12-0.29; Vs. among women: 0.06; CI: -0.04-0.16, p for interaction = 0.02). At the age of 43, last year experience of violence was related to both functional somatic and depressive symptoms in both genders. Finally, a cumulative relationship between the experience of violence over time and mental health symptoms was observed in all participants.

CONCLUSIONS

Our findings revealed that while the relationship between the experience of interpersonal violence and mental health symptoms may differ among men and women and with age, the experience of violence can be negatively related to the mental health in both genders.

International student trauma during COVID-19: Relationships among mental health, visa status, and institutional support

Objective: This study explored the predictive relationship among international student trauma responses, visa status anxiety, and perceived institutional support. Researchers also sought to understand the relationship between help seeking behaviors and trauma exposure responses. Participants: International students (n = 172) from U.S. colleges and universities enrolled since March 2020. Methods: Data were collected via an electronic survey administered during the fall 2020 academic term. Results: The model was found to be significant, explaining 67% of the variance of student trauma responses. Anxiety surrounding students' ability to stay in the U.S. was found to be the greatest contributor to the model. Additionally, particular clusters of trauma symptomatology were significantly correlated with help seeking from specific individuals within student networks. Finally, students reported moderate levels of mental health help seeking behaviors, with friends and family being the most likely sources sought out for help. Conclusions: Despite focus on students' health and wellness concerns related to the COVID-19 pandemic, visa policy uncertainty was a primary driver of self-reported trauma symptomatology at the onset of the pandemic.

"I Am A Living Testimony to the Human Spirit": A Thematic Analysis of Middle Aged and Older Adults' Resilience after Child Sexual Abuse

Despite extensive documentation of the adverse impacts of child sexual abuse (CSA), less is known about long-term effects of CSA, that is, the impact in middle and late adulthood, when one is further removed from the CSA. This study describes coping strategies and positive outcomes reported by adult female survivors of child sexual abuse ages 50+ (n = 58). Responses came from an anonymous online survey of adult survivors of CSA. We conducted a qualitative "RADaR" rapid analysis on the survey's open-ended questions. Survivors employed both internal attitudes and specific activities to cope with their childhood CSA. Most (n = 55) reported positive outcomes from CSA: self, others, and relational and/or emotive strengths. Due to survey limitations, we were unable to identify factors that contributed to survivors reporting positive outcomes and survivors who reported negative or no positive outcomes. This study suggests CSA survivors in middle and late adulthood may feel stronger as a result of abuse. More research is needed to identify factors that contribute to resilience.

Routes Out of Child Abuse to School Adjustments: A Comparison Between North Korean Adolescent Refugees and Native South Korean Adolescents

This study aimed to examine pathways from child abuse to school adjustment and the roles of self-control and academic stress on the link among North Korean adolescent refugees living in South Korea and native South Korean adolescents. A total of 610 students (adolescents from South Korea = 325 and adolescents from North Korea = 285) living in South Korea, from juniors in middle schools to seniors in high schools, were interviewed in 2017. Multigroup structural equation modeling was used to examine differences in the country of origin on the pathways from abuse to school adjustment via self-control and academic stress. North Korean adolescent refugees were less likely to adjust to their school life than South Korean adolescents. Academic stress was found as a significant mediator between self-control and school adjustment in both South Korean and North Korean adolescents. Child abuse was associated with self-control of South Korean adolescents. Childhood abuse from parents can have an overall influence on individual characteristics and school life for adolescents. By paying attention to this process, comprehensive solutions are urgently required not only to intervene in the problem of abusive parenting behaviors but also to block the path of the expanding negative consequences among both groups of adolescents.

The relationship between adverse childhood experiences and common mental disorders among pregnant women living with HIV in Malawi

INTRODUCTION

Adverse childhood experiences (ACEs) have been linked to common mental disorders (CMDs) such as anxiety and depressive thoughts. We examined the prevalence of ACEs and their association with CMDs among pregnant women living with HIV (PWLHIV) in Malawi-an HIV endemic resource-limited setting.

METHODS

This is a cross-sectional study of 798 PWLHIV enrolled in the VITAL Start trial in Malawi (10/2018 to 06/2021) (NCT03654898). ACE histories were assessed using WHO's Adverse Childhood Experiences International Questionnaire (ACE-IQ) tool. Depressive symptoms (somatic complaints, reduced vital energy, anxiety, and depressive thoughts) were assessed using WHO's Self Reporting Questionnaire 20-Item (SRQ-20) tool. Log-binomial regressions were used to examine the association between cumulative ACEs and each depressive symptom, as well as identify ACEs driving this association.

RESULTS

The mean age of our sample was 27.5 years. Over 95 % reported having experienced ≥1 ACE. On average, each participant reported four ACEs; 11 % reported sexual abuse. About 52 % and 44 % reported anxiety and depressive thoughts, respectively. In regressions, cumulative ACE scores were significantly associated with depressive symptoms-even after adjusting for multiple testing. This association was primarily driven by reports of sexual abuse.

LIMITATIONS

Data on maternal ACEs were self-reported and could suffer from measurement error because of recall bias.

