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Willcott-Benoit W, Cummings JA. Vicarious Growth, Traumatization, and Event Centrality in Loved Ones Indirectly Exposed to Interpersonal Trauma: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2024:15248380241255736. [PMID: 38868909 DOI: 10.1177/15248380241255736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
It is well-known that interpersonal traumatic events can impact the physical and mental health of those indirectly exposed to the events. Less studied are populations of loved ones who have been indirectly exposed to interpersonal trauma. We conducted a scoping review to synthesize literature related to potential consequences of indirect interpersonal trauma exposure, specifically vicarious traumatization (VT) and vicarious posttraumatic growth (VPTG). We used the Joanna Briggs Institute methodology. Inclusion criteria included: (1) participants were indirectly exposed to the interpersonal trauma of a loved one in adulthood, (2) discussion of VT, VPTG, or related terms, (3) published peer-reviewed empirical journal articles, and (4) available in English. We used a three-step search strategy to find relevant articles. Keywords found from the first two steps were entered into PsycINFO, PsycArticles, PubMed, Scopus, and Web of Science databases. Reference lists of the included articles were also examined. The identified articles were then screened using the inclusion and exclusion criteria. Twenty-eight articles met inclusion and exclusion criteria. Twenty-six articles referenced VT or related terms, one referenced VPTG, and one referenced vicarious trauma keywords. Results of this scoping review are summarized by definitions, measures, key findings, and knowledge gaps. Future research should focus on vocabulary management, diverse samples, and VPTG in this population, including the identification or creation of appropriate measures.
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Nomamiukor FO, Wisco BE. Social Media's Impact on Rape Myth Acceptance and Negative Affect in College Women: Examining the #MeToo and #HimToo Movement. Violence Against Women 2024; 30:1498-1516. [PMID: 37345426 DOI: 10.1177/10778012231181045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
This study examined how the #MeToo movement, and backlash against it (#HimToo), influence rape myth acceptance (RMA) and negative affect among female sexual trauma survivors and controls. We randomly assigned college women (N = 389) to three social media conditions that either promoted RMA (#HimToo), challenged RMA (#MeToo), or did not address rape myths (general social media (GSM)). The findings demonstrated that women in the #HimToo condition reported more RMA, whereas women in the #MeToo and GSM conditions reported less negative affect. The results highlight that the way we talk about rape on social media influences momentary affect and RMA.
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Affiliation(s)
| | - Blair E Wisco
- University of North Carolina at Greensboro, Greensboro, NC, USA
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Strøm IF, Wentzel-Larsen T, Stensland S, Dyb G, Stene LE. Health care needs, experiences, and satisfaction after terrorism: a longitudinal study of parents of survivors of the Utøya attack. BMC Health Serv Res 2024; 24:277. [PMID: 38454472 PMCID: PMC10921612 DOI: 10.1186/s12913-024-10592-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 01/11/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND There is scarce knowledge on the health care follow-up of parents of terror attack survivors. This study focused on the mothers and fathers of survivors and examined (1) their perceived health care needs relative to their psychological reactions, physical health problems (unmet health care needs), and adaptation to work; (2) whether sociodemographic characteristics, health problems and social support were associated with unmet health care needs; and (3) how unmet health care needs, sociodemographic characteristics, and experiences with health services associated with overall dissatisfaction during the health care follow-up. METHODS Interview and questionnaire data from three waves of the Utøya parent study were analyzed (n = 364). Chi-square tests and t- tests were used to compare unmet physical and psychological health care needs, sociodemographic factors and post-terror attack health reported by mothers and fathers. Logistic regression analyses were used to examine whether sociodemographic characteristics, unmet health care needs, and health care experiences were associated with overall dissatisfaction among mothers and fathers of the survivors during the health care follow-up. RESULTS Among the mothers, 43% reported unmet health care needs for psychological reactions, while 25% reported unmet health care needs for physical problems. Among the fathers, 36% reported unmet health care needs for psychological reactions, and 15% reported unmet health care needs for physical problems. Approximately 1 in 5 mothers and 1 in 10 fathers reported "very high/high" needs for adaptation to work. Poorer self-perceived health, higher levels of posttraumatic stress and anxiety/depression symptoms, and lower levels of social support were significantly associated with reported unmet psychological and physical health care needs in both mothers and fathers. Parents with unmet health care needs reported significantly lower satisfaction with the help services received compared to parents whose health care needs were met. Low accessibility of help services and not having enough time to talk and interact with health care practitioners were associated with overall dissatisfaction with the help received. CONCLUSIONS Our findings highlight that parents of terror-exposed adolescents are at risk of having unmet psychological and physical health care needs and thus need to be included in proactive outreach and health care follow-up programs in the aftermath of a terror attack.
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Affiliation(s)
- Ida Frugård Strøm
- Norwegian Centre for Violence and Traumatic Stress Studies, Pb 181 Nydalen, 0409, Oslo, Norway.
| | - Tore Wentzel-Larsen
- Norwegian Centre for Violence and Traumatic Stress Studies, Pb 181 Nydalen, 0409, Oslo, Norway
- Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Synne Stensland
- Norwegian Centre for Violence and Traumatic Stress Studies, Pb 181 Nydalen, 0409, Oslo, Norway
- Research and Communication Unit for Musculoskeletal Health (FORMI), Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
| | - Grete Dyb
- Norwegian Centre for Violence and Traumatic Stress Studies, Pb 181 Nydalen, 0409, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lise Eilin Stene
- Norwegian Centre for Violence and Traumatic Stress Studies, Pb 181 Nydalen, 0409, Oslo, Norway
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4
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Hornor G. Nonoffending Caregiver Support After Child Sexual Abuse: Essentials for the Forensic Nurse. JOURNAL OF FORENSIC NURSING 2023; 19:60-66. [PMID: 36812374 DOI: 10.1097/jfn.0000000000000360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Child sexual abuse (CSA) is a pediatric health problem of epidemic proportions. CSA can result in significant lifelong physical and mental health consequences. A disclosure of CSA affects not only the child but also everyone close to the child. Nonoffending caregiver support after a disclosure of CSA is key to optimal victim functioning. Forensic nurses play an integral role in the care of CSA victims and are uniquely positioned to ensure best outcomes for both child victims and their nonoffending caregivers. In this article the concept of nonoffending caregiver support is explored, and = implications for forensic nursing practice delineated.
