A prospective study of memory for child sexual abuse: new findings relevant to the repressed-memory controversy

Factors influencing adult cognitive appraisals of childhood sexual abuse

BACKGROUND

Adult appraisals of their childhood sexual experiences as abusive are associated with increased risk for long-term psychological problems. Factors that underlie whether adults appraise their childhood sexual experiences as abusive remain unknown.

OBJECTIVE

To determine factors associated with adult cognitive appraisals of childhood sexual abuse.

PARTICIPANTS AND SETTING

Participants were 1196 adults ages 19-41 (M = 29.23, SD = 3.84) with documented cases of childhood maltreatment (sexual abuse, physical abuse, and neglect) during the years 1967-1971 and demographically matched controls who were followed-up and interviewed in adulthood.

METHODS

Using a prospective cohort design, participants were asked to recall whether they had any sexual experiences in childhood, and if so, the frequency of abuse, age at the onset of abuse, relationship to perpetrator, and whether they appraised the experiences as sexually abusive.

RESULTS

Over half of the sample (52%) reported childhood sexual experiences, yet only 44% considered those experiences sexually abusive. Participants with documented cases of child sexual abuse and neglect were more likely to appraise their childhood sexual experiences as abusive compared to controls. Participants who reported more severe abuse, more frequent abuse, younger age at the onset of abuse, and intrafamilial and both intra- and extrafamilial abuse (vs. extrafamilial abuse) were more likely to consider their experiences abusive. Compared to males and Black participants, females and White participants were more likely to appraise their experiences as abusive.

CONCLUSIONS

Understanding factors that determine adult cognitive appraisals of childhood sexual experiences as abusive can inform clinical interventions for maltreated populations.

False memories in forensic psychology: do cognition and brain activity tell the same story?

One of the most important problems in forensic psychology is the impossibility of reliably discriminating between true and false memories when the only prosecution evidence comes from the memory of a witness or a victim. Unfortunately, both children and adults can be persuaded that they have been victims of past criminal acts, usually of a sexual nature. In adults, suggestion often occurs in the context of suggestive therapies based on the belief that traumatic events are repressed, while children come to believe and report events that never occurred as a result of repeated suggestive questioning. Cognitive Researchers have designed false memory paradigms (i.e., misinformation effect, Deese-Roediger-McDermott paradigm, event implantation paradigm) to first form false memories and then determine whether it is possible to reliably differentiate between false and true memories. In the present study, we review the contribution of cognitive research to the formation of false memories and the neuropsychological approaches aimed to discriminate between true and false memories. Based on these results, we analyze the applicability of the cognitive and neuropsychological evidence to the forensic setting.

Mediating role of depressive symptoms in the association between adverse childhood experiences and asthma

BACKGROUND

Adverse childhood experiences (ACEs) are associated with asthma, but the role of depressive symptoms (DS) in this is poorly studied.

OBJECTIVE

The aim of this study was to investigate the mediating effect of DS on ACEs and asthma.

PARTICIPANTS AND SETTING

This study was a retrospective cohort study of participants from the China Longitudinal Study of Health and Retirement from 2011 to 2018. A total of 12,277 participants including 5942 males and 6335 females were involved in the study.

METHODS

DS were assessed using the 10-item short form of the Center for Epidemiological Research Depression Scale. Logistic regression adjusted for confounders was used to explore the relationship between ACEs with asthma. Mediating effect analysis was used to assess the role of DS in the relationship between ACEs and asthma.

RESULTS

The results of logistic regression showed that there were an association between ACEs and asthma. Mediating effect analysis revealed that among the 15 ACEs examined, DS had partial mediating effects on the association between asthma and 5 specific ACEs (feeling alone, peer bullied, self-reported health status, health limitation, and death of parents), and fully mediated the relationship between asthma and another 5 ACEs (death of siblings, childhood neighborhood safety, childhood neighborhood quality, physical abuse, and parents' mental health) (all p < .05).

CONCLUSION

ACEs are significantly associated with an increased risk of asthma, and DS play a mediating role in the relationship between ACEs and asthma.

A systematic review of factors associated with disclosure of child sexual abuse

BACKGROUND AND OBJECTIVE

Disclosure of CSA is key to victims having access to support and protection, but the current understanding of what factors play a key role is still limited. The present review aims to understand a range of socio-ecological factors that can either facilitate or obstruct the disclosure of CSA.

METHODS AND RESULTS

Through a systematic review of 27 quantitative studies published from 2000 to 2022, the current review identified 17 significant predictors of CSA disclosure. Facilitators of disclosure included older age, being female, higher IQ, recent abuse, resistance during abuse, clergy perpetrator, non-offending caregiver support, and acculturation. Barriers to disclosure included intellectual disability, avoidant coping, romantic relationships with the perpetrator, family criminality, domestic violence, adherence to traditional Asian values, and ethnic minority identity. The findings also suggested that the relationship between predictors and disclosure tends to be mixed, contradictory, or indirect/interactional, emphasizing the importance of situating the findings in specific social-ecological contexts.

CONCLUSIONS

The findings can inform future research and practice by providing a comprehensive understanding of the predictors of CSA disclosure and highlighting the importance of considering the socio-ecological context when interpreting findings. Moreover, the review provides a valuable resource for professionals who work with victims of CSA, helping them better identify factors that may facilitate or hinder disclosure and allowing for tailored interventions.

Childhood Sexual Abuse: A Longitudinal Study of Disclosures and Denials

In legal cases regarding child sexual abuse (CSA), children have various options, such as to disclose or deny maltreatment. When interviewed in adulthood, their accounts may be consistent with their childhood responses. Alternatively, denial in childhood could be followed in adulthood by disclosure ("deferred disclosure"), confirming previous suspicions. Or the adults could possibly recant. We conducted a longitudinal study of CSA disclosures and denials (N = 99; Time 1 [T1], 3- to 16-year-olds). T1 CSA disclosures and denials at a forensic unit were compared to the individuals' responses 20 years later (Time 2 [T2]. 22- to 37-years-old). We found that consistent disclosure was associated with being older at T1 and female. Deferred disclosure was significantly associated with greater T2 trauma-related symptoms. Corroboration and higher CSA severity predicted T2 recantation. Consistent denial was related to less severe CSA. Our findings add to knowledge about CSA disclosures, which affect legal pathways available to child victims.

