The Prevalence of Sexual Revictimization: A Meta-Analytic Review

Empowering Young People with Special Educational Needs to Recognize and Report Child Sexual Exploitation and Abuse: A Mixed-Methods Review

Young people with special educational needs (SEN), such as intellectual disability and/or autism, are particularly vulnerable to child sexual exploitation and abuse (CSEA). This mixed-methods systematic literature review consolidates findings in respect to how young people with SEN are currently being taught about CSEA in the UK, incorporating empirical and practice-based findings to counteract publication bias. Key databases were searched, and relevant organizations were contacted regarding studies published between 2015 and 2022 (inclusive). Thirteen articles met the inclusion criteria. Of these, 10 adopted a qualitative methodology, and three a mixed-methods approach. The thematic synthesis of the qualitative studies identified the following themes: (a) beliefs and stereotypes about CSEA, vulnerability. and risk have led to young people with SEN being misinformed and misunderstood, and (b) anxiety about the topic of sex and abuse creates polarized views regarding CSEA education in adult guardians of young people with SEN. Themes are discussed in the context of societal biases in respect to vulnerability and risk, and these biases are considered to have a negative effect on how young people with SEN are supported. The findings of this review encourage providers of CSEA awareness education to be mindful of not endorsing harmful stereotypes, and to involve parent-carers as much as possible. This review additionally encourages services and organizations to increase focus on practitioner reflexivity and regular training to counteract potential biases in respect to gender, vulnerability, and risk.

"I Did Not Want to Make a Bigger Deal Out of It than It Was": A Mixed-Method Study on the Help-Seeking Behavior of Victims of Image-Based Sexual Harassment and Abuse

Experiencing image-based sexual harassment and abuse (IBSHA), or the sending of unsolicited nude or sexual images and the nonconsensual taking, sharing, or threats to share nude or sexual images, may have severe consequences for victims' well-being. While seeking help may be beneficial, not every victim seeks help. Little research has been conducted on IBSHA victims' help-seeking behavior. Therefore, the present mixed-method study examined the help-seeking behavior of IBSHA victims, particularly the barriers and facilitators to seeking help. The study used data from an online survey (N = 163) and interviews (N = 6) among 12-to-25-year-old victims. The quantitative data indicated that the majority of victims disclosed the incident (72.8%), but only a third received help (34.4%). Help-seekers reported greater experienced barriers to help-seeking, when compared to non-help-seekers. The experienced barriers positively predicted victims' reported help-seeking behavior. From the qualitative data, four types of barriers were identified: (a) individual barriers (e.g., feelings of shame), (b) practical barriers (e.g., affordability of help), (c) interpersonal barriers (e.g., fear of negative reactions from one's social environment), and (d) sociocultural barriers (e.g., normalization of IBSHA). Moreover, two types of facilitators were identified: (a) individual facilitators (e.g., the impact of victimization) and (b) interpersonal facilitators (e.g., social support). This suggests victims experience multiple barriers, which altogether can influence their help-seeking behavior. As a help-seeking trajectory is complex and unique to the individual, victims may encounter multiple new hurdles along the way. This may explain why help-seekers reported more barriers. The findings and corresponding implications highlight the importance of providing education on IBSHA and help-seeking on various levels in society.

Exploring the Experiences of Regional and Rural Revictimized Women in a Group Empowerment Program

Sexual revictimization can have a negative impact on many facets of women's wellbeing, yet limited evidence exists regarding specific interventions that support healing and the reduction of further revictimization. This paper will explore regional and rural women's experience of a group-based empowerment program, the Shark Cage program, in Victoria, Australia. The "Shark Cage" program aims to address revictimization by empowering women and girls to build personal boundaries and assertiveness within the context of gender equality and human rights. Data were collected via participant observations across the 8-week program, in combination with semi-structured interviews with participants (N = 11) pre and post intervention. All participants had access to therapeutic support outside of the program. Findings indicate that the program fostered connections among women with shared experiences of sexual revictimization, reducing feelings of isolation. Participants detailed the benefit of developing and practicing skills in reducing revictimization, such as assertiveness and boundary setting. Program learning and recovery was embedded within a network of embodied emotions, social connections, cultural norms and place-based relations that influenced how participants recovery could be understood, processed and addressed.

Levels of Involvement with Child Protection Services Associated with Early Adolescent Police Contact as a Victim and Person of Interest

The relationship between childhood maltreatment and subsequent offending/victimization is well established. However, the magnitude of this relationship for different levels of child protection services (CPS) involvement is poorly understood, due to measurement issues, lack of longitudinal data, and reliance on reports of substantiated maltreatment, which can underestimate the impact of maltreatment. This study examined associations between CPS involvement during childhood (ages 0 to <11 years) and police services contact (as a victim and/or a person of interest) for criminal incidents in early adolescence (11 to ~14 years), differentiated according to levels of CPS involvement (i.e., no risk of significant harm [non-ROSH], unsubstantiated ROSH, substantiated ROSH, and out-of-home care; each examined relative to no CPS contact). Data for 71,465 children were drawn from the New South Wales Child Development Study, an intergenerational, longitudinal investigation that uses administrative records from CPS and police alongside other health, justice, and education data. Multinomial regression analyses were conducted to determine associations between increasing levels of CPS involvement and police contact as a victim only, a person of interest only, and as both victim and person of interest while accounting for covariates (i.e., child's sex, Aboriginal, and/or Torres Strait Islander background, socioeconomic status, maternal age at child's birth, and parental offending history). Children exposed to any of the four levels of CPS involvement had higher odds of police contact, relative to children with no CPS involvement. Odds ratios were higher for contact with police as both a victim and a person of interest, compared to police contact as a victim or a person of interest only. These findings highlight that children with even unsubstantiated CPS reports (i.e., non-ROSH and unsubstantiated ROSH reports) are at heightened risk of police contact compared to children who are unknown to CPS, underlining the need to support all families in contact with CPS.

Continuous chains: childhood maltreatment and intimate partner violence victimization among displaced women in a war context

BACKGROUND

Childhood victimization has been associated with long-term psychological effects and an increased risk of being victimized in later life. Previous research has primarily focused on sexual abuse during childhood, and a wide range of consequences have been identified. However, a significant gap remains in our understanding of the complex interaction between different forms of childhood abuse and violence in later life, particularly in the context of broader social stressors such as armed conflict and displacement.

METHODS

This study examines the association between exposure to different types of childhood maltreatment in the context of family and intimate partner violence (IPV) among displaced women living in refugee camps in northern Iraq. Structured interviews were conducted by trained female psychologists with 332 women aged between 20 and 62 years.

RESULTS

Results indicated that over one-third of the participating women reported experiencing at least one occurrence of IPV by their husbands within the past year. In addition, participants reported experiences of different types of maltreatment (physical, emotional, and sexual violence and physical and emotional neglect) perpetrated by family members in their childhood. While all forms of childhood maltreatment showed an association with IPV within the past year, only emotional childhood maltreatment was found to be a significant predictor of IPV in a multivariate analysis.

CONCLUSION

The study highlights the ongoing impact of child maltreatment and its contribution to increased vulnerability to IPV victimization in later life. In addition, this study describes the specific cultural and contextual elements that contribute to IPV in refugee camps.

Lifetime victimization experiences, depressiveness, suicidality, and feelings of loneliness in youth in care

BACKGROUND

Research has demonstrated the damaging effects of poly-victimization on the mental health of children and adolescents. However, few studies have been conducted in high-risk youth in care (Y-IC) samples.

OBJECTIVE

The study examines the frequency of lifetime victimization and the association of poly-victimization and victimization types on depressiveness, suicidality, and feelings of loneliness among Y-IC.

PARTICIPANTS AND SETTING

164 participants aged 14 and 21 years (M = 17.39, SD = 1.95), who live in family-based care or residential care.

METHODS

The Juvenile Victimization Questionnaire (JVQ) was used to assess lifetime victimization. The Patient Health Questionnaire (PHQ-9), and the Loneliness Scale-SOEP (LS-S) to measure depressiveness, suicidality, and loneliness. Hierarchical regression models were calculated.

RESULTS

Participants reported on average 12.66 (SD = 6.58) victimization experiences. The female and diverse gender groups reported higher rates of victimization, loneliness, depressiveness, and suicidality than the males. Participants in residential care reported more victimizations and stronger feelings of loneliness than those in family-based care. Poly-victimization was not associated with any of these internalizing symptoms but peer victimization was significantly associated with depressiveness (β = 0.23, p = .002) and loneliness (β = 0.22, p = .006), sexual victimization with depressiveness (β = 0.22, p = .004).

CONCLUSION

Y-IC show high levels of victimization and internalizing symptoms, with higher burden on girls and youth living in residential care. Findings underscore the relevance of social exclusion experiences among peers within Y-IC. Interventions should address multiple forms of victimization, with a special focus on sexual and peer victimization.

