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St-Arnaud V, Chicoine AX, Tardif JC, Busseuil D, D’Antono B. Childhood Maltreatment and Body Mass Index in Older Adults With Chronic Illness. CJC PEDIATRIC AND CONGENITAL HEART DISEASE 2024; 3:87-97. [PMID: 39070955 PMCID: PMC11282884 DOI: 10.1016/j.cjcpc.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 03/06/2024] [Indexed: 07/30/2024]
Abstract
Background Childhood trauma has been associated with greater psychological and physical morbidity, including a greater risk of developing coronary artery disease (CAD). Emotional dysregulation and increased body mass index (BMI) may be involved. This study evaluated whether (1) childhood maltreatment is associated with a higher BMI at study onset and with greater increases in BMI 5 years later among older adults with CAD or other chronic illnesses; (2) sex and/or CAD status moderate these results; and (3) baseline symptoms of anxiety, depression, and perceived stress (emotional dysregulation) mediate the association between childhood maltreatment and BMI at follow-up. Methods A total of 1232 men and women (aged 60.86 [6.95] years) completed validated questionnaires on childhood maltreatment and symptoms of psychological distress. The weight and height of the participant were measured, and the BMI was calculated using the weight (kg)/height (m2) ratio. Results Childhood maltreatment was not significantly associated with BMI at study onset nor at follow-up. This relation did not differ as a function of sex nor CAD status. Although childhood maltreatment was associated with significantly greater psychological distress at study onset (all P < 0.001), there latter was not found to mediate the relation between maltreatment and change in BMI at follow-up. Conclusions In contrast to previous literature, childhood maltreatment was not associated with BMI nor with the change in BMI over 5 years in men and women with chronic disease. However, as psychological distress increases risk for morbidity and mortality, it may represent an important target for prevention and intervention in survivors of childhood maltreatment.
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Affiliation(s)
- Vicki St-Arnaud
- Research Centre, Montreal Heart Institute, Montreal, Québec, Canada
- Psychology Department, Université de Montréal, Montreal, Québec, Canada
| | - Ann Xiuli Chicoine
- Research Centre, Montreal Heart Institute, Montreal, Québec, Canada
- Psychology Department, Université de Montréal, Montreal, Québec, Canada
| | - Jean-Claude Tardif
- Research Centre, Montreal Heart Institute, Montreal, Québec, Canada
- Department of Medicine, Université de Montréal, Montreal, Québec, Canada
| | - David Busseuil
- Research Centre, Montreal Heart Institute, Montreal, Québec, Canada
| | - Bianca D’Antono
- Research Centre, Montreal Heart Institute, Montreal, Québec, Canada
- Psychology Department, Université de Montréal, Montreal, Québec, Canada
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Nobels A, De Schrijver L, Van Landuyt M, Vandeviver C, Lemmens GMD, Beaulieu M, Keygnaert I. "In the End You Keep Silent": Help-Seeking Behavior Upon Sexual Victimization in Older Adults. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:2318-2343. [PMID: 38149594 DOI: 10.1177/08862605231220017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
Sexual violence is considered a prominent mental health problem. Exposure to sexual victimization during lifetime has been linked to mental health problems in old age. Research in adult victims has shown that they experience many barriers for disclosure and seeking professional help upon sexual victimization. However, information on help-seeking behavior in older victims of sexual violence is non-existent. With this study we aim for a better understanding of help-seeking behavior upon sexual violence in older adults. We used a mixed methods approach with an explanatory sequential design. Data were collected through structured face-to-face interviews with a random sample of 227 sexual violence victims of 70 years and older living in Belgium. Quantitative data were triangulated with qualitative data from 15 in-depth interviews with older victims. We found that up to 60% of older sexual violence victims never disclosed their experiences and 94% never sought professional help. Help-seeking is a complex process comprising several phases, which are affected by strong feelings of shame and self-blame, ageist premises and taboos about sexuality. In the end, most victims choose to cope on their own. Occasional disclosure only happens decades after the sexual violence took place. Older victims do not spontaneously disclose to healthcare workers but expect professionals to initiate the conversation. In conclusion, few older victims disclose or seek professional help upon sexual victimization. Healthcare professionals working with older adults need capacity building through training, screening tools, and care procedures to initiate conversation on sexual violence, and to detect signs, prevent, mitigate and respond to sexual victimization in older adults.
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Affiliation(s)
- Anne Nobels
- Department of Public Health and Primary Care, International Center for Reproductive Health, Ghent University, Ghent, Belgium
- Department of Psychiatry, Ghent University Hospital, Ghent, Belgium
| | - Lotte De Schrijver
- Department of Public Health and Primary Care, International Center for Reproductive Health, Ghent University, Ghent, Belgium
- Vlaamse Vereniging van Klinisch Psychologen, Brussels, Belgium
| | - Mira Van Landuyt
- Department of Public Health and Primary Care, International Center for Reproductive Health, Ghent University, Ghent, Belgium
| | - Christophe Vandeviver
- Department of Criminology, Criminal Law, and Social Law, Ghent University, Ghent, Belgium
| | - Gilbert M D Lemmens
- Department of Psychiatry, Ghent University Hospital, Ghent, Belgium
- Department of Head and Skin-Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium
| | - Marie Beaulieu
- School of Social Work, Research Chair on Mistreatment of Older Adults and Research Center on Aging, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Ines Keygnaert
- Department of Public Health and Primary Care, International Center for Reproductive Health, Ghent University, Ghent, Belgium
- Women's Clinic, Ghent University Hospital, Ghent, Belgium
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Wang W, Cui Y, Hu Q, Wei Y, Xu L, Tang X, Hu Y, Liu H, Wang Z, Chen T, Wang R, An C, Wang J, Zhang T. Childhood maltreatment and personality disorders in adolescents and adults with psychotic or non-psychotic disorders. Front Psychiatry 2024; 15:1336118. [PMID: 38577403 PMCID: PMC10991748 DOI: 10.3389/fpsyt.2024.1336118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 03/06/2024] [Indexed: 04/06/2024] Open
Abstract
Introduction While the attention to personality disorders (PD) and childhood maltreatment (CM) has grown in recent years, there remains limited understanding of the prevalence and distinctions of PD and CM in clinical populations of Chinese adolescents in comparison to adults. Methods A total of 1,417 participants were consecutively sampled from patients diagnosed with either psychotic or non-psychotic disorders in the psychiatric and psycho-counseling clinics at Shanghai Mental Health Center. The participants were categorized into two groups based on their age: adolescents (aged 15-21 years) and adults (aged 22-35 years). PDs were evaluated using a self-reported personality diagnostic questionnaire and a structured clinical interview, while CMs were assessed using the Chinese version of the Child Trauma Questionnaire Short Form. Results When comparing self-reported PD traits and CM between adolescents and adults, differences emerge. Adolescents, particularly in the psychotic disorder group, exhibit more pronounced schizotypal PD traits (p=0.029), and this pattern extends to non-psychotic disorders (p<0.001). Adolescents in the non-psychotic disorder group also report higher levels of emotional abuse (p=0.014), with a notable trend in physical abuse experiences compared to adults (p=0.057). Furthermore, the most prevalent PDs in the clinical sample are avoidant, borderline, and obsessive-compulsive PDs. Among patients with psychotic disorders, adolescents exhibit higher rates of schizoid, schizotypal, and obsessive-compulsive PDs compared to adults. Logistic regression analyses highlight distinct predictors for psychotic and non-psychotic disorders in adolescents and adults. Discussion The findings emphasize distinct differences in PDs and CMs between adolescent and adult groups, shedding light on their potential roles in psychotic and non-psychotic disorders.