A scientometric and descriptive review on the debate about repressed memories and traumatic forgetting

Recent work suggests that the debate surrounding repressed memory and traumatic forgetting continues today. To further investigate this debate, we performed preregistered scientometric analyses on publications on the debate about repressed memory to provide information about its bibliometric evolution. Furthermore, we reviewed these publications to highlight the different positions taken by scholars on this debate. We reviewed 434 publications extracted from Scopus and Web of Science from 1969 to 2022. Our scientometric analyses permitted us to visualize the development of the publications on repressed memories and identify the terminology used to label this phenomenon. We identified three waves of publications (i.e., 1994-2000; 2003-2009; 2012-2021) showing that there is a recent peak of scholarly attention into this topic. 40% of scholars supported the phenomenon of repressed memory while 29% did not. Moreover, although in the last wave of publications, 35% of articles included critical arguments against the existence of repressed memory, a sizable number of publications (21%) supported ideas in favour of repressed memory. Finally, we observed that the term dissociative amnesia is another expression used to refer to the phenomenon. Our results provide additional evidence that the debate on repressed memories (and dissociative amnesia) is far from being over.

Posttraumatic stress disorder, traumatic events, and longitudinal eating disorder treatment outcomes: A systematic review

OBJECTIVE

Many individuals diagnosed with an eating disorder (ED) have been exposed to traumatic events, and some of these individuals are diagnosed with posttraumatic stress disorder (PTSD). Although theorized by researchers and clinicians, it is unclear whether traumatic event exposure or PTSD interferes with outcomes from ED treatment. The objective of the current study was to systematically review the literature on traumatic events and/or PTSD as either predictors or moderators of psychological treatment outcomes in EDs.

METHOD

A PRISMA search was conducted to identify studies that assessed the longitudinal association between traumatic events or PTSD and ED outcomes. Eighteen articles met the inclusion criteria for review.

RESULTS

Results indicated that traumatic event exposure was associated with greater ED treatment dropout, but individuals with a traumatic event history benefited from treatment similarly to their unexposed peers. Findings also indicated that traumatic events may be associated with greater symptom relapse posttreatment.

DISCUSSION

Given the limited number of studies examining PTSD, results are considered very tentative; however, similar to studies comparing trauma-exposed and nontrauma-exposed participants, individuals with PTSD may have similar treatment gains compared to individuals without PTSD, but individuals with PTSD may experience greater symptom relapse posttreatment. Future researchers are encouraged to examine whether trauma-informed care or integrated treatment for EDs and PTSD mitigates dropout from treatment and improves symptom remission outcomes. Furthermore, researchers are encouraged to examine how the developmental timing of traumatic events, self-perceived impact of trauma, and cumulative trauma exposure may be associated with differential ED treatment outcomes.

PUBLIC SIGNIFICANCE

Eating disorders (EDs), trauma, and posttraumatic stress disorder (PTSD) often co-occur. Individuals with traumatic event exposure and/or PTSD demonstrate greater ED symptoms; it is unclear whether these individuals benefit similarly in ED treatment to their peers. The current study found that individuals with traumatic event exposure are more likely to drop out of treatment but benefit from treatment with similar symptom remission. Traumatic history was associated with greater relapse posttreatment.

Seeing the past in a new light: change in reports of childhood abuse and neglect before and after inpatient psychotherapy and its relevance for change in depression symptoms

OBJECTIVE

As changes in mental representations have been discussed as mechanisms of change in psychotherapy, the question arises whether recollections of childhood abuse and neglect are altered as well and how they relate to symptom changes.

METHOD

Individuals in psychosomatic inpatient treatment (N = 488, 60.5% women) filled out the Childhood Trauma Questionnaire (CTQ) and Patient Health Questionnaire (PHQ-9). Changes in both were investigated with correlations and t-tests. Linear regression analysis was used to test whether CTQ changes predicted symptom changes. Network analysis was performed to ascertain structural connections between somatic and emotional-cognitive depression symptoms and CTQ subscales before and after treatment.

RESULTS

After treatment (duration in days: M = 52.83, SD = 20.94), patients reported fewer depression symptoms (d = 0.84), while CTQ scores increased slightly (d = 0.11). Changes in the CTQ predicted recovery from depression symptoms in a statistically significant way (β = .133, p = .001). We did not observe changes in the overall network structure between baseline assessment and discharge.

CONCLUSION

The findings suggest that the evaluation of past experiences can change over multiple weeks of psychotherapy. Further, these updated mental representations, indicating a greater recognition of past adversity, may contribute to symptom relief.

Longitudinal consistency of self-reports of adverse childhood experiences among adolescents in a low-income setting

A sizeable literature documents the associations between adverse childhood experiences (ACEs) and poor health in later life. By and large, ACEs are measured using retrospective self-reports. Little is known about the longitudinal consistency of these self-reports in panel data with multiple measurements. This is especially true in adolescence, as most studies using ACEs self-reports have been conducted among adults. Furthermore, very few studies have explored the consistency of ACEs self-reports in low- and middle-income countries, where the reported prevalence of ACEs tends to be higher than in high-income countries. Addressing these gaps, the current study examines the consistency of ACEs self-reports among a cohort of adolescents (N = 1,878, age 10 to 16 at survey baseline) in rural Malawi. We use data from two waves of the ACE project of the Malawi Longitudinal Study of Families and Health carried out in 2017-18 and 2021. In addition to the high prevalence of self-reported ACEs among adolescents in our sample, we document very low consistency of self-reports over time (average Kappa coefficient of 0.11). This low consistency is attributable not only to adolescents reporting more ACEs over time, which could be due to new exposures, but also to adolescents reporting fewer ACEs over time. Analyses of survey vignettes indicate that individual and sociocultural perceptions of abuse do not explain this low consistency. We find that external events (such as changes in socioeconomic status and negative economic shocks) and internal psychological states (such as depression and post-traumatic stress disorder) both predict inconsistencies in ACEs self-reports. Compared with results from prior studies, our findings indicate that the longitudinal consistency of ACEs self-reports may be lower in adolescence than in adulthood. Taken together, these findings suggest that ACEs self-reports provided by adults may be biased by key processes unfolding in adolescence.