Dissociation As a Mechanism of Risk for Interpersonal Victimization Among Adolescent Girls

Childhood interpersonal violence exposure (IVE) is associated with repeated victimization in adolescence and adulthood. Research suggests dissociation, a psychological phenomenon characterized by alterations and disruptions to consciousness, memory, and perceptions of the environment, and out-of-body experiences, increases the risk of revictimization. Self-report data from a longitudinal study of 92 violence-exposed adolescent girls from a large, urban area were analyzed to assess whether dissociation predicts polyvictimization or exposure to multiple types of interpersonal violence across adolescence. Participants' mental and interpersonal health was assessed at four in-person laboratory visits scheduled across 3.5 years (i.e., T1-T4). IVE included direct or indirect victimization experienced at home, school, the neighborhood, or town, such as child maltreatment, domestic violence, peer victimization, dating aggression, and community violence. Polyvictimization was operationalized as a composite score of the different types of IVE endorsed by the participant or caregiver. A random-intercept cross-lagged panel model was used to test the bidirectional relationships between dissociation and polyvictimization longitudinally. Cross-lagged regressions were analyzed to determine whether dissociation and polyvictimization predicted subsequent dissociation symptoms and polyvictimization. Concurrent and previous dissociation significantly accounted for polyvictimization at T2, T3, and T4. Polyvictimization did not significantly predict future dissociation symptoms. The results from this study provide support for dissociation's unique contribution to polyvictimization among violence-exposed girls, making it an important target for clinical assessment and treatment.

Childhood sexual abuse, adult sexual assault, revictimization, and coping among sexual minority women

BACKGROUND

Compared with heterosexual women, sexual minority women experience higher rates and greater severity of sexual victimization. Little is known about how childhood sexual abuse (CSA), adult sexual assault (ASA), and revictimization impact coping in this population. Few studies have examined the effects of recency, developmental stage, and revictimization on coping.

OBJECTIVE

To improve psychosocial outcomes following sexual victimization, it is important to understand whether different patterns of exposure differentially impact coping over time. To do so, we investigated associations between CSA, ASA, and revictimization (both CSA and ASA) and adult sexual minority women's coping strategies.

PARTICIPANTS AND SETTING

Data are from a longitudinal community-based sample of 513 sexual minority women of diverse ages and races/ethnicities.

METHODS

Participants reported CSA (

RESULTS

High-risk (i.e., genital penetration) CSA and recent ASA were associated with more avoidant coping (compared to no CSA or no ASA). No interaction between CSA and ASA was found, but history of both CSA and ASA had a stronger effect on avoidant coping than no victimization or CSA only.

CONCLUSIONS

Although sexual revictimization had a stronger impact on coping than CSA or ASA only, we did not find a synergistic effect (i.e., CSA and ASA may have had stacked independent effects). History of ASA was more strongly associated with coping than CSA. Recency of sexual victimization appears especially salient to coping among sexual minority women.

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Key Words

• Adult sexual assault
• Childhood sexual abuse
• Coping
• Revictimization
• Sexual minority women

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MESH Headings

• Adult
• Female
• Child
• Humans
• Adolescent
• Child Abuse, Sexual/psychology
• Sexual Behavior/psychology
• Crime Victims/psychology
• Coping Skills
• Ethnicity

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Grants

• F32 AA029957 NIAAA NIH HHS
• K01 AA028239 NIAAA NIH HHS
• L60 AA029575 NIAAA NIH HHS
• R01 AA013328 NIAAA NIH HHS

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Affiliation(s)

Mariah Xu Columbia University, School of Nursing, United States of America.
Thomas Corbeil Columbia University, Department of Psychiatry, United States of America
Lauren Bochicchio Columbia University, School of Nursing, United States of America
Jillian R Scheer Syracuse University, Department of Psychology, United States of America
Melanie Wall Columbia University, Department of Psychiatry, United States of America
Tonda L Hughes Columbia University, School of Nursing, United States of America

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The Role of Mistrust in Sexual Revictimization: An Analysis of Serial Indirect Effects

A sample of 819 female college students completed measures of childhood sexual abuse (CSA), adult sexual victimization (ASV), mistrust, trauma-related symptoms, and drinking problems. Using a serial indirect effects model, we hypothesized that CSA would be associated with ASV through the indirect effects of mistrust → trauma-related symptoms → drinking problems. The results indicated that this serial indirect effects model was significant. When the order of the first two indirect effects was reversed, the model was not significant. These results highlight the importance of examining potential factors involved in sexual revictimization in tandem rather than in isolation.

Self-regulatory Sex Motives Scale in Online Dating: Exploratory Factor Analysis and Internal Consistency

Risky sex behavior is common among online dating users. Understanding the motives behind risky sex behavior might help identify suitable targets for prevention. We developed the Self-regulatory Sex Motives Scale in Online Dating (SSOD) to assess sex motives for casual sex in online dating users. This study evaluated the psychometric properties of the SSOD and examined the relationship between sex motives indexed by the SSOD and risky sex behavior. The new scale showed high internal consistency. Exploratory factor analysis suggested a one-factor solution. Sex motives were related to a higher frequency of having sex on the first date.

Empowerment Self-Defense Intervention Outcomes: A Descriptive Review of Measures

Global research about empowerment self-defense (ESD)-a sexual assault resistance intervention recommended as a component of a comprehensive sexual assault prevention strategy-continues to emerge, with studies reporting positive effects, including reduced risk of sexual assault victimization. Researchers have suggested ESD may produce additional positive public health outcomes beyond the prevention of sexual violence, but more research is needed to understand the benefits associated with ESD training. However, to conduct high-quality research, scholars have suggested a need for improved measurement tools. To better understand these measurement gaps, the purpose of this study was to identify and review measures used in ESD outcome studies; and in doing so, to determine the range of outcomes previously measured in quantitative studies. Within the 23 articles meeting study inclusion criteria, there were 57 unique scales that measured a range of variables. These 57 measures were grouped into nine construct categories: assault characteristics (n = 1); attitudes and beliefs (n = 6); behavior and behavioral intentions (n = 12); fear (n = 4); knowledge (n = 3); mental health (n = 8); any past unwanted sexual experiences (n = 7); perception of risk and vulnerability (n = 5); and self-efficacy (n = 11). Except for mental health, most scales were developed in the Global North using college student populations, so measures for diverse populations (e.g., diverse in age, culture, ethnicity, geographical origin) are critically needed. Future research should focus on identifying and/or developing standardized tools that measure the full constellation of targeted outcomes. Evaluation of the methodological quality of studies assessing psychometric performance of the tools should also be prioritized.

Reducing the Methodological Heterogeneity ("Noise") in the Literature Predicting In-Prison Interpersonal Harm in Male Populations

Interpersonal harm is a preventable public health problem. A growing body of literature shows persistently elevated exposure rates to physical and sexual victimization during incarceration. Yet how to prevent interpersonal harm during incarceration has proven far more elusive. A public health approach to prevention offers promise. To develop effective prevention strategies, the public health approach begins with defining and measuring the problem, followed by identifying risk and protective factors for the problem. The dynamic literature on in-prison interpersonal harm includes both parts of the public health approach but theoretical and methodological "noise" in this literature limits its instrumental utility to build effective prevention strategies. Herein, we critically review this evidence base (15 peer-reviewed articles published since 2000 with samples of 1,000+) to isolate the noise and the substance. We, then, minimize the methodological noise by testing for risk factors using self-report data that is representative of an entire U.S. state prison system for men and best data collection practices. Multilevel logistic regression is used to predict four types of interpersonal harm using theoretically grounded individual and prison-level covariates that are supported by the empirical literature. We conclude with recommendations for building an evidence base from which to develop prevention strategies that would create and sustain custodial conditions for people to be safe and healthy while incarcerated.

Nonconsensual Sexual Experience Histories of Incarcerated Men: A Mixed Methods Approach

Nonconsensual sexual experiences (NSEs) may contribute to mental health concerns among incarcerated individuals, yet NSEs are understudied in this population. This study takes a novel approach in examining the prevalence of NSEs among incarcerated males by utilizing both quantitative and qualitative measures. The sample consisted of 189 men from three provincial maximum-security prisons in Ontario, Canada. Based on quantitative findings, 44.2% of the sample experienced NSEs before the age of 18, and 41.7% of the sample endorsed an experience that fit the legal definition of a NSEs as adults. Participants also responded to a qualitative open-ended question about their history of NSEs. Based on qualitative findings, a total of 23% of the men reported at least one incident of a NSE (e.g., child and adult). Based Findings highlight the high prevalence of NSEs among incarcerated men with quantitative responses demonstrating how the use of a behavioral questionnaire may, to some extent, correct for underreporting of NSEs. Qualitative responses illustrate the lived experience of incarcerated men and provide a deeper understanding of their NSEs. Responses also speak to the lack of resources and support available to these men. Findings underscore the need for proactive approaches in meeting mental health needs of incarcerated men in general and with regard to NSEs in particular. Results may inform the development of future correctional procedures (i.e., intake protocols that account for men with NSEs) and resources to support incarcerated men in navigating the psychological impact of non-consensual sexual experiences.

