Links between past abuse,suicide ideation,and sexual orientation among San Diego college students

The authors explored relationships among childhood abuse, suicidal ideation, and sexual orientation of 18- to 30-year-old students enrolled in 2 San Diego area colleges, using responses from anonymous questionnaires. Sixty percent of the 138 eligible respondents were women, and 22% were self-identified gay/bisexual individuals. Women were more likely than men to report at least 1 form of emotional abuse (odds ratio [OR] = 2.3; p =.02) and unwanted sexual touching (OR = 4.3; p = .0004). Lesbian/bisexual women were significantly more likely to report past suicidal ideation than were heterosexual women (OR = 3.7, p = .03). Gay/bisexual men were more likely to report unwanted sexual touching than were heterosexual men (OR = 5.1, p = .04), but the men did not report significantly higher rates of past suicide ideation or suicide attempts. Sexual orientation and a past history of child sexual, physical, and emotional abuse could be compounding risk factors for suicidal ideation among college students.     

Suicidal behavior and associated factors in sexually abused adolescents

Objectives

The aim of the present study is to determine the rate of suicidal ideation and suicide attempts in sexually abused adolescents and to determine the factors associated with suicidal behavior.

Method

106 adolescents between the ages of 12–18 (94 girls, 12 boys) who were exposed to sexual abuse and referred for the preparation of forensic reports were included in the study. The investigators retrospectively examined the case files, forensic reports and social worker reports.

Results

It has been found that in cases exposed to sexual abuse, suicidal ideation developed in 63.2% (n = 67) of the individuals and 24.5% (n = 26) of them attempted suicide. The rate of suicidal ideation and suicide attempts was higher in cases who live separately from one or both parents, those who have ASD or PTSD after sexual abuse, cases in which abuse involved penetration, cases who were abused by someone known or someone from the family, cases where sexual abuse was accompanied by coercion and physical violence, and those who were exposed to abuse continuously. Among girls, in cases who have suicide history before sexual abuse and those who were abused by more than one abuser, the rate of suicidal ideation was higher.

Conclusion

It has been shown in many studies that sexual abuse in childhood increases the risk of suicidal behavior. Consideration of the factors associated with suicidal behavior in victims of sexual abuse will be helpful to clinicians in preventing suicide attempts.     

The association between suicidal ideation and childhood and adult victimization

Despite the burgeoning literature on suicidal behavior, there are meager data available on the relationship between suicidal ideation and emotional abuse in childhood; adult physical or sexual victimization; and adult re-victimization in those with a history of childhood maltreatment. This study addressed these gaps in the literature. In a sample of 494 female undergraduates, current suicidal ideation was assessed dichotomously using an item from the SCL-90 and victimization was assessed retrospectively with validated multi-item measures. Analyses revealed an association between suicidal ideation and emotional and physical abuse in childhood and a history of partner violence. No relationship was found between childhood sexual abuse or forced sex in adulthood and suicidal ideation. Additionally, results of multiple logistic regression analyses did not support the hypothesis that the relationship between childhood victimization and SI is moderated by re-victimization in adulthood.     

Suicide ideation,attempts and abuse among incarcerated gang and nongang delinquents

The present study examines suicide ideation and attempts as well as reported levels of physical and sexual abuse among gang and nongang-involved incarcerated youth. The self-report survey data were collected from 334 males and 61 females who were incarcerated in Nevada youth correctional facilities in the summer of 1994. Over half (58.3 percent) of the males and nearly half (45.2 percent) of the females reported being gang members. Surprisingly high rates of abuse (more than 70 percent for both physical and sexual abuse) were found among the incarcerated females of this study. Females reported significantly more suicide attempts and were more likely to have been physically and sexually abused than males. Nongang males reported significantly more suicide attempts and were more likely to report sexual abuse than gang-involved males. Among the gang-involved delinquents, females reported significantly more suicide attempts than males. In addition, gang members who reported sexual abuse were more likely to have higher levels of suicide ideationand to have attempted suicide. Implications for youth correction specialists and social workers are discussed.The data for this study were collected under Grant #000616 from the Nevada Agricultural Experiment Station.     