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Very low consistency of ACEs self-reports in a cohort of adolescents.

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Individual and sociocultural perceptions of abuse do not explain low consistency.

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Psychological states such as depression and PTSD predict inconsistent self-reports.

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Consistency of ACEs self-reports may be lower in adolescence than in adulthood.

A court ruled case on therapy-induced false memories

We report on a unique Italian criminal case in which a court ruled that a therapist implanted false memories of abuse in a young girl. Using therapeutic excerpts, we show that the therapist used a multitude of problematic interventions that are all linked to false memory creation. Specifically, an analysis of the therapeutic excerpts showed that across many sessions, the therapist asked highly suggestive questions to the girl, implying that she was abused by her father. In addition, the girl underwent EMDR techniques that have been associated with memory undermining effects. Our analyses showed that although before treatment the girl did not have any recollection of being abused by her father, she gradually started to remember the abuse and identified the father as her abuser during the therapeutic sessions. Our case report clearly shows the danger of suggestive pressure in a therapeutic context causing patients to form false memories of abuse and supports the need to prevent the therapeutic practice of suggestive techniques.

A Systematic Review of the Effect of Parental Adverse Childhood Experiences on Parenting and Child Psychopathology

Adverse childhood experiences (ACEs) are defined as early exposure to maltreatment and household dysfunction. Researchers have demonstrated the link between ACEs and negative psychological, behavioral, interpersonal, and health outcomes. A growing area of interest in the ACE literature concerns the relationship between ACEs, parenting, and child psychopathology due to the intergenerational effect of ACEs. Emotional availability and discipline strategies are two domains of parenting that can increase understanding of the associations between ACEs, parenting, and child psychopathology from an attachment framework because they are both salient during early childhood and directly influence a child's later behavior. This paper utilized the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to elucidate the relationships between parental ACEs, parents' emotional availability and discipline strategies, and children's psychopathology. PubMed, PSYCINFO, and Psychology and Behavioral Sciences Collection were used to access the literature on June 16, 2020, and 26 studies met the inclusion criteria. Results from this review suggested that there is a direct association between ACEs and parental emotional availability and discipline techniques. Depression and dissociation were identified as potential mediators. There was support for the direct association between parental ACEs and children's internalizing and externalizing difficulties. Maternal anxiety and depressive symptoms, emotional availability, attachment, and children's maltreatment experiences were found to be possible mediators. Recommendations are proposed to address limitations within the literature to further expand upon the research of ACEs, parenting, and child psychopathology.

Victims of sexual offences: aspects impacting on participation, cooperation and engagement with the interview process

The way in which police officers interview sexual offence victims is pivotal to how their cases proceed through the criminal justice system (CJS). However, such interviews have previously been found to be lacking in overall quality, with some interviewers finding them technically difficult and stressful to conduct. In addition, victims often feel disbelieved, unsafe and/or uncomfortable during their police interview. The present study provides insight into the personal experiences of five female adult rape/sexual assault victims regarding their police interviews and the aspects that encouraged them to cooperate and engage during the interview process. Following semi-structured interviews, interpretative phenomenological analysis (IPA) was used to identify three key themes: (i) heading into the unknown, (ii) difficulty of talking about the crime and (iii) helpful and unhelpful interviewer approaches. Implications for practice are discussed, together with the need to further our understanding of this specialist area of police work.

Believing in dissociative amnesia relates to claiming it: a survey of people's experiences and beliefs about dissociative amnesia

Dissociative amnesia is one of the most controversial categories in the field of psychiatry and clinical psychology. Self-reports of dissociative amnesia in the general population, and beliefs about this topic, have so far not been subjected to empirical scrutiny. Here, we surveyed a sample from the general population (N = 1017), revealing that about a tenth (n = 102) claimed to have experienced dissociative amnesia. Some claims pertained to amnesia for traumatic autobiographical experiences (e.g., sexual assault), while other claims reflected memory loss for experiences that can be regarded as non-traumatic or non-stressful (e.g., dissociative amnesia for an anniversary). Importantly, many participants believed in the existence of dissociative amnesia, and those who claimed dissociative amnesia indicated even more belief in this phenomenon than the rest of the sample. Finally, many participants indicated to have at least once claimed to have feigned memory loss in their life, and that they experienced some form of forgetting when trying to retrieve events for which they lied upon. Overall, our findings suggest that claiming dissociative amnesia goes hand in hand with believing in dissociative amnesia.

Vaginismus, Dyspareunia and Abuse History: A Systematic Review and Meta-analysis

BACKGROUND

Genito-pelvic pain/penetration disorder, which consists of a combination of vaginismus and dyspareunia, is considered a new diagnosis in the latest version of the Diagnostic and Statistical Manual of Mental Disorders. Although the etiology of this diagnosis is not well known, a history of abuse has been suggested to be a primary factor in the emergence of this disorder.

AIM

This systematic review and meta-analysis aimed to determine the association of abuse history with vaginismus and dyspareunia diagnosis.

METHODS

Related keywords were used to search articles in PubMed, PsycArticles, PsycINFO, Scopus, Web of Science, and the Turkish scientific information database (TRDizin). All articles published in English and Turkish until August 2020 were systematically reviewed. A total of 14 case-control studies, including 1428 participants, were included in the final analysis. The fixed-effects model was used to pool odd ratios (ORs) and 95% confidence intervals (CIs) of the studies. Heterogeneity was evaluated using the I² statistic.

