Risk of sexual revictimization: A theoretical model

Survivors of child sexual abuse suffer serious short- and long-term psychological consequences. Sexual revictimization as an adult is one of the consequences that has been reported. At present, there is no theoretical model identifying the risk factors that result in child sexual abuse survivors being at greater risk of experiencing an adult sexual assault. The proposed model is designed to integrate existing research, stimulate further empirical work, and eventually aid in the development of a program to prevent revictimization. The variables hypothesized to play a mediating role in the pathway to revictimization include: severe psychological symptoms as a consequence of the child sexual abuse, poor coping styles, an insecure attachment style, hyperfemininity, delinquent behavior, drug use, and high risk sexual behavior.     

Mediating effects of family social support on child psychological adjustment in juvenile rheumatoid arthritis

This study assessed the mediating effects of social support on psychological adjustment in children having to cope with the ongoing chronic strain of juvenile rheumatoid arthritis. Disease activity, family social support, and peer social support were entered into hierarchical multiple regression analyses to statistically predict internalizing and externalizing behavior problems. Family social support was a statistically significant predictor of child psychological adjustment for both internalizing and externalizing behavior problems, accounting for 22% of the variance in each. These findings are consistent with the stress-social support-psychological adjustment relationship that has received empirical attention in studies on physically healthy children. The results are discussed in terms of their implications for primary and secondary prevention efforts for those chronically ill and handicapped children who are at increased risk for psychological adjustment problems.     

Personality, coping, and family resources in stress resistance: a longitudinal analysis

Earlier cross-sectional analyses have made causal inferences about stress-resistance variables problematic. This study used a longitudinal analysis where stress-resistance factors in the areas of personality, coping, and family support assessed at an initial testing were used to predict psychological and physical adjustment one year later, controlling for initial adjustment. The study involved a survey of 245 men and 248 women in randomly selected families in the San Francisco Bay area. Findings demonstrated that feelings of self-confidence, an easy-going disposition, a disinclination to use avoidance coping, and the availability of family support operate jointly to protect individuals from negative psychological consequences of life stress. For women the stress-resistance index also predicted psychosomatic complaints experienced one year after initial testing.     

SEVERITY OF CHILD SEXUAL ABUSE AND REVICTIMIZATION: THE MEDIATING ROLE OF COPING AND TRAUMA SYMPTOMS

Child sexual abuse (CSA) has consistently been associated with the use of avoidant coping; these coping methods have been associated with increased trauma symptoms, which have, in turn, been linked to increased risk for adult sexual revictimization. Given these previous findings, the purpose of the current study was to test a model that conceptualized the relationships among these variables. Specifically, CSA severity was conceptualized as leading to the use of avoidant coping, which was proposed to lead to maintenance of trauma symptoms, which would, in turn, impact severity of revictimization indirectly. This comprehensive model was tested in a cross-sectional study of a large, geographically diverse sample of college women. Participants were 99 female undergraduates classified as having experienced CSA who completed measures of abuse history, coping style, current levels of trauma symptoms, and adult sexual revictimization. Multivariate path analysis indicated that the data fit the hypothesized model for verbally coercive, but not physically aggressive, revictimization. Specifically, increased CSA severity was associated with the use of avoidant coping, which, in turn, predicted greater levels of trauma symptomatology and severity of sexual coercion in adulthood. Although cross-sectional in nature, findings from this study suggest that coping strategies and trauma symptoms may represent modifiable factors that place women at increased risk for verbally coercive sexual revictimization.     

Risk factors for psychological morbidity in women attending a one-stop diagnostic clinic with suspected breast disease

Abstract

The present study was designed to identify risk factors for psychological morbidity in women attending a one-stop diagnostic clinic with suspected breast disease. A cohort of 158 women were recruited and were asked to complete scales measuring psychological morbidity and psychosocial factors in the period immediately before their appointment and to repeat the assessments of psychological morbidity on the day of the appointment. Relevant clinical and demographic data were also collated. Within the cohort 1.4% of respondents received a diagnosis of malignant disease. Psychological morbidity, both prior to and during the diagnostic appointment was strongly predicted by psychosocial factors (i.e., acceptance-resignation coping, personal self esteem and discrepancies in social support), accounting for 54% and 63% of the variance at pre-appointment and appointment day phases respectively. Other measured variables were found not to be correlated with and/or to account for a significant proportion of the variance in the measures of morbidity. These results suggest that these psychosocial variables should be targeted in interventions designed to reduce psychological morbidity in this patient group.     

