Exploring Posttraumatic Outcomes as a Function of Childhood Sexual Abuse

There is sparse systematic examination of the potential for growth as well as distress that may occur for some adult survivors of childhood sexual abuse. The presented study explored posttraumatic growth and its relationship with negative posttrauma outcomes within the specific population of survivors of childhood sexual abuse (N = 40). Results showed that 95% of the participants experienced clinically significant post-traumatic stress disorder symptomatology related to their childhood sexual abuse. In conjunction with these high levels of negative symptoms, the population evidenced posttraumatic growth levels that were comparable to other trauma samples. This research has clinical relevance in terms of adding to the knowledge base on sexual abuse and the usefulness of this knowledge in therapeutic interventions and relationships.     

Mothers' abusive childhood predicts child abuse

To examine the intergenerational transmission of abuse, the study compared 25 mothers whose child had been under the supervision of the child protection services (CPS) with 25 mothers who had had no contact with the CPS. The groups were compared with respect to their own self‐reported childhood abuse, their abuse of their own child and punitiveness. The data were gathered using interviews and files. There were no significant differences between the groups in self‐reported childhood physical abuse, but the CPS mothers had experienced more childhood psychological abuse, especially rejection, accusations, terrorizing and corrupting. The groups did not differ in the self‐reported physical or psychological abuse inflicted upon one's own child. In the total sample of 50 mothers, hierarchical regression analyses showed, however, that the mothers' childhood abuse experiences predicted their abuse of their own child. Punitiveness was best predicted by maternal childhood psychological abuse. The results thus provide evidence for the cycle of abuse model. Copyright © 1999 John Wiley & Sons, Ltd.     

Prevalence of childhood abuse in mothers taking part in a study of parenting their own children

This paper describes the incidence of maltreatment histories in a community sample of mothers of one‐year‐old infants in Northern Ireland. The occurrence of five subsets of childhood maltreatment is examined: emotional abuse, emotional neglect, physical abuse, physical neglect and sexual abuse. Of the 201 women who completed the Childhood Trauma Questionnaire, 70 mothers (35%) reported that they had experienced one or more types of maltreatment during childhood. Forty‐eight mothers (24%) gave a history of being emotionally abused, 43 (21%) of emotional neglect, 27 (13%) of physical abuse, 20 (10%) of sexual abuse and 19 (10%) of physical neglect. Physical abuse was the only type of maltreatment which showed an association with maternal socio‐economic status, with a higher incidence reported amongst Occupational Classes 4 and 5 (lower supervisory and technical occupations and semi‐routine and routine groups). More than half of those with a history of abuse experienced more than one type of maltreatment (42 mothers or 60% of those reporting maltreatment). Differences in rates of incidence to more recent studies on younger adults are discussed, as well as implications for prevention and intervention. Copyright © 2009 John Wiley & Sons, Ltd.     

Risky Sexual Behaviors and Pregnancy Outcomes in Young Adulthood Following Substantiated Childhood Maltreatment: Findings From a Prospective Birth Cohort Study

Childhood maltreatment is associated with a range of adverse mental and physical health outcomes, including increased rates of sexually transmitted infections (STIs) later in life. However, the impact on risky sexual behaviors and pregnancy outcomes has not been adequately studied. This is particularly true for physical abuse, emotional abuse, and neglect. We examined associations between prospectively substantiated childhood maltreatment and reports of risky sexual behaviors by men and women, as well as selected pregnancy outcomes in women. We followed up 3,081 (45.7% female) participants from the Mater-University of Queensland Study of Pregnancy, a prospective Australian birth cohort study. Using logistic regression, we examined the association between substantiated childhood maltreatment from birth to 14 years, and self-reported risky sexual behaviors and youth pregnancy outcomes at the 21-year follow-up. In adjusted analyses, children who had experienced multiple childhood maltreatment exhibited more risky sexual behaviors than their nonmaltreated counterparts. In specific models, those exposed to each form of childhood maltreatment, independent of co-occurring forms of childhood maltreatment, had an increased likelihood of risky sexual behaviors, particularly an early sexual debut and, for women, youth pregnancy. Neglect was also associated with multiple sexual partners, and emotional abuse with higher rates of miscarriage. There was no difference between men and women in how different forms of childhood maltreatment predicted risky sexual behaviors in young adulthood. All forms of substantiated childhood maltreatment, including multiple substantiations, were associated with risky sexual behavior in both sexes as well as higher rates of youth pregnancy in women. Moreover, emotional abuse persistently predicted miscarriages in young adult women. Understanding the association between childhood maltreatment and risky sexual behaviors and youth pregnancy outcomes may help suggest preventive strategies.     