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Affiliation(s)
- WenZheng Wang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Yin Cui
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Qiang Hu
- Department of Psychiatry, ZhenJiang Mental Health Center, Zhenjiang, China
| | - YanYan Wei
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - LiHua Xu
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - XiaoChen Tang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - YeGang Hu
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - HaiChun Liu
- Department of Automation, Shanghai Jiao Tong University, Shanghai, China
| | - ZiXuan Wang
- Shanghai Xinlianxin Psychological Counseling Center, Shanghai, China
| | - Tao Chen
- Big Data Research Lab, University of Waterloo, Waterloo, ON, Canada
- Labor and Worklife Program, Harvard University, Cambridge, MA, United States
| | - Ran Wang
- Department of Psychiatry, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - CuiXia An
- Hebei Technical Innovation Center, Mental Health Assessment and Intervention, Shijiazhuang, Hebei, China
- Hebei Clinical Research Center of Mental Disorders, Institute of Mental Health, Shijiazhuang, Hebei, China
| | - JiJun Wang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
- Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China
- Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, Shanghai, China
| | - TianHong Zhang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
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Hong SH, Yu CL, Rousson AN, Bender AE, Fedina L, Herrenkohl TI. Examining the Association Between Trauma Characteristics and Adult Depression and Anxiety: Analysis of Types, Variety, Repetition, and Timing of Past Trauma. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:569-586. [PMID: 37728007 DOI: 10.1177/08862605231198056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
Past research has emphasized the impact of prior trauma on adult depression and anxiety rates. However, few studies have examined the simultaneous connection between various trauma characteristics (e.g., type, variety, repetition, timing) and symptoms of depression and anxiety in adults. Understanding how these different trauma characteristics relate to mental health issues can offer valuable insight into predicting the onset of such problems. We conducted a cross-sectional analysis with 356 adult participants to explore the associations between lifetime trauma history and depression/anxiety scores. Participants retrospectively reported on five different traumatic experiences from birth to the present, including childhood physical abuse, witnessing parental violence, lifetime experiences of rape, witnessing trauma to loved ones, and the unexpected death of loved ones. For each trauma type, participants indicated the timing of their first exposure and the frequency of subsequent occurrences. Depression and anxiety symptoms in the past 2 weeks were also self-reported. Multiple regression analyses with covariates were employed. On average, participants experienced two out of the five trauma types. Regardless of the type, having at least one traumatic experience was linked to higher depression and anxiety scores. Those who experienced all five trauma types reported the highest levels of depression and anxiety. Repeated instances of rape, witnessing trauma to loved ones, and the death of loved ones were significantly associated with elevated depression and anxiety scores. The timing of exposure to the unexpected death of loved ones predicted higher depression scores in childhood compared to adulthood, while no relationship between timing and anxiety scores was observed. Other trauma types did not show significant associations. Our study enhances knowledge of the link between trauma and depression/anxiety by elucidating how various trauma characteristics, such as type, variety, repetition, and timing of trauma, have differential influences on depression and anxiety scores.
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Goldman-Mellor S, Qin P. Interpersonal violent injury and subsequent risk of suicide and deliberate self-harm: a register-based national cohort study from Norway, 2010-2018. EClinicalMedicine 2024; 68:102442. [PMID: 38333541 PMCID: PMC10850407 DOI: 10.1016/j.eclinm.2024.102442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 01/01/2024] [Accepted: 01/11/2024] [Indexed: 02/10/2024] Open
Abstract
Background Interpersonal violence is a leading cause of morbidity, with potentially severe adverse consequences for the mental health of the injured persons. The extent to which violent injury is associated with subsequent suicidal behavior, however, remains unclear. This study aimed to examine how violent injury was associated with subsequent deliberate self-harm and death by suicide. Methods This retrospective cohort study used nationwide longitudinal registry data from Norway to identify all individuals presenting to emergency services in 2010-2018 with a violence-related injury, along with sex- and age-matched control individuals from the general population. The primary outcomes were any emergency visit for deliberate self-harm (DSH) and suicide death, observed through 31 December 2018. Rates of each outcome were compared between violence-injured patients and comparison individuals using stratified multivariable Cox regression models, controlling for sociodemographic characteristics as well as history of psychiatric treatment and DSH. Secondary analyses tested for moderation by sex, age, and prior psychiatric treatment. Findings Violence-injured patients (n = 28,276) had substantially higher rates of DSH (946.7 per 100,000 person-years) and suicide death (74.5 per 100,000) when compared to controls (n = 282,760; 90.0 and 15.2 per 100,000, respectively). The hazard ratios (HRs) remained significantly higher even after accounting for covariates (HRadj for DSH: 5.11; 95% CI: 4.62, 5.66; HRadj for suicide: 2.40; 95% CI: 1.78, 3.24). Sex differences in this association were negligible, but the association between violence injury and DSH increased with age. Violence-injured patients with prior psychiatric treatment had the highest risk of suicidal behavior. Interpretation Violence-injured patients experience significantly excess rates of suicidal behavior, a finding with potential to inform both clinical intervention and population-level suicide prevention strategies. Funding Fulbright Norway Scholarship.
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Affiliation(s)
- Sidra Goldman-Mellor
- Department of Public Health, University of California, Merced, 5200 N. Lake Rd., Merced, CA, USA
- Health Sciences Research Institute, University of California, Merced, 5200 N. Lake Rd., Merced, CA, USA
| | - Ping Qin
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Nobels A, Meersman C, Lemmens G, Keygnaert I. "Just something that happened?": Mental health impact of disclosure and framing of sexual violence in older victims. Int J Geriatr Psychiatry 2023; 38:e6036. [PMID: 38088814 DOI: 10.1002/gps.6036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 11/18/2023] [Indexed: 12/18/2023]
Abstract
INTRODUCTION Despite the important impact of sexual violence (SV) on mental health, few victims disclose their experiences. Although research in adult victims suggests that SV disclosure could protect against long-term mental health problems, studies in older adults are lacking. OBJECTIVES To establish the prevalence of depression, anxiety, posttraumatic stress disorder (PTSD), suicide attempts, and self-harm, their association with SV disclosure, and the moderating effect of sociodemographic characteristics and SV framing in the relation between SV disclosure and the different mental health outcomes in older SV victims. METHODS Data on sexual victimisation, mental health, SV framing, and disclosure were collected through structured face-to-face interviews with 171 randomly selected sexually victimised adults of 70 years and older living in Belgium. SV was measured using behaviourally specific questions based on a broad definition. Mental health outcomes were measured using validated scales. RESULTS Depression, anxiety and PTSD were reported by 34%, 33% and 9% of participants respectively, 5% had attempted suicide and 1% reported self-harm during lifetime. SV framing was associated with the kind of help victims consulted. SV disclosure was not linked with depression and anxiety, but was associated with an increase of PTSD symptoms in older victims with care dependency (p = 0.004) or a chronic illness and/or disability (p = 0.025). CONCLUSIONS SV disclosure in itself does not protect against adverse mental health outcomes in old age. Capacity building of professionals trough training and development of clinical guidelines and care procedures may increase appropriate response to SV disclosure by older victims.
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Affiliation(s)
- Anne Nobels
- Department of Psychiatry, Ghent University Hospital, Ghent, Belgium
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | | | - Gilbert Lemmens
- Department of Psychiatry, Ghent University Hospital, Ghent, Belgium
- Department of Head and Skin, Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium
| | - Ines Keygnaert
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- Women's Clinic, Ghent University Hospital, Ghent, Belgium
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7
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Breddemann A, Schilbach L, Kunerl E, Witzmann M, Schuwerk T. [Gender Differences in Autism Diagnostics]. PSYCHIATRISCHE PRAXIS 2023; 50:299-307. [PMID: 37146640 DOI: 10.1055/a-2043-9812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Autism spectrum condition (ASC) is predominantly diagnosed in boys and men. There is evidence that this is also because girls and women with ASC don't receive a diagnosis, or, if they do, only later in life. This study investigates gender differences in diagnosis, support needs, mental health, and life satisfaction among individuals with autism spectrum condition (ASC) in Germany. Data of an online questionnaire study with 659 persons with ASC from 3-67 years of age living in Bavaria, Germany, were analyzed (215 thereof were female). It was found that women with ASC are diagnosed 7-11 years later than men and are more likely to receive at least one misdiagnosis. They are more likely than men to have unmet educational support needs and comorbid internalizing psychiatric disorders. The results of this study point towards a strong gender bias in clinical diagnosis of ASC in Germany and need for improvements in the case of women.