Childhood Maltreatment and Revictimization: A Systematic Literature Review

There is established evidence that childhood/adolescent victimization is associated with victimization in adulthood although the underlying mechanisms are not still clear. The current study aimed to systematically review empirical studies examining potential psychological factors linking childhood maltreatment to victimization in adulthood and the gaps in the literature. Following PRISMA protocol, 71 original studies consisting of a total sample of n = 31,633 subjects were analyzed. Symptom severity for various trauma-related disorders, dissociation, emotion dysregulation, and risky sexual behaviors emerged as potential predictors of revictimization. While these potential risk factors mediate the relationship between childhood maltreatment and adulthood victimization, evidence for additional factors such as social support, attachment styles, maladaptive schemas, and risk detection is very limited. Addressing these intrapersonal risk factors, found by prior studies, in interventions and preventive programs might decrease the probability of revictimization. The interactions between the identified risk factors have not been studied well yet. Hence, more research on mediating risk factors of revictimization is needed.

Risk factors for sexual harassment and abuse victimization among adolescent athletes and non-athletes: A one-year follow-up study

BACKGROUND

The association between SHA and negative mental health increases the need to understand risk factors for SHA victimization, which is important for future development of prevention programs.

OBJECTIVE

To examine which combinations of demographic- and mental health factors were associated with subsequent SHA victimization, and the prevalence of elite athletes, recreational athletes, and reference students who experienced sexual revictimization.

PARTICIPANTS AND SETTING

Norwegian elite athletes and recreational athletes attending sport high schools, and reference students attending non-sport high schools (mean age: 17.1 years) were eligible for participation.

METHODS

The participants answered an online questionnaire at two measurement points one year apart, T1 and T2 (n = 1139, 51.1 % girls). After testing for measurement invariance, data were analyzed with Classification and Regression Tree analysis (CRT) using demographic- and mental health variables from T1 as independent variables, and SHA at T2 as outcome.

RESULTS

The combination of being a girl with high level of symptoms of eating disorders and other psychological symptoms was associated with subsequent reporting of SHA. Among the students with lifetime experience of SHA at T1 (n = 533, 58.3 %), 49.5 % reported revictimization at T2 (60.9 % girls, 32.2 % boys, p ≤ .001). The prevalence of SHA revictimization was lower among elite athletes (44.3 %) compared with recreational athletes (49.1 %) and reference students (59.4 %, p = .019).

CONCLUSION

The combination of female gender and mental health symptoms are risk factors for subsequent SHA victimization. These findings, and the high prevalence of SHA revictimization is important knowledge for developing preventive programs targeting elite athletes, recreational athletes, and reference students.

Magnitude and factors associated with sexual re-victimization among adolescent girls and young women in Kinshasa, Democratic Republic of the Congo: a retrospective multicenter study

BACKGROUND

Adolescent girls and young women are more exposed to sexual violence. A significant proportion of victims of sexual abuse are victims of sexual re-victimization. However, information on the burden of sexual re-victimization among AGYW in contexts other than conflict-affected areas in the Democratic Republic of the Congo (DRC) is limited. The aim of this study was to assess the magnitude of sexual re-victimization among AGYW and to identify associated risk factors in the capital, Kinshasa.

METHODS

We conducted a retrospective multicenter cohort study in which sexual violence records between 2015 and 2020 were used to extract and analyze victims' sociodemographic and behavioral characteristics and profiles of sexual violence perpetrated. Multivariate logistic regression models were employed to identify factors associated with sexual re-victimization using the adjusted odds ratio (AOR) with its 95% confidence interval (95% CI) and p value < 0.05.

RESULTS

We found that 74 (31%) of the 241 AGYW included in this study had experienced sexual re-victimization. Sexual re-victimization was associated with being older (> 19 years), sexually active, and living in a single-parent family, and with perpetrator types, particularly intimate partners and family members.

CONCLUSIONS

Our findings provide tools for developing and implementing targeted prevention and intervention programs to reduce sexual violence in general and sexual re-victimization in particular.

The role of child maltreatment and adolescent victimization in predicting adolescent psychopathology and problematic substance use

BACKGROUND

Maltreated children are more likely to experience adolescent victimization, which may underlie the association between maltreatment and adolescent psychopathology and substance use.

OBJECTIVE

To determine whether number of adolescent victimization types predicts adolescent psychopathology and problematic substance use over and above number of child maltreatment subtypes; whether adolescent victimization mediates the relations between maltreatment and change in adolescent psychopathology and problematic substance use; and whether maltreatment moderates the relation between adolescent victimization and changes in these outcomes.

PARTICIPANTS AND SETTING

Participants were 545 (295 maltreated, 250 non-maltreated; 328 males, 217 females) racially and ethnically diverse (52.8 % Black, 27.5 % White, 12.8 % Bi-racial; 13.4 % Latino/a) children and families from the Rochester, New York, USA area assessed across three waves of data (Wave 1, Mage = 7.6 years; Wave 2, Mage = 13.8 years; Wave 3, Mage = 16.2 years).

METHODS

Maltreatment was coded at Wave 1 using Department of Human Services records. Adolescents self-reported psychopathology, problematic substance use, and victimization at Waves 2 and 3.

RESULTS

Structural equation modeling revealed that adolescent victimization predicted adolescent psychopathology (β = 0.24, p < .001) and problematic substance use (β = 0.27, p < .001) over and above child maltreatment. Adolescent victimization did not mediate the association between child maltreatment change in psychopathology and problematic substance use and child maltreatment did not moderate the association between adolescent victimization and these outcomes.

CONCLUSIONS

We discuss the importance of future research utilizing multi-wave designs to examine relations between these constructs and of assessing for more proximal victimization.

Do Risk Factors for Incapacitated and Other Sexual Assault Differ for Black and White College Women? A Preliminary Investigation

Heavy episodic drinking (HED) and hookups are risk factors for college women's sexual assault (SA). Black women engage in these behaviors less frequently than White women. We prospectively examined HED and hookups as mechanisms of incapacitated SA (ISA) and other SA (OSA) risks for Black and White first-year college women and sociocontextual factors that may contribute differentially to risk. In mediation analyses, Black women's less frequent HED predicted lower ISA. SA characteristics (e.g., setting) also differed by race. Mechanisms and types of assault risk may not be the same for all college women, an important consideration for intervention efforts.

Impacts of child sexual abuse: The mediating role of future orientation on academic outcomes

BACKGROUND

Child Sexual Abuse (CSA) has significant impacts on an individual's physical and mental well-being including substance use, depression, anxiety, post-traumatic stress disorder, relationship issues, as well as sexual revictimization in adulthood. Positive future orientation is associated with higher educational outcomes and successful goal attainment, but CSA survivors have lower educational attainment and less employment opportunities leading to less financial security in adulthood.

OBJECTIVE

Our study seeks to examine whether future orientation mediates the relationship between CSA and academic outcomes using data from the Kaplan Longitudinal and Multigenerational Study (KLAMS).

PARTICIPANTS & SETTING

KLAMS is a U.S. based panel study which captures information about the mental health, relationships, academic outcomes, and deviant behavior of two generations of family members at multiple points in time. In the present study, we use data from two separate interviews with the children (N = 2084) of the original respondents.

METHODS

We estimated a series of regressions using generalized structural equation modeling to examine the relationship between child sexual abuse, future orientation, and three different types of academic outcomes.

RESULTS

Youth who experienced sexual abuse had lower grades in school, were more likely to drop out, and had lower levels of education than children with no history of sexual abuse. Negative future orientation mediated the relationship between child sexual abuse and all three outcomes.

CONCLUSIONS

In support of existing research, we found child sexual abuse has a negative impact on positive future orientation, and positive future orientation contributes to better academic outcomes.

Variables affecting the attitudes of teachers and school principals in reporting child abuse: An analysis of demographic characteristics, awareness, and self-efficacy

BACKGROUND

Teachers and school principals have an important role in the lives of children because they spend so much time with them, creating trusting relationships that make it easier to disclose abuse events. As a result, it's critical to look at the factors that influence teachers' and principals' attitudes towards reporting child abuse.

OBJECTIVE

The purpose of this study was to look at the factors that influence preschool teachers, primary school teachers, and school principals (N = 432) attitudes towards reporting child abuse in a Turkish sample.

PARTICIPANTS AND SETTING

The study comprised 432 participants, including preschool teachers, primary school teachers, and school principals. Seniority, educational levels, knowledge of abuse, awareness of abuse, and self-efficacy were among the criteria considered while analysing the participants.

