Childhood sexual abuse, stigmatization, internalizing symptoms, and the development of sexual difficulties and dating aggression

Self-stigma mediates the relationships between childhood maltreatment and symptom levels of PTSD, depression, and anxiety

Background: Childhood maltreatment is a risk factor for developing multiple forms of psychopathology, including depression, posttraumatic stress disorder (PTSD), and anxiety. Yet, the mechanisms linking childhood maltreatment and these psychopathologies remain less clear.Objective: Here we examined whether self-stigma, the internalization of negative stereotypes about one's experiences, mediates the relationship between childhood maltreatment and symptom severity of depression, PTSD, and anxiety.Methods: Childhood trauma survivors (N = 685, Mage = 36.8) were assessed for childhood maltreatment, self-stigma, and symptoms of depression, PTSD, and anxiety. We used mediation analyses with childhood maltreatment as the independent variable. We then repeated these mediation models separately for childhood abuse and neglect, as well as the different subtypes of childhood maltreatment.Results: Self-stigma significantly mediated the relationship between childhood maltreatment and depression, PTSD, and anxiety symptoms. For sexual abuse - but not physical or emotional abuse - a significant mediation effect of self-stigma emerged on all symptom types. For childhood neglect, self-stigma significantly mediated the relationship between both emotional and physical neglect and all symptom types.Conclusion: Our cross-sectional study suggests that different types of childhood maltreatment experiences may relate to distinct mental health problems, potentially linked to increased self-stigma. Self-stigma may serve as an important treatment target for survivors of childhood abuse and neglect.

Sexual Self-Concept After Child Maltreatment: The Role of Resilient Coping and Sexual Experience Among U.S. Young Adults

Evidence supports sexual experience as normative and health-promoting for many, but this picture is less clear for people with histories of adversity. Amazon Mechanical Turk (MTurk) was used to garner data from a sample of 362 young adults (aged 18-25) wherein 44.5% (n = 161) identified as women. We assessed longitudinal associations between child maltreatment and sexual self-concept, as mediated by sexual behaviors and sexual partners, and whether resilient coping moderated these associations using structural equation modeling. Although both child maltreatment and resilient coping were directly associated with aspects of sexual experience, only resilient coping was directly associated with sexual self-concept. In addition, we found support for sexual experience as a mediator between child maltreatment/resilient coping and sexual self-concept. Specifically, cumulative maltreatment was associated with more sexual partners, which was associated with higher sexual self-monitoring. Resilient coping was associated with more sexual partners and more sexual behaviors, which was associated with higher sexual self-monitoring and higher sexual self-consciousness, sexual assertiveness, sexual self-esteem, and sexual motivation, respectively. Thus, sexual behaviors and sexual partners operated independently. Findings contrast messaging that sexual experience is universally risky regardless of maltreatment history. Rather, sexual experience may foster positive sexual self-concept for some. Sexual health advocates must attend to differences between sexual behaviors and sexual partners in relation to sexual well-being, and support resilience in the sexual domain.

A Network Comparison of Sexual Dysfunction, Psychological Factors, and Body Dissociation between Individuals with and without Sexual Trauma Histories

Sexual dysfunction is associated with psychological symptoms, including depression and anxiety. Sexual dysfunctions are often attributed to dissociation symptoms in individuals who reported sexual trauma histories. This study utilized a network approach to analyze relationships between sexual and psychological symptoms and examine whether the identified network structures differed between individuals who reported a history of sexual trauma and those who did not. Sexual dysfunction, history of sexual trauma, internalizing symptoms, dissociation symptoms, sex-related shame, and negative body image were assessed in 1,937 United States college students (women = 69.5%). Nearly half (46.8%) of the participants reported a sexual trauma history in their lifetime. Using regularized partial correlation networks, the relationships between sexual and psychological symptoms were analyzed and compared between groups with and without trauma histories. Internalizing symptoms were positively correlated with sexual dysfunction regardless of the presence of sexual trauma history. Anxiety had a stronger influence in the trauma network than in the no-trauma network. Feeling separated from the body during sexual activity was a central symptom and was related to difficulties relaxing and enjoying sex only in the trauma network. Sex-related shame appeared to play a more important role in men compared to women. To improve clinical practice of assessing and treating sexual dysfunction, researchers and clinicians should consider core symptoms that connect different aspects of sexual and psychological functioning while being aware of the unique role of dissociation in the context of traumatic stress.

The Legacy of Shame following Childhood Sexual Abuse Disclosures

Shame has been recognized as a barrier to child sexual abuse (CSA) disclosures, but there has been less focus on the impact of shame on post-disclosure. This study explores how shame is experienced by CSA survivors following disclosure. Semi-structured interviews were conducted with eleven CSA survivors aged 14-25 years on their CSA disclosure experiences. Thematic analysis of the transcripts produced four themes that highlight the various impacts of shame post-disclosure: 1) struggles with identifying as a sexual abuse survivor; 2) manifestations of shame; 3) shaming responses to disclosures; and 4) strategies to overcome shame. Clinical implications are presented using a social ecological perspective.

The Experience of Partner Relationships for Male Survivors of Childhood Sexual Abuse: A Qualitative Synthesis

Research has documented wide-ranging psychological impacts of childhood sexual abuse (CSA) for male survivors, but their experience of relationships is understudied. This qualitative review aimed to synthesize the qualitative literature concerning the experience of partner relationships for male CSA survivors. Electronic searches were conducted across PsycINFO, CINAHL, and PubMed, complemented by hand searches of references. Searches were limited to English-language peer-reviewed studies. Studies were included if they sampled adult male CSA survivors and reported qualitative data on their experience of partner relationships. Sixteen studies met the review criteria. Articles were quality-appraised using the Critical Appraisal Skills Programme qualitative checklist (2018), and narrative synthesis derived five themes: "sexual orientation confusion," "sexual intimacy difficulties," "the barrier of emotional intimacy," "navigating agency," and "healing and growth through love." Key findings were male CSA survivors can face considerable barriers to relational intimacy; however, romantic relationships also offer a space to heal and experience post-traumatic growth (PTG). Clinicians should be aware of the diffuse impacts CSA can have upon male survivors' intimate relationships. Helping survivors and their partners build a safe space in which to process CSA, reassert agency and relational boundaries, and express love and validation can support survivors toward PTG.

A Review of Undergraduate Student Disclosures of Sexual Violence

INTRODUCTION

Sexual violence (SV) has been a prevalent issue on college campuses for decades. Researchers, universities, and legislators have tried to understand and prevent it. Despite these efforts, 25% of female and 6% of male undergraduate students will experience a nonconsensual sexual experience (NSE) as a student. An immense amount of research has been conducted on the prevalence, effects, resources for, and outcomes of SV over the last few decades.

OBJECTIVES

The current paper aims to compile and summarize the extant literature on undergraduate student disclosures of sexual violence. The objective is to provide a comprehensive review of the research.

