Validity of a short measure of child sexual abuse for use in adult mental health surveys

An 18-yr. follow-up of 49 children for whom presence or apparent absence of sexual abuse was independently verified by social service reports in childhood, indicated partial validity for a recently developed measure of sexual abuse. Of 19 subjects known to have been sexually abused in childhood, 74% recalled details of such abuse when young adults.     

Autobiographical Memory Disturbances in Childhood Abuse Survivors

Summary

Clinicians have noted that childhood abuse survivors frequently report that they have forgotten large parts of their childhood. While memory for abusive experiences has attracted a great deal of attention from researchers, other types of memory disturbances may also accompany a history of childhood trauma. Many clinicians report that certain types of sexual abuse, and abuse at certain developmental stages, is more likely to result in reports of gaps in memory for the abuse. However, because information has been mainly collected in clinical populations, the possibility of confounding between abusive experiences and psychological disturbances cannot be ruled out. This article reports on data gathered from a large, epidemiologic study conducted within a health maintenance organization. A history of childhood physical or sexual abuse doubled the prevalence of general autobiographical memory loss for women, while for men, the rate increased 1.5 times over those with no abuse history. Higher rates of autobiographical memory loss were noted where both types of abuse were reported. Further, multiple incidents of sexual abuse, sexual abuse by a relative, and more severe sexual abuse increased reports of autobiographical memory loss. Theoretical perspectives on changes in the memory system that may affect trauma survivors are discussed.     

Retrospective measures of childhood abuse: concurrent validity and reliability in a nonclinical sample with borderline features

This study evaluated the psychometric properties of retrospective reports of childhood sexual and physical abuse by comparing two assessment formats, interview and questionnaire, and looking at both the concurrent validity and test-retest reliability over 2 years. Nonclinical participants completed the Family Experiences Interview (FEI; Ogata et al., 1990) and the Family Experiences Questionnaire (FEQ; Wheelock, Lohr, & Silk, 1997) at age 18 and the FEQ again at age 20. Both assessments evaluate individuals for sexual and physical abuse before age 18, and the two have similar formats and wording. There were no significant differences in the reported frequency of childhood abuse on the interview versus on the questionnaire when given at the same point in time, and the agreement between the two measures was high. The test-retest reliability in childhood abuse reports was moderate. Taken together, these results suggest that interview and questionnaire reports of childhood abuse are roughly equivalent.     

Retrospective assessment of childhood sexual and physical abuse: a comparison of scaled and behaviorally specific approaches

This study compared retrospective reports of childhood sexual and physical abuse as assessed by two measures: the Childhood Trauma Questionnaire (CTQ), which uses a Likert-type scaling approach, and the Computer Assisted Maltreatment Inventory (CAMI), which employs a behaviorally specific means of assessment. Participants included 1,195 undergraduate students recruited from three geographically diverse universities. Agreement was high across the two measures in the classification of victim status (92% and 80% for sexual and physical abuse, respectively). However, the CTQ classified more participants as sexually abused than did the CAMI, whereas the opposite trend was found for physical abuse. For child physical abuse, many participants reporting abusive acts on the CAMI scored below the cut-point for physical abuse on the CTQ. Classification differences for both types of abuse were largely unrelated to demographic factors, socially desirable responding, or self-reported withholding of information. The implications of these results are discussed in light of future research using retrospective methods of assessing childhood abuse.     

Using Multiple Informants to Assess Child Maltreatment: Concordance between Case File and Youth Self-Report

To understand the psychosocial implications of child maltreatment, methods used to document prevalence must be clear. Yet, rates of maltreatment found in child self-report are generally inconsistent with data found in case files from state social service agencies. Although it is known that self-reports and case file reports of abuse disagree on occurrence of specific events, it is unclear if reporters agree when overall categories of abuse are considered. This study investigated differences between case file and youth report of abuse by examining four types of abuse—physical, sexual, neglect, and psychological—in a within-subjects design using a sample of 97 youth in foster care aged 8 to 22. Case files were coded for the presence of any indication of each type of abuse. Self-report of abuse was also assessed for any indication of each type of abuse. Results indicated that, overall, youth reported more physical and psychological abuse, and younger youth reported more sexual abuse than documented in their file. Implications for research and service provision for maltreated youth are discussed.     

