An examination of risky sexual behavior and HIV in victims of child abuse and neglect: a 30-year follow-up.

OBJECTIVE: This article examined links between childhood maltreatment and risky sexual behavior (early sexual contact, promiscuity, prostitution) and HIV in adulthood. DESIGN: Using a prospective cohort design, physically and sexually abused and neglected children (ages 0-11) with documented cases during 1967-1971 were matched with nonmaltreated children and followed into adulthood. MAIN OUTCOME MEASURES: Early sexual contact, promiscuity, and prostitution were assessed through in-person interviews and official records (prostitution) at approximate age 29 (N=1196). HIV tests were conducted at approximate age 41 (N=631). RESULTS: Child maltreatment was associated with prostitution (OR=2.47, 95% CI=1.35-4.50) and early sexual contact (OR=1.73, 95% CI=1.24-2.40). Prevalence of HIV in the abuse/neglect group was twice that in controls (OR=2.35, 95% CI=.64-8.62), although this difference did not reach conventional levels of statistical significance. SEM provided significant support for a model linking child abuse and neglect to prostitution through early sexual contact and a marginal link to HIV through prostitution. CONCLUSION: These findings provide prospective evidence that maltreated children are more likely to report sexual contact before age 15, engage in prostitution by young adulthood, and test positive for HIV in middle adulthood.     

Family Functioning Moderating the Effects of Childhood Sexual Abuse on Memory Specificity

The main goal of this study was to investigate if adults sexually abused as children who were raised in a functional family are more able to generate specific autobiographical memories and suffer fewer depressive symptoms than sexually abused adults who were raised in a dysfunctional family. We found that abused males retrieved fewer specific memories than nonabused males, abused females, and nonabused females. The three latter groups did not differ from each other. Further, childhood sexual abuse did not predict depression among males and females. After accounting for family functioning, there were no group differences regarding memory specificity. Functional families appear to have beneficial effects on the adjustment of male victims of childhood sexual abuse.     

Pathways to Adolescent Substance Use Among Sexually Abused Girls

This study examined the link between childhood sexual abuse and adolescent substance use among girls, and evaluated depressive self-concept and behavioral under-control (BUC) as pathways to substance use for sexually abused girls. Participants (n = 150) were drawn from a longitudinal study of the impact of domestic violence on the lives of women and children. Structural equation modeling revealed that girls childhood sexual abuse was associated prospectively with their later substance use. This relationship persisted when age, co-occurring forms of child abuse (physical, exposure to domestic violence), childhood depression and aggression, family income, maternal substance use, and parenting practices were controlled. Behavioral under-control mediated the relationship between childhood sexual abuse and later substance use, but depressive self-concept did not. Implications, limitations, and directions for future research are discussed.     

The Effect of Adolescent Sex Offender Abuse History on Counselor Attitudes

Counseling students' judgments of adolescent sex offenders with sexual or physical abuse histories were examined. Sexually abused offenders were more desirable as prospective clients than were nonabused offenders. Sexually abused counselors desired to see physically abused offenders as clients over sexually abused offenders. Implications for counseling are presented.     

Child Sexual Abuse in India: Current Issues and Research

Child sexual abuse (CSA) is a serious and widespread problem in India as it is in many parts of the world today. The trauma associated with sexual abuse can contribute to arrested development, as well as a host of psychological and emotional disorders, that some children and adolescents may never overcome. When sexual abuse goes unreported and children are not given the protective and therapeutic assistance they need, they are left to suffer in silence. This article discusses the nature and incidence of the sexual abuse of minors in India and presents an overview of research findings to date. Socio-cultural and familial risk factors involved in CSA are discussed. Common symptoms and disorders associated with sexual abuse are outlined. Finally, some implications for counselors working with children in India who have been sexually abused are highlighted.     