METHODS

A literature search was performed using the terms sexual violence, NSE, undergraduate students, informal and formal reporting, and disclosure.

RESULTS

Disclosure patterns and outcomes for survivors vary widely based on individual factors including type of disclosure source (ie, informal or formal reporting), disclosure recipient response, previous history of NSEs, and personal identity (ie, gender identity, sexual orientation, race/ethnicity). Though there are many formal resources (ie, police, Title IX), the majority of survivors report to informal sources (ie, family or friends). In addition to researching survivors' experiences and rates of disclosures, research also evaluates how disclosure recipients perceive their response to a survivor's disclosure, their likelihood of receiving a disclosure based on their own individual identities, and how the disclosure impacts the recipient and their relationship with the survivor.

CONCLUSION

The individualized response and decision to report SV has made prevention and the creation of effective resources difficult. As there are so many individual factors to consider when evaluating how or whether a NSE will be disclosed, future research should consider these individual differences and use them to create more effective reporting sources and resources. Sears-Greer MA, Friehart BK, Meston CM. A Review of Undergraduate Student Disclosures of Sexual Violence. Sex Med Rev 2022;XX:XXX-XXX.

Sexual Dysfunction Among Childhood Sexual Abuse Survivors: The "Functional" Dysfunction?

Various studies have established the association between child sexual abuse and sexual dysfunction. Although sexual dysfunction can be a distressing and undesirable condition for survivors of child sexual abuse, the current article suggests viewing sexual dysfunction not solely as a negative outcome but as a condition with a potent psychological function in regulating various psychological and relational needs among survivors. The main question addressed in the current paper is: What are the functional aspects of sexual dysfunction among child sexual abuse survivors? Four main protective purposes for sexual dysfunction among survivors of child sexual abuse are proposed: avoiding re-traumatization, regulating closeness within the relationship, gaining a sense of power and control and avoiding vulnerability, and restoring a positive sense of self. Although healthy sexual functioning is a desirable long-term goal for survivors, therapists need to view sexual dysfunction within the context of trauma, and to understand the protective functions of dysfunctions, before attempting to restore sexual function.

Sexual Self-Concept and Psychological Functioning of Women With a History of Childhood Sexual Abuse in Hong Kong

Sexual self-concept (SSC) is an important component of health that is closely associated with the well-being of survivors of child sexual abuse (CSA). Compared with non-CSA respondents, SSC of CSA survivors was deleteriously affected, resulting in ineffective psychological functioning (negative self-evaluation, psychological ill-health, and difficulties in interpersonal relationships). Negative SSC (sexual anxiety, sexual depression, and sexual fear) played a significant role in mediating the adverse effects of CSA on psychological functioning. Future studies may recruit a sample with greater variation in CSA characteristics and use externalizing problems as outcome measures to cross-validate findings of this study.

#Me2PT: A qualitative analysis of a social media network campaign to raise awareness of the consequences of childhood sexual abuse

BACKGROUND

Childhood sexual abuse (CSA) is a highly prevalent and serious stressor, linked to short- and long-term psychopathology and to posttraumatic stress disorder (PTSD) specifically. The hashtag #Me2PT, which stands for "me-too-post-trauma," was created in order to raise awareness of the longitudinal consequences of sexual abuse, as specifically manifested in symptoms of PTSD or complex PTSD. It was disseminated on social media networks during 2019 and offered a platform for CSA survivors to share their own personal experience of living with CSA-related posttraumatic symptoms.

OBJECTIVE

The current study was designed in order to examine the way survivors conveyed their experiences and perceptions with response to the invitation of the hashtag #Me2PT. All the posts were written in the Hebrew-language, and thematic analysis was carried on all the written narratives.

PARTICIPANTS AND SETTING

40 Posts that were written in the Hebrew language under the hashtag campaign of #Me2PT.

METHODS

Thematic analysis was carried on the 40 posts by two of the authors. Shenton four criterions for qualitative study trustworthiness were employed with peer discussion on main results were discussed with the leaders of the campaign, survivors of CSA.

RESULTS

The authors identified four main themes within the written narratives of the survivors: (1) why am I writing, (2) my personal PTSD, (3) between life and death, and (4) post-trauma as 'a bleeding wound'.

CONCLUSIONS

These findings exemplify the constant mental pain and struggle that survivors deal with, but at the same time demonstrate the importance of hope, the comfort found in being understood, and the wish to live a meaningful life despite the pain. This paper may contribute to the understanding of survivors' experiences of living with CSA-related posttraumatic symptoms, as conveyed by them spontaneously and authentically, potentially informing best practice for professionals working with this population.

Characterizing Typologies of Polytraumatization: A Replication and Extension Study Examining Internalizing and Externalizing Psychopathology in an Urban Population

A person-centered approach to examining trauma has uncovered typologies of polytraumatization that are differentially associated with psychopathology. However, previous research is limited by narrow conceptualizations of trauma, limited distal outcomes, and underrepresentation of minorities. To address these gaps, we used latent profile analyses to uncover distinct polytraumatization typologies and examine four symptom-based (PTSD, depression, aggression, and substance abuse) and two behavior-based (self-harm, jail counts) outcomes in a sample of low-income adults (n = 7,426, 94% African American). The models were indicated by 19 traumatic experiences (e.g., accident, sexual assault, witnessing/experiencing violence). The best fitting model uncovered five classes: minimal trauma, physical abuse, violence exposure, sexual abuse, and polytrauma. Classes characterized by significant and varied trauma were higher on both internalizing and externalizing psychopathology, while those characterized by specific types of trauma were only higher on one type of psychopathology. Implications for the assessment and treatment of trauma-related disorders are discussed.

Relational and Sexual Experiences of Betrayal From the Point of View of Sexually Victimized Young Women

Worldwide, it is estimated that one in five women have reported being sexually victimized before the age of 18. Girls are particularly at risk of sexual abuse at the end of adolescence and are more vulnerable to revictimization during this period. However, there is a paucity of findings related to the relational and sexual impacts of child sexual abuse among young women. The traumagenic dynamics model, proposed by Finkelhor and Browne, postulates that the consequences of sexual abuse can be analyzed in light of four distinct dynamics: traumatic sexualization, betrayal, powerlessness, and stigmatization. Among the four postulated dynamics, betrayal appears to be a key element to gain insight on the relational challenges experienced by victims, as betrayal situations can recur in romantic relationships. The present study aimed to describe, from the point of view of young women victims of child sexual abuse, the issues related to betrayals in their relational and sexual experiences. Semi-structured interviews were conducted with 19 young women aged 18 to 25 years old who had reported sexual victimization. Two main conceptual categories emerged from the narratives of the participants: (a) relational situations that echo the betrayal dynamic and (b) strategies to cope with relational situations involving betrayal: protection, reparation, and the use of both strategies, which leads to ambivalence. Findings highlight the importance of addressing the traumagenic dynamic of betrayal in interventions with sexually abuse youths, given their likelihood to experience betrayal in the context of romantic relationships and their increased risk of revictimization.

