Characteristics of child sexual abuse cases referred for psychological services in Hong Kong:a comparison between multiple incident versus single incident cases

Prevalence and clinicians' awareness of psychiatric comorbidities among first-episode schizophrenia

BACKGROUND

To explore the prevalence and clinicians' awareness of psychiatric comorbidities, and to identify factors associated with current psychiatric comorbidities in first-episode schizophrenia (FES) patients.

METHOD

In this cross-sectional study, 128 patients with FES, who were in symptomatic remission, were consecutively recruited from a local early intervention clinic. All patients were interviewed using the Chinese bilingual version of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Axis I Disorders, Positive and Negative Syndrome Scales, Scale to Assess Unawareness of Mental Disorder, Social and Occupational Functioning Assessment Scale, Simpson-Angus Scale, Barnes Akathisia Rating Scale and Abnormal Involuntary Movement Scale. Bivariate and multivariate analyses were performed to investigate factors associated with psychiatric comorbidities in FES patients.

RESULTS

The lifetime and point prevalence of psychiatric comorbidities among FES patients were 47.7% and 27.3%, respectively. Current psychiatric comorbidities were documented on the medical records of 39.3% of the patients. The FES patients with current psychiatric comorbidities had a lower level of functioning. Depression in FES was also associated with akathisia.

CONCLUSION

Psychiatric comorbidities are prevalent among community FES patients. In addition to achieving symptomatic remission in schizophrenia, both treating psychiatric comorbidities and minimizing the side-effects of treatment, particularly akathisia, are fundamental for supporting FES patients in their journey to recovery.

Disclosure and Psychological Well-Being of Sexually Abused Adolescents in Hong Kong

The role of disclosure on psychological well-being of adolescents with child sexual abuse experience was investigated in a subsample of 74 disclosers among 800 adolescents recruited in the community in Hong Kong. The results supported that CSA experiences have differential impact on adolescents' psychological well-being. Family characteristics of the disclosers accounted for only a small amount of the variance in an array of psychological well-being measures. CSA characteristics were robust predictors of disclosers' sexual eroticism and externalizing behavioral symptoms. Disclosers' cognitive appraisal of CSA experience and quality of parental attachment were strong predictors of their self-esteem and internalizing behavioral problems. After controlling for the aforementioned factors, negative disclosure experience still significantly predicted lower self-esteem, higher sexual anxiety, more internalizing behavior, and more severe post-traumatic stress disorder responses. Research to understand the factors that generate negative disclosure experiences is needed for developing effective intervention strategies to mitigate the negative consequences of disclosure.

Developmental trauma and its correlates: a study of Chinese children with repeated familial physical and sexual abuse in Hong Kong

The present study examined the relevance of the developmental trauma disorder (DTD) framework (van der Kolk, ) in Hong Kong Chinese children with repeated familial physical and/or sexual abuse. Self-reports of (a) key dimensions of DTD including emotion regulation, attribution and perceptions in self and relationships, belief in future victimization, behavioral difficulties, and self-esteem; and (b) attachment styles and posttraumatic stress disorder (PTSD) reactions were obtained from children aged 9-15 years in clinical and school settings. Children were categorized into an abused trauma group (n = 82), a nonabused trauma group (n = 83), and a no-trauma control group (n = 201). The findings indicated that the DTD framework was applicable to abused children who showed a lower level of attachment security (Cohen's d from 0.50-0.61) and a higher level of PTSD reactions (Cohen's d = 0.71) than the comparison groups. After adding attachment security and emotion dysregulation to the model, there were no longer significant group differences in most of the variables.

Factors associated with adolescents' disclosure of sexual abuse experiences in Hong Kong

This research project is the first study conducted in Hong Kong using adolescent subjects to explore predictors of child sexual abuse disclosure. Eight-hundred male and female adolescents aged 13 to 16 years were recruited from the community while another 30 adolescents joined the study from a clinical setting. One hundred and seventy-seven adolescents acknowledged having a child sexual abuse experience. Results showed that the severity of sexual abuse activities and parent attachment were associated with disclosure in the clinical setting, while abuser's gender and the adolescents' disclosure tendency were associated with disclosure among participants in the community setting. Among the 104 participants who had disclosed their childhood sexual abuse, 70% of them had disclosed it within one month and 63% of them had disclosed to 2 to 5 people. The majority of the disclosers (81%) shared their child sexual abuse experience(s) with their friends. Participants from the clinical setting tended to reveal the experience more to adults than those from the community. The study suggested that when choosing a potential confidant, adolescents paid more attention to confidant characteristics than to anticipated confidant responses to their disclosure. Limitations and practical implications for increasing child sexual abuse disclosure rates are discussed.

Association between childhood sexual abuse and adult sexual victimization in a representative sample in Hong Kong Chinese

OBJECTIVE

The current study investigated the prevalence and impact of childhood sexual abuse (CSA) on adult sexual victimization (ASV) in Hong Kong, China. This study also examines correlates of demographic characteristics, depression, suicidal ideation, and self-esteem with ASV.

METHODS

A total of 5,049 Chinese adult respondents were interviewed face-to-face about their experiences of CSA, childhood witness of parental violence, ASV (by non-partner), and intimate partner violence (IPV). Self-reports also measured depression, suicidal ideation, self-esteem, and demographic details.

RESULTS

Of all respondents, 0.9% reported some form of CSA, with a higher percentage being women. CSA was found to pose a significant risk for preceding year IPV (sexual) after controlling for demographic factors. Gender, age, indebtedness, alcohol and drug abuse, depression, and low self-esteem significantly increased the odds of IPV (sexual), whereas suicidal ideation and being newly arrived from China increased the risk of ASV (by non-partner). Childhood witness of parental psychological aggression and physical violence were also associated with a higher risk of IPV (sexual).

CONCLUSIONS

Childhood sexual abuse may have an independent association with future sexual victimization in adulthood, but many covariates can also affect the impact of CSA and increase the risk of revictimization.

PRACTICAL IMPLICATIONS

Intervention with ASV should include an assessment of CSA history and thus a screening for multiple victimization from IPV among victims. Prevention of revictimization for IPV victims with CSA histories may focus on making social and individual changes.

Perceptions of child sexual abuse-a qualitative interview study with representatives of the socio-legal system in urban Tanzania

Through in-depth interviews, this study explored perceptions and experiences of key players handling child sexual offense cases in Dar es Salaam, Tanzania. The informants included public police investigators, magistrates, legal workers, and social workers working with nongovernmental organizations. The interviews were recorded, transcribed verbatim, and analyzed using qualitative content analysis. Five themes emerged summarizing factors associated with sexual offenses, including community passivity, legal system weaknesses, legal framework inadequacy, and key players' vulnerabilities. Addressing the identified weaknesses may promote justice, while changes in attitudes and norms are needed for the prevention of sexual offenses to children.

Sexual violence against women and children in Chinese societies

This article provides a comprehensive overview of the reported patterns of sexual violence against women and children in China. It reviews the prevalence of and risk factors for various types of sexual violence and discusses community knowledge and perceptions of these violent acts. It also critically examines three major problems of sexual violence research in China. First, the diversity of findings and study methods reported by surveys and criminal reports reflects the problems in obtaining accurate figures on the scope of the problem. Second, precautions must be taken in reading studies on Chinese culture-specific risk factors for domestic violence. Third, the study of culture-specific factors should not focus solely on cultural factors in a vacuum but rather, should examine traditional culture in the context of modern societies and consensus international standards of human rights. Recommendations for future research are also discussed.