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Affiliation(s)
- Alina Breddemann
- MUNIK - Münchner Universitäres Institut für Kinder- und Jugendlichenpsychotherapie, Ludwig-Maximilians-Universität München
| | - Leonhard Schilbach
- Munich Center for Neurosciences, Ludwig-Maximilians-Universität München
- Psychiatrie, LVR-Klinikum Düsseldorf - Kliniken der Heinrich-Heine-Universität Düsseldorf
| | - Eva Kunerl
- Pädagogik, Ludwig-Maximilians-Universität München
| | - Markus Witzmann
- Fakultät für angewandte Sozialwissenschaften, Hochschule München
| | - Tobias Schuwerk
- MUNIK - Münchner Universitäres Institut für Kinder- und Jugendlichenpsychotherapie, Ludwig-Maximilians-Universität München
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de Roos MS, Oliver C, Carré JR, Jones DN. Mimicry Deception Theory applied to sexual abuse of children. CHILD ABUSE & NEGLECT 2023; 143:106339. [PMID: 37406466 DOI: 10.1016/j.chiabu.2023.106339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 06/16/2023] [Accepted: 06/29/2023] [Indexed: 07/07/2023]
Abstract
Sexual abuse of children remains a widespread problem with well-documented, adverse consequences. Often, abuse ending is contingent on a disclosure made by the victim, but victims delay disclosure if they tell someone at all. The factors associated with (non)disclosure are complex and interrelated. In this paper, we propose a new theoretical framework (Mimicry Deception Theory; MDT) to explore various aspects of the grooming process, using a qualitative content analysis of US court appeal cases (N = 25). Specifically, we focus on how MDT components contribute to the likelihood of a CSA disclosure. MDT is made up of five components: Victim Selection, Community Integration, Complexity of Deception, Resource Extraction, and Detectability. These five components allow us to look at several characteristics of abuse in tandem and examine how they interact to impact various outcomes, such as (non)disclosure. We provide a detailed codebook for this framework, that can be used to systematically extract relevant information from large amounts of data. Through the application of this framework, we were able to identify several factors that may play a role in delayed or non-disclosure. Further, we found repeat offenders were likely to use the exact same methods of access, grooming, and remaining undetected across victims. Implications for prevention, as well as clinical interventions with perpetrators as well as victims are discussed.
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Affiliation(s)
| | - Chloe Oliver
- Roehampton University, United Kingdom of Great Britain and Northern Ireland
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Helmus LM, Kyne A. Prevalence, Correlates, and Sequelae of Child Sexual Abuse (CSA) among Indigenous Canadians: Intersections of Ethnicity, Gender, and Socioeconomic Status. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095727. [PMID: 37174245 PMCID: PMC10178094 DOI: 10.3390/ijerph20095727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 04/11/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023]
Abstract
Child sexual abuse (CSA) is a severe and concerning public-health problem globally, but some children are at higher risk of experiencing it. The harms caused by colonization and particularly the inter-generational legacy of residential schools would presumably increase the vulnerability of Indigenous children in former British colonies. Among 282 Indigenous participants in Canada recruited from Prime Panels, CSA was reported by 35% of boys, 50% of girls, and 57% of trans and gender non-conforming participants. These rates are substantially higher than global meta-analytic estimates (7.6% of boys and 18.0% of girls). There was evidence of intersectionality based on socioeconomic status. CSA was associated with a variety of other indicators of negative childhood experiences and significantly predicted numerous negative outcomes in adulthood, including mental-health issues (e.g., PTSD), unemployment, and criminal legal-system involvement. Sexual abuse of Indigenous Canadian children is a public-health crisis, and layers of marginalization (e.g., gender, social class) exacerbate this risk. Trauma-informed services to address the harms of colonization are severely needed, in line with recommendations from Canada's Truth and Reconciliation Commission.
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Affiliation(s)
- L Maaike Helmus
- Department of Criminology, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
| | - Ashley Kyne
- Department of Criminology, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
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10
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Winterstein TB, Avieli H, Gichaz M. Recovering the Lost Soul: Older Women's Reflections on Past Intrafamilial Child Sexual Abuse. QUALITATIVE HEALTH RESEARCH 2023; 33:426-439. [PMID: 36882288 DOI: 10.1177/10497323231159802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Intrafamilial child sexual abuse (IFCSA) is a social problem with longstanding effects on victims' lives. While scholarly literature has focused on the adverse aftermath of sexual abuse, only a few studies have acknowledged older women's perspectives on their experience of IFCSA and their journey of healing and recovery. The aim of the present study was to explore how older survivors of IFCSA construct and shape their experience of healing in later life and the meaning they assign to this process. Narrative inquiry was selected to explore the narratives of 11 older women survivors of IFCSA. Participants were interviewed using a biographical narrative interviewing method. The narratives were then transcribed and analyzed using thematic, structural, and performance analyses. Four major themes emerged from the participants' narratives: Achieving closure; Spiritual framing of IFCSA as a platform for self-growth; Becoming whole in old age; and Looking to the future after IFCSA. During the aging years, IFCSA survivors may redefine their identity and their place in the world. Using life review processes, older women in this study were striving to heal and reconcile with their past.
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Affiliation(s)
| | - Hila Avieli
- Department of Criminology, Ariel University, Ariel, Israel
| | - Mili Gichaz
- Department of Gerontogy, University of Haifa, Ariel, Israel
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11
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Brown MJ, Nkwonta CA, Kaur A, James T, Conserve DF, Small BJ, Haley WE. "Psychologically and emotionally, it affects me 'til this day": exploration of childhood sexual abuse perspectives among older adults living with HIV in South Carolina. Aging Ment Health 2022; 26:2208-2213. [PMID: 34861806 PMCID: PMC9163201 DOI: 10.1080/13607863.2021.2007354] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 11/12/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVES The influence of childhood sexual abuse (CSA) may be seen immediately or across the life course. CSA is also associated with increased HIV-risk behavior, and greater likelihood of an HIV/STI diagnosis. The aim of this study was to explore the perspectives of CSA among older adults living with HIV. METHODS Twenty-four adults living with HIV aged 50 to 67 years (mean age = 58.5 years), with a history of CSA, receiving care from an HIV clinic in South Carolina, participated in the study. In-depth semi-structured interviews were conducted, audio recorded and analyzed using a thematic analytic approach. The iterative analytic process included a three-step approach: discussion of initial thoughts and key concepts, identification and reconciliation of codes, and naming of emergent themes. RESULTS Four themes emerged: Psychological issues due to CSA, relationship challenges due to CSA, self-blame, and reliving childhood trauma (subtheme: lack of influence of CSA today). Some participants reported feeling the influence of CSA several years after the event while others noted that that there was a lack of influence of CSA at present. CONCLUSIONS Trauma-informed intervention programs are needed for older adults living with HIV who still experience the influence of their CSA experience. Future research should delve into the design and feasibility of implementing these programs.
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Affiliation(s)
- Monique J. Brown
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- Office for the Study on Aging, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Chigozie A. Nkwonta
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- Rory Meyers College of Nursing, New York University, New York, New York
| | - Amandeep Kaur
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Titilayo James
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Donaldson F. Conserve
- Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, D. C
| | - Brent J. Small
- School of Aging Studies, Community of Behavioral and Community Sciences, University of South Florida, Tampa, Florida
| | - William E. Haley
- School of Aging Studies, Community of Behavioral and Community Sciences, University of South Florida, Tampa, Florida
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Pfluger V, Rohner SL, Eising CM, Maercker A, Thoma MV. Associations Between Complex Trauma Exposure in Childhood/Adolescence and Psychopathology in Older Age: The Role of Stress Coping and Coping Self-Perception. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:539-551. [PMID: 35958721 PMCID: PMC9360395 DOI: 10.1007/s40653-021-00419-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/26/2021] [Indexed: 06/15/2023]
Abstract
Complex trauma exposure in childhood and/or adolescence is common and has repeatedly been linked to mental ill-health across the lifespan. While the correlates of complex trauma and mental health are well-studied in individuals up to middle adulthood, correlates in older adulthood, as well as potential mediators of this relationship, such as stress coping, are insufficiently studied. Therefore, this study aimed to (a) examine the mental health of Swiss older adults affected by complex trauma exposure in childhood and/or adolescence, in comparison to non-affected individuals; and (b) to examine the potential mediating role of coping strategies and coping self-perception. Data from N = 257 participants (complex trauma [CT] group: n = 161; M age = 69.66 years, 48.4% female; non-complex trauma [nCT] group: n = 96; M age = 72.49 years, 42.7% female) were assessed using self-report questionnaires and a clinical interview. The CT group presented with significantly more current and lifetime mental health disorders, more disadvantageous coping strategies, and significantly lower coping self-perception, compared to the nCT group. Mediation analyses revealed that maladaptive coping and coping self-perception were relevant mediators of the relationship between complex trauma exposure and psychopathology. Results suggest that complex trauma exposure in childhood and/or adolescence can have a lasting impact on mental health in later life and can be negatively associated with stress coping. Findings emphasize the relevance of a lifespan perspective in research and clinical practice for addressing consequences of complex trauma exposure.