Infertility and Adjustment in Women: The Effects of Attachment Style and Social Support

The moderating effects of two psychological resources—attachment style and perceived social support—on adjustment were studied in 109 infertile women, examining the effects of duration of infertility and of primary (the woman has no child of her own) versus secondary (the woman already has a child of her own) infertility. Subjects were administered questionnaires measuring marital adjustment, psychological distress, and well-being. A model viewing attachment style and social support as moderators between stress psychological well-being was explored. The results showed that among the objective characteristics, only duration of infertility had any impact on the psychological measures. Furthermore, the psychological resources were highly associated with the adjustment scores in general. A hierarchical regression analysis showed that attachment style and social support both were related to marital quality and to psychological well-being and that these two resources function as stress moderators. It was concluded that attachment style and social support are important resources for individuals in times of stress, as exemplified in the infertility situation.     

Conservatism,Locus of Control and Life Satisfaction: A Person/Environment Fit Analysis

Pettigrew's (1958) hypothesis that quality of psychological adjustment is partly a function of the fit between a person's political values and those of the surrounding social milieu was tested using student samples from Queensland and South Australia. The measures of psychological adjustment were two factors of locus of control (political and general) and general life satisfaction. As predicted, in the Queensland sample conservatism was positively associated with higher general life satisfaction while this correlation was reversed for the South Australian sample. Results for the locus of control measures failed to support the hypothesis. The results provided support for the general Person/Environment fit model and indicated the feasibility and value of studying regional differences in Australia.     

Support networks of adolescent mothers: Effects on parenting experience and behavior

The relation between social support and lower-income African-American adolescent mothers' parenting experience, parenting behavior, and psychological symptoms was studied. Larger support networks were associated with better maternal adjustment unless individuals providing support were also providers of conflict. The young women's own mothers were their most prominent providers of support, and the number of different types of support the grandmother provided was related positively to quality of the adolescent's parenting behavior, but negatively to her experience of parenting. Having more friends in the network was related to better parenting behavior, but having more siblings in the network was related to poorer parenting behavior as well as more psychological symptoms. Although most of the young women relied on male partners for support, no variables related to provision of support by male partners were correlated with maternal adjustment.     

Predictors of relationship adjustment among couples coping with a high risk of developing breast/ovarian cancer

This study investigated the association between supportive and collaborative processes and dyadic adjustment in 94 women at increased risk of breast/ovarian cancer and their partners. Participants were recruited through two familial cancer clinics. They completed mailed, self-report questionnaires that included measures of psychological distress, dyadic adjustment (consensus, cohesion and satisfaction) and couple predictor variables (perceived support and team approach). Most couples reported average-to-high levels of consensus, cohesion and satisfaction, with a small proportion of couples (6.4%) reporting scores that reached clinically significant levels of dyadic distress. Greater perceived support was associated with better dyadic consensus and satisfaction, and dyadic cohesion and satisfaction were higher among couples who reported greater use of a team approach. General distress did not moderate the association between dyadic coping and relationship quality. There were no significant relationships between intra-couple congruence on support or team approach, and dyadic adjustment. Most couples had a functional relationship in the face of the current health stressor, although a subgroup may be at elevated risk of negative psychological consequences, including further relationship strain. The results highlight that dyadic coping strategies are important factors involved in the quality of couples' relationship following genetic counselling for breast/ovarian cancer risk.     

Illness representations and emotion in people with abnormal screening results

The present study examined the relationship of cognitive and emotional representations of illness specified by self-regulation theory on emotional responses of patients with abnormal screening results. Participants were 660 women who received an abnormal cervical smear and 701 men and women who received an abnormal colorectal cancer screening result. Participants completed postal questionnaires containing measures of illness representations and specific emotions. Factor analyses of cause components produced three factors for each sample, corresponding to psychological stress, biological, and behavioural causes. Regression analyses showed that, after controlling for demographic variables, perceived consequences, illness identity, and causal attributions to psychological stress explained significant variance in emotion. Emotional representations also accounted for unique variance in emotional responses. Results indicate congruence in the relationships between illness representations of an emotionally salient event and emotion in patients from the two cancer screening programmes and support the internal validity of self-regulation theory.     