Parents Making Meaning of High‐Conflict Divorce

This article reports on the findings of an empirical study conducted with 25 parents in British Columbia, Canada, who experienced a high‐conflict divorce and later came to see the experience as having been transformative despite the difficulties they faced. While considerable research and policy initiatives frame high‐conflict divorce as an individual and interpersonal problem, there is less reference to the fact that these disputes occur in a social, political, and legal context that also changes over time and across generations. There has been little research examining long‐term divorce outcomes, and no research to date examining how mothers and fathers who experienced a high‐conflict divorce process overcome their difficulties and make meaning of their experiences retrospectively. This interdisciplinary study starts to fill these gaps. Following an overview of the study findings, the article highlights common themes arising from parents' narratives with a particular focus on agency, voice, and meaning‐making across the life course. I argue that by taking a long view of the challenges participants faced, it is possible to move away from decontextualised understandings of high‐conflict divorce.     

Long‐Term Physical Health Consequences of Adverse Childhood Experiences

This study examined associations between adverse childhood family experiences and adult physical health using data from 52,250 U.S. adults aged 18 to 64 from the 2009 to 2012 Behavioral Risk Factor Surveillance System. We found that experiencing childhood physical, verbal, or sexual abuse, witnessing parental domestic violence, experiencing parental divorce, and living with someone who was depressed, abused drugs or alcohol, or who had been incarcerated were associated with one or more of the following health outcomes: self‐rated health, functional limitations, diabetes, and heart attack. Adult socioeconomic status and poor mental health and health behaviors significantly mediated several of these associations. The results of this study highlight the importance of family‐based adverse childhood experiences on adult health outcomes and suggest that adult socioeconomic status (SES) and stress‐related coping behaviors may be crucial links between trauma in the childhood home and adult health.     

‘Failure to thrive’ revisited

The term ‘non‐organic failure to thrive’ (FTT) has long been used in relation to young children with faltering growth for which no organic cause is found. In this paper, problems arising from dichotomised organic/non‐organic responses to FTT are explored and reasons for the assumption that non‐organic FTT was always due to emotional abuse or neglect are presented. The case is made that, except in a minority of cases, children fail to grow because they consume insufficient calories. Research studies on reasons for poor intake, from factors related to the child and their parents to the wider family and environment, are summarised. Following a brief reference to literature on outcomes, I argue that centile charts should be routinely completed for all young children. If faltering growth is identified, a multi‐factorial assessment should be undertaken. Such an assessment reduces the risk of interventions being based on outdated assumptions about non‐organic FTT and maximises the potential for successful resolution of poor growth. After briefly summarising the literature on interventions, I conclude with suggestions for improving practice in this field, including working in partnership with families and with health and social care professionals already known to them. Copyright © 2008 John Wiley & Sons, Ltd.     