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Affiliation(s)
- Viviane Pfluger
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- Dynamics of Healthy Aging”, University Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Shauna L. Rohner
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- Dynamics of Healthy Aging”, University Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Carla M. Eising
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- Dynamics of Healthy Aging”, University Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Andreas Maercker
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- Dynamics of Healthy Aging”, University Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Myriam V. Thoma
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- Dynamics of Healthy Aging”, University Research Priority Program, University of Zurich, Zurich, Switzerland
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Pfluger V, Rohner SL, Eising CM, Maercker A, Thoma MV. Internalizing Mental Health Disorders and Emotion Regulation: A Comparative and Mediational Study of Older Adults With and Without a History of Complex Trauma Exposure. Front Psychol 2022; 13:820345. [PMID: 35814079 PMCID: PMC9260226 DOI: 10.3389/fpsyg.2022.820345] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 05/17/2022] [Indexed: 12/04/2022] Open
Abstract
Individuals with complex trauma exposure (CTE) in early life (i.e., childhood/adolescence) are at heightened risk for developing problems in various domains of functioning. As such, CTE has repeatedly been linked to internalizing mental health disorders, such as depression and anxiety, as well as emotion dysregulation across the lifespan. While these correlates of CTE are comparatively well studied up to middle adulthood, they are insufficiently studied in older adulthood. Therefore, this study aimed to (a) compare Swiss older adults with and without a CTE history regarding current and lifetime internalizing mental health disorders and emotion regulation strategies; and (b) to examine the potential mediating role of emotion regulation in the mental health disparities between these groups. A total of N = 257 participants (age = 49-95 years; 46.3% female) were assessed in a retrospective, cross-sectional study, using two face-to-face interviews. The CTE group (n = 161; M age = 69.66 years, 48.4% female) presented with significantly more current and lifetime internalizing mental health disorders than the non-affected (nCTE) group (n = 96; M age = 72.49 years, 42.7% female). The CTE group showed significantly higher emotion suppression and lower emotion reappraisal compared to the nCTE group. Mediation analysis revealed that the two emotion regulation strategies were significant mediators between CTE history and internalizing mental health disorders. Findings emphasize the relevance of emotion (dys-)regulation in understanding mental health disparities in older age and deciding about treatment strategies. Research and practice should pay more attention to the needs of this high-risk group of older individuals.
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Affiliation(s)
- Viviane Pfluger
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program Dynamics of Healthy Ageing, University of Zurich, Zurich, Switzerland
| | - Shauna L. Rohner
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program Dynamics of Healthy Ageing, University of Zurich, Zurich, Switzerland
| | - Carla M. Eising
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program Dynamics of Healthy Ageing, University of Zurich, Zurich, Switzerland
| | - Andreas Maercker
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program Dynamics of Healthy Ageing, University of Zurich, Zurich, Switzerland
| | - Myriam V. Thoma
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program Dynamics of Healthy Ageing, University of Zurich, Zurich, Switzerland
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Gámez-Guadix M, Mateos-Pérez E, Wachs S, Wright M, Martínez J, Íncera D. Assessing image-based sexual abuse: Measurement, prevalence, and temporal stability of sextortion and nonconsensual sexting ("revenge porn") among adolescents. J Adolesc 2022; 94:789-799. [PMID: 35719041 DOI: 10.1002/jad.12064] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 06/02/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION The aim of this study is to develop a new measure of victimization and perpetration of two frequent forms of image-based sexual abuse, namely sextortion (i.e., the threat of distributing sexual images to pressure the victim into doing something) and nonconsensual sexting (i.e., distributing sexual images of someone without the consent of the victim). Additional aims were to analyze the prevalence of these forms of victimization and perpetration and to examine their temporal stability over a 1-year period. METHODS The sample was made up of 1820 Spanish adolescents (mean age = 13.38, SD = 1.42; 929 girls, 878 boys, 3 nonbinary, and 10 did not indicate gender) who completed self-report instruments on image-based sexual abuse and related variables (e.g., cyberbullying victimization). RESULTS Confirmatory factor analysis supported a structure composed of the four hypothesized factors: sextortion victimization and perpetration, and nonconsensual sexting victimization and perpetration. Higher sexting, cyberbullying victimization, and symptoms of depression and anxiety had stronger associations with image-based sexual victimization than with perpetration, which showed evidence of concurrent validity. Prevalence was 2.6% and 0.7% for sextortion victimization and perpetration, respectively, and 3.4% and 4.9% for nonconsensual sexting victimization and perpetration, respectively. Temporal stability over 1 year was .26 for sextortion victimization, .19 for nonconsensual sexting victimization, .33 for nonconsensual sexting perpetration (all ps < .001), and nonsignificant for sextortion perpetration. The stability of nonconsensual sexting victimization was significantly higher for girls compared to boys, whereas nonconsensual sexting perpetration was more stable over 1 year for boys. CONCLUSIONS Future studies must advance the analysis of the predictors and consequences of image-based sexual abuse among adolescents to better prevent this problem. Prevalence of sextortion and nonconsensual sexting is not negligible, and these problems should be particularly addressed in prevention programs.
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Affiliation(s)
- Manuel Gámez-Guadix
- Biological and Health Psychology Department, Universidad Autónoma de Madrid, Madrid, Spain
| | - Estibaliz Mateos-Pérez
- Department of Social Psychology and Methodology of Behavior Science, University of Basque Country, Leioa, Spain
| | - Sebastian Wachs
- Department of Educational Sciences, University of Potsdam, Potsdam, Germany
| | - Michelle Wright
- Department of Psychology, Child Study Center, Pennsylvania State University, State College, Pennsylvania, USA
| | - Jone Martínez
- Biological and Health Psychology Department, Universidad Autónoma de Madrid, Madrid, Spain
| | - Daniel Íncera
- Biological and Health Psychology Department, Universidad Autónoma de Madrid, Madrid, Spain
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15
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Song A, Yoon Y, Cho Y. The Association Between Polyvictimization in Childhood and Intimate Partner Violence and Child Abuse in Adulthood. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:6009-6033. [PMID: 35128978 DOI: 10.1177/08862605211073088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The main purpose of this study was to examine the association of family polyvictimization in childhood with the victimization or perpetration of spousal abuse and the perpetration of child abuse in adulthood. While associations between maltreatment in childhood and subsequent perpetration or victimization in adulthood are well documented, their association with polyvictimization in childhood (i.e., experiencing multiple types of victimization) has received less attention. This research aims to empirically investigate 1) whether early experiences of family polyvictimization are predictive of subsequent experience or spousal abuse or perpetration of child abuse and 2) whether there are gender differences in those associations. Through conducting Chi-square analysis and logistic regression analysis with South Korea's National Domestic Violence Survey 2019, the study found significant empirical evidence that polyvictimization is predictive of perpetration or experience of spousal abuse and perpetration of child abuse. Particularly, adults who experienced polyvictimization in childhood were more likely to perpetrate child abuse regardless of the type of abuse (p < .001). Polyvictimization in childhood was also significantly associated with perpetration and victimization of spousal abuse (p < .001). In regard to gender differences, this study found that males were more likely to be polyvictimized by family in childhood (15.11%) than females (10.23%), and polyvictimization was found to increase the likelihood of females being revictimized in adulthood. More attention should be paid to victimization by multiple types of violence within the family and its influence on intergenerational transmission of violence.