Stigma as a barrier to addressing childhood trauma in conversation with trauma survivors: A study in the general population

Victims of childhood trauma report shame and anticipation of stigma, leading to non-disclosure and avoidance of help. Stigma is potentially aggravating the mental health consequences of childhood trauma. So far there is no comprehensive study examining stigma toward adult survivors of various forms of childhood trauma, and it is unclear whether stigma interferes with reaching out to affected individuals. In a vignette study based on a representative sample of the German general population (N = 1320; 47.7% male) we randomly allocated participants to brief case vignettes pertaining to past childhood sexual/physical abuse or accidents, and adult physical abuse. Stigma was elicited by applying the Social Distance Scale, assessing respondents’ attitudes/stereotypes toward the persons in the vignette and their reluctance to address the specific trauma in conversation. While one aim was to establish the prevalence of stigma toward persons with CT, we hypothesized that attitudes differ according to type of trauma. Of the respondents, 45% indicated they were unlikely to reach out to a victim of childhood sexual abuse, 38% to a victim of childhood physical abuse, 31% to someone reporting a childhood accident and 25% to someone reporting adult physical abuse. Contrary to our expectations, childhood sexual abuse did not consistently elicit more stigma than childhood physical abuse in Krukall-Wallis tests. Equally, childhood interpersonal trauma did not consistently elicit more stigma than childhood accidental trauma. Structural equation modeling revealed social distance as mediator of the relationship between negative stereotypes and reluctance to address childhood trauma in conversation. Our analyses further revealed an ambiguous role of negative stereotypes in addressing childhood trauma in conversation with trauma victims, which has yet to be examined. There is evidence for stigma associated with having survived childhood trauma, which is interfering with offering help.

Trauma-Informed Sex Positive Approaches to Sexual Pleasure

This paper develops a trauma-informed sex-positive framework as a public health, clinical, and research approach to sexual experience over the life course. The framework centers trauma-informed sex positivity as the linkage for sexual pleasure (along with sexual wellbeing and sexual health) to the social, cultural, and legal concepts of sexual justice. By providing a conceptual distinction of sexual pleasure from sexual wellbeing and sexual health, the framework improves clarity about how these constructs are related as well as provides possibilities for detailed operationalization in public health surveillance and in the new research.

Die Entwicklung von Sexualität bei Kindern und Jugendlichen mit sexuellen Gewalterfahrungen

Zusammenfassung. Theoretischer Hintergrund: Zu den Folgen sexueller Gewalt gehören neben somatischen und psychischen Folgen auch Veränderungen in der Entwicklung der Sexualität. Fragestellung: Ziel dieses Reviews ist es, einen systematischen Überblick über den aktuellen Forschungsstand bezüglich der Entwicklung von Sexualität bei Kindern und Jugendlichen nach sexuellen Gewalterfahrungen zu geben. Methode: Eine systematische Literaturrecherche wurde in den Datenbanken PubMed, ERIC, Cochrane und PubPsych durchgeführt. Die Folgen von sexueller Gewalt bezüglich der Sexualität wurden systematisch analysiert. Ergebnisse: Es konnten insgesamt 127 Studien zur Sexualität nach sexueller Gewalt identifiziert werden, die acht Unterkategorien zugeordnet werden konnten: Sexuelles Risikoverhalten, Teenagerschwangerschaft, jugendliche Sexualstraftäter_innen, sexuelle Verhaltensauffälligkeiten, sexuelle Überzeugungen, Prostitution, Geschlechtskrankheiten und körperliche Symptome. Diskussion und Schlussfolgerung: Insgesamt zeigt die Literaturrecherche, dass die Sexualität von Kindern und Jugendlichen mit sexuellen Gewalterfahrungen teilweise nur lückenhaft untersucht wurde.

Sexual Shame in the Sexual Excitation and Inhibition Propensities of Men With and Without Nonconsensual Sexual Experiences

For men with nonconsensual sexual experience (NSEs) histories, sexual shame may play a critical role in their sexual responses. Through online surveys, the current study examined sexual shame in the sexual excitation and inhibition responses of men with NSE histories who both do (identifiers; n = 255) and do not identify (non-identifiers; n = 239) their NSEs with sexual violence labels (e.g., rape) and men with no NSEs (n = 289). Regardless of identification, men with NSEs reported greater sexual shame than men with no NSEs and higher levels of excitatory (e.g., arousability) and inhibitory (e.g., inhibitory cognitions) domains of sexual response propensities. Sexual shame predicted inhibitory domains of sexual response for all of the men. NSE history and identification moderated the relationship between sexual shame and arousability. Sexual shame had a stronger positive association with arousability for both identifiers and those with no NSEs than non-identifiers. The results provide support for the role of sexual shame in men's sexual response and suggest sexual shame is an important target for interventions with men with NSEs.

Child Sexual Abuse as a Unique Risk Factor for the Development of Psychopathology: The Compounded Convergence of Mechanisms

Meta-analytic, population cohort, prospective, and clinical studies provide systematic evidence that child sexual abuse accounts for unique variation in several deleterious outcomes. There is strong evidence for psychiatric disorders, including posttraumatic stress disorder and mood, anxiety, and substance use disorders, and mixed evidence for personality disorders. Evaluation of sex-specific outcomes shows strong evidence for teenage childbearing, sexual revictimization, and sexual dysfunction and mixed evidence for heightened sexual behaviors and sexual offending. This review further demonstrates not only that survivors suffer the noxious impact of traumatic sexualization but that additional transdiagnostic mechanisms, including the biological embedding of stress, emotion dysregulation, avoidance, and insecure attachment, converge to compound risk for deleterious outcomes. A road map to enhance the rigor of future research is outlined, and specific recommendations for evidence-based policy making to boost prevention efforts and increase access to treatment are discussed.

Relationship Variables in Group Psychotherapy for Women Sexual Trauma Survivors

This study examined relational group psychotherapy processes, including group cohesion, bond with group leaders, perceptions of shame, and posttraumatic stress disorder (PTSD) symptomatology for sexual trauma survivors. Six separate treatment groups of women who were either adult sexual assault survivors (N = 24) or adult survivors of childhood sexual abuse (N = 9) participated in the study. Participants completed the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) pre- and posttreatment, the Group Climate Questionnaire, Bond scale of the Working Alliance Inventory Short Form (WAI-S), and Compass of Shame Scale at four intervals. Growth curve models analyzed Engagement, Bond, and Shame Reactions over time. PCL-5 scores were compared pre- and posttreatment and examined in relationship to the process variables of Engagement and Bond. Results showed increases in group cohesion and perceptions of Bond with group leaders and decreases in PTSD symptoms and attacking self-shame reactions. Clinical implications and recommendations for this population are presented.