OUTCOMES

Case-control studies that reported vaginismus or dyspareunia outcomes in individuals with or without a history of abuse.

RESULTS

A significant relationship was found between a history of sexual (1.55 OR; 95% CI, 1.14-2.10; 12 studies) and emotional abuse (1.89 OR; 95% CI, 1.24-2.88; 3 studies) and the diagnosis of vaginismus. A significant relationship was found between sexual abuse and dyspareunia (1.53 OR; 95% CI, 1.03-2.27; 6 studies). No statistically significant relationship was observed between physical abuse, vaginismus, and dyspareunia. No significant difference was found between sexual or physical abuse in terms of assessment methods for the diagnosis of vaginismus and dyspareunia.

CLINICAL IMPLICATIONS

This systematic review and meta-analysis points out that in the assessment of vaginismus patients, the risk of sexual and emotional abuse and in the assessment for dyspareunia patients, the risk of sexual abuse should be questioned and addressed in its treatment.

STRENGHT AND LIMITATIONS

The strength of the current meta-analysis is the inclusion of all forms of abuse, and studies published in Turkish and English with a broad and reproducible search strategy. The limitations of this meta-analysis are the exclusion of sources and design other than journal articles and case-control studies, including studies both childhood and adult abuse, which in some studies were not differentiated, having potential language and recall bias.

CONCLUSION

The study analysis suggests an association of vaginismus with sexual and emotional abuse and dyspareunia with sexual abuse. However, both disorders showed no association with physical abuse. S. Tetik, ÖY. Alkar, Vaginismus, Dyspareunia, and Abuse History: A Systematic Review and Meta-analysis. J Sex Med 2021;18:1555-1570.

Childhood maltreatment predicts poorer executive functioning in adulthood beyond symptoms of internalizing psychopathology

BACKGROUND

A history of childhood maltreatment predicts poorer functioning in several domains during childhood, including executive function (EF). While there is also evidence of poorer EF in adults with a history of childhood trauma, results are mixed. Notable limitations of previous research are (a) the use of single indicators of EF, and/or (b) not consistently assessing whether childhood maltreatment predicts poorer EF beyond internalizing psychopathology.

OBJECTIVE

We sought to overcome limitations of prior work by examining relationships between childhood maltreatment and EF in adulthood by using a latent factor of EF derived from multiple indicators and including psychopathology covariates in our analyses.

PARTICIPANTS AND SETTING

The present study included a large sample of community adults (n = 489) who were oversampled for internalizing psychopathology symptoms.

METHODS

Primary analyses examined whether childhood maltreatment (cumulative and subtypes) predicted EF using a latent factor approach and linear mixed effects models. Follow-up analyses assessed the impact of childhood maltreatment on EF beyond internalizing psychopathology symptoms and assessed whether gender moderated relationships between EF and childhood maltreatment.

RESULTS

Greater cumulative maltreatment predicted poorer EF (B = -0.15), and emotional neglect emerged as a unique predictor of EF (B = -0.18). These results remained after controlling for psychopathology symptoms. Gender moderated the relationship between physical abuse and EF, with physical abuse predicting poorer EF among males (B = 0.30), but not females (B = -0.04).

CONCLUSIONS

Overall, results indicate that general EF deficits are related to a history of childhood maltreatment, which is not accounted for by internalizing psychopathology symptoms. Potential implications and future directions are discussed.

The Influence of Harsh Parenting and Parental Warmth During Childhood on Later Involvement in Prison Misconduct

Research has shown that childhood victimization is associated with later involvement in delinquency. Prevalence rates of childhood victimization also tend to be higher among prison inmates compared with the general population. However, it has rarely been examined if childhood experiences-both negative and positive-have an effect on prison misconduct. We analyzed self-report data from more than 4,800 male and female adult prisoners in Germany to examine if childhood experiences of harsh parenting and parental warmth are associated with physical inmate-on-inmate violence. We also assessed the inmates' attitude toward violence and examined if violence approval mediates the relationship between childhood experiences and violent misconduct. The results of the structural equation models show that both harsh parenting and positive, caring parental behavior have a small, but significant effect on violent prison misconduct, which is completely mediated by the inmates' attitude toward violence. Furthermore, the results suggest that the same model holds for both male and female inmates, indicating that childhood victimization is not a gender-responsive need. The strength of the direct association between violence approval and violent misconduct underscores the need to assess the inmates' attitude toward violence to identify those most at risk of engaging in violence during incarceration.

Potential Traumatic Events through the Life Cycle in an Immigrant Population

Existing studies on traumatic events focused on children, while it has been understudied in older adults. This study aims to examine prevalence, frequency, and severity of life events in older Chinese Americans. The data were drawn from the Population Study of Chinese Elderly (PINE) in 2017–2019. Twenty life events were evaluated, including natural disasters, personal traumatic events, and historical events. Among 3125 participants, the mean age was 75.33 (standard deviation (SD) = 8.22) with 61.06% female. Cultural Revolution (73.27%) has the highest prevalence. A total of 1819 (58.39%) participants reported typhoon and experienced multiple times. Falsely accused of crime was reported as the most severe event. Women were more likely to report family-related life events. Those with higher education were more likely to report personal traumatic events. This study is among the first to profile life events in older Chinese Americans. Age cohorts, gender roles, and socioeconomic status shape individuals’ exposure to life events. This study could help identify which vulnerable groups have high risks of exposure to traumatic events.