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Affiliation(s)
- Ahyoung Song
- Department of Social Welfare, 65440Gachon University, Seongnam, Korea
| | - Yoewon Yoon
- Department of Social Welfare, 34942Dongguk University, Seoul, Korea
| | - Yusun Cho
- Center for Government Performance Evaluation, 65791Korea Institute of Public Administration, Seoul, Korea
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Nobels A, Lemmens G, Thibau L, Beaulieu M, Vandeviver C, Keygnaert I. "Time Does Not Heal All Wounds": Sexual Victimisation Is Associated with Depression, Anxiety, and PTSD in Old Age. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052803. [PMID: 35270496 PMCID: PMC8910002 DOI: 10.3390/ijerph19052803] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/15/2022] [Accepted: 02/17/2022] [Indexed: 11/21/2022]
Abstract
Sexual violence (SV) has an important impact on mental health. Childhood sexual abuse is linked to internalising disorders in later life. In older adults, SV occurs more often than previously believed. Moreover, health care workers lack the skills to address SV in later life. Studies researching the mental health impact of lifetime SV, i.e., SV during childhood, adulthood, and old age, are lacking. Between July 2019 and March 2020, 513 older adults living in Belgium participated in structured face-to-face-interviews. Selection occurred via a cluster random probability sampling with a random walk finding approach. Depression, anxiety, and posttraumatic stress syndrome (PTSD) were measured using validated scales. Participants were asked about suicide attempts and self-harm during their lifetime and in the past 12 months. SV was measured using behaviourally specific questions based on a broad SV definition. We found rates for depression, anxiety, and PTSD of 27%, 26%, and 6% respectively, while 2% had attempted suicide, and 1% reported self-harm in the past 12 months. Over 44% experienced lifetime SV and 8% in the past 12 months. Lifetime SV was linked to depression (p = 0.001), anxiety (p = 0.001), and PTSD in participants with a chronic illness/disability (p = 0.002) or no/lower education (p < 0.001). We found no link between lifetime SV and suicide attempts or self-harm in the past 12 months. In conclusion, lifetime SV is linked to mental health problems in late life. Tailored mental health care for older SV victims is necessary. Therefore, capacity building of professionals and development of clinical guidelines and care procedures are important.
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Affiliation(s)
- Anne Nobels
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium;
- Department of Psychiatry, Ghent University Hospital, 9000 Ghent, Belgium;
- Correspondence: (A.N.); (I.K.)
| | - Gilbert Lemmens
- Department of Psychiatry, Ghent University Hospital, 9000 Ghent, Belgium;
- Department of Head and Skin–Psychiatry and Medical Psychology, Ghent University, 9000 Ghent, Belgium
| | - Lisa Thibau
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium;
| | - Marie Beaulieu
- School of Social Work, Research Chair on Mistreatment of Older Adults and Research Centre on Aging, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada;
| | - Christophe Vandeviver
- Department of Criminology, Criminal Law and Social Law, Ghent University, 9000 Ghent, Belgium;
| | - Ines Keygnaert
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium;
- Correspondence: (A.N.); (I.K.)
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Graham K, Patterson T, Justice T, Rapsey C. "It's Not a Great Boulder, It's Just a Piece of Baggage": Older Women's Reflections on Healing from Childhood Sexual Abuse. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:705-725. [PMID: 32306845 DOI: 10.1177/0886260520916270] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
In this study, we explored older women's reflections on processes of healing related to childhood sexual abuse (CSA). We aimed to answer questions about how childhood trauma was integrated into the life story and to identify factors or coping strategies that aided, or hindered, healing. Participants within this study included 12 women who were aged 60 or older and had reported CSA as adults at the beginning of the research project, 25 years prior. Qualitative interviews were conducted exploring women's reflections on the place of CSA in their lives over time and factors the participants thought were helpful or unhelpful in being able to come to terms with the abuse. Data were analyzed using thematic analysis, which resulted in three themes related to processes of healing. The themes identified were need for resolution, thinking about it differently, and developing agency over disclosure. The findings show that some form of resolution was needed for the women to recover and move on from their experiences of CSA. The two key strategies used to reach this resolution were reframing their experience or drawing upon positive life philosophies. Decisions around disclosure were also an important part of the healing process, with the women developing an agency over if, and how, they talked to people about their experience. Those women who were not able to make sense of their experience continued to be influenced by the negative feelings and memories associated with the experience. Our findings have implications for health professionals working with those who have experienced trauma. They demonstrate that there are a number of ways that people heal from trauma and find personal resolution across their lifespan.
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Affiliation(s)
| | - Tess Patterson
- University of Otago, Dunedin, New Zealand
- North-West University, Potchefstroom, South Africa
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Wolf M, Kusmaul N, Mucha B. It gets better: childhood sexual abuse and trauma symptoms in female older adults. J Women Aging 2021; 34:800-809. [PMID: 34704917 DOI: 10.1080/08952841.2021.1995305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
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.
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Affiliation(s)
- Molly Wolf
- Department of Social Work, Edinboro University of Pennsylvania, U.S.A
| | - Nancy Kusmaul
- Department of Social Work, University of Maryland Baltimore County, U.S.A
| | - Brooke Mucha
- Department of Social Work, Edinboro University of Pennsylvania, U.S.A
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Nobels A, Cismaru-Inescu A, Nisen L, Hahaut B, Beaulieu M, Lemmens G, Adam S, Schapansky E, Vandeviver C, Keygnaert I. Sexual violence in older adults: a Belgian prevalence study. BMC Geriatr 2021; 21:601. [PMID: 34702179 PMCID: PMC8546387 DOI: 10.1186/s12877-021-02485-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 08/26/2021] [Indexed: 11/10/2022] Open
Abstract
Background Sexual violence (SV) is an important public health problem which may cause long-lasting health problems. SV in older adults remains neglected in research, policies and practices. Valid SV prevalence estimates and associated risk factors in older adults are currently unavailable. In this study we measured lifetime and past 12-months sexual victimisation in older adults living in Belgium, its correlates, assailant characteristics and the way that victims framed their SV experiences. Methods SV was measured using behaviourally specific questions based on a broad definition of SV. Participants were selected via a cluster random probability sampling with a random route finding approach. Information on sexual victimisation, correlates, assailant characteristics and framing was collected via structured face-to-face interviews with adults aged 70 years and older living in Belgium (community-dwelling, assisted living and nursing homes). Results Among the 513 participants, the lifetime SV prevalence was 44% (55% F, 29% M). Past 12-months prevalence was 8% (9% F, 8% M). Female sex and a higher number of sexual partners were associated with lifetime SV (p < .05), non-heterosexual sexual orientation with past 12-months SV (p < .05). Correlates identified to be linked to elder abuse and neglect in previous studies were not linked with SV in our sample. ‘Someone unknown’ was identified as most common assailant. Conclusions Sexual victimisation appears to be common in older adults in Belgium. Both correlates and assailant characteristics seem to differ from previous studies on elder abuse and neglect. Recognizing older adults as a risk group for sexual victimisation in research, policies and practices is of the utmost importance. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02485-3.
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Affiliation(s)
- Anne Nobels
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium. .,Department of Psychiatry, Ghent University Hospital, Ghent, Belgium.
