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Grady MD, Yoder J, Jones SN, Williams A. Seeking an Integrated Approach to Trauma and Problematic Sexual Behaviors in Adolescents: Learning from Practitioners. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2024; 17:383-397. [PMID: 38938949 PMCID: PMC11199444 DOI: 10.1007/s40653-023-00604-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/13/2023] [Indexed: 06/29/2024]
Abstract
More than a third of all sexual crimes are committed by adolescents. In addition, many adolescents struggle with problematic sexual behaviors (PSB) that may not rise to a criminal offense, but cause harm to themselves and those around them. A significant number of these adolescents also have histories of their own trauma; yet there are no treatment models that integrate both PSB and trauma into one comprehensive treatment for this population. This qualitative study's aim was to use the expertise of clinicians who work with adolescents with PSB as well as clients and their caregivers who had completed PSB treatment to understand what they believe are the necessary components and elements needed for an integrated model that seeks to simultaneously address both PSB and the consequences of traumatic experiences. Twenty-six mental health professionals and one former client and his caregiver participated in focus groups (three with clinicians and one with the caregiver and former client) to share their experiences and expertise regarding an integrated model. The thematic analysis procedure yielded six major themes: family, external systems, treatment structure, therapeutic themes, specialized PSB targets, and trauma and PSB integration. Each of these major themes was comprised of subthemes that are presented as well. Implications for practice and future research are discussed, including that clinicians could benefit from guidance and structure to assist them in structuring their interventions to address the multiple needs of their clients that seek to reduce their risk of reoffending while simultaneously enhancing the quality of their lives.
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Affiliation(s)
- Melissa D. Grady
- The Catholic University of America, National School of Social Service, 620 Michigan Ave., NE, Washington, DC 20064 USA
| | - Jamie Yoder
- School of Social Work, Colorado State University, Fort Collins, USA
| | - Sina Nofoagatoto’a Jones
- The Catholic University of America, National School of Social Service, 620 Michigan Ave., NE, Washington, DC 20064 USA
| | - Abigail Williams
- The Catholic University of America, National School of Social Service, 620 Michigan Ave., NE, Washington, DC 20064 USA
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Grady MD, Yoder J. Attachment Theory and Sexual Offending: Making the Connection. Curr Psychiatry Rep 2024; 26:134-141. [PMID: 38319534 DOI: 10.1007/s11920-024-01488-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/24/2024] [Indexed: 02/07/2024]
Abstract
PURPOSE OF REVIEW The purpose of this review is to discuss how attachment theory can be applied to explain sexual violence. Specifically, it discusses how the development of certain risk factors contributes to these behaviors and how attachment-based models can be used to address this issue through prevention and therapeutic interventions. RECENT FINDINGS Recent research demonstrates that individuals who commit sexual offenses have higher rates of insecure attachment styles and that these styles are associated with a number of criminogenic risk factors associated with sexual offending. Such risk factors include cognitive processing difficulties, affect dysregulation, and challenges in interpersonal relationships, among others. Fortunately, treatment interventions have been shown to foster more secure attachment styles and reduce these risk factors. Attachment theory is a viable theory to both understand and intervene with those who have committed sexual violence to reduce the risk factors associated with sexual violence.
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Affiliation(s)
- Melissa D Grady
- Catholic University of America, 620 Michigan Ave, NE, Washington DC, 20064, USA.
| | - Jamie Yoder
- Colorado State University, Fort Collins, USA
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Akintunde TY, Chen S, Isangha SO, Di Q. Adverse childhood experiences, emotional distress and dissatisfaction with motherhood among first-time mothers: Mediations and child differences. Glob Ment Health (Camb) 2024; 11:e18. [PMID: 38414725 PMCID: PMC10897492 DOI: 10.1017/gmh.2024.15] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 12/27/2023] [Accepted: 01/28/2024] [Indexed: 02/29/2024] Open
Abstract
Despite the challenges associated with motherhood, studies have not consistently identified factors contributing to first-time mothers' dissatisfaction with motherhood in resource-limited regions. To fill this research gap, this study investigates how adverse childhood experiences (ACEs) result in first-time mothers' dissatisfaction with motherhood through emotional distress in Nigeria. Results from the partial least square structural equation model suggests that ACEs are associated with dissatisfaction with motherhood ( = 0.092; p < 0.01) and emotional distress ( = 0.367; p < 0.001). There is also a significant association between emotional distress and dissatisfaction with motherhood ( = 0.728; p < 0.001). Indirect path from first-time mothers' ACEs to dissatisfaction with motherhood through emotional distress shows significance ( = 0.267; 95% CI (0.213, 0.323); p < 0.001). In addition, the indirect path from first-time mothers' ACEs to dissatisfaction with motherhood through child emotional closeness showed significant dampening effects ( = 0.044; 95% CI (0.025, 0.066); p < 0.001). No serial impact of emotional distress and child emotional closeness was found in the study. The findings based on child gender indicated that only among first-time mothers of female children are ACEs predictors of dissatisfaction with motherhood. Trauma-informed interventions should be introduced in primary care settings to screen for ACEs and emotional dysfunctions among first-time mothers.