METHODS

The study employed a survey model to assess the attitudes of the participants. Seniority, educational levels, knowledge of abuse, awareness of abuse, and self-efficacy were all considered predictors of attitudes towards reporting abuse.

RESULTS

The investigation found that elementary school teachers were more likely than other participants to report abuse. The branch of education, awareness of sexual abuse, and self-efficacy were found to be important predictors of attitudes towards reporting abuse in a hierarchical analysis. The complete study report will include specific effect sizes and their statistical significance.

CONCLUSIONS

The findings of this study contribute to a better understanding of the factors influencing teachers' and principals' attitudes towards reporting child abuse in Turkey. Primary school teachers had more favourable attitudes, with the education branch, awareness of sexual abuse, and self-efficacy emerging as important predictors.

Childhood maltreatment and adulthood victimization: An evidence-based model

There is ample evidence showing that childhood maltreatment increases two to three fold the risk of victimization in adulthood. Various risk factors, including posttraumatic stress disorder (PTSD) symptoms, dissociation, self-blame, and alcohol abuse are related to revictimization. Although previous research examined associations between risk factors for revictimization, the evidence is limited and the proposed models mostly include a handful of risk factors. Therefore, it is critical to investigate a more comprehensive model explaining the link between childhood maltreatment and adulthood (re)victimization. Accordingly, this study tested a data-driven theoretical path model consisting of 33 variables (and their associations) that could potentially enhance understanding of factors explaining revictimization. Cross-sectional data derived from a multi-wave study were used for this investigation. Participants (N = 2156, age mean = 19.94, SD = 2.89) were first-year female psychology students in the Netherlands and New Zealand, who responded to a battery of questionnaires and performed two computer tasks. The path model created by structural equation modelling using modification indices showed that peritraumatic dissociation, PTSD symptoms, trauma load, loneliness, and drug use were important mediators. Attachment styles, maladaptive schemas, meaning in life, and sex motives connected childhood maltreatment to adulthood victimization via other factors (i.e., PTSD symptoms, risky sex behavior, loneliness, emotion dysregulation, and sex motives). The model indicated that childhood maltreatment was associated with cognitive patterns (e.g., anxious attachment style), which in turn were associated with emotional factors (e.g., emotion dysregulation), and then with behavioral factors (e.g., risky sex behavior) resulting in revictimization. The findings of the study should be interpreted in the light of the limitations. In particular, the cross-sectional design of the study hinders us from ascertaining that the mediators preceded the outcome variable.

The Indirect Effect of Avoidant Motives for Sex on the Pathways From Childhood Maltreatment to Risky Sex Behaviors

Literature supports a strong link between engagement in risky sex and childhood maltreatment, with engagement in risky sexual behavior proposed as a manifestation of avoidant coping. Sex motives refer to underlying motivations for engaging in sex such as increased intimacy, or peer pressure. Limited research has examined the role of sex motives on the relationship between childhood maltreatment and risky sex. This study sought to examine this path between childhood maltreatment types and later engagement in risky sex through sex motivations that seek to avoid or reduce negative affect (i.e., sex to cope and sex to affirm self-esteem). A sample of sexually active undergraduate women (n = 551) completed a series of questionnaires on childhood maltreatment, risky sexual behavior, and motivations for sexual intercourse as part of a larger parent study on revictimization. Path analysis was conducted to examine differential indirect effects of childhood maltreatment on risky sex (i.e., sex with a stranger and hookup behaviors). Results suggested sex to cope with negative affect mediated the relationship between emotional abuse, sexual abuse, physical neglect, and hookup behavior. Only an indirect path between childhood emotional abuse and sex with a stranger was identified through sex to cope. Emotional abuse was the only maltreatment to predict sex to affirm, but sex to affirm did not predict risky sex outcomes. Findings provide support for differential pathways from various forms of childhood maltreatment, specifically sexual abuse, emotional abuse, and physical neglect, to increased risky sex as a manifestation of avoidant coping. Furthermore, results support the call for more inclusion of nonsexual forms of childhood maltreatment in studies of risky sex and avoidant coping as a potential intervention target for risky sexual behavior regardless of childhood maltreatment type.

Pathways from childhood sexual abuse to sexual aggression victimization and perpetration in adolescence and young adulthood: a three-wave longitudinal study

BACKGROUND

Childhood sexual abuse (CSA) has been identified as a risk factor for later sexual aggression perpetration and vulnerability factor for sexual victimization. However, the use of cross-sectional designs, the focus on female victimization and male perpetration, and the lack of evidence from outside North America limit the existing knowledge base.

OBJECTIVE

The study was designed to examine pathways from CSA to sexual revictimization and sexual aggression perpetration after the age of consent.

METHOD

A total of 588 university students in Germany (308 female) took part in a three-wave longitudinal study covering 23 months. At each wave (T1-T3), all participants completed measures of sexual aggression victimization and perpetration. Experiences of CSA were measured at T1.

RESULTS

The rate of CSA was significantly higher for women (20.8%) than for men (12.4%). Rates of sexual victimization for women were 60.9% at Time 1 (since age 14), 22.3% at Time 2 (since T1), and 17.4% at Time 3 (since T2). For men, the rates were 39.2% at Time 1, 15.9% at Time 2, and 14.1% at Time 3. Rates of sexual aggression perpetration for women were 10.6% at Time 1 (since age 14), 3.5% at Time 2 (since T1), and 3.6% at Time 3 (since T2). For men, the rates were 18.0% at Time 1, 6.2% at Time 2, and 3.8% at Time 3. The gender differences in victimization and perpetration were significant only at T1. CSA predicted higher odds of sexual aggression victimization and perpetration cross-sectionally at T1 and indirectly at T2 and T3 via T1. Gender did not moderate the associations.

CONCLUSION

The results confirm previous findings of elevated rates of sexual aggression victimization and perpetration in adolescence and young adulthood in victims of CSA. The implications for understanding and preventing adverse sexuality-related outcomes of CSA are discussed.

Revictimization Risk Factors Following Childhood Maltreatment: A Literature Review

Revictimization research, to date, has primarily focused on sexual revictimization (i.e., child sexual abuse and adult sexual assault), which has resulted in a lack of understanding of trauma revictimization more generally. Specifically, it is unclear what factors are placing individuals with a history of child maltreatment (i.e., sexual abuse, physical abuse, and witnessing intimate partner violence [IPV]) at greater risk for subsequent adult victimization (i.e., sexual assault and IPV). Existing theoretical and empirical work on revictimization suggest that multiple risk factors are likely present within this framework (e.g., posttraumatic stress symptoms [PTSS], emotion dysregulation, and risk-taking behaviors). Prior research has suggested that PTSS are often linked with these other risk factors, and it is possible that the development of PTSS following child maltreatment may be related to the development or maintenance of additional factors that increase the likelihood of revictimization. The purpose of this review was to synthesize findings regarding risk factors that place maltreated individuals at greater risk for adult revictimization. Approximately 228 studies were identified following a thorough search of the peer-reviewed literature using multiple databases (PsycINFO, PILOTS, and Google Scholar). Each study was critically analyzed for relevance. The included studies were used in our review of prevalence, specific risk factors that have been identified, and unanswered questions in this literature. PTSS were noted to be particularly important in the revictimization framework, and thus, a novel model of revictimization was also proposed where PTSS are illustrated as being associated with the development and maintenance of other factors within the revictimization framework.

Leveraging Telehealth to Address Sexual Assault Nurse Examiner Access Disparities in Rural Communities

BACKGROUND

There are persistent gaps in access to sexual assault nurse examiners (SANEs) in rural and underserved areas, yielding health and legal disparities for survivors. These inequities prompted federal investment in novel telehealth programs to improve SANE access.

PURPOSE

The aim of this study was to examine program case studies from two sexual abuse/assault (SA) telehealth centers, illuminating successes, challenges, and lessons learned.

METHODS

Two state SA telehealth program directors used a collective instrumental case study approach to understand telehealth SANE (teleSANE) program challenges/lessons learned, outcomes, and recommendations for the field. Cross-program commonalities and differences were examined, pooling experiences to derive recommendations to sustain telehealth to increase SA health equity.

RESULTS

Collectively, the two programs have served 18 remote sites and provided 335 consultations. Both programs provide access to 24/7 teleSANE consultation, quality assurance, and mentoring. Unique to each program were engagement of hospital leadership in advisory boards, use of telehealth technology, training programs, and fiscal sustainability. Both programs identified flexibility, offering a tailored implementation approach, regular site support and communication, and teleSANE mentoring aligned with the Quality Caring Model as essential to success. Critical needs identified to sustain programs included (a) multilevel community and hospital buy-in, (b) sustainable funding specific to local institution needs, and (c) robust processes to oversee clinical and technology support.