| | - Adina Cismaru-Inescu
- CARE-ESPRIst, Études et évaluations, University of Liège, Liège, Belgium.,Psychology of Aging Unit, University of Liège, Liège, Belgium
| | - Laurent Nisen
- CARE-ESPRIst, Études et évaluations, University of Liège, Liège, Belgium
| | - Bastien Hahaut
- CARE-ESPRIst, Études et évaluations, University of Liège, Liège, Belgium
| | - Marie Beaulieu
- School of Social Work and Research Centre on Aging, University of Sherbrooke, Quebec, Canada
| | - Gilbert Lemmens
- Department of Psychiatry, Ghent University Hospital, Ghent, Belgium.,Department of Head and Skin - Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium
| | - Stéphane Adam
- Psychology of Aging Unit, University of Liège, Liège, Belgium
| | - Evelyn Schapansky
- Department of Criminology, Criminal Law and Social Law, Ghent University, Ghent, Belgium
| | - Christophe Vandeviver
- Department of Criminology, Criminal Law and Social Law, Ghent University, Ghent, Belgium.,Research Foundation-Flanders (FWO), Brussels, Belgium
| | - Ines Keygnaert
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
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Nobels A, Keygnaert I, Robert E, Vandeviver C, Haekens A, Lemey L, Strobbe M, Van Den Noortgate N, Lemmens GMD. 'Breaking the silence': Sexual victimisation in an old age psychiatry patient population in Flanders. Int J Geriatr Psychiatry 2021; 36:1550-1558. [PMID: 33969546 DOI: 10.1002/gps.5565] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/06/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND Sexual violence (SV) is linked to mental health problems in adulthood and old age. However, the extent of sexual victimisation in old age psychiatry patients is unknown. Due to insufficient communication skills in both patients and healthcare workers, assessing SV in old age psychiatry patients is challenging. AIMS To assess lifetime and sexual victimisation in the past 12-months, correlates and SV disclosure in an old age psychiatry population. METHODS Between July 2019 and March 2020, 100 patients at three old age psychiatry wards across Flanders participated in a face-to-face structured interview receiving inpatient treatment. The participation rate was 58%. We applied the WHO definition of SV, encompassing sexual harassment, sexual abuse with physical contact without penetration, and (attempted) rape. RESULTS In 57% of patients (65% F, 42% M) SV occurred during their lifetime and 7% (6% F, 9% M) experienced SV in the past 12-months. Half of the victims disclosed their SV experience for the first time during the interview. Only two victims had disclosed SV to a mental health care professional before. CONCLUSIONS Sexual victimisation appears to be common in old age psychiatry patients, yet it remains largely undetected. Although victims did reveal SV during a face-to-face interview to a trained interviewer, they do not seem to spontaneously disclose their experiences to mental health care professionals. In order to provide tailored care for older SV victims, professionals urgently need capacity building through training, screening tools and care procedures.
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Affiliation(s)
- Anne Nobels
- Department of Public Health and Primary Care, International Centre for Reproductive Health, Ghent University, Ghent, Belgium
| | - Ines Keygnaert
- Department of Public Health and Primary Care, International Centre for Reproductive Health, Ghent University, Ghent, Belgium
| | - Egon Robert
- Department of Public Health and Primary Care, International Centre for Reproductive Health, Ghent University, Ghent, Belgium
| | - Christophe Vandeviver
- Department of Criminology, Criminal Law and Social Law, Ghent University, Ghent, Belgium.,Research Foundation-Flanders (FWO), Brussels, Belgium
| | - An Haekens
- Psychiatric Hospital Alexianen Zorggroep Tienen, Tienen, Belgium
| | - Lieve Lemey
- Department of Psychiatry and Psychosomatic Medicine, AZ Sint-Jan Bruges-Ostend AV, Bruges, Belgium
| | | | | | - Gilbert M D Lemmens
- Department of Psychiatry, Ghent University Hospital, Ghent, Belgium.,Department of Head and Skin - Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium
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Gichaz M, Winterstein TB, Avieli H. Growing Older in the Shadow of Childhood Intra-Familial Sexual Abuse: Women's Reflections on Parenthood Experiences Throughout the Life Course. THE GERONTOLOGIST 2021; 62:232-240. [PMID: 34282446 DOI: 10.1093/geront/gnab102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The long-term effect of intra-familial sexual abuse for the survivors' parenting, rarely focuses on older women who are mothers of adult children. The aim of the present study was to explore the parenthood experiences of aging women survivors of intra-familial sexual abuse, using the life-course perspective as a conceptual framework. RESEARCH DESIGN AND METHODS Interpretive phenomenological analysis was used to analyze the narratives of 19 older women survivors of intra-familial sexual abuse. RESULTS The narratives revealed four themes: (1) "How did I raise those kids? I really don't know": Early parenthood experiences of aging women incest survivors; (2) "This is a true gift they are giving me now": Revealing the IFSA secret to the adult children; (3) "Is it possible to say that something good came out of it?": Adult children as a victory over incest experiences; and (4) "When my granddaughter was born, I suddenly felt that I couldn't go near her": Grandparenting in the shadow of incest memories. DISCUSSION AND IMPLICATIONS Aging seems to open up a new avenue for parent-child relationships in the shadow of the parent's traumatic past, allowing reframing of parenthood in later life and demonstrating the power of parenthood as a source of healing in the lives of sexual abuse victims.
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Affiliation(s)
- Mili Gichaz
- Department of Gerontology, University of Haifa, Haifa, Israel
| | | | - Hila Avieli
- Department of Criminology, Ariel University, Ariel, Israel
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Zhang Y, Zuo X, Mao Y, Lian Q, Luo S, Zhang S, Tu X, Lou C, Zhou W. Co-occurrence subgroups of child sexual abuse, health risk behaviors and their associations among secondary school students in China. BMC Public Health 2021; 21:1139. [PMID: 34126970 PMCID: PMC8201738 DOI: 10.1186/s12889-021-11199-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Little is known on the co-occurrence and heterogeneity of child sexual abuse (CSA) or health risk behavior (HRB) prevalence nor the associations among the victims. OBJECTIVES To detect the prevalence and subgroups of adolescents reporting CSAs or HRBs, and to examine the association between the subgroups. METHODS Participants were secondary school students in a national survey in China (N = 8746). Self-reported CSA and HRB experiences were collected through a computer assisted questionnaire. Prevalence and confidence intervals were calculated. Multigroup latent class analysis (LCA) was used to examine latent subgroups of CSA and HRB. Dual latent class regression analysis was used to examine the association between CSA and HRB classes. RESULTS A total of 8746 students participated in our study. The prevalence of having ever experienced any of the reported seven CSA items was 12.9%. The preferred LCA model consisted of a three-class CSA latent variable, i.e. "Low CSAs"(95.7% of the total respondents), "Verbal or exhibitionism CSAs"(3.3%), and "high multiple CSAs" (1.1%); and a three-class HRB latent variable, i.e. "Low HRBs"(70.5%), "externalizing HRBs" (20.7%), and "internalizing HRBs" (8.7%). Students in the "Verbal or exhibitionism CSAs" or "high multiple CSAs" classes had higher probabilities of being in "externalizing HRBs" or "internalizing HRBs" classes. The probabilities were higher in "high multiple CSAs" class(male externalizing OR 4.05, 95%CI 1.71-9.57; internalizing OR 11.77, 95%CI 4.76-29.13; female externalizing OR 4.97, 95%CI 1.99-12.44; internalizing OR 9.87, 95%CI 3.71-26.25) than those in "Verbal or exhibitionism CSA"(male externalizing OR 2.51, 95%CI 1.50-4.20; internalizing OR 3.08, 95%CI 1.48-6.40; female externalizing OR 2.53, 95%CI 1.63-3.95; internalizing OR 6.05, 95%CI 3.73-9.80). CONCLUSIONS Prevalence of CSA items varies. Non-contact CSAs are the most common forms of child sexual abuse among Chinese school students. There are different latent class co-occurrence patterns of CSA items or HRB items among the respondents. CSA experiences are in association with HRB experiences and the associations between latent classes are dose-responded. Multi-victimization has more significantly negative effects. The results could help identify high-risk subgroups and promote more nuanced interventions addressing adverse experiences and risk behaviors among at-risk adolescents.
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Affiliation(s)
- Yan Zhang
- School of Public Health, Fudan University, 779 Laohumin Road, Shanghai, 200237, China.,NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), School of Public Health, Fudan University, 779 Laohumin Road, Shanghai, 200237, China
| | - Xiayun Zuo
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), School of Public Health, Fudan University, 779 Laohumin Road, Shanghai, 200237, China
| | - Yanyan Mao
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), School of Public Health, Fudan University, 779 Laohumin Road, Shanghai, 200237, China
| | - Qiguo Lian
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), School of Public Health, Fudan University, 779 Laohumin Road, Shanghai, 200237, China
| | - Shan Luo
- West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shucheng Zhang
- National Research Institute for Family Planning, Beijing, China
| | - Xiaowen Tu
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), School of Public Health, Fudan University, 779 Laohumin Road, Shanghai, 200237, China
| | - Chaohua Lou
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), School of Public Health, Fudan University, 779 Laohumin Road, Shanghai, 200237, China
| | - Weijin Zhou
- School of Public Health, Fudan University, 779 Laohumin Road, Shanghai, 200237, China. .,NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), School of Public Health, Fudan University, 779 Laohumin Road, Shanghai, 200237, China.