Pediatric Emergency Department Visits for Mental Health Crisis: Prevalence of Cyber-Bullying in Suicidal Youth

The objective of this work is to (1) study the prevalence of cyber-bullying amongst adolescents referred by Pediatric Emergency Department (PED) for urgent psychiatric assessment and (2) to examine the association between cyber-bullying and suicidal behavior to assist emergency department professionals in screening for risk and triage. This is a retrospective study of patients referred by PED to an urgent psychiatric clinic. Data was extracted for those with bullying victimization. Clinical variables included demographics, reason for referral, type of bullying, substance use, abuse, past psychiatric history, diagnosis and outcome. The cyber-bullying group was compared to those with traditional bullying and a group with no-bullying. Data analysis was conducted using Chi squares, multinomial and bimodal logistic regression. The urgent psychiatric clinic assessed 805 patients in 24 months, the prevalence of bullying was 26.9 % (n = 217). The prevalence of Cyber-bullying was 13.5 % (n = 109) and traditional bullying was 13.4 % (n = 108). Cyber-bullying victims have more suicidal ideation (χ² = 7.82, p = .005; 85.3  vs. 69.4 %), more sexual abuse (χ² = 5.75, p = .02; 29.4  vs. 15.7 %), more emotional abuse (χ² = 10.8, p = .01; 30.3  vs. 12.0 %) and physical abuse (χ² = 6.13, p = .01; 27.5  vs. 13.9 %) and a higher inpatient admission rate. Suicidal ideation is the presenting problem in more than two-thirds of patients, especially females, with history of cyber-bullying who present to the PED. Screening questions about cyber-bullying could assist emergency room professionals in establishing risk and making triage decisions.     

Pre/Early Adolescent Onset of Gambling and Psychosocial Problems in Treatment-Seeking Pathological Gamblers

This study examined the association between pre- or early-adolescent onset of gambling and severity of gambling and psychosocial problems in treatment-seeking adult pathological gamblers. A total of 236 pathological gamblers entering outpatient treatment completed the South Oaks Gambling Screen (SOGS) and the Addiction Severity Index (ASI). Using a quartile split procedure, gamblers who began gambling during their pre- or early-adolescent years (mean age of 10.5 years; 1st quartile) were compared to gamblers who began gambling later in life (mean age of 23.0 years; 2nd to 4th quartiles). Compared to later onset gamblers, pre/early adolescent onset gamblers reported increased severity of psychiatric, family/social, and substance abuse problems on the ASI. They were more likely to report cognitive problems (trouble understanding, concentrating, or remembering), suicidal ideation, and a history of inpatient psychiatric treatment, and were less likely to be satisfied with their current living situation. Pre/early adolescent onset gamblers also reported earlier age of initiation of drinking, and were more likely to have received treatment for an alcohol use disorder, and to have used cannabis and cocaine in their lifetimes. Taken together, these data suggest that pre/early adolescent-onset of gambling may be a risk factor for later-life psychiatric, family/social, and substance abuse problems in treatment-seeking pathological gamblers.     

Physical,sexual and psychological abuse in high school dating relationships: Prevalence rates and self-esteem issues

The present study examined the rates of victimization by physical, sexual and psychological abuse in adolescent dating relationships, with self-esteem being explored as a mediating variable. Subjects included 257 students from a coed, ethnically diverse, religiously affiliated high school. Information was obtained using a self-report questionnaire on teenage dating behaviors. Of the 114 male and 118 female subjects who had dating experience, 59% had been victimized at least once in some past or current dating relationship by physical violence, 96% had experienced some form of psychological maltreatment and 15% had been forced to engage in sexual activity. Significantly more males than females reported experiencing physical abuse overall. Significantly more males than females experienced acts of moderate physical abuse, while there was no significant gender difference in the experience of acts of severe physical abuse. Thirteen percent of the subjects stated they had remained in a physically abusive relationship at one time, with females being more likely to remain than males. Self-esteem was not a factor in the level of physical abuse sustained in dating relationships, nor was there a significant difference in the levels of self-esteem between subjects who remained in, terminated, or never were involved in, physically abusive dating relationships. For all subjects, self-esteem negatively correlated with the level of psychological maltreatment sustained in dating relationships, but separate analysis by gender found the correlation was significant only for female subjects.     