The Views of Ex-Police Officers on Child Abuse Case Attrition in the United Kingdom

Attrition in child abuse cases is of continuing concern. International research has produced evidence to suggest that the form and quality of the evidence available in many child abuse cases is of insufficient quality to allow progression through the judicial system. Recent revelations have led to an increase in public and professional awareness of the prevalence of child sexual abuse, and how this is managed by the legal and social care systems. The aim of this research was to explore the opinions of ex-Police Officers who had direct experience relating to the management of child abuse cases about the factors affecting case progression. Seven ex-Police Officers were interviewed and the transcribed data were thematically analyzed. The five main themes derived from the data were Global Myths, Assumptions, and Misconceptions; Suitability; Resources; Professionals' Attributes; and Working Together. These themes demonstrated that the primary issues indicated by ex-Police Officers were more about relationships between professionals, an understanding of the child's perspective, and their subsequent involvement in the legal processes than simply being related to a lack of resources.

Detecting children's true and false denials of wrongdoing: Effects of question type and base rate knowledge

One common and unfortunately overlooked obstacle to the detection of sexual abuse is non-disclosure by children. Non-disclosure in forensic interviews may be expressed via concealment in response to recall questions or via active denials in response to recognition (e.g., yes/no) questions. In two studies, we evaluated whether adults' ability to discern true and false denials of wrongdoing by children varied as a function of the types of interview question the children were asked. Results suggest that adults are not good at detecting deceptive denials of wrongdoing by children, even when the adults view children narrate their experiences in response to recall questions rather than provide one word answers to recognition questions. In Study 1, adults exhibited a consistent "truth bias," leading them toward believing children, regardless of whether the children's denials were true or false. In Study 2, adults were given base-rate information about the occurrence of true and false denials (50% of each). The information eliminated the adults' truth bias but did not improve their overall detection accuracy, which still hovered near chance. Adults did, however, perceive children's denials as slightly more credible when they emerged in response to recall rather than recognition questions, especially when children were honestly denying wrongdoing. Results suggest the need for caution when evaluating adults' judgments of children's veracity when the children fail to disclose abuse.

Childhood abuse history and attention bias in adults

Attention biases toward unpleasant information are evident among children and adults with a history of abuse and have been identified as a potential pathway through which abused children develop psychopathology. Identifying whether a history of childhood abuse affects the time course of attention biases in adults is critical, as this may provide intervention targets. The present study examined the time course of attention bias during an emotion-word Stroop task using event-related potentials (ERPs) in a sample of adults with a range of child abuse histories using a categorical approach (comparing adults with or without a history of moderate-to-severe childhood abuse) and a dimensional approach (analyzing the range from no abuse to severe abuse in a continuous manner). Although behavioral performance did not vary as a function of abuse history, adults with a history of moderate-to-severe childhood abuse showed ERP evidence of early reduced processing of emotional stimuli (smaller N200) and later reduced processing of emotional and nonemotional stimuli (smaller P300), followed by later increased processing of unpleasant stimuli (larger slow wave [SW]). Results suggest that early disengagement from emotional stimuli may help individuals with moderate-to-severe abuse histories to achieve normal behavioral performance on the emotion-word Stroop task. Additionally, regardless of analytic approach, adults with elevated levels of childhood abuse exhibited prolonged engagement (larger SW) specifically with unpleasant stimuli. Present results demonstrate attention bias patterns in adults with a history of childhood abuse and clarify the time course of attention bias. Results are discussed in the context of potential treatment implications.

From surviving to thriving: factors associated with complete mental health among childhood sexual abuse survivors

BACKGROUND

Despite many negative health and social consequences of childhood sexual abuse (CSA), some of those with a history of adversity manage to thrive in adulthood and achieve complete mental health (CMH). CMH is defined as the absence of mental illness in combination with almost daily happiness and/or life satisfaction, as well as high levels of social and psychological well-being. The objectives of this study were (1) to identify the pathways linking CSA to CMH in adulthood and (2) to estimate the magnitude of risk and protective factors associated with CMH among those exposed to CSA.

METHODS

A sample of 17,014 respondents aged 20 years and older from the 2012 Canadian Community Health Survey-Mental Health was selected including 651 with a history of CSA. Path analysis was used to estimate indirect and direct pathways between CSA, a priori hypothesized risk and protective factors, and CMH. Multivariable logistic regression was then used to investigate the magnitude of effects of the same risk and protective factors on CMH among CSA survivors.

RESULTS

After controlling for age, sex, race, education, and marital status, the association between CSA and CMH was mediated by lifetime depression, anxiety, substance abuse, chronic pain, and having a confidant. The strongest predictor of past-year CMH among those with a history of CSA was lifetime depression (OR 0.12, 95% CI 0.07-0.20) followed by having a confidant (OR 6.78, 95% CI 1.89-24.38). The odds of CMH was decreased by over three times among those with a history of substance misuse, and halved for those with lifetime anxiety and/or presence of pain.

CONCLUSIONS

These findings suggest that CMH among survivors of CSA is related to social and emotional factors such as social support and lifetime history of mental health conditions. Future research should investigate the effectiveness of multilevel interventions for promoting recovery among CSA survivors.

Amygdala subnucleus volumes in psychosis high-risk state and first-episode psychosis

Structural and functional abnormalities of the amygdala in schizophrenia have been well documented. Post-mortem studies suggest that the lateral nucleus is particularly affected in schizophrenia. It is not known whether the amygdala subnuclei are differently affected at the time of the first-episode psychosis or already at high-risk state. 75 first-episode psychosis patients (FEP), 45 clinical high-risk patients (CHR) and 76 population controls participated in this cross-sectional case-control study. Participants underwent T1-weighted 3T MRI scans, from which the amygdala was segmented using a newly developed automated algorithm. Because early adverse events increase risk for psychosis and affect the amygdala, we also tested whether experiences of childhood maltreatment associate with the putative amygdala subnuclei abnormalities. Compared to the population controls, FEP had smaller volumes of the lateral, and basal nuclei. In CHR, only the lateral nucleus was significantly smaller compared to the control subjects. Experience of childhood maltreatment was inversely associated with lateral nucleus volumes in FEP but not in CHR. These results show that the lateral and basal nuclei of the amygdala are already affected in FEP. These volumetric changes may reflect specific cellular abnormalities that have been observed in post-mortem studies in schizophrenia in the same subnuclei. Decreased volume of the lateral nucleus in CHR suggest that a smaller lateral nucleus could serve as a potential biomarker for psychosis risk. Finally, we found that the lateral nucleus volumes in FEP may be sensitive to the effects of childhood maltreatment.