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Abstract
Assessment of Maltreatment in Childhood and Adolescence In view of mounting evidence for substantial prognostic relevance of child maltreatment for the future developmental course, assessment of maltreatment in children and adolescents is increasingly gaining attention. At the same time, maltreatment assessment is replete with difficulties, ranging from the definition of maltreatment and establishment of threshold values determining when events meet prognostically relevant criteria, to poor agreement between sources. The aim of this paper is to provide an overview of instruments for assessing maltreatment in children and adolescents. This overview serves as a point of departure to emphasize the importance of various sources for the purpose of assessing maltreatment and to consider the unique role of the child's or young person's perspective. We conclude with preliminary proposals regarding the role of maltreatment assessment in clinical practice.
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Nakazawa H, Masuya J, Tanabe H, Kusumi I, Inoue T, Ichiki M. Interpersonal Sensitivity Mediates the Effects of Childhood Maltreatment on the Evaluation of Life Events and Anxiety States in Adult Community Volunteers. Neuropsychiatr Dis Treat 2021; 17:2757-2766. [PMID: 34447251 PMCID: PMC8384342 DOI: 10.2147/ndt.s310010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 08/04/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Childhood maltreatment has long-lasting psychological effects, which often manifest in adulthood. Previous studies have suggested that the effects of childhood maltreatment are not only direct but also indirect, being mediated by other factors. In this study, we hypothesized that the effects of childhood maltreatment on state anxiety in adulthood are mediated by interpersonal sensitivity and the evaluation of life events, and investigated this possibility by covariance structure analysis. SUBJECTS AND METHODS Self-administered questionnaires (Child Abuse and Trauma Scale, State-Trait Anxiety Inventory Form Y, Life Experiences Survey, and Interpersonal Sensitivity Measure) were distributed to adult community volunteers in Japan, and 404 eligible responses were collected. A structural equation model was constructed to analyze the direct and indirect effects of childhood maltreatment on state anxiety, with interpersonal sensitivity and the evaluation of life events as potential mediators. RESULTS Our model showed that childhood maltreatment increases state anxiety in adulthood both directly and indirectly via interpersonal sensitivity. In addition, interpersonal sensitivity mediated the effects of childhood maltreatment on the negative evaluation of life events, and the negative evaluation of life events mediated the effects of interpersonal sensitivity on anxiety symptoms. LIMITATIONS There may be possible recall bias owing to the self-administration of the questionnaire. In addition, this study had a cross-sectional design, and hence the results should be validated by a prospective study. CONCLUSION The effects of childhood maltreatment on the state anxiety of adult volunteers are not only direct but are also mediated by interpersonal sensitivity. Our results suggest that assessing interpersonal sensitivity may help to determine optimal treatments for patients with anxiety who experienced maltreatment in childhood.
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Affiliation(s)
- Hiroshi Nakazawa
- Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Jiro Masuya
- Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Hajime Tanabe
- Faculty of Humanities and Social Sciences, Shizuoka University, Suruga-ku, Shizuoka, 422-8529, Japan
| | - Ichiro Kusumi
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Kita-ku, Sapporo, 060-8638, Japan
| | - Takeshi Inoue
- Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Masahiko Ichiki
- Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, 160-0023, Japan
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Al-Saadoon M, Al-Adawi M, Al-Adawi S. Socio-Cultural Constraints in Protecting Child Rights in a Society in Transition: A Review and Synthesis from Oman. CHILD INDICATORS RESEARCH 2021; 14:239-267. [PMID: 32837628 PMCID: PMC7412292 DOI: 10.1007/s12187-020-09759-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/21/2020] [Indexed: 05/18/2023]
Abstract
In line with international best practice, the Arabian Gulf countries have ratified the Convention on the Right of the Child (CRC), which has some clauses on child abuse and neglect. The present discourse, made from within an Arabian Gulf society, specifically Oman, reviews the socio-cultural differences of the region and explores the potential regional challenges for effectively implementing the CRC mandated child protection legislation. The international best practices evolved for individualistic, "guilt-based" societies, which may need to be modified to suit the "shame-based" collective societies in the Arabian Gulf where the individual autonomy is overridden by that of the family and society. This may mean that the entire spectrum of child abuse may need to be studied in-depth, starting from what constitutes child abuse and neglect, the methods adopted for identifying cases, setting preventive measures in place, applying penal and corrective action on the perpetrators, and helping the victims recover. It is posited that while modifying the laws may be straightforward, implementation of certain clauses may initially come into conflict with deeply engrained socio-cultural conventions on these societies which have different parenting styles and child-rearing practices. The country in focus is Oman. Pointing out the sparsity of research on the topic in the region, the study suggests additional research to understand how to reconcile these sociocultural constraints with the international best practices of protecting child rights.
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Affiliation(s)
- Muna Al-Saadoon
- Department of Child Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Manal Al-Adawi
- Department of Behavioural Science & Psychiatry, College of Medicine and Health Sciences, Sultan Qaboos University, P.O. Box 35, Al-Khoudh, 123 Muscat, Oman
| | - Samir Al-Adawi
- Department of Behavioural Science & Psychiatry, College of Medicine and Health Sciences, Sultan Qaboos University, P.O. Box 35, Al-Khoudh, 123 Muscat, Oman
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Goessmann K, Ssenyonga J, Nkuba M, Hermenau K, Hecker T. Characterizing the prevalence and contributing factors of sexual violence: A representative cross-sectional study among school-going adolescents in two East African countries. CHILD ABUSE & NEGLECT 2020; 109:104711. [PMID: 32927296 DOI: 10.1016/j.chiabu.2020.104711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 08/20/2020] [Accepted: 08/28/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Sexual violence against minors is a global phenomenon with wide-ranging negative consequences. Global reports suggest that it is a particularly serious issue in East African countries, although research on prevalence and characteristics of violence in these countries is scarce. OBJECTIVE The aim of this study was to assess sexual violence and its circumstances among Tanzanian and Ugandan adolescents. PARTICIPANTS AND SETTING Two representative samples of secondary school students aged 12-17 from Tanzania and Uganda (N = 1402) were included in this study. METHODS Data assessed using standardized questionnaires were analyzed to determine prevalence, characteristics, and contributing factors of sexual violence among youth. RESULTS We found high levels of sexual violence (27.2 %) exceeding global average estimates of under 20 %. Significantly more sexual violence experiences were reported by boys (29.9 %) than girls (24.6 %) and by older compared to younger adolescents (30.2 % vs. 19.6 %). Peers were the most frequent perpetrator group, named by 47.6 % of those reporting abuse. Several potential contributing factors for victimization were identified, such as rural living area, external financial support, and being in a romantic relationship. CONCLUSIONS Sexual violence is a relevant issue among East African adolescents that occurs in a variety of settings but appears to be most prevalent between peers. Comprehensive sexual education approaches may help to improve the protection of adolescents and to enhance autonomous sexual development.
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Affiliation(s)
- Katharina Goessmann
- Department of Psychology, Bielefeld University, Postbox 100131, 33501, Bielefeld, Germany.
| | - Joseph Ssenyonga
- Department of Psychology, University of Konstanz, 78567, Konstanz, Germany; Department of Educational Foundations and Psychology, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda.
| | - Mabula Nkuba
- Department of Educational Psychology and Curriculum Studies, Dar es Salaam University College of Education, 2329, Dar es salaam, Tanzania; Vivo International e.V., Postbox 5108, 78430, Konstanz, Germany.
| | - Katharin Hermenau
- Department of Psychology, University of Konstanz, 78567, Konstanz, Germany; Vivo International e.V., Postbox 5108, 78430, Konstanz, Germany.
| | - Tobias Hecker
- Department of Psychology, Bielefeld University, Postbox 100131, 33501, Bielefeld, Germany; Vivo International e.V., Postbox 5108, 78430, Konstanz, Germany.