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Affiliation(s)
- Gail Hornor
- Author Affiliations: International Association of Forensic Nurses
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5
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van Duin EM, Verlinden E, Tsang VMW, Verhoeff AP, Brilleslijper-Kater SN, Voskes Y, Widdershoven GAM, Lindauer RJL. A sexual abuse case series of infants and toddlers by a professional caregiver: A qualitative analysis of parents' experiences during the initial crisis period post-discovery. CHILD ABUSE & NEGLECT 2022; 125:105460. [PMID: 35065473 DOI: 10.1016/j.chiabu.2021.105460] [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: 07/24/2020] [Revised: 09/12/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND The discovery that one's child has been sexually abused may be one of the worst events a parent can experience. The importance of parental support for the recovery of child sexual abuse (CSA) victims emphasizes the need to gain insight in difficulties parents face after disclosure. OBJECTIVE To improve crisis intervention by exploring how parents of very young, mostly male CSA victims involved in a large unique CSA case, look back on their initial reactions after disclosure, the impact of media coverage, and their experiences with service responses during the immediate aftermath of CSA discovery. PARTICIPANTS AND SETTING We conducted 18 qualitative interviews with 21 parents enrolled in the longitudinal Amsterdam Sexual Abuse Case (ASAC) study. METHODS We used thematic analysis, combining a deductive and inductive approach. RESULTS We identified four themes regarding parents' initial experiences after disclosure: shock, uncertainty, roller coaster and survival mode. Four themes emerged regarding the impact of media coverage: vulnerable to exposure, fear that the child would recognize the suspect, no escape possible, and burden versus acknowledgement. Parents' experiences regarding the actions of professionals also generated four themes: stressful and confronting, need for support, need for information, and need for professional competence. CONCLUSIONS Disclosure of extrafamilial CSA left parents in shock, affecting their sense of control. Media coverage exacerbated stress for many parents, although some also drew support from it. Actions of professionals defined by parents as helpful included: being supportive, compassionate, accessible, and competent, providing information, and promoting autonomy. Implications for professionals are discussed.
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Affiliation(s)
- Esther M van Duin
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, the Netherlands; Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, the Netherlands.
| | - Eva Verlinden
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, the Netherlands; Department of Epidemiology, Health Promotion & Healthcare Innovation, Amsterdam Public Health Service, Amsterdam, the Netherlands.
| | - Vionna M W Tsang
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, the Netherlands.
| | - Arnoud P Verhoeff
- Department of Sociology, University of Amsterdam, Amsterdam, the Netherlands.
| | - Sonja N Brilleslijper-Kater
- Department of Social Pediatrics, Child Abuse and Neglect Team, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, the Netherlands.
| | - Yolande Voskes
- Department of Ethics, Law and Humanities, Amsterdam UMC, location VUMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
| | - Guy A M Widdershoven
- Department of Ethics, Law and Humanities, Amsterdam UMC, location VUMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
| | - Ramón J L Lindauer
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, the Netherlands; Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, the Netherlands.
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6
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Daignault IV, Hébert M, Cyr M, Pelletier M, McDuff P. Correlates and Predictors of Mothers' Adaptation and Trauma Symptoms Following the Unveiling of the Sexual Abuse of Their Child. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP5784-NP5808. [PMID: 30388043 DOI: 10.1177/0886260518808849] [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: 06/08/2023]
Abstract
Child sexual abuse (CSA) can severely affect the mental health of children and their parents. While correlates of recovery have been documented in children, factors exacerbating parents' adaptation to their child's unveiling of CSA deserves further attention. Parents' history of abuse has been inconsistently identified as a predictor of their distress in reaction to their child's abuse disclosure. This study proposes a mediation model that explores various processes underlying mother's psychological distress (posttraumatic stress disorder [PTSD], dissociation, and their comorbidity) following their children's unveiling of CSA. It investigates the influence of mother's own CSA, as well as of her exposure to additional forms of past and current victimization, on her reaction to the child's CSA disclosure, while considering coping mechanisms as mediators (avoidance, problem solving, search for social support, and feeling of guilt). Data were collected through self-report measures completed by 298 mothers of children who had recently disclosed CSA. Path analyses revealed that mother's exposure to interparental violence as a child acted as a primary predictor of dissociation and of its comorbidity with PTSD, while a history of CSA was directly and exclusively linked to dissociation. Being exposed to recent partner violence was indirectly related to trauma symptoms, with coping mechanisms acting as mediators. This study outlines the relationship between mother's psychological distress and her cumulative, past, and current exposure to various forms of victimization. Exposure to interparental violence as a child represents a particularly important factor for identifying mothers most in need of support, as it is a significant predictor of dissociation and of its comorbidity with PTSD.
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Tsang VMW, Verlinden E, van Duin EM, Twisk JWR, Brilleslijper-Kater SN, Gigengack MR, Verhoeff AP, Lindauer RJL. The Amsterdam Sexual Abuse Case: What Scars did it Leave? Long-Term Course of Psychological Problems for Children Who have been Sexually Abused at a Very Young Age, and their Parents. Child Psychiatry Hum Dev 2021; 52:891-902. [PMID: 33011833 PMCID: PMC8405499 DOI: 10.1007/s10578-020-01067-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/15/2020] [Indexed: 11/30/2022]
Abstract
Longitudinal research of CSA in infancy and early childhood is scarce. The current study examined the long-term course of psychological outcomes (PTSD, dissociation and internalizing and externalizing behavioral problems) in children who were sexually abused in the early childhood. Additionally, we looked into the outcomes for their parents by assessing PTSD symptoms and negative emotional reactions towards the sexual abuse of their child. We examined the outcomes for five consecutive years in a sample of children (n = 45) who were sexually abused at a very young age (0-3) and their parents (n = 42), included in the Amsterdam Sexual Abuse Case-study. We found that outcomes following CSA in early childhood go beyond PTSD symptoms and can manifest in atypical symptoms such as behavioral problems. Parents experienced persistent PTSD in the years following CSA disclosure. CSA in very young children warrants long-term monitoring, as negative outcomes still present 8 years later.