The Return of the Repressed: The Persistent and Problematic Claims of Long-Forgotten Trauma

Can purely psychological trauma lead to a complete blockage of autobiographical memories? This long-standing question about the existence of repressed memories has been at the heart of one of the most heated debates in modern psychology. These so-called memory wars originated in the 1990s, and many scholars have assumed that they are over. We demonstrate that this assumption is incorrect and that the controversial issue of repressed memories is alive and well and may even be on the rise. We review converging research and data from legal cases indicating that the topic of repressed memories remains active in clinical, legal, and academic settings. We show that the belief in repressed memories occurs on a nontrivial scale (58%) and appears to have increased among clinical psychologists since the 1990s. We also demonstrate that the scientifically controversial concept of dissociative amnesia, which we argue is a substitute term for memory repression, has gained in popularity. Finally, we review work on the adverse side effects of certain psychotherapeutic techniques, some of which may be linked to the recovery of repressed memories. The memory wars have not vanished. They have continued to endure and contribute to potentially damaging consequences in clinical, legal, and academic contexts.

Reports of recovered memories of childhood abuse in therapy in France

Recovered memories of abuse in therapy are especially controversial if the clients were not aware they were abused before therapy. In the past, such memory recovery has led to legal action, as well as a debate about whether such memories might be repressed, forgotten, or false memories. More than two decades after the height of the controversy, it is unclear to what degree such memories are still recovered today, and to what extent it occurs in France. In our French survey of 1312 participants (M_age = 33; 53% female), 551 reported having done therapy at some point. Of that 551, 33 (6%) indicated they had recovered memories of abuse in therapy that they did not know about before therapy. Sexual abuse was the most commonly reported type that was recovered in therapy (79%). As in past research, discussing the possibility of repressed memories with therapists was associated with reports of recovered memories of abuse. Surprisingly, memory recovery occurred just as much in behavioural and cognitive therapies as it did in therapies focused on trauma. We found recovered memories in a proportion of clients who began therapy recently. Recovered memories in therapy appears to be an ongoing concern in France.

The risk of Telling: A Dyadic Perspective on Romantic Partners' Responses to Child Sexual Abuse Disclosure and Their Associations with Sexual and Relationship Satisfaction

Among 70 community couples who reported childhood sexual abuse (CSA) and disclosure to their partner, this study examined associations between survivors' perception of partner responses to their disclosure, and both partners' sexual and relationship satisfaction. Participants completed self-report questionnaires online. Results of path analyses within an actor-partner interdependence model indicated that survivors' perceived partner responses of emotional support to disclosure were associated with their own and their partners' higher sexual satisfaction. Survivors' perceived responses of being stigmatized/treated differently by the partner were associated with their own and their partners' poorer relationship satisfaction. Findings suggest that survivor-perceived partner responses to the disclosure of CSA can have a positive and a negative impact on the sexual and relationship satisfaction of both partners.

Maternal History of Childhood Maltreatment and Children's Cognitive and Social Development

A growing literature provides evidence of long-term effects of childhood sexual trauma (CST), however the intergenerational consequences of CST are not well understood. In the current study we examine the adjustment of children whose mothers reported a history of CST compared to children whose mothers did not report childhood trauma across multiple domains of functioning. Data for these analyses were obtained from a longitudinal study of low-income, rural families. Propensity score matching (PSM) methodology was used to create a contrast group matched on maternal family of origin variables in an effort to isolate and examine the long-term associations of maternal CST history beyond the effects of other childhood adversities such as poverty (total N = 204). After controlling for numerous child and primary caregiver covariates, findings indicate that a maternal history of CST is related to higher levels of teacher reports of behavioral problems and academic skills in the classroom setting in Kindergarten and First grade. This study adds to the growing literature on the effects of maternal CST on offspring development. Implications for interventions with children with mothers reporting a history of CST and directions for future study are proposed.

Agreement Between Prospective and Retrospective Measures of Childhood Maltreatment: A Systematic Review and Meta-analysis

IMPORTANCE

Childhood maltreatment is associated with mental illness. Researchers, clinicians, and public health professionals use prospective or retrospective measures interchangeably to assess childhood maltreatment, assuming that the 2 measures identify the same individuals. However, this assumption has not been comprehensively tested.

OBJECTIVE

To meta-analyze the agreement between prospective and retrospective measures of childhood maltreatment.

DATA SOURCES

MEDLINE, PsycINFO, Embase, and Sociological Abstracts were searched for peer-reviewed, English-language articles from inception through January 1, 2018. Search terms included child* maltreatment, child* abuse, child* neglect, child bull*, child* trauma, child* advers*, and early life stress combined with prospective* and cohort.

STUDY SELECTION

Studies with prospective measures of childhood maltreatment were first selected. Among the selected studies, those with corresponding retrospective measures of maltreatment were identified. Of 450 studies with prospective measures of childhood maltreatment, 16 had paired retrospective data to compute the Cohen κ coefficient.

DATA EXTRACTION AND SYNTHESIS

Multiple investigators independently extracted data according to PRISMA and MOOSE guidelines. Random-effects meta-analyses were used to pool the results and test predictors of heterogeneity.

MAIN OUTCOMES AND MEASURES

The primary outcome was the agreement between prospective and retrospective measures of childhood maltreatment, expressed as a κ coefficient. Moderators of agreement were selected a priori and included the measure used for prospective or retrospective assessment of childhood maltreatment, age at retrospective report, sample size, sex distribution, and study quality.