Common correlates of suicidal ideation and physical assault among male and female university students in Hong Kong

This study examined prevalence and correlates of suicidal ideation and dating partner violence in a cohort of 651 university students in social sciences classes at three universities in Hong Kong. A standard questionnaire was completed within one class period to examine the rates of occurrence of physical assault perpetration and suicidal ideation. Separate rates are presented for male and female perpetrators and for severe and overall levels of violence. The differences between subjects having suicidal ideation are compared using t tests. Logistic regression is used to predict the presence or absence of physical assault in the preceding year of reporting and suicidal ideation based on the variables such as Personal Relationship Profile, age, relationship length, and socioeconomic status. Results showed that 55% of suicidal persons had a history of violence, whereas 39% of violent people had a history of suicidal ideation. Logistic regression showed that physical assault shared a total of seven associated factors with suicidal ideation. Suicidal ideation seems to have no direct relation to physical and sexual assault, but they do share some common associated factors that are essential for the development of suicide prevention.     

Identification of Sexually Abused Female Adolescents at Risk for Suicidal Ideations: A Classification and Regression Tree Analysis

This study explored the clinical profiles of 77 female teenager survivors of sexual abuse and examined the association of abuse-related and personal variables with suicidal ideations. Analyses revealed that 64% of participants experienced suicidal ideations. Findings from classification and regression tree analysis indicated that depression, posttraumatic stress symptoms, and hopelessness discriminated profiles of suicidal and nonsuicidal survivors. The elevated prevalence of suicidal ideations among adolescent survivors of sexual abuse underscores the importance of investigating the presence of suicidal ideations in sexual abuse survivors. However, suicidal ideation is not the sole variable that needs to be investigated; depression, hopelessness and posttraumatic stress symptoms are also related to suicidal ideations in survivors and could therefore guide interventions.     

Correlates of Sexual Abuse in a Sample of Adolescent Girls Admitted to Psychiatric Inpatient Care

We examined correlations of child sexual abuse among 300 adolescent girls in psychiatric inpatient treatment. Diagnostic and Statistical Manual of Mental Disorders (4th ed.)-based psychiatric diagnoses were obtained from the Schedule for Affective Disorder and Schizophrenia for School-Age Children—Present and Lifetime and from data on family and behavioral characteristics from the European Addiction Severity Index (EuropASI). A total of 79 girls (26.3%) had experienced child sexual abuse during their lifetime. Child sexual abuse was associated with an adolescent’s home environment, sibling status, smoking, posttraumatic stress disorder diagnosis, self-mutilating behavior, and suicidal behavior. At least 62% of the perpetrators were acquaintances of the victims. Correlates of child sexual abuse can be used to identify child sexual abuse victims and persons at heightened risk for child sexual abuse.     

Psychological impact of writing about abuse or positive experiences

Writing often helps people deal with trauma. To see if writing about childhood physical or sexual abuse, or positive experiences, helps, psychology undergraduates wrote for 20 minutes on 4 days about their abuse, a positive experience, or a trivial topic. Among 102 who began and 85 who completed pre-, post-, and 4-week follow-up measures of depression, anxiety, and suicidal ideas, abuse writers were more likely to discontinue, and positive writers were more depressed and anxious. Compared to pretest, all completers were less depressed, anxious, and suicidal at follow-up, but nonsignificantly different in health visits. Completers who wrote about abuse rated the study as more valuable than did those who wrote about positive experiences. College students who wrote about childhood physical or sexual abuse benefited from any type of structured writing assignment (where they interacted with a researcher and got extra credit) in terms of reduced anxiety, depression, and suicidal ideas, but they found value in writing about their trauma more than writing about innocuous topics.     

Childhood Sexual Abuse and Brain Development: A Discussion of Associated Structural Changes and Negative Psychological Outcomes

The effects of traumatic exposure have been researched for many years and studies have shown that the parts of the brain affected by sexually traumatic experiences in childhood are also linked to many physical and psychological problems, such as depression, posttraumatic stress disorder, somatic complaints and suicide. Neuroimaging studies have provided a breadth of evidence that childhood sexual abuse is related to structural changes in the brain. Taken together, childhood sexual abuse affects brain development, leading to differences in brain anatomy and functioning that have lifelong consequences for mental health. Several limitations of neuroimaging research on childhood sexual abuse are discussed, including a lack of refined and sensitive neuroimaging measures and problems interpreting results of structural imaged subjects with associated psychiatric conditions. Future, large‐scale studies are warranted to examine the type and severity of the sexual abuse and how each of the levels of childhood sexual abuse contributes to structural and functional changes. Furthermore, future studies are needed to control for comorbid psychiatric conditions in order to disentangle the effects of childhood sexual abuse from psychiatric conditions that damage brain development. © 2018 John Wiley & Sons, Ltd.

