A qualitative study of childhood sexual abuse survivors in Taiwan: toward a transactional and ecological model of coping

In this study, we aimed to explore the experiences of 10 female Taiwanese childhood sexual abuse (CSA) survivors (age range = 20-39 years) to broaden our understanding of the post-abuse coping process in a Chinese sociocultural context. This investigation was grounded on a feminist paradigm, and the consensual qualitative research method (Hill et al., 2005; Hill, Thompson, & Williams, 1997) was utilized as the strategy of inquiry. The transactional and ecological model of coping that emerged from the data describes the dynamic interplay among (a) intrapersonal, interpersonal, and sociocultural factors and (b) the coping process and outcomes of CSA survivors. Implications for research on CSA recovery and culturally appropriate interventions in a collectivistic sociocultural context are discussed.     

Psychological assessment of adult survivors of childhood sexual abuse within a naturalistic clinical sample

This study investigates the long-term effects of childhood sexual abuse (CSA). Differences between abused and nonabused individuals in psychiatric symptomatology, interpersonal functioning, social and occupational functioning, personality dynamics, and therapeutic alliance were examined. The relationship between abuse severity and long-term effects was also analyzed. Data were gathered from 51 patients seeking individual psychotherapy at a community outpatient clinic. Findings suggested that CSA survivors tend to experience greater psychiatric distress and poorer interpersonal functioning than nonabused clinical controls. No significant differences were found in social and occupational functioning or in alliance developed by the end of the therapeutic assessment process. Abuse severity was significantly related to increased symptomatology and poorer interpersonal functioning. Findings support and extend existing literature and are especially useful for clinicians working with abuse survivors.     

A short-term group treatment model for gay male survivors of childhood sexual abuse living with HIV/AIDS

HIV-positive gay male survivors of childhood sexual abuse (CSA) face three layers of trauma: childhood abuse, homophobic oppression, and HIV/AIDS. Additionally, CSA has been shown to increase HIV risk behavior among gay men, and the trauma of HIV infection often parallels the experience of CSA. Effective coping strategies are particularly important for people living with HIV/AIDS in order to adapt to physical, psychological, and social implications of infection. However, coping strategies once adaptive in the context of CSA may become maladaptive in adulthood. Interventions are needed that enhance coping and address CSA for survivors living with HIV/AIDS to protect their own health and to prevent new transmissions. This article presents a group model found to be efficacious for treating gay male survivors of CSA living with HIV/AIDS.     

Coping style and memory specificity in adolescents and adults with histories of child sexual abuse

Individuals with histories of childhood trauma may adopt a nonspecific memory retrieval strategy to avoid unpleasant and intrusive memories. In a sample of 93 adolescents and adults with or without histories of child sexual abuse (CSA), we tested the hypothesis that nonspecific memory retrieval is related to an individual's general tendency to use avoidant (i.e., distancing) coping as a personal problem-solving or coping strategy, especially in victims of CSA. We also examined age differences and other individual differences (e.g., trauma-related psychopathology) as predictors of nonspecific memories. Distancing coping was significantly associated with less specific autobiographical memory. Younger age, lower vocabulary scores, and non-CSA childhood maltreatment (i.e., physical and emotional abuse) also uniquely predicted less autobiographical memory specificity, whereas trauma-related psychopathology was associated with more specific memory. Implications for the development of autobiographical memory retrieval in the context of coping with childhood maltreatment are discussed.     

The impact of child sexual abuse on adult interpersonal functioning: A review and synthesis of the empirical literature

The many studies that have examined the long-term impact of child sexual abuse (CSA) on adult functioning have primarily focused on the personal distress of survivors, largely ignoring the impact of CSA on interpersonal relationships. This article reviews empirical findings concerning the interpersonal distress of survivors as expressed in their intimate and sexual relationships. First, current conceptualizations of the relationship between CSA and interpersonal relationships are reviewed, with a focus on the theoretical models that appear to have implications for the long-term interpersonal sequelae associated with CSA. This is followed by a review of the research conducted on intimacy within the area of social psychology and a summary of the empirical findings related to intimacy functioning in CSA survivors. A hypothesized typology of intimacy functioning for survivors is suggested. The effects of CSA on three components of sexuality—sexual dysfunctions, underlying psychological components of sexuality, and sexual orientation—are discussed. Finally, the interpersonal issues believed to be most salient for CSA survivors in the therapeutic setting are discussed, along with implications for the client–therapist relationship. Methodological, assessment, and conceptual issues are discussed throughout. Recommendations for future research and clinical endeavors are suggested.     