CONCLUSIONS

Cross-program similarities and differences show the impact telehealth can have on equitable SA care. Program evaluation showed common challenges, lessons learned, and recommendations to advance equitable SA care access in underresourced communities.

Treatment Issues While Addressing Child Sexual Abuse: A Review

Child sexual abuse is a traumatic life event that has social, psychological, political and cultural dimensions which is observed in many societies. Sexual abused children are at risk of developing behavioral, emotional, cognitive and physical health problems throughout their lives, and are especially vulnerable when their current condition is combined with other risk factors, such as poverty. In the relevant literature, it is reported that these children have a greater risk of having psychological problems and require treatment. There is evidence that psychotherapeutic treatments have beneficial effects, including ensuring the physical and emotional safety of victims, helping to relieve trauma symptoms, improving quality and functioning of life, and preventing recurrence of abuse. In this review, some of the most common treatment issues for sexual abused children are presented. The appropriateness of the treatment issues and proposed interventions addressed may vary for each victim. These treatment issues and interventions are designed not only to remedy any harm that may have occurred, but also to minimize the negative consequences of experiences of child abuse and prevent future recurrence of maltreatment.

A preliminary examination of sexual and physical victimization 6 months after recent rape

One in four US women will experience a completed or attempted rape in their lifetime, and more than 50% of survivors will experience two or more rapes. Rape and physical violence also co-occur. Multiple experiences of sexual and physical violence are associated with elevated mental and physical health problems. This secondary analysis examined the prevalence and correlates of experiencing sexual or physical violence within 6 months of a sexual assault medical forensic exam (SAMFE). Between May 2009 and December 2013, 233 female rape survivors aged 15 and older were enrolled in a randomized controlled trial during a SAMFE in the emergency department (ED). Demographics, rape characteristics, distress at the ED, and pre-rape history of sexual or physical victimization were assessed. New sexual and physical victimization was assessed 6 months after the SAMFE via telephone interview. Six months after the exam, 21.7% reported a new sexual or physical victimization. Predictors of revictimization during follow-up included sexual or physical victimization prior to the index rape, making less than $10,000 annually, remembering the rape well, life threat during the rape, and higher distress at the ED. In adjusted models, only pre-rape victimization and making less than $10,000 annually were associated with revictimization. Factors assessed at the ED can inform subsequent victimization risk. More research is needed to prevent revictimization among recent rape victims. Policies to provide financial support to recent rape victims and/or targeted prevention for those with pre-rape victimization at the SAMFE could reduce revictimization risk. TRIAL REGISTRATION: NCT01430624.

Implementation of a Universal School-Based Child Sexual Abuse Prevention Program: A Longitudinal Cohort Study

Child sexual abuse (CSA) is a public health problem of considerable magnitude. The prevailing primary prevention strategies are universal, school-based CSA prevention programs, some of which have been designated as evidence-based, such as Safe Touches. However, to reach their public health impact potential, effective universal school-based CSA prevention programs require effective and efficient dissemination and implementation strategies. The purpose of this study was to demonstrate the reach and effectiveness of a school-based CSA prevention curriculum, Safe Touches, when implemented on a wide scale. Using a longitudinal cohort design, children in second grade classrooms in public elementary schools in five counties received the Safe Touches workshop and completed surveys designed to assess gains in knowledge at four timepoints (one week prior, immediately post-workshop, 6- and 12-months post-workshop). In total, the Safe Touches workshop was delivered in 718 classrooms in 92% of school districts, reaching ~14,235 second graders. Multilevel models (n = 3,673) revealed that Safe Touches significantly increased CSA-related knowledge, and that these gains were maintained 12-months post-workshop (ps < .001). There were some small but significant time-varying effects among participants in schools with a greater percentage of low income and minority students, but these effects largely disappeared 12-months post workshop. This study demonstrates that a single-session, universal school-based CSA prevention program can effectively increase children's knowledge when implemented and disseminated on a wide scale and knowledge gains can be retained 12-months post intervention.

Multivariate Patterns of Substance Use, Minority Stress and Environmental Violence Associated with Sexual Revictimization of Lesbian and Bisexual Emerging Adult Women

This study documented between-group differences in factors associated with sexual revictimization histories in a sample of young sexual minority women. Diverse samples of lesbian (N = 204, age_M = 23.55 years) and bisexual (N = 249, age_M = 23.35 years) women from the United States were recruited using the CloudResearch platform to assess factors associated with recent experiences of intimate partner violence (IPV). Participants were categorized into four groups based on self-reports of sexual victimization (a) during childhood and (b) during adulthood in intimate relationships. Multivariate Analysis of Variance (MANOVA) was used to model between-group differences in three variable domains: Past-year substance use involvement, minority stress, and violence in relationship and community settings. Lesbian women reporting sexual revictimization in adulthood reported significantly higher scores for measures of past-year substance use involvement and negative consequences, daily discrimination experiences, relational victimization, and criminal victimization, compared to their counterparts with no history of sexual victimization. Among bisexual women, sexual revictimization was associated with a similar pattern of between-group differences. The sexual revictimization experiences of sexual minority women appear to occur in the context of multivariate patterns of harmful substance use, minority stress, and violence in both relationship and community settings. Our findings have implications for how intervention services are provided to emerging adult sexual minority women who experience multiple episodes of sexual abuse during their lifespans. Recommendations include specialized training for counseling or intervention service providers, integrated trauma-informed services that address both substance use and sexual assault issues, and affirmative services for sexual minority women.

Predictors of Sexual Harassment Using Classification and Regression Tree Analyses and Hurdle Models: A Direct Replication

Sexual harassment affects a large percentage of higher education students in the US. A previous study identified several risk factors for sexual harassment using hurdle models and classification and regression tree (CART) analyses. The purpose of the present study was to assess the robustness of these findings by replicating the analyses with a new sample of students. Secondary data analysis was conducted using data from 9,552 students from two- and four-year colleges. Hurdle model coefficients were assessed for replicability based on statistical significance and consistency of the replication effect size relative to the original effect size. Kotzé et al.'s findings were robust, with 91% of all tested effects meeting at least one of two replication criteria in the hurdle models and 88% of the variables replicating in the CARTs. Being younger, consuming alcohol more frequently, attending a four-year college, and having experienced more prior victimization and adversity were important predictors of peer harassment whereas being LGBQ+ was an important predictor of sexual harassment from faculty/staff. These findings can inform targeted prevention and intervention programs. More research is needed to understand why certain demographic and contextual variables are associated with greater harassment risk.

Exposure to self-reported traumatic events and probable PTSD in a national sample of Poles: Why does Poland's PTSD prevalence differ from other national estimates?

BACKGROUND

There is a lack of studies on trauma exposure and PTSD prevalence in Poland on representative samples. Available data from studies on convenient samples show very high rates of probable PTSD compared with relevant estimates in other countries.

OBJECTIVE

This study aimed to measure the exposure to self-report traumatic events (PTEs) and to estimate the current rate of prevalence of probable posttraumatic stress disorder (PTSD) in accordance with DSM-5 criteria in a population-based sample of Poles. Additionally, the link between PTSD intensity and level of life satisfaction was investigated.

METHOD

A representative sample of 1,598 adult Poles was recruited. Probable PTSD was assessed with the Posttraumatic Diagnostic Scale for DSM-5 (PDS-5) and the Satisfaction with Life Scale (SWLS) was also used.

RESULTS

The findings showed that 60.3% of Poles had experienced at least one PTE and 31.1% of those who had been exposed to trauma reported symptoms of PTSD. At the level of the entire sample, the obtained rate for probable PTSD was 18.8%. The traumatic events with the highest probabilities of PTSD symptoms were child abuse and sexual assault. Levels of life satisfaction were significantly lower in the group of participants with probable PTSD.

CONCLUSIONS

We found that the current prevalence of probable PTSD in Poland is intriguingly high relative to rates reported in comparable representative samples from other countries across the world. Possible mechanisms are discussed, including a lack of social acknowledgement of WWII and other traumas as well as poor access to trauma-focused care. We hope that this research may inspire more studies investigating cross-national differences in PTSD and trauma exposure.

Preventive Education Outreach on Social Media: The Quest to Enroll Community Members in a Child Sexual Prevention Workshop

Social media is a frequently used tool in health promotion efforts although less so for the prevention of child sexual abuse (CSA). This is due, in part, to the lack of standardized branding guides for community-based efforts in how to craft messages related to CSA prevention. This study examined the use of Twitter (now "X") as a means of promoting participation in the adult-focused Stewards of Children CSA prevention workshop, prior to and following the implementation of a standardized branding guide. The exposure, reach, and engagement of the top tweets and top media tweets were examined over 24-months pre- and post-implementation of a five-point branding guide. Engagement was descriptively compared to the number of adults who enrolled in the Stewards of Children workshop. As evidenced by the increase in tweet impressions and the number of adults trained, it is likely the implementation of the branding guide was beneficial in promoting participation in the Stewards of Children workshop. Though participation in a program does not inherently suggest behavior change, getting participants to enroll is a crucial first step. The findings emphasize the potential of using social media to ultimately promote behavior change in the field of CSA prevention and beyond.