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Affiliation(s)
- Tosin Yinka Akintunde
- Department of Sociology, School of Public Administration, Hohai University, Nanjing, China
| | - Shaojun Chen
- Department of Sociology, School of Public Administration, Hohai University, Nanjing, China
| | - Stanley Oloji Isangha
- Department of Social and Behavioral Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong
| | - Qi Di
- Department of Sociology, School of Public Administration, Hohai University, Nanjing, China
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Grady MD, Yoder J, Deblinger E, Mannarino AP. Developing a trauma focused cognitive behavioral therapy application for adolescents with problematic sexual behaviors: A conceptual framework. CHILD ABUSE & NEGLECT 2023; 140:106139. [PMID: 36965434 DOI: 10.1016/j.chiabu.2023.106139] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 02/07/2023] [Accepted: 03/08/2023] [Indexed: 05/06/2023]
Abstract
Sexual abuse (SA) perpetration is a significant public health problem; SA perpetration is most likely to emerge during adolescence and youth ages 13 to 17 account for a significant portion of all child sexual abuse. While research shows that these youth have high rates of adversity, once they have engaged in problem sexual behavior (PSB), their own trauma histories are often ignored with treatment primarily focused on reducing risk for reoffending. Although sexual re-offense rates among adolescents with PSB are very low, the rates of non-sexual recidivism are considerably higher; with almost half of known youth have reoffended non-sexually, requiring development, implementation, and testing of therapeutic interventions responsive to the indicated risks and unmet needs of adolescents who have engaged in a range of problematic sexual behaviors (PSB-A) and their families. Yet, there are no empirically supported interventions designed specifically to address PSB-A with trauma histories. This article introduces how Trauma-Focused Cognitive Behavioral Therapy can be applied to PSB-A and provides implications for practice and future research.
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Affiliation(s)
- Melissa D Grady
- The Catholic University of America, National School of Social Service, United States of America.
| | - Jamie Yoder
- Colorado State University, Department of Social Work, United States of America
| | - Esther Deblinger
- Child Abuse Research Education Service (CARES) Institute Rowan University, School of Osteopathic Medicine, United States of America
| | - Anthony P Mannarino
- Center for Traumatic Stress in Children and Adolescents Psychiatry and Behavioral Health Institute, Allegheny Health Network, Drexel University College of Medicine, United States of America
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Stinson JD, Puszkiewicz KL, Lasher MP. Associations Between Self-Regulation, Experiences of Childhood Adversity, and Problematic Sexual and Aggressive Behaviors. SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 2023; 35:31-53. [PMID: 35313758 DOI: 10.1177/10790632211058067] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Problems with self-regulation are often theoretically and empirically linked to sexually abusive behavior, as is also true of experiences of early childhood abuse and maltreatment. Questions remain regarding how indicators of dysregulation and self-regulatory deficits interact and are associated with prior maltreatment. In the current study, a range of variables potentially indicative of emotional, cognitive, interpersonal, and behavioral dysregulation and adverse childhood experiences (ACEs) were examined using the frame of the multimodal self-regulation theory among 156 adult men residing in secure forensic care who were receiving treatment for prior sexual offenses. Data were subjected to principal components analysis, resulting in four components that described varying aspects of dysregulated behavior and experiences: Problematic Sexual Behavior (PSB)-Impulsivity, Serious Mental Illness (SMI)-Aggression, ACEs-Suicidality, and Paraphilic Interests-Behavioral Stability. One component comprised of variables associated with maltreatment was associated with impulsivity and PSBs, as well as SMI and violence via linear regression analysis. Theoretical and clinical implications are discussed.