RESULTS

Sixteen unique studies including 25 471 unique participants (52.4% female [SD, 10.6%]; mean [SD] age, 30.6 [11.6] years) contained data on the agreement between prospective and retrospective measures of childhood maltreatment. The agreement between prospective and retrospective measures of childhood maltreatment was poor, with κ = 0.19 (95% CI, 0.14-0.24; P < .001). Agreement was higher when retrospective measures of childhood maltreatment were based on interviews rather than questionnaires (Q = 4.1521; df = 1; P = .04) and in studies with smaller samples (Q = 4.2251; df = 1; P = .04). Agreement was not affected by the type of prospective measure used, age at retrospective report, sex distribution of the sample, or study quality.

CONCLUSIONS AND RELEVANCE

Prospective and retrospective measures of childhood maltreatment identify different groups of individuals. Therefore, children identified prospectively as having experienced maltreatment may have different risk pathways to mental illness than adults retrospectively reporting childhood maltreatment. Researchers, clinicians, and public health care professionals should recognize these critical measurement differences when conducting research into childhood maltreatment and developing interventions.

When psychological science fails to be heard: the lack of evidence-based arguments in a ministerial report on child sexual abuse

One of the most debated issues in relation to child sexual abuse (CSA) is whether there should be a limitation period for prosecutions. In 2017 a French ministerial report was released proposing extension of the limitation period in part because of the sometimes long delay between the alleged events and the disclosure of the abuse. For this, the report relied on dissociative amnesia. It also advocated for the development of child victim interview protocols by victim associations. We show that dissociative amnesia is not consensual within the scientific community. Instead, we recommend scientifically reliable cognitive principles to explain the lack of memory. Moreover, interviewing techniques for children have already been designed by memory researchers to enhance recall and report of CSA, from which any uncontrolled deviation might put the child's testimony at risk. We conclude by advocating for the use of evidence-based psychology, and for co-operation between practitioners, judges and researchers.

Exploring Trajectories of Pornography Use Through Adolescence and Emerging Adulthood

While the scholarly literature on pornography use is growing, much of this literature has examined pornography use as a static feature that does not change. Despite this trend, pornography use, like most sexual behaviors, is likely best viewed as a dynamic feature that may shift across the developmental life span. Using a sample of 908 adults from the United States, retrospective data on pornography use through adolescence and emerging adulthood were gathered to explore trajectories of pornography use across these developmental periods. Latent mixture models suggested the presence of common patterns of use across both developmental periods. Adolescence patterns appeared to largely be distinguished by those who either engaged or did not engage with pornography, while emerging adulthood data revealed the presence of a group of experimenters who engaged in pornography through adolescence but then decreased use through their 20s. Men were found to be more likely to have consistent profiles of pornography use, while single adults were likely to have delayed entry into pornography use. Associations with adult mental health and pornography use were found, suggesting that early exposure to pornography was related to elevated current pornography use patterns and, to a lesser extent, dysfunctional pornography use. Trajectories also had a weak association with life satisfaction, with individuals reporting trajectories involving consistent pornography use reporting lower life satisfaction after controls.

The Secret of Intrafamilial Child Sexual Abuse: Who Keeps It and How?

This article analyzes how women survivors of intrafamilial child sexual abuse perceive the family members who took part in keeping it secret and their tactics for doing so. Analysis of 20 in-depth interviews with Jewish Israeli women revealed unique ways of guarding the secret. These were attributed to the perpetrator, the mother and the family. Secret-keeping tactics included presenting a normative public identity or an unstable psychological identity, presenting multiple personas, reframing the abuse, concealing any trace of the secret after it was disclosed, as if the abuse had never happened, and making a monument of the abuser. These tactics are discussed in the context of silencing, the interpersonal relations orientation model, and the wider concepts of secrecy in society. Implications for professional practice and for society are considered, and new attitudes toward intrafamilial child sexual abuse secrecy are suggested.

Emotion Language in Trauma Narratives is Associated with Better Psychological Adjustment among Survivors of Childhood Sexual Abuse

Traumatized individuals are often encouraged to confront their experiences by talking or writing about them. However, survivors of childhood sexual abuse (CSA) might find it especially difficult to process abuse experiences, particularly when the abuse is more severe, which could put them at greater risk for mental health problems. The current study examined whether CSA survivors who use emotion language when describing their abuse experiences exhibit better mental health. We analyzed the trauma narratives of 55 adults who, as children, were part of a larger study of the long-term emotional effects of criminal prosecutions on CSA survivors. Abuse narratives were analyzed using the Linguistic Inquiry and Word Count (LIWC) program. We examined whether positive and negative emotion language in participants' abuse narratives were associated with self- and caregiver-reported mental health symptoms and whether these associations differed according to the severity of the abuse. As hypothesized, participants who used more positive and negative emotion language had better psychological outcomes, especially when the abuse was severe. Our findings suggest that survivors of more severe abuse might benefit from including emotion language, whether positive or negative in valence, when describing the abuse.

Common Beliefs About Child Sexual Abuse and Disclosure: A College Sample

Adults' common beliefs about child sexual abuse and disclosure were explored. Participants (N = 670) were questioned about key areas of child sexual abuse that could affect decision-making processes of jurors evaluating child sexual abuse cases. These areas included victim and perpetrator characteristics, medical and behavioral indicators of child sexual abuse, memories for the event, and disclosure of the event. The scientific literature pertaining to these same areas are reviewed. While individual beliefs were consistent with some areas of the scientific literature (e.g., victim and perpetrator characteristics), they strongly contrasted the literature in other important areas (e.g., memories for the event, indicators of child sexual abuse, and the likelihood of denial and recantation). Implications, including the option of providing expert testimony to reduce discrepancies, are discussed.

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

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

Traumatic Impact Predicts Long-Term Memory for Documented Child Sexual Abuse

Prospective studies of adults' memories of documented child sexual abuse (CSA) reveal that the majority of individuals remember their victimization. However, the accuracy of these memories has rarely been investigated scientifically. The present study examined predictors of memory accuracy and errors 12 to 21 years after abuse ended for individuals with legal experiences resulting from documented CSA. Severity of posttraumatic stress disorder (PTSD) symptomatology was positively associated with memory accuracy. However, individuals nominating CSA as their most traumatic life event exhibited relatively accurate memory regardless of indicators of PTSD. Predictors of memory errors were also identified (e.g., less maternal support). These results indicate that, in addition to understanding the role of traditional cognitive factors, understanding an event's traumatic impact is important for predicting the accuracy of long-term memory for reported CSA.