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Affiliation(s)
- Vionna M. W. Tsang
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Eva Verlinden
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands ,Department of Epidemiology, Health Promotion & Healthcare Innovation, Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, The Netherlands
| | - Esther M. van Duin
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jos W. R. Twisk
- Department of Clinical Epidemiology and Biostatistics, Amsterdam UMC, VU University, Amsterdam, The Netherlands
| | - Sonja N. Brilleslijper-Kater
- Department of Social Pediatrics, Child Abuse and Neglect Team, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Maj R. Gigengack
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Arnoud P. Verhoeff
- Department of Epidemiology, Health Promotion & Healthcare Innovation, Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, The Netherlands ,Department of Sociology, University of Amsterdam, Amsterdam, The Netherlands
| | - Ramón J. L. Lindauer
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands ,De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
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Halse I, Bjørkløf GH, Engedal K, Rokstad AMM, Persson K, Eldholm RS, Selbaek G, Barca ML. Applicability of the locus of control of behaviour scale for people with dementia. Aging Ment Health 2020; 24:2111-2116. [PMID: 31402698 DOI: 10.1080/13607863.2019.1652244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To investigate the applicability of the Locus of Control of Behaviour scale (LoCB) for people with dementia. METHOD A sample of 534 participants with dementia (78.4 mean age, 58% female) were included. Assessment included the LoCB, the Montgomery-Aasberg Depression Rating Scale (MADRS), the Mini-Mental Status Examination Norwegian revised (MMSE-NR) and the Instrumental Activities of Daily Living (I-ADL). Completion percentages and internal reliability of LoCB were examined for predefined MMSE-NR groups (0-4, 5-9, 10-14, 15-19, 20-24, 25-27, and 28-30). Factors associated with completion were analysed, and a principal component analysis (PCA) of the LoCB was performed. Sum score and component subscale scores were compared to MADRS and MMSE-NR scores. RESULTS In total, 234 participants completed the LoCB. Completion percentages ranged from 74% (MMSE-NR 28-30) to 0% (MMSE-NR 0-9). Internal reliability was between 0.80 and 0.72 in groups with MMSE-NR > 9, except in MMSE-NR 20-24 (0.52). Age, MMSE-NR and education were associated with completion. The PCA yielded three components - powerful others, internal, and luck/fate - with explained variance of 41.3%. Participants with MADRS > 7 scored higher on the LoCB sum score, powerful others and internal subscale scores. No difference was found regarding the luck/fate subscale score. MMSE-NR did not affect LoCB scores. CONCLUSION Older age, less education, and more cognitive impairment decreased the likelihood of completion. However, psychometric test results indicate that those who completed the LoCB understood the questions, even with severe cognitive impairment. We conclude, therefore, that the LoCB is applicable for investigating control orientation among people with dementia.
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Affiliation(s)
- Ingeborg Halse
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital-Ullevål, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Guro Hanevold Bjørkløf
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Knut Engedal
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital-Ullevål, Oslo, Norway
| | - Anne Marie Mork Rokstad
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
| | - Karin Persson
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital-Ullevål, Oslo, Norway
| | - Rannveig Sakshaug Eldholm
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Geriatrics, St. Olavs Hospital, Trondheim, Norway
| | - Geir Selbaek
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital-Ullevål, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Maria Lage Barca
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital-Ullevål, Oslo, Norway
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9
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Bright SJ, Kane R, Marsh A, Bishop B. Psychometric Properties of the Locus of Control of Behaviour Scale (LCBS) among Australians Seeking Alcohol and Other Drug (AOD) Treatment. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/j.1742-9544.2012.00094.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
| | - Robert Kane
- School of Psychology, Curtin University of Technology
| | - Ali Marsh
- School of Psychology, Curtin University of Technology
| | - Brian Bishop
- School of Psychology, Curtin University of Technology
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10
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McGillivray CJ, Pidgeon AM, Ronken C, Credland-Ballantyne CA. Resilience in Non-Offending Mothers of Children Who Have Reported Experiencing Sexual Abuse. JOURNAL OF CHILD SEXUAL ABUSE 2018; 27:793-810. [PMID: 29897311 DOI: 10.1080/10538712.2018.1477221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Growing evidence shows that non-offending mothers experience significant loss and trauma following their child reporting experiencing sexual abuse. Maternal support offered to sexually abused children following disclosure can be a crucial factor in children's recovery. Although mothers are often seen as playing a central role in facilitating the recovery of their sexually abused child, there has been little focus on their own needs and profiles. This present study aimed to increase our understanding of the diversity of profiles of non-offending mothers of sexually abused children by exploring the differences in psychosocial traits of non-offending mothers (N = 68; age range 28-67 years) reporting higher and lower resilience. The mediating role of these psychosocial factors on the relationship between resilience and psychological distress will also be explored. Results found that non-offending mothers in the higher resilience group reported higher levels of positive reappraisal, self-compassion, social support, and significantly lower levels of psychological distress compared to non-offending mothers in the lower resilience group. Additionally, multiple mediation analysis indicated positive reappraisal, self-compassion, and social support to be significant mediators of the relationship between resilience and psychological distress. Increased levels of self-compassion and social support were found to be predictive of lowered psychological distress, while increased positive reappraisal predicted increased psychological distress. The findings of the present study provide support for the targeting of the psychosocial factors such as self-compassion, social support, and positive reappraisal in interventions for non-offending mothers in an effort to promote resilience.