Sexuality education groups in juvenile detention

Several major studies have described the magnitude and character of adolescent sexual activity and sexual knowledge related to contraception and sexually transmitted diseases (Diepold & Young, 1979; Hass, 1979; Sorenson, 1973; Zelnick & Kantner, 1980). Few systematic studies have been conducted, however, which analyze the attitudes toward sexuality and contraception of delinquent adolescents who are generally school dropouts and who may engage in socially unacceptable behaviors such as running away, drug abuse, and prostitution. Delinquent youths, especially delinquent girls, have been characterized as being more sexually active and less sexually knowledgeable than their nondelinquent peers (Gibbon, 1981; Mannarino & Marsh, 1978). Despite the assumed high-risk nature of this delinquent population, few juvenile detention facilities have offered systematically evaluated coeducational sex education programs. One barrier to implementation of such programs in juvenile detention centers is the lack of a treatment or program orientation of most staff, and/or staff denial of adolescent sexuality in general, an attitude which suppresses the development of healthier sexual values and often promotes pathologic sexual interaction within institutions (Shore & Gochros, 1981). A recent survey of adolescent sexuality (Diepold, 1979) points out that teenagers' feelings about their "sexual selves" impacts greatly upon their general self-image. Low self-esteem is more frequently found among delinquents than nondelinquents (Jones & Swain, 1977; Lund & Salury, 1980), and treatment for delinquent girls often focuses on increasing self-esteem and developing assertiveness skills based on feelings of self-worth (DeLange, Lanahan, & Barton, 1981; NiCarthy, 1981). Two studies carried out with juvenile detainees from a large urban center confirmed that sexual activity among delinquent adolescents is significantly greater than that of the general adolescent population, and that the delinquents have little or no knowledge of birth control methods or venereal disease (Deisher, 1980; Schroeder, 1981). Further, these adolescents appear to endorse constricted and conventional values related to sexual activity, abortion, and relationship issues and frequently have a background of sexual abuse and prostitution. These findings form the basis of the current study which attempts to develop an effective coeducational sex education program for this population within a detention facility. This program is specifically designed for a sexually active adolescent group aged 14 to 17.     

Internalizing and externalizing characteristics of sexually and/or physically abused children

This study evaluates the behavioral consequences of childhood abuse (sexual, physical, or both), with particular focus on prevalence of posttraumatic stress disorder (PTSD). Three abuse type groups and nonabused controls were contrasted on behavioral rating scales and on structured psychiatric interview data. The participants (109 abused children and 16 normal control children) were recruited from Arkansas Children’s Hospital and local agencies for abused children. As expected, proportionately more females than males were sexually abused. Overall, males were rated as more disturbed than females. Type of abuse did not consistently influence behavioral ratings. Externalizing scores were significantly higher than internalizing scores in all abused groups. PTSD was diagnosed in 50% of the abused children, with a higher rate for boys who had been sexually abused as opposed to physically abused only (58% versus 13%). The most frequent comorbid condition with PTSD was Separation Anxiety. Sexually abused boys were hospitalized for psychiatric treatment at a higher rate than were other abused children.     

The case against the routine provision of psychotherapy to children/adolescents labeled “sexually abused”

Whether symptomatic or asymptomatic, children labeled sexually abused are routinely offered treatment at considerable financial cost. One result of this is that mental health professionals are being charged with exploiting the problem of child sexual abuse (CSA). Is the routine provision of psychotherapy for children and adolescents labeled sexually abused warranted? In this paper, it is argued that the evidence indicates it is not warranted. Further, its provision is not in the best interests of either the children or mental health professionals. A number of recommendations are given which follow from the evidence.     

Child molestations by homosexual foster parents: Illinois, 1997--2002

Do those who engage in homosexuality disproportionately sexually abuse foster or adoptive children as reported by child protective services? Illinois child services reported sexual abuse for 1997 through 2002. 270 parents committed "substantiated" sexual offenses against foster or subsidized adoptive children: 67 (69%) of 97 of these mother and 148 (86%) of 173 of these father perpetrators sexually abused girls; 30 (31%) of the mothers and 25 (14%) of the father perpetrators sexually abused boys, i.e., 92 (34%) of the perpetrators homosexually abused their charges. Of these parents 15 both physically and sexually abused charges: daughters by 8 of the mothers and 4 of the fathers, sons by 3 of the mothers, i.e., same-sex perpetrators were involved in 53%. Thus, homosexual practitioners were proportionately more apt to abuse foster or adoptive children sexually.     

Sexual and Physical Abuse Among Adolescent Girls with Disruptive Behavior Problems

We examined the prevalence and age of onset of physical and sexual abuse in a clinic-referred sample of adolescent girls, as well as differences in diagnoses and symptoms among abused and non-abused girls. Forty-nine girls (aged 13–17 years) with disruptive behavior were interviewed along with their primary caretaker. Data were gathered through both a structured interview with the girl and her parent, as well as self and parent-report questionnaires. Findings indicated that the prevalence of Conduct Disorder (CD) and Major Depression were higher for abused girls. Somatoform Pain Disorder was significantly less likely for physically abused girls, compared to girls who were both physically and sexually abused. Of CD symptoms, truancy was twice as high for the physically and sexually abused group, compared to the prevalence for non-abused girls. Internalizing symptoms were also highest for the dual abuse group. Onset graphs show that the onset of sexual abuse usually occurred at an earlier age than the onset of physical abuse. Abused girls showed an earlier age of onset of CD symptoms. Results indicated that the experience of combined types of abuse is associated with a poorer psychiatric prognosis.     