The Occurrence and Traumatic Impact of Sexual Revictimization in Newlywed Couples

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

Individual Differences in Emotional Memory: Adult Attachment and Long-Term Memory for Child Sexual Abuse

In the present study, attachment-related differences in long-term memory for a highly emotional life event, child sexual abuse (CSA), were investigated. Participants were 102 documented CSA victims whose cases were referred for prosecution approximately 14 years earlier. Consistent with the proposal that avoidant individuals defensively regulate the processing of potentially distressing information (Bowlby, 1980), attachment avoidance was negatively associated with memory for particularly severe CSA incidents. This finding was not mediated by the extent to which participants reported talking about the abuse after it occurred, although postabuse discussion did enhance long-term memory. In addition, accuracy was positively associated with maternal support following the abuse and extent of CSA-related legal involvement. Attachment anxiety was unrelated to memory accuracy, regardless of abuse severity. Implications of the findings for theories of avoidant defensive strategies and emotional memory are discussed.

Maternal Childhood Sexual Trauma and Early Parenting: Prenatal and Postnatal Associations

Existing research suggests that approximately 19% of females experience childhood sexual trauma (CST). Little is known, however, about the parenting behaviour of mothers who have experienced CST. Using propensity-matched controls, the present study examines prenatal psychosocial distress, postnatal depressive symptomatology, and caregiving behaviours of women reporting CST at or before the age of 14. Data for these analyses were obtained from mother reports and from observational protocols from a longitudinal study of low-income, rural families. Propensity score methodology was used to create a contrast group matched on family of origin variables in an effort to isolate and examine the long-term associations of CST beyond the effects of other childhood adversities such as poverty. Study findings provide evidence that women with CST histories report greater prenatal psychosocial distress compared to women without trauma histories. Findings further provide evidence for a spillover process from prenatal distress to the broader caregiving system including less sensitive parenting through postnatal depressive symptoms for women with CST histories. These results highlight the importance of screening for CST and psychosocial distress and depression prenatally. Interventions for women with CST histories and directions for future study are proposed.

Abuse Characteristics and Individual Differences Related to Disclosing Childhood Sexual, Physical, and Emotional Abuse and Witnessed Domestic Violence

Many adult survivors of childhood abuse hide their victimization, avoiding disclosure that could identify perpetrators, end the abuse, and bring help to the victim. We surveyed 1,679 women undergraduates to understand disclosure of childhood sexual, physical, and emotional abuse, and, for the first time, witnessed domestic violence, which many consider to be emotionally abusive. A substantial minority of victims failed to ever disclose their sexual abuse (23%), physical abuse (34%), emotional abuse (20%), and witnessed domestic violence (29%). Overall, abuse-specific factors were better predictors of disclosure than individual-level characteristics. Disclosure of sexual abuse was related to experiencing more frequent abuse (by the same and by multiple perpetrators), being more worried about injury and more upset at the time of the abuse, and self-labeling as a victim of abuse. Disclosure of physical abuse was related to experiencing more frequent abuse (by the same and multiple perpetrators), being less emotionally close to the perpetrator, being older when the abuse ended, being more worried and upset, and self-labeling as a victim. Disclosure of emotional abuse was associated with being older when the abuse ended, and being more worried and upset. Disclosure was unrelated to victim demographic characteristics or defensive reactions (dissociative proneness, fantasy proneness, repressive coping style, and temporary forgetting), except that among physical and emotional abuse victims, repressors were less likely to disclose than non-repressors. Disclosure of witnessing domestic violence was not significantly related to any factors measured.

Challenges in the retrospective assessment of trauma: comparing a checklist approach to a single item trauma experience screening question

BACKGROUND

Research on trauma and its impact on mental health typically relies on self-reports which can be influenced by recall bias and an individual's subjective interpretation of events. This study aims to compare responses on a checklist of life events with a trauma experience screening question, both of which assessed trauma experience retrospectively.

METHODS

A community sample of adults were asked about life events from a checklist before asking them whether they ever had a trauma experience, i.e. "an event that either puts them or someone close to them at risk of serious harm or death".

RESULTS

Less than half of the sample who reported at least one life event on the checklist that qualified as a trauma reported a trauma experience that they perceived put them or close others at risk of serious harm. Women responders, those reporting early life traumas, and a greater number of lifetime trauma events were more likely to report a trauma experience. Current symptoms of Common Mental Disorder did not account for differences in reporting of trauma experiences.

CONCLUSIONS

Epidemiological approaches which require participants to make subjective judgement on the severity of the trauma experience will capture individual differences that we have shown are influenced by gender and previous trauma experience.

Factors Associated with Delays of Days to Decades to Criminal Prosecutions of Child Sexual Abuse

Until the latter part of the 20th century, legal doctrines made it almost impossible to successfully prosecute in criminal court a case involving child sexual abuse (CSA), whether the complaint was timely or delayed. Many English-speaking countries have abrogated most formal legal barriers to prosecuting CSA cases, and courts are faced with the singular challenge of adjudicating sexual offenses against children that are reported to have happened years or decades earlier. We conducted analyses of 4,237 criminal complaints of CSA heard in Canadian criminal courts. There were several differences between timely and delayed prosecutions that led us to conclude that delayed prosecutions of CSA are common and due, in part, to the nature of the offense. Offense duration was associated with longer delays to prosecution. When the accused had access to the child through his position in the community, length of delay to prosecution was very long, particularly for male complainants. More research is needed on delayed CSA prosecutions, particularly given an apparent trend for jurisdictions to abolish barriers to criminal prosecutions of CSA that occurred years or decades earlier.