Validity and reliability of the internalized stigma of Mental Illness Scale-Adolescent Form

PURPOSE

The goal of this study was to assess the validity and reliability of the Turkish version of the Internalized Stigma of Mental Illness Scale-Adolescent Form (ISMI-AF).

METHODS

A total of 145 adolescents (12-18 years of age) who were diagnosed with at least one mental disorder according to DSM-5-TR participated in the study. Data were collected at a mental health hospital between October 2017 and 2019 using a sociodemographic information form, the ISMI-AF, and Beliefs towards Mental Illness (BMI) Scale. Reliability (Cronbach's alpha, Split-Half, Spearman-Brown, Hotelling T² test) and validity analyses of the ISMI-AF were performed. SPSS 26.0 and LISREL 8.80 software were used for statistical analyses.

RESULTS

The Cronbach's alpha coefficient for total score was .88, Split-Half score was .84, and the Spearman-Brown factor score was .85. Confirmatory factor analysis showed that the scale confirmed to the five-factor structure in adolescents, but factor loadings and reliability coefficients were low in the "stigma resistance" subscale. There was a positive and weak correlation between ISMI-AF and BMI (r = .37, p = .00).

CONCLUSION

The ISMI-AF is a valid and reliable measurement tool that can be used in adolescents. This scale can help psychiatric nurses who work in this field identify and address internalized stigma, which is one of the key factors affecting adherence to treatment, especially in adolescents.

Addressing Sexual Dysfunction After Childhood Sexual Abuse: A Clinical Approach from an Attachment Perspective

Sexual dysfunctions are very prevalent among survivors of childhood sexual abuse. While the relationship between sexual abuse and sexual dysfunction is well-established, understanding of the mechanisms explaining this relationship is still limited and has not been studied thoroughly. The current article presents a preliminary, theoretical model of the association between childhood sexual abuse, and sexual dysfunctions in adulthood from an attachment-trauma perspective. This model is based on previous literature and hours of clinical work in sex therapy and attachment theory-based therapy, and identifies important factors that have not been adequately accounted for in the literature.

Self-Blame, Shame, Avoidance, and Suicidal Ideation in Sexually Abused Adolescent Girls: A Longitudinal Study

Depressive symptoms, posttraumatic stress disorder, and suicidal ideation are among the most prevalent problems associated with sexual abuse. Based on the Traumagenic dynamic of stigmatization model, the aim of this study was to investigate whether self-blame, shame, and maladaptive coping strategies predicted posttraumatic stress disorder, depressive symptoms, and suicidal ideation among sexually abused adolescent girls using a longitudinal design. A total of 100 adolescent girls completed a series of questionnaires at the initial visit at the intervention center (T1) and 6 months later (T2). Path analysis reveals shame at T1 predicted posttraumatic stress disorder symptoms at T2 whereas self-blame at T1 predicted depressive symptoms at T2. Furthermore, avoidance coping at T1 and depressive symptoms at T2 predicted suicidal ideation at T2 and accounted for 54% of the variance. These findings suggest that interventions designed for sexually abused adolescent girls should target shame, self-blame, and avoidance coping to foster recovery in this vulnerable population.

Pathways from childhood sexual abuse to trait anxiety

BACKGROUND

Children exposed to sexual abuse are at risk for developing several psychological and behavioral difficulties during adulthood. Here, direct and indirect effects of family conflict, insecurity within the family system (manifested as disengagement and/or preoccupation), and negative feelings provoked by childhood sexual abuse (CSA) on trait anxiety scores were analyzed with structural equation modeling. Both Finkelhor and Browne's traumagenic dynamics model and Davies and Cummings Emotional Security Theory were applied.

METHODS

A total of 168 female college student survivors of CSA participated in this study. Information regarding each participant's abuse was obtained from a self-reported questionnaires. Emotional security was assessed with the Security in the Family System scale. To assess negative feelings regarding abuse and trait anxiety, Children's Impact of Traumatic Events Scale-Revised and State-Trait Anxiety Inventory were applied, respectively.

RESULTS

Level of family conflict was found to directly relate to emotional insecurity and trait anxiety. In addition, preoccupation strategies were found to be directly related to trait anxiety. Conversely, disengagement strategies were indirectly related to anxiety through the negative feelings provoked by abuse. Experience with other types of abuse and/or neglect was also related to emotional insecurity and feelings provoked by CSA. Meanwhile, continuity of abuse only correlated with feelings provoked by abuse.

CONCLUSIONS

Strong relationships between family conflict, emotional insecurity, negative feelings provoked by CSA and trait anxiety were observed. These results suggest that treatment of CSA survivors should focus on improving security within the survivors' family system and reducing negative feelings provoked by abuse.

Adaptation and Validation of the Shame Questionnaire Among Ugandan Youth Living with HIV

The purpose of this study was to adapt and validate a measure of HIV-related shame, the Shame Questionnaire (SQ), among Ugandan youth living with HIV. Culturally relevant, reliable and valid measurement is critical in the accurate assessment of HIV-related shame (a painful internalized emotion encompassing feelings that the self is damaged and defective) on psychosocial functioning, as well as the determination of the efficacy of interventions among youth living with HIV in sub-Saharan Africa. We utilized qualitative (i.e., cognitive interviews; N = 31) and quantitative (i.e., classical test theory and item response theory; N = 150) methods to establish, content, criterion and construct validity of the SQ. Cognitive interviews resulted in the revision in the wording of 2 out of 8 SQ items. Participants who endorsed having shame had statistically significant higher SQ scores than participants who did not endorse having shame (p < 0.001), suggesting criterion validity. We found a statistically significant positive relationship between SQ scores and average trauma symptom scores among participants (p < 0.001), also suggesting criterion validity. Finally, we found construct validity with discrimination parameters of the graded response IRT model all in the high range with a wide range of difficulty parameters across the 8 items of the SQ. Overall our results suggest that the SQ is a contextually relevant, valid and reliable assessment tool among Ugandan youth living with HIV. Findings provide support for the utilization of qualitative and quantitative methods in the adaptation of measures for cross-cultural use in order to maintain validity and contextual relevance.

Childhood maltreatment and intimate partner violence victimization: A meta-analysis

BACKGROUND

Intimate partner violence (IPV) victimization is a serious public health problem in the world. It is imperative to examine risk factors for IPV victimization.

OBJECTIVE

This meta-analysis aimed to explore the relationship between childhood maltreatment (CM) and IPV victimization and investigate the moderating effects of gender and marital status.

PARTICIPANTS AND SETTING

Examination of the literature produced a sample of 56 effect sizes (N = 23,127) for review.

METHODS

PsycINFO, PsycArticles, EBSCO-ERIC, Medline, Google Scholar, and ProQuest Dissertations & Theses databases were systematically searched until March 31, 2018. Forty-six eligible studies were included in the meta-analysis. Random effects model was used for meta-analysis of the studies.