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Affiliation(s)
- Cher J McGillivray
- a Faculty of Society and Design, Bond University , Robina , Queensland , Australia
| | - Aileen M Pidgeon
- a Faculty of Society and Design, Bond University , Robina , Queensland , Australia
| | - Carol Ronken
- b Bravehearts Foundation , Arundel , Queensland , Australia
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11
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Cyr M, Frappier JY, Hébert M, Tourigny M, McDuff P, Turcotte ME. Impact of child sexual abuse disclosure on the health of nonoffending parents: A longitudinal perspective. ACTA ACUST UNITED AC 2018. [DOI: 10.1080/15379418.2018.1460649] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Mireille Cyr
- Département de Psychologie, Université de Montréal, Montréal, Québec, Canada
| | - Jean-Yves Frappier
- Centre Hospitalier Universitaire Ste-Justine, Université de Montréal, Montréal, Québec, Canada
| | - Martine Hébert
- Département de Sexologie, UQAM, Montréal, Québec, Canada
| | - Marc Tourigny
- Département de Psychoéducation, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Pierre McDuff
- Département de Psychologie, Université de Montréal, Montréal, Québec, Canada
| | - Marie-Eve Turcotte
- Chaire de recherche Nicolas Steinmetz - Gilles Julien en Pédiatrie Sociale en Communauté, Université McGill, Montréal, Québec, Canada
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12
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van Duin EM, Verlinden E, Vrolijk-Bosschaart TF, Diehle J, Verhoeff AP, Brilleslijper-Kater SN, Lindauer RJL. Sexual abuse in very young children: a psychological assessment in the Amsterdam Sexual Abuse Case study. Eur J Psychotraumatol 2018; 9:1503524. [PMID: 30206471 PMCID: PMC6129781 DOI: 10.1080/20008198.2018.1503524] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 06/29/2018] [Accepted: 07/02/2018] [Indexed: 12/13/2022] Open
Abstract
Background: Child sexual abuse (CSA) is a worldwide problem affecting children of all ages and socioeconomic backgrounds. A knowledge gap exists regarding the psychological outcomes for children, boys in particular, who are abused during their early lives. Objective: To provide a descriptive psychological profile of children who experienced sexual abuse as infants or toddlers from a male daycare worker and babysitter, and to assess the psychopathological impact on their parents. Method: Parents of children involved in the Amsterdam Sexual Abuse Case (41 parents; 44 children, age range 3-11 years, 30 boys, 14 girls) completed measures on post-traumatic stress disorder (PTSD), dissociation, sexual and non-sexual behaviour problems, and attachment insecurity in their children, as well as on parental psychological well-being, 3 years after disclosure. Sexual abuse characteristics were obtained from police records. Results: We found that 3% of confirmed child victims had PTSD, 30% sexual behaviour problems, 24% internalizing problems, 27% attachment insecurity, and 18% any psychiatric disorder (including PTSD); 39% were asymptomatic. In parents, we found feelings of guilt, shame, and anger about the abuse of their child; 19% showed PTSD symptoms and 3% showed avoidant and 8% anxious attachment problems in their intimate relationship. Parental symptomatology was related to child symptomatology, except for child sexual behaviour problems. One-quarter of confirmed child victims and 45% of parents had received psychological treatment. Conclusions: Three years after disclosure, extrafamilial CSA in very young children was associated with sexual and non-sexual behaviour problems and attachment insecurity, but rarely with PTSD or dissociation. For parents it was associated with PTSD symptoms and emotional reactions. Assessments and interventions should focus on the wide spectrum of problems that follow CSA, as well as on parental psychopathology and the parent-child relationship. Future follow-up assessments in our longitudinal study should provide insights into longer-term outcomes.
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Affiliation(s)
- Esther M van Duin
- Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Eva Verlinden
- Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Department of Epidemiology, Health Promotion & Healthcare Innovation, Public Health Service Amsterdam, Amsterdam, The Netherlands
| | - Thekla F Vrolijk-Bosschaart
- Department of Social Pediatrics, Child Abuse and Neglect Team, Academic Medical Center, Amsterdam, The Netherlands
| | - Julia Diehle
- Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Arnoud P Verhoeff
- Department of Epidemiology, Health Promotion & Healthcare Innovation, Public Health Service Amsterdam, Amsterdam, The Netherlands
| | - Sonja N Brilleslijper-Kater
- Department of Social Pediatrics, Child Abuse and Neglect Team, Academic Medical Center, Amsterdam, The Netherlands
| | - Ramón J L Lindauer
- Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
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13
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Haga JM, Thoresen S, Stene LE, Wentzel-Larsen T, Dyb G. Healthcare to parents of young terrorism survivors: a registry-based study in Norway. BMJ Open 2017; 7:e018358. [PMID: 29273662 PMCID: PMC5778306 DOI: 10.1136/bmjopen-2017-018358] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To assess changes in parents' short-term and long-term primary and specialised healthcare consumption following a terrorist attack threatening the lives of their children. DESIGN Registry-based study comparing parental healthcare service consumption in the 3 years before and the 3 years after a terrorist attack. SETTING The aftermath of the Utøya terrorist attack. The regular, publicly funded, universal healthcare system in Norway. INTERVENTION Parents learning of a terrorist attack on their adolescent and young adult children. PARTICIPANTS Mothers (n=226) and fathers (n=141) of a total of 263 survivors of the Utøya terrorist attack (54.6% of all survivors 13-33 years, n=482). MAIN OUTCOME MEASURES We report primary and specialised somatic and mental healthcare service consumption in the early (0-6 months) and delayed (>6-36 months) aftermath of the attack, both in terms of frequency of services consumed (assessed by age-adjusted negative binomial hurdle regression) and proportions of mothers and fathers provided for (mean semiannual values). The predisaster and postdisaster rates were compared by rate ratios (RRs), and 95% CI were generated through bootstrap replications. RESULTS Frequency of primary healthcare service consumption increased significantly in both mothers and fathers in the early aftermath of the attack (mothers: RR=1.97, 95% CI 1.76 to 2.23; fathers: RR=1.73, 95% CI 1.36 to 2.29) and remained significantly elevated throughout the delayed aftermath. In the specialised mental healthcare services, a significant increase in the frequency of service consumption was observed in mothers only (early: RR=7.00, 95% CI 3.86 to 19.02; delayed: RR=3.20, 95% CI 1.49 to 9.49). In specialised somatic healthcare, no significant change was found. CONCLUSION Following terrorist attacks, healthcare providers must prepare for increased healthcare needs in survivors and their close family members, such as parents. Needs may present shortly after the attack and require long-term follow-up.