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Lalchandani P, Lisha N, Gibson C, Huang AJ. Early Life Sexual Trauma and Later Life Genitourinary Dysfunction and Functional Disability in Women. J Gen Intern Med 2020; 35:3210-3217. [PMID: 32875503 PMCID: PMC7661667 DOI: 10.1007/s11606-020-06118-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 08/06/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Past research has examined the health outcomes of early sexual trauma in reproductive age women, but little is known about potential long-term effects in older age. OBJECTIVE To examine associations between early life sexual trauma and later life sexual/genitourinary dysfunction and general functional disability in women. DESIGN Cross-sectional analysis of nationally representative observational data from the National Social Life, Health, and Aging Project (2010-2011) PARTICIPANTS: One thousand seven hundred forty-five US women aged ≥ 50 years MAIN MEASURES: Two forms of early life sexual trauma (childhood sexual abuse and unwanted first sexual experience), sexual/genitourinary dysfunction (pain during sex, lack of pleasure during sex, urinary incontinence, other urinary symptoms), and general functional disability (difficulty performing 7 activities of daily living (ADLs) or 8 instrumental activities of daily living (IADLs)), assessed by interview and questionnaire. KEY RESULTS Of 1745 women, 11% reported a history of childhood sexual abuse and 39% an unwanted first sexual experience. Childhood sexual abuse was associated with later life sexual/genitourinary dysfunction (pain during sex [OR 1.9, 95% CI 1.1-3.3], other urinary problems [OR 1.9, 95% CI 1.2-3.1]), and difficulty with multiple ADLs/IADLs (walking across the room [OR 1.9, 95% CI 1.2-3.1], getting in or out of bed [OR 2.0, 95% CI 1.2-3.3], bathing [OR 2.0, 95% CI 1.2-3.5], prepping meals [OR 2.4, 95% CI 1.5-3.8], shopping for food [OR 1.6, 95% CI 1.0-2.4], and completing light work [OR 1.6, 95% CI 1.0-2.4]), after adjusting for age, race, and education. Unwanted first sexual experience was associated with later life lack of pleasure with sex (OR 1.7, 95% CI 1.1-2.5) and difficulty with ADLs/IADLs (walking one block [OR 1.5, 95% CI 1.1-2.1], completing light work [OR 1.6, 95% CI 1.1-2.1]) in adjusted analyses. CONCLUSIONS Early sexual trauma may be an under-recognized marker of risk of aging-related functional decline in women. Findings underline the importance of providing trauma-informed care for women across the aging spectrum.
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Affiliation(s)
- Pooja Lalchandani
- University of California, San Francisco, 1545 Divisadero Street, Box 0320, San Francisco, CA, 94143-0320, USA.
| | - Nadra Lisha
- University of California, San Francisco, 1545 Divisadero Street, Box 0320, San Francisco, CA, 94143-0320, USA
| | - Carolyn Gibson
- San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
| | - Alison J Huang
- University of California, San Francisco, 1545 Divisadero Street, Box 0320, San Francisco, CA, 94143-0320, USA
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28
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Janů A, Malinakova K, Kosarkova A, Tavel P. Associations of childhood trauma experiences with religious and spiritual struggles. J Health Psychol 2020; 27:292-304. [PMID: 32830557 DOI: 10.1177/1359105320950793] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Childhood trauma is associated with many interpersonal and psychosocial problems in adulthood. The aim of this study was to explore the associations with a spiritual area of personality, namely religious and spiritual struggles (R/S struggles). A nationally representative sample of 1,000 Czech respondents aged 15 years and older participated in the survey. All types of CT were associated with an increased level of all six types of R/S struggles, with the highest values for demonic struggles. Thus, the findings of this study might be important for clinical practice and pastoral care as well as a further research.
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Affiliation(s)
- Anna Janů
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czech Republic
| | - Klara Malinakova
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czech Republic
| | - Alice Kosarkova
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czech Republic
| | - Peter Tavel
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czech Republic
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Lacey RE, Pinto Pereira SM, Li L, Danese A. Adverse childhood experiences and adult inflammation: Single adversity, cumulative risk and latent class approaches. Brain Behav Immun 2020; 87:820-830. [PMID: 32201253 PMCID: PMC7327510 DOI: 10.1016/j.bbi.2020.03.017] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 02/26/2020] [Accepted: 03/18/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs) have long been known to be related to poorer health across the life course. Previous studies typically relied on cumulative risk scores or individual adversities measured through retrospective self-reports. However, these approaches have important limitations. Cumulative risk scores assume equal weighting of adversities and the single adversity approach ignores the high probability that adversities co-occur. In contrast, latent class analysis (LCA) offers an alternative approach to operationalise ACEs that respects the clustering of adversities and may identify specific patterns of ACEs important for health outcomes. Furthermore, prospective and retrospective reports of ACEs show poor agreement. Therefore, it is important to compare findings based on prospective and retrospective measures in the same individuals. Despite an increasing number of studies applying LCA to ACEs data, no studies have yet simultaneously investigated LCA to cumulative risk and single adversity approaches in their relationships with adult inflammation. Identifying the specific ACEs or combinations of ACEs which are strongly related to inflammation is important for investigating the mechanisms involved and the planning of effective interventions. METHODS Using data on 8810 members of the 1958 British birth cohort we investigated 12 ACEs - physical, psychological and sexual abuse, physical and emotional neglect, parental mental health problems, witnessing abuse, parental conflict, parental divorce, parental offending, parental substance misuse and parental death. LCA was applied to explore the clustering of prospectively and retrospectively reported ACEs separately. Associations between latent classes, cumulative risk scores and individual adversities with three inflammatory markers (C-Reactive Protein, fibrinogen and von Willebrand Factor) were tested using linear regression. RESULTS There was co-occurrence between adversities, and particularly for retrospectively reported adversities. Three latent classes were identified in the prospective data - 'Low ACEs' (95.7%), 'Household dysfunction' (2.8%) and 'Parental loss' (1.5%) which were related to increased inflammation in mid-life, as were high ACE scores and individual measures of offending, death, divorce, physical neglect and family conflict. Four latent classes were identified in the retrospective data - 'Low ACEs', 'Parental mental health and substance misuse', 'Maltreatment and conflict' and 'Polyadversity.' The latter two (5.2%) were related to raised inflammation in mid-life, as was a retrospective ACE score of 4+ (8.3%) and individual measures of family conflict, psychological and physical abuse, emotional neglect and witnessing abuse. CONCLUSIONS Specific ACEs or ACE combinations might be important for chronic inflammation. LCA is an alternative approach to operationalising ACEs data but further research is needed.
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Affiliation(s)
- Rebecca E. Lacey
- Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom,Corresponding author.
| | - Snehal M. Pinto Pereira
- Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom
| | - Leah Li
- Population, Policy and Practice Research and Teaching Department, University College London Great Ormond Street Institute of Child Health, London, 30 Guilford Street, WC1N 1EH, United Kingdom.
| | - Andrea Danese
- Social, Genetic and Developmental Psychiatry Centre and Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, United Kingdom; National and Specialist CAMHS Clinic for Trauma, Anxiety, and Depression, South London and Maudesley NHS Foundation Trust, De Crespigny Park, London SE5 8AZ, United Kingdom.
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Identifying Distinct Latent Classes of Adverse Childhood Experiences Among US Children and Their Relationship with Childhood Internalizing Disorders. Child Psychiatry Hum Dev 2019; 50:668-680. [PMID: 30796680 DOI: 10.1007/s10578-019-00871-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study aimed to determine the relationship between latent classes of adverse childhood experience (ACEs) and internalizing disorders (anxiety and depression) among US children. The 2016 National Survey of Children's Health data for children aged 6-17 was used. Latent class analysis was performed to identify distinct sub-types of ACE exposures and survey-weighted logistic regression models were employed to determine whether these classes were associated with any or comorbid childhood internalizing disorders, after controlling for meaningful covariates. Four latent classes were identified: income hardship, divorce, mental health or substance abuse exposure, and high ACEs overall. Children in three of the four classes were significantly more likely to have any childhood internalizing disorder when compared to children reporting no ACEs, while children in all classes were significantly more likely to have a comorbid history of anxiety and depression. Thus, children exposed to ACEs should receive necessary mental health screenings and treatments.
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Declining effects of child maltreatment on mental health in the elderly: Another nail in the coffin of the deficit model of aging or a healthy survivor bias?: A comment on Rapsey, Scott and Patterson's 25-year longitudinal study. J Affect Disord 2019; 255:S0165-0327(18)32889-1. [PMID: 31000209 DOI: 10.1016/j.jad.2019.04.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 04/06/2019] [Indexed: 11/21/2022]
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