RESULTS

Results indicated a significant association between total CM and IPV victimization (r = .18, p < .001). Further subgroup analyses revealed that all four types of CM (childhood physical abuse, psychological abuse, sexual abuse, and neglect) were positively related to IPV victimization (r = .19, .18, .17, and .12, respectively). Moreover, the moderation analyses revealed that the association between CM and IPV victimization was stronger for dating couples than for married ones. However, this relation did not show significant difference between males and females.

CONCLUSIONS

There is an association between CM and IPV victimization, and it is moderated by marital status.

Exploring the relation between posttraumatic stress disorder and interpersonal outcomes: The role of social acknowledgment and trauma type

OBJECTIVES

Research demonstrates consistent relations between posttrauma symptoms and interpersonal dysfunction. The current study examined the extent to which perceptions of community rejection account for the relation between posttraumatic stress disorder (PTSD) and interpersonal outcomes in students exposed to assaultive and nonassaultive trauma.

METHOD

Participants (N = 137; 66.4% female; M = 20 years) completed a trauma history interview, questionnaires assessing symptom severity, social disapproval, and interpersonal outcomes.

RESULTS

Assault survivors (n = 83) reported greater symptoms (d = 0.57), disapproval (d = 0.80), and social impairment (d = 0.51) relative to the nonassault group (n = 54). However, regression analyses indicated stronger associations between PTSD and community disapproval in survivors of nonassaultive (β = 0.69; p < 0.001) versus assaultive (β = 0.34; p < 0.001) events. Indirect effects of PTSD on perceived support and interpersonal functioning through social disapproval were also larger for nonassaultive versus assaultive groups (p < 0.05).

CONCLUSION

Despite greater dysfunction among assault survivors, perceptions of disapproval may be a more salient factor for interpersonal dynamics following nonassaultive trauma.

The family and peer origins of coercion within adult romantic relationships: A longitudinal multimethod study across relationships contexts

Using coercive strategies to resolve conflicts with romantic partners has toxic effects on relationships. Coercion predicts relationship dissatisfaction, instability, and intimate partner violence. The early adult romantic relationships model hypothesizes that such strategies first emerge within the family and continue to affect romantic relationships into adulthood. We tested whether adolescent antisocial behaviors and deviancy training with peers mediated between early disruptive parenting and adult romantic relationship coercion. Furthermore, we tested the impact of trauma in this longitudinal model. We studied 230 adults in committed relationships, whom we initially recruited and studied when they were age 11. We collected videotaped observations with friends (when participants were ages 16-17) and with intimate partners (when participants were ages 28-30). As hypothesized, disruptive parenting predicted antisocial behaviors and deviancy training with friends in adolescence, which in turn predicted coercion within intimate adult relationships. Moreover, disruptive parenting in early adolescence also directly predicted romantic partner coercion 15 years later. No significant effects were found for trauma. Findings suggest the promise of promoting healthy adult intimate relationships through early relationships with parents and friends. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Childhood sexual abuse, risky sexual behaviors and adverse reproductive health outcomes among Chinese college students

BACKGROUND

Childhood sexual abuse (CSA) is a serious public health problem worldwide.

OBJECTIVES

We reported the prevalence of CSA and examined its association with risky sexual behaviors and adverse reproductive health outcomes among college students in China.

PARTICIPANTS AND SETTING

Participants were 17,966 college students from 130 colleges in Eastern, Central, and Western China, who completed the online questionnaire in January-August 2015.

METHODS

Data were obtained from a cluster-random Internet-based survey. Multivariate logistic regression analyses were employed: risky sexual behaviors and adverse reproductive health outcomes were outcome variables, and various types of CSA were predictor variables, while adjusting for socio-demographic and lifestyle characteristics.

RESULTS

The overall prevalence of any type of CSA was 27.5%. Most perpetrators were friends/acquaintances (34.6%) or intimate partners (24.7%) of the victims. Respondents who reported penetrative CSA were strongly associated with regular unprotected sex (odds ratio (OR): 3.0, 95% confidence interval (CI): 2.2-4.0), early sexual debut (OR: 5.5, 95% CI: 3.3-9.1), having genital tract symptoms in the last 12 months (OR: 5.0, 95% CI: 4.1-6.0), unintended pregnancy (OR: 6.2, 95% CI: 4.2-9.0), and induced abortion (OR: 5.5, 95% CI: 3.7-8.2) (for boys, the survey asked about history of unintended pregnancy and induced abortion of their sexual partners). A dose-response relationship was found across non-contact, contact, and penetrative CSA.

CONCLUSIONS

CSA experience may increase the likelihood of risky sexual behaviors and adverse reproductive health outcomes in victims' early adulthood.

Evaluation of supplemental samples in longitudinal research with non-normal missing data

Missing data is a commonly encountered problem in longitudinal research. Methodological articles provide advice on ways to handle missing data at the analysis stage, however, there is less guidance for researchers who wish to use supplemental samples (i.e., the addition of new participants to the original sample after missing data appear at the second or later measurement occasions) to handle attrition. The purpose of this study is to evaluate the effects of using supplemental samples when analyzing longitudinal data that are non-normally distributed. We distinguish between two supplemental approaches: a refreshment approach where researchers select additional participants using the same criteria as the initial participants (i.e., random selection from the population of interest) and a replacement approach where researchers identify auxiliary variables that explain missingness and select new participants based on those attributes. Overall, simulation results suggest that the addition of refreshment samples, but not replacement samples, is an effective way to respond to attrition in longitudinal research. Indeed, use of refreshment samples may reduce bias of parameter estimates and increase efficiency and statistical power, whereas use of replacement samples results in biased parameter estimates. Our findings may be utilized by researchers considering using supplemental samples and provide guidance for selecting an appropriate supplemental sample approach.

A resilience framework: Sexual health trajectories of youth with maltreatment histories

There is a wealth of knowledge regarding negative sexual outcomes experienced by youth with childhood maltreatment (CM) histories, yet a dearth of research examines healthy sexual development among these youth. This gap exists despite evidence of resilience highlighting alternative and healthy physical, social, and psychological futures for youth who were abused. This study tested whether trajectories of resilience identified in studies of psychological functioning were applicable to sexual health. Using data from the first four waves of the National Longitudinal Study of Adolescent to Adult Health, latent class growth analysis was conducted among individuals with histories of CM (N = 1,437). On average, participants were 15, 16, 21, and 28 years old, respectively, by waves of data collection. About half of the sample was female (55%), the majority were White (66%), and a sizeable portion had experienced multiple forms of CM prior to Wave I (38%). Controlling for CM severity, three distinct sexual health trajectory classes were identified: resilient, survival, and improving, which were differentiated by age and biological sex. Older participants' sexual health was more likely to diminish over time, girls were more likely to show gains in sexual health over time, and significant differences in levels of sexual behaviors between the classes were only present during adolescence. Findings support the need for increased attention on the potential for sexual health despite experiences of CM, and highlight the applicability of resilience theory to youth sexuality.