"I'm in a Bloody Battle without Being Able to Stop It": The Dissociative Experiences of Child Sexual Abuse Survivors

Dissociation in child sexual abuse (CSA) survivors remains under-recognized and diagnosed, partly because of the difficulties involved in identifying dissociative symptoms. Qualitative research can contribute to a better understanding of the lived experiences of dissociation. This study focused on the experiences of dissociation in the context of CSA. In all, 22 female incest survivors, all diagnosed with different dissociative disorders, provided narratives about their experiences of dissociation. The narratives were analyzed using interpretative phenomenological analysis. The narrative analysis revealed four central themes. The first theme deals with reliving the experience of the abuse. The second theme refers to the experience of disconnection from the body, the self, and the surroundings. The third theme covers the lack of coherence in the narrative, and the fourth theme describes the bridge between voluntary controlled and nonvoluntary uncontrolled use of dissociation. The data are discussed in light of several traumagenic constructs, including a lack of self-sense, being entrapped in a victim-aggressor relationship, and distorted time perception. It is suggested that the extent to which participants can control their dissociation and the coherency of their narratives reflects the severity of their dissociation. Clinicians can consider helping clients use dissociation as an adaptive defense mechanism.

Meaning Making Mechanisms in Women Survivors of Childhood Sexual Abuse: A Scoping Review

Childhood sexual abuse (CSA) is a complex and prevalent problem with devastating long-term consequences for survivors. Despite these consequences, some survivors seem to find a source of meaning and fulfillment throughout their recovery process, which may facilitate resilience and posttraumatic growth (PTG). However, little is known from the literature about the specific meaning making mechanisms that CSA survivors experience. A scoping review was conducted by searching relevant journals and several online databases such as EbscoHost, Scopus, ProQuest, ScienceDirect, and Google Scholar. Studies published in English and that discussed meaning making as a topic of recovery from CSA in the context of women survivors' experiences were included, where a total of 57 articles were selected including qualitative (n = 32), quantitative (n = 9), mixed method (n = 9), and review (n = 7) articles. Using thematic analysis, the results of the scoping review found four mechanisms of meaning making and seven sources of meaning describing the meaning making processes of women survivors of CSA. The mechanisms were identified as being benevolent; restoring and empowering the inner self; mobilizing external and social resources; and lastly actively integrating the trauma narrative. This study contributes toward the global knowledge base on meaning making mechanisms of women survivors of CSA by providing the first known summary of studies to date. Future research is recommended to further confirm these findings to inform treatment interventions for women survivors of CSA.

An ecological approach to understanding the impact of sexual violence: a systematic meta-review

Aim

A systematic meta-review was conducted to examine (1) the broad range of negative and positive individual and interpersonal changes following adult sexual violence, as well as (2) the risk/protective factors at multiple levels of the social ecology (e.g., individual, assault, and micro/meso/exo/macro/chronosystem factors)-influencing the impact of sexual violence.

Methods

Searches of Web of Science, Pubmed, and ProQuest resulted in inclusion of 46 systematic reviews or meta-analyses. Review findings were extracted for summary and a deductive thematic analysis was conducted.

Results

Experiencing sexual violence is associated with many negative individual and sexual difficulties as well as revictimization risk. Only a limited number of reviews reported on interpersonal and positive changes. Factors at multiple levels of the social ecology play a role in the intensity of these changes. Reviews including macrolevel factors were non-existent, however.

Conclusion

Reviews on sexual violence are fragmented in nature. Although the use of an ecological approach is often lacking, adopting such a perspective in research is necessary for a fuller understanding of the multiple influences on survivor outcomes. Future research should evaluate the occurrence of social and positive changes following sexual violence, as well as the role of macrolevel factors in influencing post-assault outcomes.

Emerging Adults' Adverse Life Events and Psychological Functioning: A Comparison Based on Intergenerational Trajectories of Child Maltreatment

Intergenerational continuity of child maltreatment (CM) is a well-documented phenomenon of concern; however, its effects on the child's level of exposure to CM, as well as subsequent trauma exposure and adult functioning remain undocumented. The present study aimed to further explore the intergenerational effects of CM by comparing emerging adults (EA; ages 18-25) on their exposure to CM, adult victimization, and psychological functioning according to their mother's CM histories. One hundred and eighty-five mothers and their EA completed independently an online survey measuring sociodemographics, material deprivation, CM, adult victimization, and psychological functioning. The participating dyads (primarily White and female-identifying) were recruited online through social media, universities, and advertisements in non-profit organizations throughout Canada. Findings revealed that maternal histories of CM were associated with increased neglectful and physically abusive acts endured in childhood for maltreated EA. Maternal histories of CM, regardless of the EA' victimization status, were associated with a higher EA' number of adulthood interpersonal-but not non-interpersonal-traumas experienced. While a maternal history of CM was a risk factor for intimate partner violence (IPV) in maltreated EA, it was protective for non-maltreated EA. Maltreated EA with maltreated versus non-maltreated mothers presented more psychological difficulties, but only if they also reported material deprivation. Practitioners working with children at-risk or exposed to CM should document parents' histories of CM and take that into account in their assessments and intervention practices. This study also provides further evidence to support social policies targeting the family system as a whole.

The Role of Dimensions of Emotion Dysregulation Following Exposure to Maltreatment and Adult Victimization

Child maltreatment is related to a host of negative consequences, including difficulties with emotion regulation (ER), posttraumatic stress symptoms (PTSS), and greater risk for revictimization. Yet, the literature has largely focused on sexual revictimization, while relations between maltreatment and other adult victimization types (e.g., intimate partner violence [IPV]) are less clear. Further, associations between emotion dysregulation and both child and adult trauma exposure have been identified, but aspects of dysregulation (i.e., nonacceptance of emotional responses, difficulties engaging in goal-directed behavior, impulsivity, lack of emotional awareness, limited access to ER strategies, and lack of emotional clarity) have received less attention. This study aimed to: (1) investigate the associations between maltreatment and adult victimization and the six ER dimensions while accounting for PTSS, and (2) determine whether there are indirect effects between maltreatment and adult victimization through each ER component. Seven hundred and forty-four undergraduates from two universities participated in the study (M_age = 21.48, SD = 4.12; 80.9% women; 56.2% white). Maltreatment and PTSS were directly linked with adult victimization (B = 0.14, B = 0.01, respectively). PTSS was inversely associated with each ER aspect (Bs = 0.02-0.10). Unexpectedly, neither maltreatment nor adult victimization was related to the ER dimensions, and no indirect effects were observed between maltreatment and adult victimization through emotion dysregulation. These findings suggest that specific components of emotion dysregulation may not be tied to trauma exposure outside of PTSS. Further, it may be that the ER dimensions are not differentially related to increased risk for adult victimization.

Child abuse and wellbeing: Examining the roles of self-compassion and fear of self

INTRODUCTION

Childhood abuse is linked to poorer well-being, yet some survivors show no prolonged effect, suggesting multifinality. Men and women also differ in the experience and sequelae of abuse supporting gender-specific analyses. To assist in circumventing poor outcomes associated with child abuse, this study examined fear of self (FoS) and self-compassion (SC) as risk and protective factors between child abuse and well-being.

METHOD

Australian women (N = 1302, M_age = 47.28 [13.63]) completed an online assessment of childhood abuse, psychological distress, perceived quality of life, SC, FoS. Moderated-moderation examined the different abuses as predictors of psychological distress and quality of life (QoL) and FoS and SC as primary and secondary moderators, respectively.

RESULTS

Physical abuse did not predict psychological distress or QoL. FoS and SC were independent predictors of distress and QoL. Similarly, childhood sexual abuse was not found to predict distress or QoL. FoS and SC were independent predictors of distress and QoL. There was also an interaction between childhood sexual abuse and SC in predicting QoL. A moderated-moderation was found for the relationship between child sexual abuse and distress. Psychological abuse predicted distress and QoL, and FoS and SC both moderated this relationship. Moreover, a moderated-moderation was observed for the relationship between psychological abuse and QoL.

CONCLUSIONS

Greater FoS is associated with poorer outcomes for child abuse survivors; SC may mitigate this impact. Psychological abuse was the strongest predictor of well-being. Interventions that increase SC and raise awareness of psychological abuse and its impacts are needed.