THE NEED FOR POWER IN WOMEN WHO WERE SEXUALLY ABUSED AS CHILDREN An Exploratory Study

Ten women who had been sexually abused as children and a matched group of women who had not been sexually abused participated in a preliminary study to explore the hypothesis that feelings of powerlessness and a compensatory need for power continue into adulthood for survivors of childhood sexual abuse. The Picture-Story Exercise (PSE) was used as an indirect assessment technique to determine the level of the need for power (McClelland, 1985; Winter, 1973, 1988). Results indicated that the stories of women with sexual abuse histories revealed a higher need for power and greater fear of power than those of nonabused women. Further content analysis of the PSE revealed that sexual abuse survivors' stories also contained more references to Finkelhor and Browne's (1986) dynamics of powerlessness, traumatic sexualization, betrayal, and stigmatization. These findings suggest important directions for future research as well as areas for therapeutic exploration.     

Even When You Win You Lose: Targeted Parents' Perceptions of Their Attorneys

The author attempts to deal with three important issues in relation to child sex abuse allegations. These are (1) some potential signs in the behavior of children who might have suffered sexual abuse; (2) how an evaluation of an allegedly sex abused child can be carried out; (3) the possible long term affects on a child who has suffered from being sexually abused. The complexity of drawing the right conclusions are considered when there are false positives due to the overlap of evidence between sexually abused and non abused children.     

The Implications of Conjunctive and Disjunctive Forgiveness for Sexual Abuse

This article examines the relationship between forgiveness styles (conjunctive and disjunctive models) and sexual abuse. Surveys from 114 university students were analyzed for differences between non-sexually abused and sexually abused subjects on a number of psychological and physical well-being variables. A number of differences were found including higher levels of reported verbal and physical abuse for the sexually abused subjects. Only one sexually abused subject was found that fit the pattern of conjunctive forgiveness (one of reconciliation) towards the offender. The majority of sexually abused subjects preferred to keep their distance from the abuser, regardless of the extent to which the abuser had been forgiven. The results suggest that reconciliation within forgiveness may not be an appropriate goal for all subjects.     

False recognition in women reporting recovered memories of sexual abuse

False recognition—the mistaken belief that one has previously encountered a novel item—was examined in four groups of subjects: women reporting recovered memories of childhood sexual abuse, women who believe that they were sexually abused as children but who cannot recall this abuse (the "repressed" group), women who were sexually abused as children and always remembered the abuse, and women with no history of childhood sexual abuse. Subjects were administered a Deese/Roediger-McDermott paradigm. The results suggest that the recovered-memory group was more prone to false recognition than the other groups. In addition, women reporting recovered and repressed memories showed greater reduction in false recognition across study trials than did other subjects, perhaps reflecting strategic changes in performance.     

Gender differences in victimized homeless adolescents

Most of what we know about sexual abuse comes from efforts to examine female children victimized by men. Although some researchers have identified similarities between male and female victims of sexual abuse, few studies have examined gender-specific factors associated with sexual health practices among homeless adolescents. The aim of this study was to explore how gender and history of sexual abuse influence cognitive-perceptual and behavioral factors associated with sexual health practices of homeless adolescents. This study was a secondary analysis of data collected for a cross-sectional study of the sexual health practices of homeless adolescents. The sample consisted of 414 youths (104 males who reported sexual abuse and 124 who did not; and 95 females who reported sexual abuse and 75 who did not; 16 did not provide these data). Homeless adolescent females with a history of sexual abuse scored higher (indicating a shorter perspective) on a measure of future time perspective than females with no sexual abuse. Males who reported no sexual abuse scored higher than abused females on perceived health status and higher than abused males on assertive communication. With respect to perceived health status, males who reported no sexual abuse scored significantly higher than females who reported sexual abuse (p = .04). Males with no sexual abuse had significantly higher assertive communication scores than did males who had experienced sexual abuse (p = .015). We found that male and female abuse victims differ in terms of their cognitive-perceptual and behavioral factors associated with sexual health practices. Early identification of those who have been abused is critical so that interventions can be developed. Effective short-term interventions are needed for the adolescent victims of Child Sexual Abuse (CSA), particularly those who are homeless and prone to further sexual victimization.     