"I Am Not A Victim. I Am A Survivor": Resilience as a Journey for Female Survivors of Child Sexual Abuse

This study was designed to expand our understanding of the positive aspects of coping and resilience in female survivors of child sexual abuse. Research questions focused on women's lived experiences of being survivors of child sexual abuse and how they have experienced resilience, developed healthy intimate relationships, and viewed themselves as sexual beings. Using a qualitative research lens of phenomenology, we captured the essence of survivors' experiences of resilience. Although each woman's experience was unique, similar patterns of processes and outcomes emerged as meaningful in their development of resilient and healthy sexuality and relationship functioning. However, participants emphasized resilience as a process or journey-recovery from trauma, reconceptualization of self, and development of healthy sexuality included deliberate efforts occurring over time. Implications for future research and practice using a positive lens of resilience are provided.

Skills-assistierte Exposition in der Dialektisch Behavioralen Therapie der Posttraumatischen Belastungsstörung (DBT-PTSD)

Zusammenfassung. Gewalterfahrungen in der Kindheit haben mit hoher Wahrscheinlichkeit schwerwiegende Folgen im Erwachsenenalter. Neben einer Posttraumatischen Belastungsstörung leiden die Betroffenen häufig unter Störungen der Emotionsregulation sowie vielfältiger weiterer Symptomatik. Als wesentliches Element praktisch aller wirksamen Behandlungsverfahren gilt die Auseinandersetzung mit den traumatischen Erinnerungen. Ziel dieser Übersichtsarbeit ist es, ein Behandlungsmodell vorzustellen, welches die Möglichkeit zur Expositionsbehandlung auch bei dieser schwerbelasteten Patientengruppe mit Störungen der Emotionsregulation bietet. Die Dialektisch Behavioralen Therapie der Posttraumatischen Belastungsstörung (DBT-PTSD) sowie die im Behandlungsprogramm integrierte Skills-assistierte Exposition werden hergeleitet und beschrieben. Die DBT-PTSD ist ein hoch-strukturiertes, multiple Komponenten beinhaltendes Therapieverfahren, welches im stationären Setting bereits sehr gut Wirksamkeitsnachweise erbringen konnte. Dadurch können auch bei Betroffenen einer Posttraumatischen Belastungsstörung nach interpersonellen Gewalterfahrungen in der Kindheit Expositionsverfahren erfolgreich angewendet werden.

Caregivers' abuse stigmatization and their views of mental health treatment following child sexual abuse

Many families do not utilize mental health services after the discovery of child sexual abuse (CSA), even when trauma-focused treatments are offered at low or no cost. Non-offending caregivers frequently serve as gatekeepers to youths' treatment, and their reactions to CSA may figure into decisions about treatment engagement. The current study examined caregivers' abuse stigmatization (i.e., self-blame and shame about their children's CSA) and associations with two factors predictive of treatment engagement (motivation, obstacles). Participants were recruited from a Child Advocacy Center where they received forensic interviews and were offered services following CSA discovery. Participating caregiver-child dyads included 52 non-offending caregivers (83% biological parents) and their children (69% girls; M_age=10.94, SD_age=2.62). Caregiver abuse stigmatization was associated with higher motivation for treatment but also more obstacles to treatment. Further, abuse stigmatization moderated associations between children's PTSD symptoms and perceived obstacles to treatment with medium effect sizes (M f²=0.287). Among caregivers experiencing high abuse stigmatization, greater child PTSD symptoms were associated with more obstacles to treatment. Among caregivers experiencing low stigmatization, child PTSD was either associated with fewer treatment obstacles or was unrelated to treatment obstacles. Results highlight the potential significance of reducing parents' abuse stigmatization for increasing mental health service utilization following CSA discovery, especially for more symptomatic youth.

Psychological maltreatment, coping strategies, and mental health problems: A brief and effective measure of psychological maltreatment in adolescents

Psychological maltreatment is an important social and public health problem and associated with a wide range of short and long-term outcomes in childhood to adulthood. Given the importance of investigating mitigating factors on its effect, the purpose of the present study is to investigate the mediating effect of active and avoidant coping strategies on the association between psychological maltreatment and mental health- internalizing and externalizing- problems in adolescents. Participants of the study consisted of 783 adolescents, ranging in age from 14 to 18 years (M=15.57, SD=0.88), with 52.9% female and 47.1% male. Several structural equation models were conducted to investigate the mediating role of coping strategies on the effect of psychological maltreatment on adolescents' internalizing and externalizing problems. Findings from mediation analyses demonstrated the mediating effect of active and avoidant coping strategies on the association between psychological maltreatment and mental health problems. The outcomes support adolescents use more avoidant coping strategies and fewer active coping strategies in the face of psychological maltreatment experiences, and this affects their mental health. Taken together, these results should contribute to the design of prevention and intervention services in order to promote mental health.

Reports of child sexual abuse of boys and girls: Longitudinal trends over a 20-year period in Victoria, Australia

Although prevalence studies show girls are more frequently sexually abused than boys, a significant proportion of boys also experience child sexual abuse (CSA). The challenges for public policy are amplified for boys due to less developed public and professional sensitisation to boys' experiences, conceptions of masculinity, and less research on boys including into reporting trends and outcomes. We conducted a 20-year longitudinal time-trend analysis of government data to identify reporting trends and report outcomes for CSA in Victoria, Australia from 1993 to 2012. We stratified by child gender and reporter status. Results indicate a new sensitisation to CSA, especially for boys, although this trend was not stable. Marked change occurred in the last five years, likely influenced by major social and political events. Comparison over time revealed that from 1993 to 2012, the rate of reporting of boys increased 2.6-fold whereas there was a 1.5-fold increase for girls. Comparing genders, with regards to rate of reporting, in 1993, the sex ratio of girls to boys was 2:1, while by 2012 this ratio changed to 1.14:1. Reports by police and other mandated reporters accounted for the majority of the increase in reports over the 20-year period, suggesting unequal sensitisation. Positive report outcomes (i.e. substantiations, findings of harm, and referral to services) increased twelve-fold for boys, and nearly five-fold for girls, indicating the increased levels of reports were based in actual clinical need. Most of this increase occurred from 2009 to 2012, influenced by a compound of social, political and agency-related factors.