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Affiliation(s)
- Jill D Stinson
- 4154East Tennessee State University, Johnson City, TN, USA
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Yoder J, Brown A, Grady M, Dillard R, Kennedy N. Positive Caregiving Styles Attenuating Effects of Cumulative Trauma Among Youth Who Commit Sexual Crimes. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2022; 66:1755-1778. [PMID: 32830582 DOI: 10.1177/0306624x20952390] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Among youth who commit sexual crimes, childhood trauma experiences have been linked to a host of outcomes including trauma symptom expression. Furthermore, research has begun assessing differential rates of cumulative adverse childhood experiences (ACEs) between youth who commit sexual and non-sexual crimes. Yet, few studies have comparatively examined rates of cumulative traumatic events using more robust measures of adversity. There is scant research on outcomes associated cumulative trauma among youth who commit sexual crimes including linkages to trauma symptoms and how positive parenting styles (PCSs) can attenuate in this relationship. This study aims to compare cumulative trauma experiences between youth who commit sexual (n = 112) and non-sexual crimes (n = 224). Among youth who commit sexual crimes, we test how PCSs mitigate or moderate the effects of cumulative trauma on trauma symptoms. Results from independent samples t-tests revealed significant group differences on singular and cumulative traumatic experiences, and trauma symptomatology, where youth who commit sexual crimes had higher rates of all. Stepwise linear regressions revealed mitigating effects of maternal PCSs and tests of moderation revealed main and interaction effects, where intermediate positive maternal caregiving styles for youth with higher cumulative trauma were associated with greater trauma symptomatology. Implications and limitations are discussed.
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Affiliation(s)
- Jamie Yoder
- Colorado State University, Fort Collins, USA
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Brown A, Yoder J, Fushi K. Trauma and Maternal Caregivers as Risks for Executive Function Deficits Among Youth Who Have Sexually Harmed. SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 2022; 34:24-51. [PMID: 33535902 DOI: 10.1177/1079063220988289] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Despite robust research linking trauma events to the commission of sexual harm by youth, the majority of victims do not become victimizers, imploring us to study potential interceding influences. Some research indicates that intermediary factors like attachment characteristics, trauma symptomatology, and executive functioning may be critical in understanding sexual harm committed by youth. This study explored relationships between trauma events, trauma symptoms, and attachment characteristics, and their relationship to executive functioning in a sample of 196 youth who committed sexual harm. Results revealed bivariate associations between trauma events, symptomatology, and maternal attachment characteristics. Structural equation modeling revealed numerous direct and indirect effects on the path to deficits in executive functioning, and that sexual abuse, above and beyond other forms of traumatic events, contributed to executive functioning deficits via trauma symptoms. The results are contextualized and implications are discussed.
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Affiliation(s)
- Adam Brown
- Silberman School of Social Work at Hunter College, New York, New York, USA
| | - Jamie Yoder
- Colorado State University, School of Social Work, Fort Collins, CO, USA
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Ozkan T, Clipper SJ, Piquero AR, Baglivio M, Wolff K. Predicting Sexual Recidivism. SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 2020; 32:375-399. [PMID: 31169067 DOI: 10.1177/1079063219852944] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The current study focuses on adolescents with sex offense histories and examines sexual reoffending patterns within 2 years of a prior sex offense. We employed inductive statistical models using archival official records maintained by the Florida Department of Juvenile Justice (FDJJ), which provides social, offense, placement, and risk assessment history data for all youth referred for delinquent behavior. The predictive accuracy of the random forest models is tested using receiver operator characteristic (ROC) curves, the area under the curve (AUC), and precision/recall plots. The strongest predictor of sexual recidivism was the number of prior felony and misdemeanor sex offenses. The AUC values range between 0.71 and 0.65, suggesting modest predictive accuracy of the models presented. These results parallel the existing literature on sexual recidivism and highlight the challenges associated with predicting sex offense recidivism. Furthermore, results inform risk assessment literature by testing various factors recorded by an official institution.
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Affiliation(s)
| | | | | | | | - Kevin Wolff
- John Jay College of Criminal Justice, City University of New York, USA
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Yoder J, Grady MD, Brown A, Dillard R. Criminogenic Needs as Intervening Factors in the Relation Between Insecure Attachments and Youth Sexual Violence. SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 2020; 32:247-272. [PMID: 30638159 DOI: 10.1177/1079063218821108] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
There is a strong theoretical and research base demonstrating the link between attachment styles and adolescent sexual offending. However, this relationship may be best explained by deficit-based mediational pathways including criminogenic needs such as emotional or affect regulation and callousness. Grady, Levenson, and Bolder propose a framework that details criminogenic needs as intermediary variables in the attachment-sexual offending relationship. Using data on adolescents adjudicated of sexual and nonsexual crimes in a Western state (N = 200), two structural equation models (SEM) tested direct and indirect relationships between ambivalent and avoidant attachment styles (in separate models), dysregulation including cognitive and behavioral transitions, emotional control, and inhibited/impulsive behaviors, callousness, delinquency, and offending type (sexual or nonsexual offending). Results revealed statistically significant direct pathways between variables of interest and a multimediational effect of dysregulation and callousness in the relationship between insecure attachments and sexual offending. Treatment, policy, and research implications are discussed.
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Affiliation(s)
- Jamie Yoder
- Colorado State University, Fort Collins, USA
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