Adverse Childhood Experiences and Healthcare Costs in Adult Life

ABSTRACT

The current study aims to present the prevalence of adverse childhood experiences and examine the healthcare costs associated with primary, allied, and specialist healthcare services. The Australian Longitudinal Study on Women’s Health is a general health survey of four nationally representative age cohorts. The current study uses 20 years of survey and administrative data (1996–2015) from the cohort born 1973–1978. Overall, 41% of women indicated at least one category of childhood adversity. The most commonly reported type of childhood adversity was having a household member with a mental illness (16%), with the most commonly reported ACES category being psychological abuse (17%). Women who had experienced adversity in childhood had higher healthcare costs than women who had not experienced adversity. The healthcare costs associated with experiences of adversity in childhood fully justify a comprehensive policy and practice review.     

Sexual Dysfunction,Paraphilias and their Relationship to Childhood Abuse in Men who have Sex with Men

ABSTRACT

This study aimed to examine 1) the occurrence of sexual dysfunctions and paraphilias and 2) the relationship between childhood abuse and current sexual disorders in a MSM sample. Participants were MSM in the Midwest who completed baseline surveys prior to attending a sexual health seminar. Most men reported a sexual dysfunction or paraphilia. Thirty-nine percent of the sample reported childhood abuse. Results indicated childhood abuse was associated with a significant increased risk of male erectile disorder (OR = 1.83) and secondary sexual dysfunction (OR = 2.01). The intent of the study was to generate hypotheses to guide future research efforts.     

The Impact of Childhood Sexual Abuse and Other Forms of Childhood Adversity on Adulthood Parenting

This study investigated the independent impact of child sexual abuse on five dimensions of adulthood parenting after controlling for other forms of childhood adversity in a predominantly African-American sample of mothers receiving public assistance (N = 483). An analysis of data previously collected as part of the Illinois Families Study Child Well-Being Supplement was conducted to address these questions. Data were analyzed using hierarchal multiple regression. Childhood sexual abuse survivors reported significantly lower rates of parental warmth, higher rates of psychological aggression, and more frequent use of corporal punishment than mothers who had not experienced childhood sexual abuse. These effects, however, were nonsignificant when sociodemographic factors and other forms of childhood adversity were considered. Implications for future research are provided.     

Coping and Adjustment in Male and Female Survivors of Childhood Sexual Abuse

ABSTRACT

This study investigates the effects of childhood sexual abuse for male and female survivors, characteristics of the abuse experience, current coping strategies, and current psychological adjustment. Nineteen male and 59 female adult survivors of childhood sexual abuse, recruited from both local and national support groups, completed a background questionnaire, dispositional coping inventories measuring current and retrospective abuse-specific coping styles, and measures of current psychological adjustment. In response to sexual abuse experienced during childhood, avoidance coping emerged as the most frequently used strategy by both sexes. Although there were no gender differences in current use of problem-focused and avoidance strategies, males related more use of acceptance whereas females utilized more emotion-focused coping. In general* females reported significantly greater trauma-related distress than males, including higher levels of anxiety, depression, and post-trauma symptoms.     

The Connections of Mental Health Problems,Violent Life Experiences,and the Social Milieu of the “Stroll” with the HIV Risk Behaviors of Female Street Sex Workers

Abstract

This paper examines the connections of mental health, victimization, and sexual risk behaviors among a sample of 278 street-based female sex workers in Miami. Using targeted sampling strategies, drug-using sex workers were recruited into an HIV prevention research program. Data were collected by trained interviewers, and focused on drug use and sexual risk for HIV, childhood abuse, recent victimization, and mental health. More than half of the participants reported histories of physical (51.1%) or sexual (53.1%) abuse as children, 37.4% were classified with moderate or severe anxiety symptoms, and 52.9% had symptoms of moderate or severe depression. Logistic regression analyses demonstrated significant associations between mental health issues and engagement in recent unprotected vaginal and oral sex. The program development and policy implications of these findings are discussed.     