Seeing How Far I've Come: The Impact of the Digital Sexual Life History Calendar on Young Adult Research Participants

The Digital Sexual Life History Calendar (d/SLHC) is a Web-based platform for collecting young adults' sexual histories. In addition to collecting diverse data, the d/SLHC was designed to benefit participants by enabling reflection on their sexual and relationship experiences in the context of other life events and circumstances. In a pilot study of the d/SLHC, survey data were collected to test whether creating a d/SLHC timeline had any impact on sexual well-being. A sample of 18- to 25-year-old participants recruited through Amazon Mechanical Turk (MTurk) completed an online survey about sexuality and relationships. Of those, 113 also completed d/SLHC timelines and 262 served as a comparison group. Six months later, participants from both groups were invited to complete a follow-up survey (total N = 249). Repeated-measures analysis of variance (ANOVA) results indicated that participants who completed d/SLHC timelines exhibited higher sexual esteem immediately following d/SLHC completion and at follow-up. No changes in sexual esteem were observed in the comparison group, and there were no differences between the groups with regard to sexual health behaviors and outcomes. These findings suggest that sexuality studies may have the potential to yield not only rich data for researchers but also rich experiences for participants.

Posttraumatic Stress Disorder and Suicidal Ideation Among Sexually Abused Adolescent Girls: The Mediating Role of Shame

Sexual abuse is associated with a host of negative repercussions in adolescence. Yet the possible mechanisms linking sexual abuse and negative outcomes are understudied. The purpose of this study was to investigate the relationships among self-blame, shame, coping strategies, posttraumatic stress disorder, depressive symptoms, and suicidal ideation. The sample included 147 sexually abused adolescent girls between 14 and 18 years of age. A total of 66% of girls reached clinical score for posttraumatic stress disorder, and 53% reached clinical score for depressive symptoms. Close to half (46%) reported suicidal thoughts in the past 3 months. Shame was found to partially mediate the relationship between self-blame and posttraumatic stress disorder. Shame and depressive symptoms were also found to partially mediate the relationship between self-blame and suicidal ideation. Results suggest that shame is a crucial target in interventions designed for sexually abused adolescent girls.

Exploring the Impact of Childhood Abuse on HIV Social and Attitudinal Factors Among Adults With and Without this History in Sub-Saharan Africa: Findings from NIMH Project Accept (HPTN 043)

Using data from four sites in three African countries, this community randomized study examined the association between childhood sexual and/or physical abuse (CSA and/or CPA) and HIV disclosure, HIV-related stigma, stress, and social support among adults with and without a history of abuse. A history of abuse among men was associated with higher levels of adult-reported stress and HIV-related stigma, and with significantly lower rates of HIV test result disclosure to current partners. Women with a history of CSA and/or CPA had significantly higher perceived stigma, discrimination and stress. Although childhood abuse was significantly associated with adult stress and stigmatization, participants with histories of CSA and/or CPA also reported significantly higher perceived social support compared to people without such experiences. These findings may reflect support received in response to disclosure of CSA or CPA or emotional ambivalence in relationships that have been found to be associated with child abuse. We conclude that it is critical for HIV prevention interventions to advocate for the primary prevention of child abuse, for early identification of adolescents and adults who report experiencing childhood abuse, and to address stigma and stress-related attitudinal, behavioral and relationship difficulties experiences as an aftermath of early abuse that increase their risk of HIV.

Impact of Child Maltreatment on Attachment and Social Rank Systems: Introducing an Integrated Theory

Child maltreatment is a prevalent societal problem that has been linked to a wide range of social, psychological, and emotional difficulties. Maltreatment impacts on two putative evolved psychobiological systems in particular, the attachment system and the social rank system. The maltreatment may disrupt the child's ability to form trusting and reassuring relationships and also creates a power imbalance where the child may feel powerless and ashamed. The aim of the current article is to outline an evolutionary theory for understanding the impact of child maltreatment, focusing on the interaction between the attachment and the social rank system. We provide a narrative review of the relevant literature relating to child maltreatment and these two theories. This research highlights how, in instances of maltreatment, these ordinarily adaptive systems may become maladaptive and contribute to psychopathology. We identify a number of novel hypotheses that can be drawn from this theory, providing a guide for future research. We finally explore how this theory provides a guide for the treatment of victims of child maltreatment. In conclusion, the integrated theory provides a framework for understanding and predicting the consequences of maltreatment, but further research is required to test several hypotheses made by this theory.

Early Stigmatization, PTSD, and Perceived Negative Reactions of Others Predict Subsequent Strategies for Processing Child Sexual Abuse

OBJECTIVE

Trauma processing is central to healthy recovery, but few studies examine how youth process experiences of child sexual abuse (CSA). The current study builds on our prior work identifying individual differences in CSA processing strategies (i.e., Constructive, Absorbed, Avoidant) to examine whether abuse stigmatization, PTSD symptoms, and negative reactions from others experienced during the year after abuse discovery were associated with subsequent CSA processing strategies.

METHOD

Participants included 160 ethnically diverse youth (8-15 years, 73% female) with confirmed cases of CSA. Predictors were measured at abuse discovery (T1) and 1 year later (T2). Individual differences in CSA processing strategies were assessed 6 years after discovery (T3) from participants' abuse narratives.

RESULTS

The persistence of abuse stigmatization from T1 to T2 significantly increased the odds of using either an Avoidant or Absorbed (vs. Constructive) strategy at T3. Higher levels of PTSD symptoms at T1 as well as their persistence from T1 to T2 each significantly increased the odds of having an Absorbed versus Constructive strategy. The persistence of perceived negative reactions from others from T1 to T2 increased the odds of an Absorbed versus Avoidant strategy. Effect sizes ranged from medium to large (M d = 0.636).

CONCLUSIONS

Results further validate prior work identifying distinct CSA processing strategies and suggest the persistence of abuse-specific disruptions over the year after abuse discovery may be associated with subsequent problems processing CSA experiences.

Positive and Negative Posttraumatic Change Following Childhood Sexual Abuse Are Associated With Youths' Adjustment

Meanings made of childhood sexual abuse (CSA) experiences are important to psychosocial adjustment. The current study examined adolescents' and young adults' perceptions of posttraumatic change (PTC) in the self, relationships, sexuality, and worldviews attributed to prior CSA experiences. We sought to document the prevalence of positive and negative PTC and examine their unique and joint associations with psychosocial adjustment. Participants included 160 youth with confirmed cases of CSA (73% female; 8-14 years at abuse discovery) who were part of a longitudinal study of the long-term effects of CSA. Six years after discovery, youth were interviewed about their abuse experiences. Interviews were coded for the valence and strength of PTC. The majority of youth reported PTC, and negative changes were more frequent and stronger than positive changes. Controlling for age, gender, abuse severity, and negative PTC, positive PTC was associated with lower abuse stigmatization for all youth. Controlling for age, gender, abuse severity, and positive PTC, negative PTC was associated with greater abuse stigmatization, post-traumatic stress disorder, sexual problems, and dating aggression for all youth. Relations of positive PTC with depression and support from friends and romantic partner were moderated by negative PTC, such that positive PTC was associated with better adjustment for youth with low versus high levels of negative PTC. Results highlight the importance of both negative and positive PTC for understanding meanings made of CSA experiences and their implications for psychosocial adjustment and intervention.