CONCLUSIONS

ACEs are widespread and have a graded relationship with depressive symptoms in motherhood. Sexual abuse was found to be a primary driver of this association. Earlier recognition of ACEs and provision of trauma-informed interventions to improve care in PWLHIV may reduce negative mental health sequelae.

Silencing by design: Lessons learned about child sexual abuse from a university sexual assault survey

Background:

University students have been recognized as particularly being vulnerable to sexual victimization.

Purpose:

With little research to date, and acknowledgement for the need of a better understanding of sexual violence, our study analysed the CQUniversity Sexual Assault Survey’s qualitative responses. An open-ended qualitative question allowed students to provide information anonymously.

Methods:

A total of 109 participants contributed responses with 17 respondents commenting on the fact that the survey omitted to ask about child sexual abuse prior to the cut-off age of 12 years.

Results:

University students revealed unexpected disclosures of prepubescent child sexual abuse victimization and ongoing sexual victimization into adulthood. Furthermore, students’ comments indicated negative impacts including distress, mental health and substance use problems, distrust, and interpersonal difficulties. Strong feelings about ‘silencing’ prepubescent child sexual abuse in university surveys were expressed with a request that questions about child sexual abuse prior to the age of 12 years be included.

Conclusion:

Our study found that child sexual abuse victimization is important to students. Recommendations indicate the need for future research about sexual violence among university students without age restrictions to gain a better understanding about the impact of trauma including revictimization experiences.

Describing associations between child maltreatment frequency and the frequency and timing of subsequent delinquent or criminal behaviors across development: variation by sex, sexual orientation, and race

Background

Child maltreatment has been linked to lower health, education, and income later in life, and is associated with increased engagement in delinquent or criminal behaviors. This paper explores trajectories of these behaviors from adolescence into early adulthood and tests maltreatment as a predictor, and whether observed patterns are consistent across different demographic groups.

Methods

Using data from the National Longitudinal Study of Adolescent to Adult Health, a longitudinal study of a nationally representative sample of U.S. adolescents (in grades 7–12 in the 1994–95 school year), we ran linear mixed effects models to estimate growth curves of two dependent variables: violent and nonviolent offending behavior. We tested if maltreatment altered the intercept or slope of the curves and how the curves of these behaviors and the associations between them and maltreatment varied by sex, race/ethnicity, and sexual orientation.

Results

The sample (n = 10,613) had equal proportions males and females, approximately one third identified as a race/ethnicity other than white, and over 10% were non-heterosexual. Experiences of maltreatment were highest for Native Americans and lowest for whites. Models indicated that males were more likely than females to engage in both violent and nonviolent offending and respondents who identified as non-heterosexual were more likely than their heterosexual peers to engage in nonviolent offending behavior. When maltreatment was included in models as a predictor, adolescents who experienced maltreatment had a more rapid increase in their non-violent offending behavior. For violent offending behavior, adolescents who experienced maltreatment had higher levels of offending and the levels progressively increased as maltreatment frequency did. Sex was a moderator; the relationship between maltreatment and predicted nonviolent offending was stronger for males than it was for females. Race/ethnicity and sexual orientation did not moderate the associations between maltreatment and offending behavior.

Conclusions

This study provides insights from a nationally representative sample into the pattern of both delinquent and criminal behaviors in adolescence and young adulthood, describing not only how the pattern varies over time, but also by sociodemographics and offending type. Additionally, it highlights how the association between maltreatment and these behaviors varies by both offending type and sex.

Disrupting the link between maltreatment and delinquency: how school, family, and community factors can be protective

Background

Past experiences of childhood maltreatment are common for youth involved in the juvenile justice system. This paper explores potential protective factors at the peer, family, school, and neighborhood levels that disrupt the relationship between maltreatment and later non-violent and violent offending behavior and how these protective effects vary by a number of different sociodemographics.

Methods

We used data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), a nationally representative longitudinal study of adolescents who were in grades 7–12 in the 1994–95 school year. Pulling data from Add Health respondents from ages 13 to 30, we used linear mixed effects modeling to create growth curves of predicted violent and non-violent offending frequency from adolescence into young adulthood, with maltreatment frequency as a predictor. Next, we tested whether potential protective factors including time with friends, a high-quality relationship with a parent figure, school connection, or neighborhood collective efficacy moderated the intercept or slope of the growth curves. Finally, we tested if sex, race/ethnicity, or sexual orientation moderated these protective effects.

Results

For violent offending, school connection, high-quality relationships with mother or father figures, and neighborhood collective efficacy were all generally protective, meaning they were associated with lower levels and shallower slopes of predicted violent offending, but they were not more or less protective for those who experienced maltreatment. For non-violent offending, the same was true of school connection, high-quality relationships with a mother figure, and neighborhood collective efficacy, which were all generally protective. We found no evidence of a protective effect for time spent with friends, though this is likely due to measurement constraints, as simply measuring time spent with friends may have heterogeneous effects on delinquent behaviors. We found no evidence that any of these protective effects varied by sociodemographics.

Conclusions

This paper identifies factors that teachers, juvenile corrections officers, policymakers and others can intervene on to prevent engagement (or re-engagement) in delinquency and offending among youth and young adults who experienced maltreatment. As they are also protective for youth who have not experienced maltreatment they also inform general delinquency prevention efforts.