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Affiliation(s)
- Jon Magnus Haga
- Norwegian Centre of Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Siri Thoresen
- Norwegian Centre of Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway
| | - Lise Eilin Stene
- Norwegian Centre of Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway
| | - Tore Wentzel-Larsen
- Norwegian Centre of Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway
- Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Grete Dyb
- Norwegian Centre of Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Blakemore T, Herbert JL, Arney F, Parkinson S. The impacts of institutional child sexual abuse: A rapid review of the evidence. CHILD ABUSE & NEGLECT 2017; 74:35-48. [PMID: 28864118 DOI: 10.1016/j.chiabu.2017.08.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 07/14/2017] [Accepted: 08/02/2017] [Indexed: 06/07/2023]
Abstract
While awareness of institutional child sexual abuse has grown in recent years, there remains limited understanding of its occurrence and outcomes as a distinct form of abuse. Drawing on research commissioned by the Australian Royal Commission into Institutional Responses to Child Sexual Abuse, this article presents a rapid review of available evidence on the impacts of institutional abuse on victim/survivors. Literature searches identified 75 sources spanning international peer reviewed work and reports to Government that document or quantify the impacts of mostly historical child sexual abuse occurring in religious, educational, sporting and residential or out-of-home care settings. Consistent with child sexual abuse in other contexts, institutional child sexual abuse is found to be associated with numerous, pervasive and connected impacts upon the psychological, physical, social, educative and economic wellbeing of victims/survivors. Further, institutional child sexual abuse is associated with vicarious trauma at the individual, family and community level, and with impacts to the spiritual wellbeing of victims/survivors of abuse that occurs in religious settings. The identified literature suggests the trauma of institutional child sexual abuse may be exacerbated by the interplay of abuse dynamics in institutional settings, which may reduce or impede circumstances supporting disclosure, belief, support and protection from future harm. Acknowledging the limitations of the present study and the available evidence, this narrative synthesis provides insights into the complex impacts of institutional child sexual abuse.
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Affiliation(s)
- Tamara Blakemore
- School of Humanities and Social Sciences, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.
| | - James Leslie Herbert
- Australian Centre for Child Protection, University of South Australia, Adelaide, SA 5000, Australia.
| | - Fiona Arney
- Australian Centre for Child Protection, University of South Australia, Adelaide, SA 5000, Australia.
| | - Samantha Parkinson
- Australian Centre for Child Protection, University of South Australia, Adelaide, SA 5000, Australia.
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Holt T, Jensen T, Dyb G, Wentzel-Larsen T. Emotional reactions in parents of the youth who experienced the Utøya shooting on 22 July 2011; results from a cohort study. BMJ Open 2017; 7:e015345. [PMID: 29042373 PMCID: PMC5652501 DOI: 10.1136/bmjopen-2016-015345] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE AND SETTING The objective of this study was to provide knowledge about the emotional reactions in parents whose offspring experienced a mass shooting on Utøya island in Norway in 2011. The research questions included whether parents' reactions were influenced by their offspring's symptom level, age, living situation and parental gender. DESIGN The study was designed as an open cohort study. The data were collected at two time points; 4-5 months and 14-15 months after the shooting. PARTICIPANTS The participants were 531 parents of youth exposed to the Utøya island attack. OUTCOME MEASURES The Parental Emotional Reaction Questionnaire measured parents' reactions, and University of California, Los Angeles Post-traumatic Stress Disorder Reaction Index measured youths' post-traumatic stress symptoms. RESULTS Parental emotional reactions were positively related to post-traumatic stress reactions in offspring at wave 1: Est.=0.20, 95% CI 0.10 to 0.30, p<0.001, over time (wave 1and wave 2 nested within individuals): Est.=0.23, CI 0.13 to 0.32, p<0.001, and at wave 2: Est.=0.26, CI 0.12 to 0.39, p<0.001. Youths' age was not significantly related to parental emotional reactions, neither at wave 1: Est.=0.19, CI -0.40 to 0.77, p=0.531, over time: Est.=0.26, CI -0.27 to 0.79, p=328, nor at wave 2: Est.=0.32, CI -0.41 to 1.05, p=0.389. Mothers were more emotionally upset than fathers both at wave 1: Est.=-5.66, CI -7.63 to -3.69, p<0.001, over time: Est.=-5.36, CI -7.18 to -3.55, p<0.001, and at wave 2: Est.=-5.33, CI -7.72 to -2.53, p<0.001. CONCLUSIONS The findings suggest that parenting after trauma should be addressed in outreach programmes and in planning of healthcare services.
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Affiliation(s)
- Tonje Holt
- Mental & Physical health, Norwegian Institute of Public Health and Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Tine Jensen
- Department of Psychology, University of Oslo, Oslo, Norway
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Grete Dyb
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
- Faculty of medicine, University of Oslo, Oslo, Norway
| | - Tore Wentzel-Larsen
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
- Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
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Haga JM, Stene LE, Thoresen S, Wentzel-Larsen T, Dyb G. Does posttraumatic stress predict frequency of general practitioner visits in parents of terrorism survivors? A longitudinal study. Eur J Psychotraumatol 2017; 8:1389206. [PMID: 29379587 PMCID: PMC5784312 DOI: 10.1080/20008198.2017.1389206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 09/22/2017] [Indexed: 12/05/2022] Open
Abstract
Background: Life threat to children may induce severe posttraumatic stress reactions (PTSR) in parents. Troubled mothers and fathers may turn to their general practitioner (GP) for help. Objective: This study investigated frequency of GP visits in mothers and fathers of adolescent and young adult terrorism survivors related to their own PTSR and PTSR in their surviving children. Method: Self-reported early PTSR (4-5 months post-disaster) in 196 mothers, 113 fathers and 240 survivors of the 2011 Utøya terrorist attack were linked to parents' three years pre- and post-disaster primary healthcare data from a national reimbursement claims database. Frequency of parents' GP visits was regressed on parent and child PTSR, first separately, then in combination, and finally by including an interaction. Negative binominal regressions, adjusted for parents' pre-disaster GP visits and socio-demography, were performed separately for mothers and fathers and for the early (<6 months) and delayed (6-36 months) aftermath of the terrorist attack. Results: Parents' early PTSR were significantly associated with higher early frequency of GP visits in mothers (rate ratio, RR = 1.31, 95%CI 1.09-1.56) and fathers (RR = 1.40, 95%CI 1.03-1.91). In the delayed aftermath, early PTSR were significantly associated with higher frequency of GP visits in mothers only (RR = 1.21, 95%CI 1.04-1.41). Early PTSR in children were not significantly associated with an overall increase in GP visits. On the contrary, in mothers, child PTSR predicted significant decrease in GP visits the delayed aftermath (RR = 0.83, 95%CI 0.71-0.97). Conclusions: Our study suggests that GPs may play an important role in identifying and providing for parents' post-disaster healthcare needs. GPs need to be aware that distressed individuals are likely to approach them following disasters and must prepare for both short- and long-term healthcare needs.