Measuring abuse stress and negative cognitive appraisals in child sexual abuse: Validity data on two new scales

The validity of two measures assessing degree of stress associated with child sexual abuse was examined in a sample of 48 girls who had been sexually abused. The Checklist of Sexual Abuse and Related Stressors (C-SARS) assessed negative life events that were part of or were related to the abuse, and the Negative Appraisals of Sexual Abuse Scale (NASAS) assessed negative cognitive appraisals of threat, harm, or loss associated with the abuse. Total scores for victim reports of both stressful events and negative appraisals were positively and significantly related to two other measures of abuse severity: therapist ratings of abuse stress and the number of types of sexual abuse reported. Stressful event scores were also related to aggressive behavior problems, sexual concerns, and total symptom scores on the Child Behavior Checklist. Negative cognitive appraisal scores were related to victims' self-reports of depression, anxiety, and posttraumatic stress symptoms, and to parent reports of child depression and total symptoms. Regression analyses indicated that there were significant effects of negative appraisals on internalizing symptoms when controlling for the level of stressful events experienced. The results suggest that negative life events and negative appraisals associated with sexual abuse are valid constructs that help account for variability in mental health outcomes among child victims. The implications of these results and future research directions in examining variable outcomes among sexual abuse victims are discussed.     

Childhood physical and sexual abuse in depressed patients with single and multiple suicide attempts

Research has shown both childhood physical and sexual abuse to be associated with later suicide attempts, although some studies have not supported these findings. However, few studies have investigated differences in physical and sexual abuse histories among single and multiple suicide attempters. The goals of the current study were two-fold: (a) to replicate previous findings of associations between childhood sexual and physical abuse and suicide attempts, and (b) to explore differences in reports of childhood physical and sexual abuse among single and multiple suicide attempters. While our results supported the findings that individuals with a history of suicide attempts are more likely to report histories of childhood physical and sexual abuse, we did not find a difference in reported abuse between single and multiple suicide attempters. Implications of these findings, as well as implications for future research, are discussed.     

WHAT INFLUENCES BELIEVING CHILD SEXUAL ABUSE DISCLOSURES? THE ROLES OF DEPICTED MEMORY PERSISTENCE, PARTICIPANT GENDER, TRAUMA HISTORY, AND SEXISM

This vignette study investigated factors that influence believing child sexual abuse disclosures. College student participants ( N = 318) in a university human subject pool completed measures about their own trauma history and responded to questions about sexist attitudes. Participants then read vignettes in which an adult disclosed a history of child sexual abuse, rated disclosures for accuracy and believability, and judged the level of abusiveness. Continuous memories were believed more than recovered memories. Men believed abuse reports less than did women, and people who had not experienced trauma were less likely to believe trauma reports. Gender and personal history interacted such that trauma history did not impact women's judgments but did impact men's judgments. Men with a trauma history responded similarly to women with or without a trauma history. High sexism predicted lower judgments of an event being abusive. Hostile sexism was negatively correlated with believing abuse disclosures. Results are considered in light of myths about child sexual abuse.     

Sexual abuse of children and youth in residential care: An international review

This paper reports the results of an international review of academic literature on sexual abuse in residential child and youth care, 1945–2011. The review focusses on questions related to the nature and scope of sexual abuse, on personal and institutional factors providing either protection or risk, and on how residential institutions have responded to signals of sexual abuse. Empirical research did not appear until the 1990s, and is still scarce. A variety of research designs and of definitions of sexual abuse obscure the prevalence of sexual abuse in residential care. Sexual abuse by peers is often overlooked, while this accounts for almost half of the known cases. Histories of sexual abuse prior to placement, group dynamics, institutional culture and insufficient knowledge of professionals on how to address issues of sexuality, appear to be crucial factors in peer abuse. Gender also plays a significant role: most, though not all, victims are females, most, though not all, perpetrators are males. Instead of understanding sexual abuse as a phenomenon related to individual characteristics, it is important to address both institutional factors (culture) and group dynamics in order to provide children in residential homes with the care they need.     

Prevention of child abuse and neglect

With the dramatic increase in recent reports of physical and sexual child abuse and neglect, professionals are well as the public are increasingly concerned about the prevention of child abuse. This article provides an overview of existing child abuse prevention programs (physical abuse and sexual abuse programs are treated separately). Five computerized data bases (psychology, social work, criminal justice, education, and social sciences) were searched for literature published between 1982 and 1991. We also call attention to critical issues that need to be considered in the development and planning of future prevention efforts and evaluations.     