Inter‐professional working in child protection with families with long‐term and complex needs

Within the United Kingdom there is growing awareness of the need to identify and support the small number of children who are living in families experiencing multiple problems. Research indicates that adverse experiences in childhood can result in poor outcomes in adulthood in terms of lack of employment, poorer physical and mental health and increases in social problems experienced. It is acknowledged that most of these children are known to child welfare professionals and that some are referred to social services, subsequently entering the child protection system. This paper reports research conducted with 28 experienced child welfare professionals. It explores their views about families known to the child protection system with long‐term and complex needs in relation to the characteristics of children and their families; the process of intervention with families; and the effects of organisational arrangements on practice. The research indicates that these families are characterised by the range and depth of the problems experienced by the adults, such as domestic violence, mental health difficulties and substance misuse problems, and the need for professionals to have good inter‐personal skills and access to specialist therapeutic services if families are to be supported to address their problems. Copyright © 2008 John Wiley & Sons, Ltd.     

Exploring the Relationship Between Adverse Childhood Experiences and Hope

ABSTRACT

To explore the relationship between adverse childhood experiences and hope, a convenience sample of caregivers bringing in children for medical investigation of child abuse at a regional child advocacy center were surveyed for adverse childhood experiences and dispositional hope. Hope in this sample had a significant negative correlation to the adverse childhood experiences subscale “abuse” (r = –.19; p < .05). The relationship between hope and the other adverse childhood experiences subscales “neglect” (r = –.14) and “dysfunctional family” (r = –.16) was not statistically significant. An analysis of variance was performed to determine if caregivers who have experienced both sexual and physical abuse (M = 29.67; SD = 15.96) have lower hope scores compared to those caregivers who have experienced neither physical nor sexual abuse (M = 42.64; SD = 18.44). This analysis (F (1, 84) = 5.28; p < 0.05) showed that caregivers who experienced both physical and sexual abuse scored significantly lower on hope compared to their counterparts who experienced no adverse events, with an estimated effect size of moderate strength (d = 0.70). Higher adverse childhood experiences scores are associated with lower hope. This result was especially true for those adult caregivers who reported experiencing both physical and sexual abuse when compared to adults who did not experience either form of child trauma. While the empirical literature continues to demonstrate the negative consequences of adverse childhood experiences across the life span, hope offers a compelling new line of inquiry in child maltreatment research especially for studies targeting prevention or intervention.     

The Long‐Term Effects of Building Strong Families: A Program for Unmarried Parents

The authors present findings from a large‐scale, random‐assignment evaluation of Building Strong Families (BSF), a program offering group sessions on relationship skills education to low‐income, unmarried parents who were expecting or had recently had a baby. Findings based on a 3‐year follow‐up survey of over 4,000 couples indicate that BSF did not succeed in its central objectives of improving the couple relationship, increasing the quality of coparenting, or enhancing father involvement. In fact, the program had modest negative effects on some of these outcomes. BSF also had little impact on child well‐being, with no effect on children's family stability or economic well‐being and only a modest positive effect on children's socioemotional development. Impacts varied across the 8 study sites. Although attendance at group sessions was relatively low, there is little evidence of program effects even among couples who attended sessions regularly.     

Maternal Employment in Childhood and Adults’ Retrospective Reports of Parenting Practices

Do adults’ perceptions of their mothers’ and fathers’ parenting practices in childhood vary by their mothers’ employment status? Among adults in the Survey of Midlife Development in United States who lived with 2 biological parents until the age of 16 years (N = 2,246), those who had employed mothers during most or all of their childhood reported less support and less discipline from both parents than those who had stay‐at‐home mothers. Sons but not daughters who had employed mothers reported more verbal or physical assaults by both parents than their counterparts who had homemaker mothers. Despite greater social acceptance of maternal employment among younger Americans, cohort differences were not evident. These findings underscore the significance of mothers’ economic roles in influencing offspring’s perceptions of family dynamics.     