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Affiliation(s)
- Jon Magnus Haga
- Norwegian Centre of Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Lise Eilin Stene
- Norwegian Centre of Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway.,Department of Social Paediatrics, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Siri Thoresen
- Norwegian Centre of Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway
| | - Tore Wentzel-Larsen
- Norwegian Centre of Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway.,Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Grete Dyb
- Norwegian Centre of Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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Cyr M, Frappier JY, Hébert M, Tourigny M, McDuff P, Turcotte MÈ. Psychological and Physical Health of Nonoffending Parents After Disclosure of Sexual Abuse of Their Child. JOURNAL OF CHILD SEXUAL ABUSE 2016; 25:757-776. [PMID: 27802126 DOI: 10.1080/10538712.2016.1228726] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Disclosure of child sexual abuse can be traumatic for nonoffending parents. Research has shown its impact on mothers' mental health, which includes heightened psychological distress, depression, and post-traumatic stress disorder. Very little is known, however, about its impact on their physical health or on fathers' health. The self-perceived mental and physical health of nonoffending parents after child sexual abuse disclosure was compared to determine gender-related differences in this regard. Interviews were conducted with 109 mothers and 43 fathers of 6- to 13-year-old sexually abused children. Bivariate analyses revealed that a fair proportion of parents reported psychological and physical problems after disclosure. However, proportionally more mothers than fathers reported psychological distress, depression, and use of professional services. Fathers were more likely to resort to health services instead of social services and to use medication for depression. Study findings provide leads for health and social service providers for the development of intervention protocols and referral procedures sensitive to gender issues, and they shed new light on specific needs of nonoffending parents.
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Affiliation(s)
- Mireille Cyr
- a Département de psychologie , Université de Montréal , Montréal , Canada
| | - Jean-Yves Frappier
- b Université de Montréal , Centre hospitalier universitaire Ste-Justine , Montréal , Canada
| | | | - Marc Tourigny
- d Département de psychoéducation , Université de Sherbrooke , Sherbrooke , Canada
| | - Pierre McDuff
- a Département de psychologie , Université de Montréal , Montréal , Canada
| | - Marie-Ève Turcotte
- a Département de psychologie , Université de Montréal , Montréal , Canada
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18
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Arnold R, Wagstaff CRD, Steadman L, Pratt Y. The organisational stressors encountered by athletes with a disability. J Sports Sci 2016; 35:1187-1196. [DOI: 10.1080/02640414.2016.1214285] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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19
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van Delft I, Finkenauer C, Tybur JM, Lamers-Winkelman F. Disgusted by Sexual Abuse: Exploring the Association Between Disgust Sensitivity and Posttraumatic Stress Symptoms Among Mothers of Sexually Abused Children. J Trauma Stress 2016; 29:237-44. [PMID: 27214793 DOI: 10.1002/jts.22099] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Nonoffending mothers of sexually abused children often exhibit high levels of posttraumatic stress (PTS) symptoms. Emerging evidence suggests that trait-like individual differences in sensitivity to disgust play a role in the development of PTS symptoms. One such individual difference, disgust sensitivity, has not been examined as far as we are aware among victims of secondary traumatic stress. The current study examined associations between disgust sensitivity and PTS symptoms among mothers of sexually abused children (N = 72). Mothers completed the Impact of Event Scale-Revised and the Three Domain Disgust Scale (Tybur, Lieberman, & Griskevicius, 2009). More than one third of mothers scored above a suggested cutoff (mean score = 1.5) for high levels of PTS symptoms. Hierarchical linear regression analysis results indicated that sexual disgust sensitivity (β = .39, p = .002) was associated with PTS symptoms (R(2) = .18). An interaction analysis showed that sexual disgust sensitivity was associated with maternal PTS symptoms only when the perpetrator was not biologically related to the child (β = -.32, p = .047; R(2) = .28). Our findings suggested that sexual disgust sensitivity may be a risk factor for developing PTS symptoms among mothers of sexually abused children.
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Affiliation(s)
- Ivanka van Delft
- Section of Clinical Child and Family Studies, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Child and Youth Trauma Center, Haarlem, The Netherlands.,EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Catrin Finkenauer
- Section of Clinical Child and Family Studies, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.,Department of Interdisciplinary Social Sciences, Utrecht University, Utrecht, The Netherlands
| | - Joshua M Tybur
- Section of Social and Organizational Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Francien Lamers-Winkelman
- Section of Clinical Child and Family Studies, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
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20
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Thoresen S, Jensen TK, Wentzel-Larsen T, Dyb G. Parents of terror victims. A longitudinal study of parental mental health following the 2011 terrorist attack on Utøya Island. J Anxiety Disord 2016; 38:47-54. [PMID: 26812593 DOI: 10.1016/j.janxdis.2016.01.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 01/07/2016] [Accepted: 01/08/2016] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS Little is known about parents' health following their children's exposure to trauma. We investigated the mental health of parents of young terrorist survivors and assessed parental distress and guilt as potential predictors of mental health. METHOD Mothers and fathers (N=531) participated in two study waves 4-5 and 14-15 months after the shooting. Posttraumatic stress reactions (PTSS) and anxiety/depression were compared with age- and gender-adjusted expected scores that were calculated from a concurrent population study. Mixed effects models investigated the associations between parental distress, parental guilt, and mental health. RESULTS Parents' level of anxiety/depression was three times higher and PTSS was five times higher than that of the general population. Parental distress and guilt about their child's traumatic experience contributed uniquely to symptoms at both time points. CONCLUSIONS Parents of traumatized youth constitute a vulnerable group that has been overlooked in the literature. Intervention strategies following trauma should include both survivors and their parents.