‘Childhood sexual abuse affects brain development, leading to differences in brain anatomy and functioning that have lifelong consequences for mental health’

Key Practitioner Messages

• Childhood sexual abuse is linked to observable structural changes in the brain.
• These structural changes in the brain are associated with a myriad number of negative psychological effects.
• Research is limited in elucidating the role of childhood sexual abuse on brain development, as the bulk of the research has focused only broadly on child maltreatment.

     

Treatment of Sexually Abused Children: Interview Technique,Disclosure, and Progress in Therapy

ABSTRACT

The closed records of 50 children referred for treatment following sexual abuse were analyzed to determine the relationships between therapist structure for disclosure of the abuse, whether the child disclosed, clinical improvement, and several other variables. Ten children revealed details of their abuse in response to introductory structure by the therapist, while 19 children required ongoing structure to disclose such details. Five children did not respond to therapist structure with a disclosure. In contrast, only 1 out of 11 cases disclosed when the therapist did not structure for disclosure. Six of the children who disclosed took five or more treatment sessions to do so. Those who disclosed showed rates of clinical improvement similar to those who did not disclose. Neither maternal support nor foster home placement was related to disclosure or to clinical improvement.     

An Overview of a Hospital-Based Child Advocacy Center’s Experience from Turkey

The purpose of the present study was to investigate sociodemographic variables, features of sexual abuse (SA), and first psychiatric evaluation results of abused children, and to analyze the relation of the psychiatric evaluation results to the children’s age and gender, type and duration of abuse, abuser–child relationship, and marital status of the children’s parents, at one of the most experienced Child Advocacy Centers (CACs) in Turkey. All data were obtained from reports prepared by child and adolescent psychiatrists. The sample of this study consists of 436 child sexual abuse (CSA) cases who admitted ?zmir CAC between April 2014 and November 2015. The statistical analyses yielded significant relations between psychiatric symptoms and chronic abuse, the gender of the children, and type of abuse. Suicidal ideation and behaviors due to sexual abuse (SA) were also examined. According to our results, it is fair to say that children exposed to SA benefit from immediate psychiatric help because of their vulnerability for psychiatric disorders due to abuse. In this context, CACs are very important multidisciplinary establishments to determine children’s multiple needs to ease their trauma with collaborative teamwork. Psychiatric evaluation should be part of this multidisciplinary context.     

A review of the epidentiological research on child sexual abuse. Community and college student samples

This article is the first of two consecutive reviews on the major empirical studies which have been carried out in an attempt to estimate the prevalence of child sexual abuse among females. The research is structured in terms of three sample categories: (a) probability and non-probability samples of the general population; (b) college student samples; and (c) clinical inpatient and outpatient samples. This part of the review deals with (a) and (b) and highlights a number of unresolved methodological issues which may contribute to the variance in reported prevalence rates. These include a myriad of definitions of child sexual abuse and different methods of eliciting information on possible histories of abuse. Despite these problems. taken as a whole the prevalence studies indicate the significant numbers of people who have experienced abuse and who are willing to disclose aspects of these abusive experiences.     

Multiple sexual victimizations among adolescent boys and girls: prevalence and associations with eating behaviors and psychological health

The purpose of this study was to assess the prevalence of sexual abuse, including multiple victimizations, among adolescents and to examine associations among history of sexual abuse, disordered eating behaviors and psychological health. The sample included 81,247 students (40,946 girls and 40,301 boys) in 9th and 12th grade in Minnesota public schools. Sexual abuse was reported by 14.7% of girls and 6.2% of boys. Sexual abuse was associated with unhealthy eating behaviors, suicidal thoughts and attempts, and lower emotional well-being and self-esteem. Students who reported a single or multiple forms of sexual abuse were more likely than their non-abused peers to binge-eat (Odds Ratio: girls = 1.93-2.32; boys = 2.26-5.61), fast (OR: girls = 1.68-2.34; boys = 1.33-2.32), use diet pills (OR: girls = 1.50-4.30; boys = 2.99-17.29) or laxatives (OR: girls = 1.87-5.11; boys = 3.89-29.22), vomit (OR: girls = 1.75-4.06; boys = 2.82-24.16), and have suicidal thoughts/attempts (OR: girls = 3.01-6.12; boys = 3.35-9.46). Boys and girls reporting multiple sexual victimizations and had the highest odds ratios for disordered eating behaviors. Future research should explore strategies for primary prevention of revictimization and secondary prevention of detrimental effects of abuse.     