Adult Life Satisfaction and the Role of Forgiveness After Childhood Sexual Abuse: Evidence from a Seventh‐day Adventist Cohort

Negative physical and mental health outcomes are well documented for those who experience child sexual abuse. We explore the role of three types of dispositional forgiveness (of self, of others, and by God) as effect modifiers of the child sexual abuse and life satisfaction relationship. In 2010–2011, a sample of 5,506 Seventh‐day Adventists reported levels of forgiveness, life satisfaction, and whether or not they had experienced sexual abuse in each of the two age periods (younger than 8 years and 8–18 years). Reported experience of childhood sexual abuse lowered life satisfaction regardless of when the child sexual abuse occurred. Forgiveness of self and of others were associated with higher life satisfaction regardless of sexual abuse exposure. Feeling forgiven by God was associated with increased life satisfaction indirectly through forgiveness of self and others. However, for those abused later in childhood, the association of abuse with reduced life satisfaction was weaker for those who felt forgiven by God. These findings suggest forgiveness by God operates primarily through forgiveness of self (and others) but can also buffer the effects of childhood sexual abuse on later life satisfaction when the abuse occurs in childhood/adolescence.     

The role of corroborative evidence in child sexual abuse evaluations

Published studies of forensic child sexual abuse (CSA) evaluations by mental health and medical professionals and paraprofessionals (MHPs) were analysed in order to evaluate two widely held assumptions. These related assumptions are (1) evidence that corroborates children's reports of sexual abuse is rare in forensic CSA evaluations; and (2) in the vast majority of evaluations, MHPs base their judgements about whether or not sexual abuse allegations are true on their assessments of children's reports of sexual abuse and other psychosocial data. Data from five chart review studies of a combined total of 894 forensic CSA evaluations provided sufficient information to assess the validity of these assumptions. Corroborative evidence was present in 36% of the 894 evaluations and in 54% of evaluations in which MHPs judged the allegations likely to be true, contradicting the first assumption. In the evaluations in which corroborative evidence was present, the presence or absence of a child's report of sexual abuse was only weakly associated with MHPs' judgements about the validity of the allegations (allegations in almost all corroborated cases were judged likely to be true, even in the absence of a child's report), partially contradicting the second assumption. Implications of this analysis for research and policy are discussed. Copyright © 2010 John Wiley & Sons, Ltd.     

Aids-risk behavior among homosexual males: The role of attitudes and substance abuse

Abstract

This paper reports the results of a broad survey of homosexual males regarding AIDS-risk behavior. A very high proportion reported both anxiety over possible HIV infection, and a high probability of exposure to HIV. Although over 80% of respondents reported changes in sexual behavior, the frequency of monogamous, stable relationships is unchanged from that found 16 years ago, and 19% reported continued frequent sexual partners. Consistent with “health belief” models, fear of future exposure and perceived control over behavior were strongly related to behavioral change. However, those who felt they had already been exposed were not substantially more likely to decrease current AIDS-risk behavior, which may have important public health ramifications. Alcohol and drug abuse were related to “high risk” behavior, particularly among respondents who are generally motivated to use substances to decrease “tension” or self-monitoring. Thus, using substances to decrease stress may not only relate to substance abuse itself, but to the role of substances in increasing AIDS-risk behavior.     

Object relations and interpersonal problems in sexually abused female patients: an empirical study with the SCORS and the IIP

In this study, we examined how retrospective reports of experiencing traumatic sexual abuse in childhood relates to both the development of self-representations and object representations and the occurrence of interpersonal problems. A total of 30 psychosomatic female patients who reported sexual abuse in childhood were compared with a corresponding number of eating-disordered patients and a nonclinical control group. The object relations technique (ORT; Phillipson, 1955), evaluated using the Social Cognition and Object Relations Scale (SCORS; Westen, 1985, 1991b), and the Inventory of Interpersonal Problems (Horowitz, Rosenberg, Baer, & Ureno, 1988) were used to measure the groups. The patients reporting sexual abuse achieved significantly lower scores in the cognitive scales of the SCORS; in the affective scales, they differed from the control group but not from the patients with an eating disorder. Concerning interpersonal problems, the patients reporting childhood sexual abuse reported interpersonal conflicts more frequently. The results of the study support the influence of traumatic sexual abuse on the formation of self-representations and object representations and on the occurrence of interpersonal conflicts.     