On the Road to Resilience: The Help‐Seeking Experiences of Irish Emigrant Survivors of Institutional Abuse

Understanding how survivors of complex trauma navigate towards resources can inform the design of interventions and health promotion strategies. However, there are little data on the resilience and help‐seeking experiences of this group or others who have experienced institutional abuse in childhood. This empirical study sets out to illustrate the help‐seeking experiences of Irish emigrant survivors of institutional childhood abuse (ICA). Twenty‐two survivors of ICA were purposefully recruited from community organisations in the UK and data were collected via semi‐structured interviews. As a result of negative initial help‐seeking experiences in Ireland, most participants engaged in long periods of self‐management and disclosed information about their childhood as part of a redress scheme in later life. Outside of this scheme, turning points, such as illness or family problems, and the needs of children were influential in seeking help. Peer support networks played an important role as a trusted signposting pathway towards formal interventions. Participants identified interpersonal barriers to formal help‐seeking as helping professionals' failure to share control, insensitivity to identity loss and literacy issues, and the lack of explicit boundaries. The paper concludes with a discussion about the implications for research and future practice.

‘This empirical study sets out to illustrate the help‐seeking experiences of Irish emigrant survivors of institutional childhood abuse’

Key Practitioner Messages:

• Turning points, such as illness and bereavement, and the desire to provide for children, influence the help‐seeking of survivors of ICA.
• Irish emigrant survivors of ICA cite failure to share control, insensitivity to identity loss, literacy issues and the lack of explicit boundaries as barriers to help‐seeking.
• General awareness of ICA can help practitioners in low‐threshold services prevent against culturally insensitive practice.
• Peer support networks can provide uniquely trusted signposting towards formal interventions.

     

Peer Crowd Affiliation and Internalizing Distress in Childhood and Adolescence: A Longitudinal Follow‐Back Study

Concurrent and longitudinal associations between peer crowd affiliation and internalized distress were examined in a sample of 246 youth (148 girls, 98 boys). Children completed measures of depression, social anxiety, loneliness, and self‐esteem when they were in grades 4 to 6 (Time 1), and again 6 years later during adolescence (grades 10 – 12; Time 2). At Time 2, adolescents also reported their self‐concept and their identification with reputation‐based peer crowds, including Populars, Jocks, Brains, Burnouts, Non‐Conformists, and None/Average crowds. Results indicated that adolescents' report of peer crowd affiliation was concurrently associated with self‐concept and levels of internalizing distress. Follow‐back analyses of internalizing trajectories revealed that Populars/Jocks had experienced significant declines in internalizing distress across development, whereas Brains exhibited some increases in internalizing distress between childhood and adolescence.     

The Effect of Severe Child Sexual Abuse and Disclosure on Mental Health during Adulthood

This study examined the relationship among severe child sexual abuse, disclosure, and mental health symptoms during adulthood. The sample consisted of 172 adults who were sexually abused in childhood. The multivariate model showed that respondents in their 30s and 40s who were abused by more than one abuser, who were injured by their abusers, who were abused by a biological relative, who told someone about the abuse when it occurred, and who did not discuss their abuse in depth within one year of the abuse had a greater number of mental health symptoms. Abuse severity and disclosure history should be assessed by professionals to identify clients who are at higher risk of mental health symptoms and to focus therapy.     

Trajectories of Substance Use: Onset and Adverse Outcomes Among North American Indigenous Adolescents

North American Indigenous communities experience disproportionately high rates of substance use, abuse, and dependence and their accompanying consequences. This study uses group‐based trajectory modeling of past‐year substance use (alcohol, marijuana, and cigarettes) with a longitudinal sample of Indigenous adolescents from the northern Midwest and Canada (spanning ages 10–18 years). The early‐onset trajectory (36.3%) had more adverse psychosocial difficulties at baseline than the mid‐onset group (38.3%); both trajectories were associated with several negative outcomes at the end of the study. The late‐onset trajectory (25.3%) did not initiate substance use until later adolescence and had far better outcomes at the last wave of the study. Timing of onset matters. Prevention efforts should begin in late childhood and continue through mid‐adolescence.     

Four‐Month Attentional Regulation and Its Prediction of Three‐Year Compliance

The extent to which 4‐month attentional regulation during an infant‐mother still‐face situation and 12‐month attachment security during the Strange Situation predicted rates of compliance and noncompliance during a cleanup task at 36 months was examined longitudinally in 70 infant‐mother dyads. Hierarchical multiple regression analyses indicated that infants who showed more attentional regulation during the still‐face situation with mothers later showed a higher rate of committed compliance and a lower rate of situational compliance during cleanup with mothers. Furthermore, lower levels of attentional regulation were later associated with higher rates of assertive behavior, but only for infants in an insecure attachment relationship.     