Mistreatment of Older People in the United Kingdom: Findings from the First National Prevalence Study

There have been few national studies of the prevalence of elder mistreatment (abuse and neglect) in private households. This article provides an overview of the UK National Prevalence Study of Elder Mistreatment that took place in 2006. It addressed 2,111 respondents in four countries who answered a face-to-face survey questionnaire. The achieved sample was weighted to be representative of the UK older population. Of respondents, 2.6% reported mistreatment by family members, close friends, or care workers. The predominant type of reported mistreatment was neglect (1.1%) followed by financial abuse (0.6%), with 0.4% of respondents reporting psychological abuse, 0.4% physical abuse, and 0.2% sexual abuse. Women were significantly more likely to have experienced mistreatment than men, but there were gender differences according to type of abuse and perpetrator characteristics. Divergent patterns were found for neglect, financial, and interpersonal abuse. Further analysis of the data indicated that the likelihood of mistreatment varied with socioeconomic position and health status.     

Gender Differences in Silencing Following Childhood Sexual Abuse

ABSTRACT

The clinical literature commonly asserts that males are less likely than females to disclose child sexual abuse at the time it occurs and take longer to discuss their experiences. These hypotheses were tested in this study. This study included 145 men and 151 women. Participants were asked about disclosure at the time of the abuse and the length of time it took for them to discuss the experience. Comparison across these two studies found that boys were significantly less likely than girls to disclose the abuse at the time it occurred and also took significantly longer to discuss their childhood experiences later in life.     

Resolution of depression among victims of intimate partner violence: is cessation of violence enough?

The objective of this article is to assess the effect of abuse cessation on depressive symptoms among women abused by a male intimate partner. This prospective cohort study of Seattle women with a history of intimate partner violence (IPV) who were classified by history of abuse and abuse status at 3 month, 9 month, and 2 year follow-up interviews. Relative risks (RR) were calculated using generalized estimating equations. Among subjects with a history of psychological abuse only, cessation of abuse was associated with a nonsignificant reduction in the likelihood of depression compared to subjects whose abuse continued (aRR = 0.88; 95%CI: 0.75,1.03). Among subjects with a history of physical/sexual abuse and psychological abuse, cessation of physical/sexual abuse only was associated with a 27% decline, and cessation of both types of abuse was associated with a 35% decline in the likelihood of depression (aRR = 0.73, 95%CI: 0.63,0.86; and aRR = 0.65; 95%CI: 0.55,0.76; respectively). Cessation of abuse among victims of IPV is associated with a decreased prevalence of depression.     

Trauma-Related Beliefs as Mediators of Sexual Abuse Impact in Adult Women Survivors:

A 56-item measure of trauma-related beliefs was piloted with 59 female adult sexual abuse survivors. The measure includes four internally-consistent subscales which assess beliefs reflective of Finkelhor and Browne's (1986) traumagenic dynames model: Self-Blame/Stigmatization, Betrayal, Powerlessness, and Traumatic Sexualization. Multiple regression analyses examined the relationships between trauma-related beliefs and other psychological/behavioral outcomes. Self-Blame/Stigmatization beliefs predicted lower self-esteem, interpersonal problems, depression, anxiety, and overall psychological distress. Betrayal beliefs predicted interpersonal problems, an external locus of control, and sexual problems. Powerlessness beliefs predicted lower self-esteem, depression, and external locus of control, and sexual problems. Powerlessness beliefs predicted lower self-esteem, depression, and external loxus of control. Traumatic sexualization beliefs predicted anxiety and sexual avoidance. Results are discussed in terms of implications for theoretical model development and treatment planning for sexual abuse survivors.