Levels of Social Support and Coping Strategies in Adult Survivors of Child Sexual Abuse

The study examined the effects of levels of social support and types of coping strategies on the psychological adjustment of adult survivors of childhood sexual abuse. Five hundred students from two universities in the Limpopo Province of South Africa participated in this study (males =115, females = 383). Mixed methods were used for the collection and data analysis. Higher the level of social support received correlated with superior psychological adjustment. The specific types of coping styles adopted did not affect psychological adjustment in the survivors.     

Social support as a multifaceted concept: Examination of important dimensions for adjustment

Four commonly used operationalizations of the social support concept: network contact frequency, satisfaction with support (including nine dimensions), perceived availability of support, and use of support, were related to two measures of psychological adjustment (Beck Depression Inventory and Symptom Checklist-90) and to one measure of physical adjustment (Cornell Medical Index). Subjects were 68 45- to 85-year-old, highly stressed care-givers to spouses with Alzheimer's disease. Results indicate that of the four operationalizations, Satisfaction with Support was the only significant predictor of depression and general psychopathology. The set of four support variables showed the strongest relationship to depression level, next strongest to general psychopathology, and least to physical health. The satisfaction with nine social support dimensions related differentially to the types of adjustment. Results suggest the importance of specificity (sample, support operationalization, dimensions, adjustment measures) in social support research.     

Gender,psychological well-being and somatic cardiovascular risk factors

The purpose of this study is to determine associations between cardiovascular risk factors and subjective experience of psychological general well-being with special reference to gender-related differences. One hundred fifty white-collar workers in a car manufacturing plant in Sweden participated in a health care screening program. Subjective experience of psychological well-being was significantly correlated with cardiovascular risk factors among both men and women. There were, however, marked differences between the genders. For men, the following specific psychological variables were significantly correlated with cardiovascular risk factors: estimation of general health, anxiety, self-control and vitality. For women, more complex significant relationships between the two sets of variables were found. Moreover, the direction of the correlations differed between the genders. For example, men with cardiovascular risk factors, such as increased blood pressure, blood lipids and body mass index, reported significantly morepositive estimation of their general health. For women the relation was the opposite with a significantly positive correlation (p-0.004) between experience of good health and a low risk factor profile indicating the concordance between physiological and psychological parameters. Possible reasons for these sex differences are discussed.     

Effect of couple illness perception congruence on psychological adjustment in women with rheumatoid arthritis.

OBJECTIVE: To characterize similarities and differences in illness perceptions between women with rheumatoid arthritis (RA) and their husbands, and examine whether illness perception congruence predicted wives' subsequent psychological adjustment. DESIGN: Women with RA and their husbands (N=190 couples) recruited from community and clinical settings completed mailed surveys at baseline and 4-month follow-up. MAIN OUTCOME MEASURES: Data for this investigation included illness perceptions in partners and illness severity, marital variables, and psychological adjustment in wives. RESULTS: In general, wives and husbands had similar views of RA. Couple congruence concerning women's personal control over RA and its cyclic nature predicted better psychological adjustment in women 4 months later. Post hoc tests showed better psychological adjustment in wives from couples with similar optimistic beliefs about personal control, illness coherence, and RA consequences, when compared to those in couples with similar pessimistic beliefs. Furthermore, when partners disagreed about RA's consequences, wives fared better when husbands overestimated rather than underestimated their beliefs. In contrast, couple congruence about the emotions and timeline of RA was unrelated to adjustment. CONCLUSION: It may be important for husbands to understand wives' views on their control over RA and its cyclic nature. Furthermore, wives may benefit when they share optimistic views with their husbands about RA, and when their husbands avoid underestimating RA's consequences. Developing interventions to enhance partners' illness understanding may be beneficial.     

Continuity in adolescent career preparation and its effects on adjustment

Career preparation represents a major developmental task of adolescence, which has not received sufficient attention in empirical research on career development. Thus, this study was designed to examine the structure, continuity, and change in adolescent career preparation and its relationships with adjustment. The data were collected from a diverse sample of 389 adolescents on four occasions beginning in Grade 11 in high school and ending 6 months after high school graduation. Using Structural Equations modeling, a four-wave, developmental model of adolescent career preparation indicated by career decidedness, planning, and confidence was shown to fit the empirical data very well. Career preparation was characterized by continuity and a consistent pattern of positive concurrent and prospective associations with various indicators of adjustment. The results of the study provide empirical support for the theoretical propositions about the adaptive role of adolescent career preparation, particularly in terms of its contribution to psychological well-being and social integration.     