A Vignettes-Based Exploration of Attitudes of Parents Toward Reporting of Child Sexual Abuse in Ghana

Reporting child sexual abuse (CSA) to law enforcement institutions is the ideal child protection imperative. The role of parents in this process is unquestionably profound. Yet, there is limited evidence on parental perspectives on reporting CSA to law enforcement agencies in developing country contexts. We apply vignettes to describe the views of parents about reporting CSA perpetrated by "family members, schoolteachers, and strangers." Data was collected from 89 parents from four culturally diverse regions of Ghana. A systematic inductive approach was used to determine patterns and similarities in participants' attitudes toward reporting. We note that the attitudes of participants about reporting CSA varied considerably; these are influenced by the nature of social relationships between the victim and perpetrator. In a seeming order of severity, CSA perpetrated by a family member was viewed less seriously compared to victimization by a teacher or a stranger. The desire to preserve familial/kin ties and reputation and keeping to the cultural heritage of resolving "disputes and disagreements" amicably were primary norms against reporting CSA. However, attitudes toward reporting CSA by teachers were influenced by expectation of higher moral standards, which made reporting CSA by a teacher a reasonable cause of action. Positive attitudes toward reporting CSA by "strangers" were prevalent. Child protection programs must recognzse the segmented attitudes toward CSA and tackle the deep-seated cultural and social norms through social and behavioral change communication (SBCC).

Childhood Abuse, Intimate Partner Violence in Young Adulthood, and Welfare Receipt by Midlife

OBJECTIVE

To investigate prospective associations between type of child abuse (physical, sexual, both), timing (childhood, young adulthood, both), and welfare receipt into middle-age.

METHODS

Database linkage study using the Quebec Longitudinal Study of Kindergarten Children cohort born in 1980 and government administrative databases (N = 3020). We assessed parental tax returns, family and personal background characteristics (1982-1987). At age 22 years, participants answered retrospective questionnaires on experienced childhood abuse (physical, sexual abuse < age 18 years) and intimate partner violence (IPV) (ages 18-22). Main outcome was years on social assistance, on the basis of participant tax returns (ages 23-37 years). Analysis included weights for population representativeness.

RESULTS

Of 1690 participants (54.4% females) with available data, 22.4% reported childhood abuse only, 14.5% IPV only, and 18.5% both. Prevalence of childhood physical, sexual, and both was 20.4%, 12.2%, and 8.3%, respectively. Adjusting for socioeconomic background and individual characteristics, we found that childhood physical abuse alone and physical or sexual abuse combined were associated with a two-fold risk of welfare receipt, as compared to never-abused (adjusted incidence risk ratio 2.43, 95% confidence interval [CI], 1.65-3.58; and adjusted incidence risk ratio 2.04, 95% CI, 1.29-3.23, respectively). Repeated abuse (childhood abuse combined with adult IPV) had a three-fold risk (adjusted incidence ratio 3.59, 95% CI, 2.39-5.37).

CONCLUSIONS

Abuse across several developmental periods (childhood and young adulthood) is associated with increased risks of long-term welfare receipt, independently of socioeconomic background. Results indicate a dose-response association. Early prevention and targeted identification are crucial to preventing economic adversity that may potentially lead to intergenerational poverty.

Is the Risk for Sexual Revictimization Cumulative? A Prospective Examination

INTRODUCTION

Sexual abuse during childhood is associated with risk for sexual assault as an adult, known as revictimization. Although multiple experiences of sexual assault in adulthood are also common, it is unclear how risk trajectories might continue to evolve in emerging adulthood, defined as ages 18-25. Clarifying risk trajectories is important to inform the development of targeted risk reduction interventions. To fill this gap, we examined cumulative risk for sexual assault in emerging adult women following multiple experiences of childhood sexual abuse (CSA) and adulthood sexual assault (ASA).

METHODS

Women (n = 447; aged 18-25 years at enrollment) completed behaviorally specific assessments of unwanted sexual experiences at up to 9 time points across 3 years. Logistic regression was used to predict any sexual assault during the 3-year period as a function of victimization history at baseline. A multilevel logistic regression analysis among ASA survivors was then used to determine whether each successive ASA increased risk for further victimization.

RESULTS

Extending prior research, findings revealed that the risk for sexual assault during the 3-year study was greater for women reporting more prior experiences of CSA and ASA. Unexpectedly, each ASA increased the risk for a subsequent ASA to a lesser extent among women with more experiences of CSA.

CONCLUSIONS

Findings suggest that the risk for sexual revictimization can be cumulative, but that risk does not increase indefinitely. Future research should investigate the points at which survivors of multiple assaults may begin to experience a decreased risk for later assaults, as well as the factors associated with change in risk status (e.g., removal from violent environments or relationships, changes in institutional policies). Such research could inform intervention targets.

Factors Influencing Recovery and Well-Being Among Asian Survivors of International Criminal Sex Trafficking in an Urban U.S. City

Sex trafficking is serious form of gender-based violence that results in profound adverse health outcomes, yet one that is poorly understood. New York City is a major hub for sex trafficking, with a significant but unquantified number of victims originating from East Asian countries and trafficked via illicit massage businesses. Peer-reviewed studies among Asian survivors of international criminal sex trafficking do not exist. The aim of this study is to qualitatively examine the factors at various levels of influence that impact the recovery and reintegration process of Asian criminal sex trafficking survivors in the United States from the perspective of survivors and front-line service providers. The study was guided by community-based participatory research and trauma-informed approaches, leveraging a collaboration with a well-established service provider organization. Ten in-depth interviews were conducted between 2018 and 2019 with three Korean survivors and seven key informants who were anti-trafficking service providers working with East Asian clients. Data were analyzed using a grounded theory approach. Survivors and service providers vocalized factors at multiple levels that either facilitate or impede recovery and well-being. Levels of influence included structural (e.g., poverty/debt bondage, immigration status, limited English proficiency), cultural (e.g., fatalism, collectivism), institutional (e.g., lack of culturally appropriate, trauma-informed care), interpersonal (e.g., exploitation, social support), and individual (e.g., resilience). Stigma was a crosscutting factor that spanned all levels of influence. This study highlights the voices of survivors and front-line service providers to understand the lives of an under-researched population of Asian sex trafficking survivors. Ultimately, the root, structural causes of survivor marginalization need to be addressed, which stem from the intersection of class-, gender-, and race-related inequities. While survivors continue to experience exploitation and marginalization post-trafficking, they also carry an enormous amount of resilience that must be leveraged in their path to recovery from trauma.

Sexual, Physical, and Emotional Maltreatment in Childhood Are Differentially Associated With Sexual and Physical Revictimization in Adulthood

Childhood maltreatment increases risk for sexual and physical revictimization in adulthood. The goal of the current study was to examine whether this risk is associated with specific maltreatment types (i.e., sexual vs. physical vs. emotional maltreatment vs. neglect) and perpetrators (i.e., mother vs. father). Participants included 720 adult women from North America and the United Kingdom, recruited through the online platform Prolific Academic. The severity of childhood maltreatment and adult physical and sexual victimization were assessed in two separate sessions through self-report questionnaires. All maltreatment types were modeled together to account for their co-occurrence. Greater severity of sexual maltreatment was significantly and independently associated with greater risk for sexual, physical, and sexual + physical revictimization. Further, in the full sample, risk of revictimization was predicted by greater severity of father-perpetrated emotional and physical maltreatment. In contrast, in subgroup analyses focusing on plurisexual (i.e., bi/pansexual) women, risk of revictimization was predicted by greater severity of mother-perpetrated emotional and physical maltreatment. These results suggest that girls with sexual and emotional maltreatment histories are at highest risk for revictimization. Future research identifying the biological, psychological, and social sequelae of these specific exposures may enable the development of specific intervention programs that have the potential for maximum efficacy in preventing further violence against women most at risk.

A Cross-Sectional Study on Public Awareness About Child Sexual Abuse in Makkah, Saudi Arabia

BACKGROUND

Child sexual abuse is a very serious and dangerous problem. It has long-term consequences and may impact children and follow them into adulthood. Without exception, regardless of their cultures and religious beliefs, all communities are vulnerable to child sexual abuse (CSA).

OBJECTIVE

Our aim in this study is to assess the level of public (caregivers) awareness of CSA in Makkah and Jeddah, Saudi Arabia.

METHODOLOGY

A cross-sectional study was conducted in Makkah and Jeddah. The target populations were Saudi parents, caregivers, and teachers who are in daily contact with children. The participants were selected randomly (n=417), and were requested to complete a questionnaire that was later analyzed using the IBM Corp. Released 2015. IBM SPSS Statistics for Windows, Version 23.0. Armonk, NY: IBM Corp.

RESULTS

369 from 417 responders were females (88.5%), while 48 were males (11.5%). About 90.2% of the responders acknowledged the existence of the child sexual abuse problem. About 95.7% of the caregivers were aware of physical, social, and psychological consequences of child sexual abuse. In contrast, only 33.8% of the responders were aware of existence of social agencies and organizations that provide supportive services to the victims of child sexual abuse.