COLLEGE WOMEN'S AGGRESSION IN RELATIONSHIPS:THE ROLE OF CHILDHOOD AND ADOLESCENT VICTIMIZATION

Despite growing evidence suggesting that women engage in verbal and physical dating aggression, there is a dearth of research examining the predictors of women's engagement in these behaviors. Utilizing a college sample, the purpose of the current study was to explore women's perpetration of dating aggression within the context of victimization experiences. Women ( N  = 374) completed surveys at the beginning and end of a 10-week academic quarter for course credit. Results from two retrospective regression analyses (all Time 1 variables) suggested that (1) paternal physical abuse and adolescent/adulthood verbal victimization predicted women's reports of verbal perpetration and (2) childhood sexual abuse, adolescent/adulthood verbal victimization, adolescent/adulthood physical victimization, and adolescent/adulthood verbal perpetration predicted women's reports of physical perpetration. Results from the two prospective, longitudinal regression analyses suggested that (1) verbal perpetration (as measured at Time 1) and verbal victimization over the interim predicted women's reports of verbal perpetration over the interim and (2) physical perpetration (as measured at Time 1), verbal perpetration over the interim, and physical victimization over the interim predicted women's reports of physical perpetration over the interim. These data suggest the importance of considering previous victimization experiences, mutual partner aggression, and a history of aggressive behaviors when examining women's use of aggression in dating relationships.     

Risk factors for male-to-female partner sexual abuse

We review the risk and protective factors for male-to-female sexual abuse. Although partner sexual abuse is a low base rate behavior, which can attenuate correlation coefficients, several relations had moderate effect sizes. Younger (under 30) and older (over 50) women, compared to those between 30 and 50 years old, were more likely to report being victims of partner sexual abuse, as were unemployed women and women from low-income households. Prior unwanted sexual experiences (from a wide variety of perpetrators) and the severity of male-to-female partner physical aggression were associated with male-to-female partner sexual abuse. It is difficult to form conclusions from only six empirical studies. More empirical studies are needed to ascertain the populations most at risk for partner sexual abuse.     

Surviving roots of trauma: prevalence of silent signs of sex abuse in patients who recover memories of childhood sex abuse as adults

Recent research suggests that victimization imagery is chronically accessible in sex-abused populations, which is helpful in distinguishing them from nonabused populations. Eight categories of victimization imagery were selectively activated by Rorschach stimuli. These 8 sex-abuse signs were replicated in a new sample of 36 patients with continuous memory of sex abuse. Classification accuracy was 83%. By contrast, these signs were present in only 4% (5 of 115) of the protocols of nonabused patients. Taken together, the 2 studies confirm reasonably high sensitivity of the 8 signs for sex-abused populations and high specificity for nonabused populations. The 8 signs were also differentially salient for patients who recovered memory of childhood sexual trauma as adults. The Rorschach protocols of 59 of 114 patients with delayed recall of sexual abuse possessed signs of sex abuse. There was no linkage between therapy and recovered-memory cases with and without sex-abuse signs. Emergence of trauma memories was not uniquely traceable to treatment. Memories arose outside of the context of therapy in over 56% of the cases. Implications for the false-memory debate are discussed.     

Forgetting of prior remembering in persons reporting recovered memories of childhood sexual abuse

Case studies of individuals reporting recovered memories of childhood sexual abuse suggest that some overestimate their prior forgetting of the abuse. People reporting recovered or continuous memories of childhood sexual abuse and control subjects reporting no history of abuse participated in two experiments examining this "forgot it all along" phenomenon. Participants in Experiment 1 were more likely to forget that they had previously recalled a studied item if they were cued to think of it differently on two recall tests than if they were cued to think of it in the same way on the two tests. This effect was stronger for recovered-memory participants than for continuous-memory and control participants. In Experiment 2, participants recalled autobiographical events three times over a period of 4 months. Much as in Experiment 1, they underestimated prior remembering when the events had been recalled in a different emotional frame (positive vs. negative) on the previous occasion. This underestimation was more pronounced for recovered-memory participants than for continuous-memory and control participants.     

IMPACT OF CHILD SEXUAL ABUSE ON FEMALES:

In the last decade, it has become clear that the sexual abuse of children is much more prevalent than previously realized and that such abuse has extensive mental health sequelae. Females are reported victims of sexual abuse much more often than males. The peak age of onset of sexual abuse for females is prepubertal—7 or 8 years of age—and the average duration tends to he about 2 years. The basic theme of this article is that there may he directly traceable mechanistic relationships between the impact of sexual abuse on specific psychological and biological developmental processes for females and some of the adult outcomes of that abuse. Specifically, it is proposed that, to understand the long-term impact of sexual abuse, it is necessary to investigate how it may interfere with both the psychological and the biological processes of pubertal development.