Postdivorce Father‐Adolescent Closeness

Research indicates that closeness of the father‐child bond following parental divorce is associated with better outcomes for children and adolescents. Unlike other investigations, this study takes a long‐term developmental approach to understanding stability and change in postdivorce father‐adolescent relationship closeness. Drawing on Add Health data (n = 483), we examine factors that explain (a) why some high‐quality father‐adolescent relationships remain the same after divorce whereas others decline, and (b) why some low‐quality relationships are stable following divorce whereas others improve. High mother‐offspring relationship quality and offspring feelings of well‐being prevented close father‐offspring relationships from deteriorating. Offspring’s childbearing and cohabitation following parental divorce increase closeness in father‐offspring relationships that were not close prior to divorce. Although a majority of offspring experienced a decline in closeness following divorce, results from this study show that some very close father‐offspring relationships are maintained and some poor relationships become closer.     

DO COLLEGE‐PREPARATORY PROGRAMS IMPROVE LONG‐TERM OUTCOMES?

This paper presents an analysis of the longer‐run effects of a college‐preparatory program implemented in inner‐city schools that provided teacher training in addition to payments to 11th‐ and 12th‐grade students and their teachers for passing scores on Advanced Placement (AP) exams. Affected students passed more AP exams, were more likely to remain in college beyond their first and second years, and earned higher wages. Effects are particularly pronounced for Hispanic students who experienced a 2.5‐percentage‐point increase in college degree attainment and an 11% increase in earnings. While the study is based on nonexperimental variation, the results are robust across a variety of specifications, and most plausible sources of bias are ruled out. The results provide credible evidence that implementing high‐quality college‐preparatory programs in existing urban schools can improve the long‐run educational and labor‐market outcomes of disadvantaged youth. (JEL I2, I24, J0)     

Parent and Child Therapy (PACT) In Action: An Attachment‐Based Intervention for a Six‐Year‐Old With a Dual Diagnosis

This case study explores Parent and Child Therapy (PACT), an attachment‐based intervention for mothers and children experiencing intractable relationship distress originally developed by Heather Chambers (a Child Psychotherapist and Family Therapist working in New Zealand). We describe the use of PACT with a mother—child dyad presenting a history of severe abuse and neglect. The child had been diagnosed with Conduct Disorder and co‐morbid Attention Deficit Hyperactivity Disorder. We consider the themes arising in the therapy, the emotional process experienced by the mother and child, the initial outcome and 10‐month follow up. The case study indicates that PACT can be learned and used by practitioners outside of the team that conceptualised and developed it. The case highlights the links between externalising difficulties and attachment disorganisation and points to PACT as a promising treatment for the chronic sequelae of early interpersonal childhood trauma. The need for research and possible directions of this research are discussed.     

Physical abuse in early childhood and transition to first sexual intercourse among youth in Cape Town, South Africa

This study examined the relationship of physical abuse in early childhood and timing of first sexual intercourse among young South Africans aged 14 to 22 in Cape Town. Using the Cape area panel survey and applying log-normal models, time ratios were estimated to show how rapidly or slowly youth experience first sexual intercourse. Results indicated that boys who experienced physical abuse in early childhood had faster timing to first sex. Boys and girls with violent school environments had faster timing to first sex. Race moderated the effects of physical abuse. Compared to Blacks, Coloreds who experienced higher levels of physical abuse in early childhood had faster timing to first sex. Youth with greater knowledge about HIV/AIDS and those with greater risk perception of contracting HIV/AIDS delayed first sex. On the basis of these findings, policy makers are encouraged to consider the early childhood experiences of youth when designing policies toward HIV/AIDS prevention in South Africa.