Childhood Sexual Abuse and Revictimization In Adolescence and Adulthood

Abstract

Childhood sexual abuse must be seen as a pervasive risk factor in children's lives: No demographic or family characteristics have as yet been identified to rule out the possibility that a child will be or has been sexually abused (Finkelhor, 1993). The adverse consequences of sexual abuse, both immediate and long term, have been documented by a large body of research. After a summary of the main findings from this research, the main objective of the present chapter is to examine the impact of childhood sexual abuse on a particular aspect of psychological functioning: the development of sexual behavior and sexual relationships. In this analysis, special consideration is given to the question of whether individuals who were sexually abused as children are at greater risk of experiencing sexual victimization in later life than individuals without experience of abuse. This question has generated a substantial body of evidence (see Messman & Long, 1996, for a review), and researchers are beginning to understand pathways from the experience of abuse in childhood to revictimization in adolescence and adulthood.     

Sexual dysfunction in women sexually abused as children

Women who were sexually victimized as children report problems in relating to both men and women. Studies have found that victims are less satisfied with their current sexual relationships and with the quality of their relationships with men in general. Fear of sex, arousal dysfunction and desire dysfunction were the most common sexual disturbances found in incest victims.The purpose of this paper was to examine the differences in sexual functioning in abused women who perceived themselves to be adjusted to the trauma of their sexual abuse and those who did not.A sample of 57 nonclinical adult women who had been sexually abused as children was studied. Data were analyzed by means of cross-tabulation, chi square statistics, analysis of variance, and multiple regression.Orgasm was experienced by 63% of the women. There was a significant interaction among ability to be an orgasmic, sexual esteem and adjustment to abuse. Over 56% of the women experienced physical discomfort during intercourse and 36% indicated that they needed sex therapy. The implications of these and other findings are discussed.     

Immediate and delayed suggestibility among suspected child victims of sexual abuse

Children suspected of being victims of sexual abuse are often interviewed by police, but little is known about the effects of sexual abuse on their suggestibility. The aim of this paper was to investigate differences in ‘immediate’ and ‘delayed’ suggestibility between children being investigated as suspected victims of sexual abuse and other children and to compare the suggestibility scores of children allegedly abused by a family member versus a person from outside the family. The participants were 180 children aged between 7 and 16 years, who had been subdivided into ‘victim’ and ‘control’ groups; each group being comprised of 90 children and matched for IQ. All children completed the Gudjonsson Suggestibility Scale (GSS 2) and a non-verbal IQ test. The children in the victim group scores significantly higher on Shift and Yield 2 than the control group, after controlling for memory capacity. Children abused by a family member coped significantly worse with interrogative pressure (high Shift) than those abused by a non-family member. Immediate suggestibility showed much stronger effects than delayed suggestibility. The findings suggest that sexually abused children are very vulnerable during questioning where there is interrogative pressure and those abused by a family member are even more vulnerable.     

The impact of a history of sexual abuse on high-risk sexual behaviors among females attending alternative schools

The goal of this study was to explore whether a history of sexual abuse is associated with high-risk sexual behaviors among female adolescents attending alternative schools in a large urban city in the southwestern United States, and to examine the role of depression and substance abuse in explaining this association. One hundred eighty-four sexually active female adolescents constituted the sample for this analysis. Forty-nine (26.6%) reported that they were forced to have sex. Having a history of sexual abuse substantially increased sexual risk behaviors. Adolescents reporting a history of sexual abuse, compared to those who did not report such a history, were significantly more likely to have initiated sexual activity (intercourse) before age 14, to have had three or more sexual partners in the last 3 months, and to have had a history of sexually transmitted diseases. These associations remained significant after controlling for age, ethnicity, and family income. Depression and substance abuse did not explain the association between sexual abuse and high-risk sexual behaviors. It seems reasonable to conclude that adolescents with a history of sexual abuse have greater difficulty practicing safe sexual behaviors than do those who have not been sexually abused. Given the prevalence of child sexual abuse and the extent of its impact, it is critical that intervention strategies for adolescent females address the issue of abuse and help them adopt self-protective sexual behaviors. The findings also highlight the importance of targeting adolescents who attend alternative schools.     

NEUROBEHAVIORAL SEQUELAE OF CHILD SEXUAL ABUSE

This study examined intellectual and memory functioning in a sample of sexually abused children compared to demographically and age-matched controls. The severity of abuse and other pertinent factors were also examined in relation to cognitive performance. Elevated levels of psychopathology were present in the abused children, as well as diminished performance on tasks influenced by attention/concentration. However, after controlling for differences in IQ and socioeconomic status (SES), significant differences in memory function were not found. Results are discussed in the context of stress effects on cognition and the potential resiliency of cognitive function in children undergoing treatment for sexual abuse.