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Affiliation(s)
- Siri Thoresen
- Norwegian Centre for Violence and Traumatic Stress Studies, Gullhaugvn 1-3, 5th floor, 0408 Oslo, Norway.
| | - Tine K Jensen
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Harald Schjelderup House, Forskningsveien 3A, 0373 Oslo, Norway; Norwegian Centre for Violence and Traumatic Stress Studies, Gullhaugvn 1-3, 5th floor, 0408 Oslo, Norway.
| | - Tore Wentzel-Larsen
- Norwegian Centre for Violence and Traumatic Stress Studies, Gullhaugvn 1-3, 5th floor, 0408 Oslo, Norway; Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Gullhaugveien 1-3, 0484 Oslo, Norway.
| | - Grete Dyb
- Norwegian Centre for Violence and Traumatic Stress Studies, Gullhaugvn 1-3, 5th floor, 0408 Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway.
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21
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Haga JM, Stene LE, Wentzel-Larsen T, Thoresen S, Dyb G. Early postdisaster health outreach to modern families: a cross-sectional study. BMJ Open 2015; 5:e009402. [PMID: 26681694 PMCID: PMC4691779 DOI: 10.1136/bmjopen-2015-009402] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 09/07/2015] [Accepted: 10/21/2015] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES This study investigated whether the early outreach programme following the Utøya massacre reached out to the parents of the young survivors. Additionally, we explored whether specialised mental healthcare services were provided to parents presenting elevated levels of PTSD and depression reactions. DESIGN Cross-sectional survey, face-to-face interviews and questionnaires. SETTING Norway, aftermath of the Utøya massacre, 4-7 months postdisaster. BACKGROUND Following the Utøya massacre, proactive early outreach programmes were launched in all municipalities that were affected, facilitating access to appropriate healthcare services. PARTICIPANTS A total of 453 parents of the Utøya survivors aged 13-33 years took part. Overall, 59.8% of the survivors were represented by one or more parent in our study. MAIN OUTCOME MEASURES Engagement with the proactive early outreach programme (psychosocial crisis teams and contact persons in the municipalities), utilisation of healthcare services (general practitioner and specialised mental healthcare services) and mental distress (UCLA PTSD-RI and HSCL-8). RESULTS A majority of the participants reported contact with the proactive early outreach programme (crisis team, 73.9%; and contact person, 73.0%). Failure of outreach to parents was significantly associated with non-intact family structure (crisis team: OR 1.69, 95% CI 1.05 to 2.72, p=0.032) and non-Norwegian origin (crisis team: OR 2.39, 95% CI 1.14 to 4.98, p=0.021). Gender of the parent was not significantly associated with failure of the outreach programme (p ≥ 0.075). Provision of specialised mental healthcare services was significantly associated with higher levels of PTSD (OR 2.08, 95% CI 1.55 to 2.79, p<0.001) and depression (OR 2.42, 95% CI 1.71 to 3.43, p<0.001) and not with the sociodemography (p ≥ 0.122). CONCLUSIONS Proactive early outreach strategies may be helpful in identifying healthcare needs and facilitating access to the required services in a population struck by disaster. Our findings prompt increased attention to the complexity of family structures in reaching out universally to modern families following a disaster.
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Affiliation(s)
- Jon Magnus Haga
- Norwegian Centre of Violence and Traumatic Stress Studies, Oslo, Norway
- Faculty of Medicine, University of Oslo, Institute of Clinical Medicine, Oslo, Norway
| | - Lise Eilin Stene
- Norwegian Centre of Violence and Traumatic Stress Studies, Oslo, Norway
- Department of Social Pediatrics, Women and Children's Division, Oslo University Hospital, Oslo, Norway
| | - Tore Wentzel-Larsen
- Norwegian Centre of Violence and Traumatic Stress Studies, Oslo, Norway
- Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Siri Thoresen
- Norwegian Centre of Violence and Traumatic Stress Studies, Oslo, Norway
| | - Grete Dyb
- Norwegian Centre of Violence and Traumatic Stress Studies, Oslo, Norway
- Faculty of Medicine, University of Oslo, Institute of Clinical Medicine, Oslo, Norway
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22
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Lindauer RJL, Brilleslijper-Kater SN, Diehle J, Verlinden E, Teeuw AH, Middeldorp CM, Tuinebreijer W, Bosschaart TF, van Duin E, Verhoeff A. The Amsterdam Sexual Abuse Case (ASAC)-study in day care centers: longitudinal effects of sexual abuse on infants and very young children and their parents, and the consequences of the persistence of abusive images on the internet. BMC Psychiatry 2014; 14:295. [PMID: 25380567 PMCID: PMC4240883 DOI: 10.1186/s12888-014-0295-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 10/13/2014] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Little research has been done on the signs of child sexual abuse (CSA) in infants and very young children, or on the consequences that such abuse - including the persistence of the abusive pornographic images on the internet - might have for the children and their parents. The effects of CSA can be severe, and a variety of risk- and protective factors, may influence those effects. CSA may affect the psychosocial-, emotional-, cognitive-, and physical development of children, their relationships with their parent(s), and the relations between parents. In the so called 'the Amsterdam sexual abuse case' (ASAC), infants and very young children were victimized by a day-care employee and most of the victims were boys. Research involving the children and their parents would enable recognition of the signs of CSA in very young children and understanding the consequences the abuse might have on the long term. METHODS/DESIGN The proposed research project consists of three components: (I) An initial assessment to identify physical- or psychological signs of CSA in infants and very young children who are thought to have been sexually abused (n = 130); (II) A cross-sequential longitudinal study of children who have experienced sexual abuse, or for whom there are strong suspicions; (III) A qualitative study in which interviews are conducted with parents (n = 25) and with therapists treating children from the ASAC. Parents will be interviewed on the perceived condition of their child and family situation, their experiences with the service responses to the abuse, the effects of legal proceedings and media attention, and the impact of knowing that pornographic material has been disseminated on the internet. Therapists will be interviewed on their clinical experiences in treating children and parents. The assessments will extend over a period of several years. The outcome measures will be symptoms of posttraumatic stress disorder (PTSD), dissociative symptoms, age-inappropriate sexual behaviors and knowledge, behavioral problems, attachment disturbances, the quality of parent-child interaction, parental PTSD, parental partner relation, and biological outcomes (BMI and DNA). DISCUSSION The ASAC-project would facilitate early detection of symptoms and prompt therapeutic intervention when CSA is suspected in very young children.