Childhood Epilepsy and Autism Spectrum Disorders: Psychiatric Problems, Phenotypic Expression, and Anticonvulsants

Epilepsy and autism spectrum disorders (ASDs) frequently co-occur during childhood, however, the characteristics of psychiatric or behavioural problems in these children remains largely unknown. This article contributes to these discussions by reporting on the prevalence and presentation of psychiatric or behavioural problems in children with epilepsy and ASDs, as well as on the use of anticonvulsants in these children. The current evidence suggests that children with epilepsy and ASDs may present with a distinct clinical profile, with a greater number of developmental difficulties, and a more severe expression of the ASD phenotype that can not solely be accounted for by level of intellectual functioning. Positive effects of anticonvulsants on behavioural symptoms associated with ASDs were also reported, though pharmacoresistance and a lack of clear treatment guidelines may contribute to an elevated risk of adverse side effects. In relation to clinical presentation and management there is a need for careful consideration of potential interaction effects between disorder specific factors (e.g., age of seizure onset/ASD diagnosis), cognitive characteristics (e.g., intellectual functioning, memory), and psychosocial variables (e.g., coping strategies). Ultimately however, many conclusions are tentative and this review highlights the need for more empirically validated research on children with epilepsy and ASDs.     

Forgetting of trauma cues in adults reporting continuous or recovered memories of childhood sexual abuse

According to betrayal trauma theory, adult survivors of childhood sexual abuse (CSA) who were molested by their caretakers (e.g., a father) are especially likely to dissociate ("repress") their memories of abuse. Testing college students, some reporting CSA, DePrince and Freyd (2004) found that those scoring high on a dissociation questionnaire exhibited memory deficits for trauma words when they viewed these words under divided-attention conditions. Replicating DePrince and Freyd's procedure, we tested for memory deficits for trauma words relative to neutral words in adults reporting either continuous or recovered memories of CSA versus adults denying a history of CSA. A memory deficit for trauma words under divided attention was expected in the recovered-memory group. Results were inconsistent with this prediction, as all three groups exhibited better recall of trauma words than neutral words, irrespective of encoding conditions.     

The relationships between self-leadership and enhanced psychological, health, and work outcomes.

Two cross-sectional studies were conducted to examine the correlations between the concept of self-leadership (as described within the framework of the internal family systems model) and enhanced psychological, health, and work outcomes. In Study 1, self-leadership was significantly related to higher psychological functioning (e.g., effective coping style, greater optimism and hardiness, and less ineffectiveness and interpersonal distrust) and better health status (e.g., greater perceived wellness, less perceived stress, and fewer symptoms of illness) in a sample of university students (N = 270). In Study 2, in which a sample of corporate employees (N = 160) was examined, self-leadership was significantly related to greater perceptions of work satisfaction, enhanced communication, quality management, effective work relationships, and in terms of health outcomes, greater perceived wellness and less work stress. Implications of the relationships between self-leadership and psychological, health, and work outcomes are discussed.     

Parent reports of children’s working memory,coping, and emotional/behavioral adjustment in pediatric brain tumor patients: A pilot study

Neurocognitive problems in childhood survivors of brain tumors are well documented. Further, research has shown that problems in cognitive functioning may be associated with impairment in the use of complex strategies needed to cope with stress, including secondary control coping strategies (e.g., acceptance and cognitive reappraisal) which have been associated with fewer adjustment problems. The present study measured cognitive function, coping strategies, and adjustment in children ages 6–16 years at the time of brain tumor diagnosis and at two follow-up time-points up to 1 year post-diagnosis. In a prospective design, working memory was assessed in a total of 29 pediatric brain tumor patients prior to undergoing surgery, child self-reported coping was assessed at 6 months post-diagnosis, and parent-reported child adjustment was assessed at 12 months post-diagnosis. Significant correlations were found between working memory difficulties and secondary control coping. Secondary control coping was also negatively correlated with child attention and total problems. Regression analyses did not support secondary control coping mediating the association between working memory difficulties and child attention or total problems. These findings represent the first longitudinal assessment of the association between working memory, coping, and adjustment across the first year of a child’s brain tumor diagnosis and suggest a possible role for early interventions addressing both working memory difficulties and coping in children with brain tumors.     