Perceived social support, self-efficacy, and adjustment to abortion

Prior to their having a 1st trimester abortion, women's perceptions of social support from their partner, family, and friends and self-efficacy for coping were assessed. Depression, mood, physical complaints, and anticipation of negative consequences were measured after the 30-min recovery period. As predicted, perceived social support enhanced adjustment indirectly through its effects on self-efficacy. Women who perceived high support from their family, friends, and partners had higher self-efficacy for coping. Higher self-efficacy, in turn, predicted better adjustment on the psychological measures but not on the physical complaint measure. No direct path between social support and adjustment was observed. In addition, women who told close others of their abortion but perceived them as less than completely supportive had poorer postabortion psychological adjustment than either women who did not tell or women who told and perceived complete support.     

Posttraumatic Growth in the Context of Heart Disease

The concept of positive consequences arising as a result of coping with traumatic experiences, such as life-threatening illness, represents an emerging area of empirical study in the stress and health literature. This study investigates three specific psychosocial variables (personality, social support, and coping) in relation to posttraumatic growth in a population of individuals coping with heart disease. The results indicate that Extraversion was the most significant predictor of growth, and there is evidence that Problem-Focused Coping partially mediated this relationship between Extraversion and posttraumatic growth. The role of Social Support Satisfaction in predicting growth remains unclear. Findings emphasize the importance of personal and environmental factors in psychological interventions aimed at improving the adjustment and posttraumatic growth of heart patients. Directions for future research are proposed.     

Optimism,appraisals, and coping in the adjustment of mothers and their children with spina bifida

Families of children with physical disabilities show substantial differences in the levels of adjustment of both the children and their parents. These differences result, in part, from the complex interplay of family and child adaptation resources, such as coping and social support. In order to identify factors which may differentiate levels of adjustment among families with children with physical disabilities, this study examined relationships among optimism, primary and secondary appraisals of and coping with child-related stressors, maternal psychological adjustment, and child adjustment in 29 families with a child with spina bifida without mental retardation and 28 comparison families with a nondisabled child. For the spina bifida group, primary appraisals were related to the use of avoidant coping strategies, and these coping strategies were related to maternal psychological adjustment and child internalizing behavior problems. No significant differences between the groups in terms of the nature of the relationships or in the levels of the variables were found with the exception that mothers of children with spina bifida were less optimistic than comparison mothers. These data support the importance of coping in understanding the psychological adjustment of mothers faced with a chronic stressor in the family.     

Research Concerning Children of Battered Women

SUMMARY

Although the negative impact on children exposed to spouse abuse is well documented, little empirical research is available to guide clinical interventions. A brief review of the research literature describing these detrimental influences on children's adjustment is presented. Factors are discussed which mediate the consequences for children exposed to spouse abuse. These variables include those that are child-related as well as factors which are situational/contextual. Next, several theoretical/conceptual models are presented to assist with an understanding of how this impact on youngsters' psychological and emotional functioning takes place. These models suggest both direct and indirect mechanisms of influence. Finally, recommendations regarding clinical interventions are delineated based on these models as well as the available literature on the treatment of children of battered women. Suggestions related to appropriate types of treatment, including symptom-and mechanism-specific interventions, are made.     

Understanding Sexual Revictimization of Women Through Metaphors: A Qualitative Research

The aim of this study was to contribute to the phenomenological understanding of revictimization through metaphors used by women when describing their revictimization experiences. Data were collected through in-depth semistructured interviews with 9 women regarding their repeated sexual victimization. Content analysis focused on metaphors used by the women when describing revictimization. Analysis of the metaphors revealed vulnerability in relation to the self and to interpersonal relationships. The metaphors relating to the self are portrayed through images of imprisonment, homelessness, contamination, and disability. Interpersonal relationships are described through the image of boundaries. These metaphors reflect duality: the profound need for security and the perception of boundaries as limiting and confining. Metaphors can be useful as a heuristic instrument for understanding women’s experience of the duality and the contradictions in coping with revictimization, and for intervention.