CONCLUSION

In conclusion, the study found a high rate of awareness in the caregivers who recognize the problem of child sexual abuse (CSA) and are aware of its magnitude and impact on children's well-being. However, these results demonstrate the need for more education of the public about the mandatory laws regarding child sexual abuse.

Psychosocial Outcomes Among Veteran and Non-Veteran Survivors of Sexual Assault

Although it is well-established that sexual assault results in variable and long-lasting negative impacts on emotional well-being, perceptions of physical health, and relationship functioning, these "psychosocial" outcomes may vary based on the type(s) of sexual trauma experienced. To identify the differential impact of sexual trauma type(s) on psychosocial outcomes among veterans and non-veterans, we conducted a secondary analysis of data from the Comparative Health Assessment Interview Research Study, a large, national survey study sponsored by the Department of Veterans Affairs. Participants included veterans (n = 3588) and non-veterans (n = 935) who endorsed experiencing childhood sexual assault (CSA), adult sexual assault (ASA, outside of military service for veteran participants), and/or military sexual assault (MSA). Eight measures were used to assess psychosocial outcomes: Well-Being Inventory (WBI) health satisfaction and physical health functioning items, Posttraumatic Stress Disorder Checklist, Patient Health Questionnaire (depression symptoms), Generalized Anxiety Disorder Questionnaire, WBI social satisfaction items, WBI social functioning items, and the Multidimensional Scale of Perceived Social Support (social). A profile analysis was used to determine how sexual trauma type(s) influenced the pattern of responding to the eight psychosocial outcome measures. Veteran sexual assault survivors reported poorer psychological outcomes compared to non-veteran sexual assault survivors. Non-veteran sexual assault survivors reported poorer outcomes on the majority of social variables compared to veteran sexual assault survivors. Survivors of MSA-only reported poorer psychosocial outcomes compared to veteran and non-veteran survivors of CSA-only and ASA-only on most of the variables assessed. Survivors of ASA-only reported similar or modestly worse psychosocial outcomes when compared to survivors of CSA-only on the majority of variables assessed. Survivors of different types of sexual trauma reported distinct psychosocial outcomes, suggesting that assessment and treatment needs may differ by trauma type.

Prevalence, Characteristics, and Factors Associated With Sexual Violence in Adulthood Among Brazilian MSM

Most studies of sexual violence are with women, and although men who have sex with men (MSM) is the group of the men that has been most investigated for sexual violence, there are still several questions to be answered about sexual violence and sexual revictimization among MSM. This study aimed to estimate the prevalence of sexual violence in different stages of life and identify factors associated with sexual violence in adulthood among Brazilian MSM. We conducted an analysis with data from the study conducted in 2016 with 4,176 MSM from 12 Brazilian cities recruited through respondent-driven sampling (RDS), who answered a survey to a set of questions, among which some specific about sexual violence. Most participants were under 25 years old (56.5%), with more than 12 years of schooling (71.2%), mixed race (40.8%), single (86.2%), and belonging to some religion (50.9%). The lifetime prevalence of sexual violence was 20.3%. In our analyses, having experienced sexual violence in childhood and adolescence increased the odds of experiencing sexual violence in adulthood (prevalence ratio ratios [PRR] 4.93 (95% CI [1.99, 12.21]), as did experiencing physical violence (PRR 1.99; 95% CI [1.07, 3.71]) and receiving money for sex (PRR 2.26; 95% CI [1.17, 4.36]). In addition to violence in childhood and adolescence being risk factors for sexual violence in adulthood, we also observed that half of the sample experienced sexual violence repeatedly, characterizing sexual revictimization. It is important that health services are prepared to receive boys and men victims in order to reduce the chances of revictimization and other outcomes.

Risk Factors for Sexual Revictimization and Dating Violence in Young Adults with a History of Child Sexual Abuse

Interpersonal revictimization, through sexual violence and psychological or physical dating violence, is one of the many consequences of childhood sexual abuse (CSA). This study examined how childhood maltreatment, sociodemographic characteristics, mental health, relational factors, and community factors are associated with 1) sexual revictimization 2) psychological dating violence victimization, and 3) physical dating violence victimization in a sample of young adults reporting a history of CSA. A sample of 190 young adults (18-25 y.o.) with self-reported experiences of CSA completed an online survey measuring childhood maltreatment (e.g. neglect, physical abuse, witness to domestic violence), sociodemographic characteristics (e.g. material deprivation, education), mental health (dissociation, posttraumatic stress symptoms), relational factors (e.g. insecure attachment style), and community factors (e.g. neighborhood disadvantage). Hierarchical logistic regressions indicated that once all risk factors were entered in the models, PTSD was positively associated with psychological dating violence, while dissociation was positively associated with physical dating violence. Physical abuse in childhood was positively associated with sexual revictimization. The present study shows the importance of simultaneously considering the impact of multiple characteristics surrounding CSA survivors when evaluating risks of revictimization. Additionally, it highlights the importance of providing CSA survivors with adequate mental health support for trauma-related disorders, as it may be crucial to prevent revictimization.

Mechanisms by which adverse childhood experiences, other traumas and PTSD influence the health and well-being of individuals with eating disorders throughout the life span

BACKGROUND

Multiple published sources from around the world have confirmed an association between an array of adverse childhood experiences (ACEs) and other traumatic events with eating disorders (EDs) and related adverse outcomes, including higher morbidity and mortality.

METHODS

In keeping with this Special Issue's goals, this narrative review focuses on the ACEs pyramid and its purported mechanisms through which child maltreatment and other forms of violence toward human beings influence the health and well-being of individuals who develop EDs throughout the life span. Relevant literature on posttraumatic stress disorder (PTSD) is highlighted when applicable.

RESULTS

At every level of the pyramid, it is shown that EDs interact with each of these proclaimed escalating mechanisms in a bidirectional manner that contributes to the predisposition, precipitation and perpetuation of EDs and related medical and psychiatric comorbidities, which then predispose to early death. The levels and their interactions that are discussed include the contribution of generational embodiment (genetics) and historical trauma (epigenetics), social conditions and local context, the ACEs and other traumas themselves, the resultant disrupted neurodevelopment, subsequent social, emotional and cognitive impairment, the adoption of health risk behaviors, and the development of disease, disability and social problems, all resulting in premature mortality by means of fatal complications and/or suicide.

CONCLUSIONS

The implications of these cascading, evolving, and intertwined perspectives have important implications for the assessment and treatment of EDs using trauma-informed care and trauma-focused integrated treatment approaches. This overview offers multiple opportunities at every level for the palliation and prevention of EDs and other associated trauma-related conditions, including PTSD.

Sexual Violence against Adolescents in the State of Espírito Santo, Brazil: An Analysis of Reported Cases

OBJECTIVE

We describe the prevalence of the reported cases of sexual violence against adolescents and analyze their associated factors.

METHODS

A cross-sectional analytical study (n = 561) was conducted with reported data on sexual violence against adolescents in the state of Espírito Santo registered in SINAN between 2011 and 2018 to understand the prevalence and predictors of sexual violence against adolescent victims, as well as to describe the perpetrators and the nature of the aggression. Variables to characterize the victim, aggression, and perpetrator were used. Bivariate analyses were performed using chi-square (χ²) and Fisher's exact tests, and multivariate analyses were conducted using log-binomial models; the results were presented with prevalence ratios. All analyses were stratified by sex.

RESULTS

The prevalence of sexual violence was 32.6%, and 93% of the victims were female. In both males and females, the reported sexual violence was associated with a younger age (10-12 years old), living at home, being related to the perpetrator, and a history of sexual violence. In females, the reported sexual violence was also associated with the number of perpetrators, and in males, with the perpetrator's age.

CONCLUSIONS

Our findings show the high frequency of reporting of sexual violence and the characteristics of the victim, the aggression, and the aggressor as factors associated with its occurrence in both sexes. The importance of health information systems for disseminating data and the need for measures to prevent and treat the violence among adolescents is urgent.

An Exploration of Factors that Mediate the Relationship Between Adverse Childhood Experiences and Sexual Assault Victimization Among LGBTQ+ College Students

Despite alarming rates of sexual assault on college campuses, little research has examined risk factors for sexual victimization among LGBTQ+ college students. This exploratory study aims to examine adolescent sexual assault, internalized homonegativity, and problematic alcohol use as mediators linking several types of adverse childhood experiences (ACEs; i.e., childhood sexual abuse, parental abuse, and household disorder) to collegiate sexual assault. Utilizing data from 241 LGBTQ+ college students, path analysis findings demonstrated that these proposed mediators increased risk for sexual assault and that various types of ACEs exerted differential impacts on sexual re-victimization, internalized homonegativity, and problematic alcohol use. Practice-based implications are offered, including the need for affirming programming that includes problem drinking prevention components and considers the role of ACEs and internalized homonegativity in increasing risk for sexual assault during college as well as the need for LGBTQ+ resource centers on campus.