Retrieval inhibition of trauma-related words in women reporting repressed or recovered memories of childhood sexual abuse

Several authors have argued that survivors of childhood sexual abuse (CSA) who report to have repressed their traumatic memories are more skilled in forgetting emotional stimuli than survivors who have always remembered the abuse. The current experiment employed a list-wise directed forgetting task to investigate whether women reporting repressed (n = 16) or recovered (n = 23) memories of CSA are better at forgetting disturbing material, relative to women reporting having always remembered their abuse (n = 55) or reporting no history of abuse (n = 20). We found no support for the hypothesis that women reporting repressed or recovered memories of CSA are especially versed in inhibiting retrieval of trauma-related words. Additional analyses revealed that participants characterized by a repressive coping style did not display a superior retrieval inhibition mechanism for negative material.     

Appraisal, coping, health status, and psychological symptoms

In this study we examined the relation between personality factors (mastery and interpersonal trust), primary appraisal (the stakes a person has in a stressful encounter), secondary appraisal (options for coping), eight forms of problem- and emotion-focused coping, and somatic health status and psychological symptoms in a sample of 150 community-residing adults. Appraisal and coping processes should be characterized by a moderate degree of stability across stressful encounters for them to have an effect on somatic health status and psychological symptoms. These processes were assessed in five different stressful situations that subjects experienced in their day-to-day lives. Certain processes (e.g., secondary appraisal) were highly variable, whereas others (e.g., emotion-focused forms of coping) were moderately stable. We entered mastery and interpersonal trust, and primary appraisal and coping variables (aggregated over five occasions), into regression analyses of somatic health status and psychological symptoms. The variables did not explain a significant amount of the variance in somatic health status, but they did explain a significant amount of the variance in psychological symptoms. The pattern of relations indicated that certain variables were positively associated and others negatively associated with symptoms.     

The Survivor Health and Resilience Education (SHARE) Program: Development and Evaluation of a Health Behavior Intervention for Adolescent Survivors of Childhood Cancer

Few evidence-based health behavior interventions for adolescent survivors of childhood cancer currently exist. These interventions are necessary to address a range of lifestyle and behavioral factors (e.g., diet and physical activity, tobacco and alcohol use, excessive sun exposure) that may place survivors at increased risk for secondary cancers other chronic diseases. To address this need, the development and evaluation of a health promotion and disease prevention program for childhood cancer survivors is described, with an emphasis on the steps leading up to conducting a randomized controlled trial to test its efficacy. Data gathered from trial participants suggest the preliminary evaluation of the intervention is favorable. Trends and future directions in behavioral intervention research with childhood cancer survivors are discussed, along with the role of behavioral research in health promotion and disease prevention.     

An Interpersonal Approach to Religiousness and Spirituality: Implications for Health and Well‐Being

The interpersonal tradition (Horowitz & Strack, 2011) provides a rich conceptual and methodological framework for theory‐driven research on mechanisms linking religiousness and spirituality (R/S) with health and well‐being. In three studies, we illustrate this approach to R/S. In Studies 1 and 2, undergraduates completed various self‐report measures of R/S, interpersonal style, and other aspects of interpersonal functioning. In Study 3, a community sample completed a wide variety of R/S measures and a measure of interpersonal style. Many, but not all, aspects of religiousness (e.g., overall religiousness, intrinsic religiousness) were associated with a warm interpersonal style, and most aspects and measures of spirituality were associated with a warm and somewhat dominant style. Spirituality and related constructs (i.e., gratitude, compassion) were associated with interpersonal goals that emphasize positive relationships with others, and with beneficial interpersonal outcomes (i.e., higher social support, less loneliness, and less conflict). However, some aspects of R/S (e.g., extrinsic religiousness, belief in a punishing God) were associated with a hostile interpersonal style. R/S have interpersonal correlates that may enhance or undermine health and emotional adjustment. This interpersonal perspective could help clarify why some aspects of religiousness and spirituality are beneficial and others are not.     

Gambling, health and age: data from the National Epidemiologic Survey on Alcohol and Related Conditions.

The health effects of recreational gambling are presently unclear, particularly across age groups. Theories of healthy aging suggest that social activities, including gambling, may be beneficial to the health of older adults. Using cross-sectional data from the National Epidemiologic Survey on Alcohol and Related Conditions (N=43,093), the authors examined associations between gambling (categorized as nongambling, recreational gambling, or problem/pathological gambling) and health and functioning measures stratified by age (40-64 years and >/=65). Problem/pathological gambling was uniformly associated with poorer health measures among both younger and older adults. Among younger respondents, poorer health measures were also found among recreational gamblers. However, among older respondents, recreational gambling was associated not only with some negative measures (e.g., obesity) but also with some positive measures (e.g., better physical and mental functioning). Longitudinal studies are needed to clarify the relationship between gambling and health in older adults in the context of healthy aging.     