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Affiliation(s)
- Ramón JL Lindauer
- />Department of Child and Adolescent Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
- />De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
| | - Sonja N Brilleslijper-Kater
- />Department of Social Pediatrics, Emma Children’s Hospital, Academic Medical Centre, Amsterdam, The Netherlands
| | - Julia Diehle
- />Department of Child and Adolescent Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
| | - Eva Verlinden
- />Department of Child and Adolescent Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
- />Department of Epidemiology & Health Promotion, Public Health Services, Amsterdam, The Netherlands
| | - Arianne H Teeuw
- />Department of Social Pediatrics, Emma Children’s Hospital, Academic Medical Centre, Amsterdam, The Netherlands
| | - Christel M Middeldorp
- />Department of Child and Adolescent Psychiatry, GGZ-InGeest/VU University Medical Center, Amsterdam, Netherlands
- />Department of Biological Psychology, VU University, Amsterdam, The Netherlands
| | - Wilco Tuinebreijer
- />Department of Epidemiology & Health Promotion, Public Health Services, Amsterdam, The Netherlands
| | - Thekla F Bosschaart
- />Department of Social Pediatrics, Emma Children’s Hospital, Academic Medical Centre, Amsterdam, The Netherlands
| | - Esther van Duin
- />Department of Child and Adolescent Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
- />De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
| | - Arnoud Verhoeff
- />Department of Epidemiology & Health Promotion, Public Health Services, Amsterdam, The Netherlands
- />Department of Sociology and Antropology, University of Amsterdam, Amsterdam, The Netherlands
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Martin KA. Making sense of children's sexual behavior in child care: An analysis of adult responses in special investigation reports. CHILD ABUSE & NEGLECT 2014; 38:1636-1646. [PMID: 25082430 DOI: 10.1016/j.chiabu.2014.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 06/23/2014] [Accepted: 07/07/2014] [Indexed: 06/03/2023]
Abstract
This paper investigates how adults respond to sexual behavior among children in child care. Culturally, childhood sexuality is variously understood as natural curiosity, a sign of sexual abuse, or a symptom of a sex-offender in the making. Given these competing cultural meanings, how are sexual-like behaviors by children managed by the adults who care for them? An analysis of qualitative data from Special Investigation Reports by childcare licensing consultants in the state of Michigan is used to examine how parents, child care providers, and child care licensing consultants manage and respond to sexual behavior between children in the context of child care. How sexual behavior is responded to depends primarily on who is doing the responding - parent, childcare provider, or state licensing consultant - rather than what type of behavior is being responded to. Parents respond to a wide range of behaviors between children as if they are incidents of sexual abuse. Childcare providers respond to many of those same incidents as misbehavior. Licensing consultants understand these incidents as violation of rules of supervision, but they were also the only group to ever ask if children's sexual behavior was potentially a sign of a child having been sexually abused in another setting. Providers and parents need more education about what kinds of sexual behavior to be concerned about and what kind to understand as common. More education that sexuality that is "rare" and persistent could be a sign of sexual abuse is needed by all parties.
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Affiliation(s)
- Karin A Martin
- Department of Sociology, University of Michigan, Ann Arbor, MI 48109-1382, USA
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Cyr M, Hébert M, Frappier JY, Tourigny M, McDuff P, Turcotte ME. Parental Support Provided by Nonoffending Caregivers to Sexually Abused Children: A Comparison Between Mothers and Fathers. ACTA ACUST UNITED AC 2014. [DOI: 10.1080/15379418.2014.954688] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Kilroy SJ, Egan J, Maliszewska A, Sarma KM. "Systemic trauma": the impact on parents whose children have experienced sexual abuse. JOURNAL OF CHILD SEXUAL ABUSE 2014; 23:481-503. [PMID: 24818809 DOI: 10.1080/10538712.2014.920458] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This article examines the impact on parents in an Irish context whose children have experienced sexual abuse and aims to explore the pathways to distress. This is in order to understand what factors facilitate or hinder parents from supporting their child to the best of their ability, given that parental support is a crucial moderating factor in children's recoveries. Semistructured interviews were carried out with 13 parents in this context and analyzed using a grounded theory methodology. The overall concept that emerged was termed "systemic trauma" and was composed of eight categories that help to explain the pathways of impact for parents. This model can help clinicians understand and respond to the needs of parents in the aftermath of CSA.
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Watts S. User Skills for Qualitative Analysis: Perspective, Interpretation and the Delivery of Impact. QUALITATIVE RESEARCH IN PSYCHOLOGY 2013. [DOI: 10.1080/14780887.2013.776156] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Abstract
The aim of the present study is to investigate the variability in clinical level of psychological distress experienced by mothers of sexually abused children by exploring the role of (a) abuse-related variables (length, severity, and identity of perpetrator), (b) a history of childhood sexual abuse and partner violence experienced in the past year, and (c) mothers' coping and feelings of empowerment. Data were collected through self-report measures completed by 149 French-speaking mothers of girls aged 4 to 12 years disclosing sexual abuse. Results revealed that more than half of the mothers reported clinical levels of psychological distress and experienced child sexual abuse, and 1 of 4 mothers experienced physical partner violence. Logistic regression analysis revealed that mother's sexual abuse and partner violence as well as avoidance coping and empowerment contributed to scores reaching clinical levels of psychological distress. In addition, mothers of child victims of intrafamilial sexual abuse are more likely to report clinical levels of distress. Results underscore the importance of evaluating for trauma history and taking coping strategies and empowerment into account in treatment interventions.
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