Prevalence of Sexual Trauma History Using Behaviorally Specific Methods of Assessment in First Year College Students

There are several challenges associated with evaluating the prevalence of sexual trauma, including child sexual abuse and adult sexual assault. The aim of this study was to assess sexual trauma prevalence rates among first year college students (N = 954) using behaviorally specific questions and a more representative recruitment sample that did not rely on self-selection. Participants completed a list of sexual trauma questions, including general questions containing labels such as "rape" or "abuse" as well as behaviorally specific questions that describe specific behaviors that qualify as sexual trauma without labels. Results indicated that 6.7% of the sample reported at least one incident of child sexual abuse, with similar rates for men and women. Women were more likely to report a history of adult sexual assault, which was reported by 12.4% of the total sample. Participants were also more likely to endorse a history of sexual trauma when answering behaviorally specific rather than general "label" questions. Women survivors in particular were more likely than men to identify their experiences as abuse/assault (66.7% versus 21.1% for child sexual abuse), which may help explain prevalence differences between men and women in prior research. Men may be less likely than women to label their experiences as abuse and may be underidentified in sexual trauma research without the use of behaviorally specific questions. Overall, the results of this study suggest that the prevalence of sexual trauma is better assessed using behaviorally specific questions and that this is an important topic of study among both men and women.

Resilience in physically abused children: protective factors for aggression

Aggression continues to be a serious problem among children, especially those children who have experienced adverse life events such as maltreatment. However, there are many maltreated children who show resilient functioning. This study investigated potential protective factors (i.e., child prosocial skills, child internalizing well-being, and caregiver well-being) that promoted positive adaptation and increased the likelihood of a child engaging in the healthy, normative range of aggressive behavior, despite experiencing physical maltreatment. Logistic regression analyses were conducted using two waves of data from the National Survey of Child and Adolescent Well-Being (NSCAW-I). Children who were physically maltreated were more likely to exhibit clinical levels of aggressive behavior at Time 1 than children who were not physically maltreated. Children's internalizing well-being, children's prosocial behavior, and caregivers' well-being were associated with lower likelihood of clinical levels of aggressive behavior at Time 1. Children's internalizing well-being and children's prosocial behavior remained significantly associated with nonclinical aggression 18 months later. These findings highlight the role of protective factors in fostering positive and adaptive behaviors in maltreated children. Interventions focusing on preventing early aggression and reinforcing child prosocial skills, child internalizing well-being, and caregiver well-being may be promising in promoting healthy positive behavioral adjustment.

Risk recognition, attachment anxiety, self-efficacy, and state dissociation predict revictimization

Background

Previous research has identified a number of variables that constitute potential risk factors for victimization and revictimization. However, it remains unclear which factors are associated not only with childhood or adolescent victimization, but specifically with revictimization. The aim of this study was to determine whether risk recognition ability and other variables previously associated with revictimization are specifically able to differentiate individuals with childhood victimization only from revictimized individuals, and thus to predict revictimization.

Methods

Participants were N = 85 women aged 21 to 64 years who were interpersonally victimized in childhood or adolescence only, interpersonally revictimized in another period of life, or not victimized. A logistic regression analysis was conducted to examine whether risk recognition ability, sensation seeking, self-efficacy, state dissociation, shame, guilt, assertiveness, and attachment anxiety predicted group membership.

Results

The logistic regression analysis revealed risk recognition ability, attachment anxiety, state dissociation, and self-efficacy as significant predictors of revictimization. The final model accurately classified 82.4% of revictimized, 59.1% of victimized and 93.1% of non-victimized women. The overall classification rate was 80%.

Conclusions

This study suggests that risk recognition ability, attachment anxiety, self-efficacy, and state dissociation play a key role in revictimization. Increased risk recognition ability after an interpersonal trauma may act as a protective factor against repeated victimization that revictimized individuals may lack. A lack of increased risk recognition ability in combination with higher attachment anxiety, lower self-efficacy, and higher state dissociation may increase the risk of revictimization.

Childhood sexual abuse and attachment insecurities as predictors of women's own and perceived-partner extradyadic involvement

We examined the association between self-reported childhood sexual abuse and a woman's own and perceived-partner extradyadic involvement (EDI). The association was examined both directly and as potentially mediated by attachment-related anxiety and avoidance in a sample of 807 French Canadian women. In line with our hypotheses, we found that a personal history of CSA is associated with a woman's own and perceived-partner EDI and with the woman's levels of attachment anxiety and avoidance. The association between CSA and own EDI was partially mediated by attachment-related avoidance. The results suggest that a sense of betrayal stemming from CSA predisposes a woman to avoidance, which in turn predisposes her to EDI. The association between CSA and perceived-partner EDI was partially mediated by both attachment anxiety and avoidance. These results suggest that victims of CSA become suspicious of others' relational behavior and intentions, which contribute to attachment-related anxiety and avoidance and both own and perceived-partner EDI.

Development of Romantic Relationships in Adolescence and Emerging Adulthood: Implications for Community Mental Health

Romantic relationships emerge in the early adolescent years and mature over the course of adolescence from initial cross-gender affiliations to dyadic partnerships. Adolescents’ romantic relationships are important because they contribute to relational development and foretell the quality of intimate relationships in adulthood. This paper summarizes current research findings on the development of romantic relationships, focusing first on the normative stages of mainstream youth and subsequently on atypical patterns of troubled youth. Peer and family influences on romantic development are considered as well as ethnocultural variation. The paper concludes with several policy implications for community mental health.

Childhood trauma and the development of paranormal beliefs

Belief in the paranormal is fairly prevalent in the general population. Previous research has shown a link between several personological characteristics and paranormal beliefs. The current study attempted to further investigate this link by replicating previous models that have shown a link between childhood trauma, fantasy proneness, and paranormal beliefs. In addition, the study attempted to expand on this model by including other variables such as stigma, resiliency, and coping style. The study used a sample of 198 undergraduate students. A significant correlation between trauma and paranormal beliefs was found. Partial correlations and path analyses revealed that fantasy proneness and avoidant coping style fully mediate the relationship between trauma and paranormal beliefs. The results imply that researchers need to take into account how a person responds to trauma via the development of coping strategies to accurately understand any observed relationship between trauma and paranormal beliefs.

Parental opinions of their child's experience in the legal process: an interpretative analysis

The aim of this study is to demonstrate how parents of children who are victims of sexual assault experience the legal process from the children's and parents' perspective. Nine parents, identified in the records of three public prosecution offices in three cities in Sweden, were interviewed. The parents described feelings of shame and guilt over what their children had experienced. They felt stigmatized and had difficulty fulfilling their parental role, perceived a lack of information and support from the professionals involved, and experienced a sense of withdrawal from their role as parents, though they felt the professionals who worked with their children were helpful and influential.