Adolescents and Young Adults Living with Congenital Heart Disease: Coping,Stress Reactivity,and Emotional Functioning

Living with congenital heart disease (CHD) presents survivors with numerous stressors, which may contribute to emotional problems. This study examined (a) whether coping with CHD-related stress predicts symptoms of depression and anxiety, and (b) whether associations between coping and emotional distress are moderated by involuntary stress reactivity. Adolescents and young adults diagnosed with CHD (M_age?=?26.4) were recruited from pediatric and adult outpatient cardiology clinics. Participants (N?=?168) completed online self-report measures. Hierarchical multiple regression analyses revealed that secondary control coping (e.g., cognitive restructuring, positive thinking) predicted lower depression and anxiety. Primary control coping (e.g., problem-solving) and stress reactivity (e.g., rumination, emotional numbing) interacted to predict depression and anxiety: the higher individuals were in involuntary stress reactivity, the stronger was the association between primary control coping and lower depression and anxiety. These results can inform clinical efforts to prevent or reduce emotional distress among CHD survivors.     

Coping with Severe Mental Illness: Relations of the Brief COPE with Symptoms, Functioning, and Well-Being

The way patients cope with the experience of having an episode and being hospitalized for psychiatric disorder may relate to symptom severity, social functioning, and psychological well-being. Coping was assessed among 70 psychiatric inpatients diagnosed primarily with schizophrenia, major depressive disorder, and schizoaffective disorder. The Brief COPE—a questionnaire developed in health psychology (C. S. Carver, 1997)—was administered in interviewer-assisted format during patients' stay on the ward. Thirty patients were re-interviewed an average of 6 weeks after discharge. Among patients with schizophrenia, schizophrenia symptom severity correlated inversely with adaptive coping (e.g., acceptance, planning, seeking support) but did not correlate with maladaptive coping (e.g., self-blame, denial). Among those with schizophrenia, deficits in adaptive coping also predicted relative increases in schizophrenia symptoms over time, controlling for intake symptom severity. Among patients without schizophrenia, maladaptive coping correlated concurrently with depressive symptoms. Several hypothesized associations between concurrent coping, functioning, and well-being were also documented.     

Brief Report: Symptoms of PTSD,Coping Strategies,and Social Adjustment among Survivors of Early Life Interpersonal Trauma

Dysphoria symptoms of posttraumatic stress disorder (PTSD) have been associated with impairments in social functioning; however, this relationship has been unexamined among interpersonal trauma populations. A sample of 303 women with a history of early life interpersonal trauma completed measures of PTSD severity, coping, and social functioning. Results revealed that dysphoria symptoms had a strong and unique association with total social adjustment and social functioning (i.e., social activities). Active coping significantly mediated the relationship between dysphoria symptoms and total social adjustment, and active coping and seeking emotional support significantly mediated the relationship between dysphoria symptoms and social functioning. Findings elucidate variants of coping that might compound impaired social functioning and highlight the value of integrating coping skills into PTSD interventions.     

Predicting the psychological health of older adults: Interaction of age-based rejection sensitivity and discriminative facility

We hypothesize that older adults who anxiously expect, readily perceive, and intensely react to social rejection because of their old age (i.e., have high age-based rejection sensitivity) are vulnerable to depression and poor social functioning. We further hypothesize that the association between age-based rejection sensitivity and poor psychological health would be attenuated among older adults who possess adequate cognitive coping ability—they can discern and respond discriminatively to subtle variations in situational demands (i.e., have high discriminative facility). Based on the results of a focus group study, we constructed an age-based rejection sensitivity measure, which predicts greater depression, poorer social functioning, greater loneliness, and lower life satisfaction among individuals in late adulthood. As hypothesized, the relationship between age-based rejection sensitivity and poor psychological health was weaker among older adults with high (vs. low) discriminative facility.     

CHILDHOOD SEXUAL ABUSE, CULTURE, AND COPING: A QUALITATIVE STUDY OF LATINAS

The purpose of this study was to articulate a model of how Latinas cope with childhood sexual abuse (CSA) and the ways in which personal and cultural variables influence their coping strategies. Nine women who identified as Latina and as survivors of CSA participated in an in-depth interview. The data were analyzed using a grounded theory methodology. Results suggested that participants' coping efforts were influenced by a variety of cultural factors and that they engaged in a wide range of coping behaviors, all of which served two main functions: (1) seeking relief from negative emotions and (2) protecting one's self from further abuse.