An Exploratory Qualitative Study of the Self-Reported Impact of Female-Perpetrated Childhood Sexual Abuse

The limited findings on the impact of female-perpetrated sexual abuse of children are often contradictory, particularly in relation to males. In this exploratory qualitative study, a sample of nine men and five women who reported that they had been sexually abused by women in their childhood were recruited from the general community. They completed a questionnaire that asked them to describe various aspects of their abuse experiences and the perceived consequences. For both men and women, the abuse was associated with negative outcomes across a range of functional areas in both childhood and adulthood. Many impacts were similar to those reported by victims of male-perpetrated sexual abuse. It is argued that the consequences of female-perpetrated child sexual abuse are serious, and further research is required to bring these issues to the awareness of both the public and professionals working in the field of child protection and counseling.     

An exploratory qualitative study of the self-reported impact of female-perpetrated childhood sexual abuse

The limited findings on the impact of female-perpetrated sexual abuse of children are often contradictory, particularly in relation to males. In this exploratory qualitative study, a sample of nine men and five women who reported that they had been sexually abused by women in their childhood were recruited from the general community. They completed a questionnaire that asked them to describe various aspects of their abuse experiences and the perceived consequences. For both men and women, the abuse was associated with negative outcomes across a range of functional areas in both childhood and adulthood. Many impacts were similar to those reported by victims of male-perpetrated sexual abuse. It is argued that the consequences of female-perpetrated child sexual abuse are serious, and further research is required to bring these issues to the awareness of both the public and professionals working in the field of child protection and counseling.     

Sexual Assault Risks Among Gay and Bisexual Men

The goal of this study was to examine lifetime patterns of sexual assault and associated risks among a purposive sample of gay and bisexual men (N = 183; 18 to 35 years old, M = 24.3). Cross-sectional data were collected via written, self-administered questionnaires and face-to-face, event-based qualitative interviews. Alcohol severity scores indicated high rates of hazardous drinking (53.0%) and possible dependence (14.2%) among participants. One-half of men (50.8%) reported childhood sexual abuse (CSA), and 67.2% reported adult sexual assault (ASA). Average age at most recent ASA was 21 years. Most perpetrators (83.9%) of recent ASA incidents were male; 67.0% of participants reported consuming alcohol and/or drugs prior to the most recent incident. Regression findings indicated more severe CSA experiences and past alcohol-related problems predicted recent severe ASA. Although we found similarities between gay and bisexual men in lifetime sexual assault history, we found some distinct differences in ASA risk factors. Bisexual men reported higher alcohol severity scores, more female ASA perpetrators, higher internalized homophobia scores, and fewer male sexual partners than gay men. Findings suggest the need for interventions that reduce ASA risk among sexual minority men—and the potential benefits of focusing on alcohol consumption in risk reduction efforts.     

Maternal Sexual Abuse of Males

This article presents one aspect of the findings of a qualitative research study which explored the impact of childhood sexual abuse on the lives of a non-clinical sample of 25 adult males who responded to advertisements for adult male survivors of childhood sexual abuse. The author conducted in-depth interviews with the men to discover how their experiences of childhood sexual abuse had influenced their psychosocial development. Thirteen of the 25 men were abused by females. This article focuses on seven men who were abused by their mothers and describes how definition, prevalence and outcomes of maternal sexual abuse are affected by male socialization, creating additional difficulties for these men. The author describes some of the psychological defence mechanisms used by this sample of men, explores some of the reasons for maternal abuse and issues to be considered by practitioners. © 1997 John Wiley & Sons, Ltd.     

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.     

Brief Report: Attitudes About Responding to Survey Questions Concerning Childhood Sexual Abuse by Hispanic Female College Students

In no studies have research participants been asked how they feel about answering questions concerning childhood sexual abuse. We have performed searches from two different search engines again and have found nothing published which specifically addresses this question in the way we have. A questionnaire about childhood sexual abuse was administered to a sample of Mexican-American female college students. Over 32% reported positive histories of childhood sexual abuse before age 18. These subjects were more uncomfortable (37%) than those who did not experience childhood sexual abuse when answering questions about childhood sexual abuse (12%; p < 0.00001), but they were not more uncomfortable in answering questions about alcohol or drug use. Women who were sexually abused in childhood also readily disclosed childhood sexual abuse histories despite revealing discomfort about being asked questions concerning childhood sexual abuse. Our findings support concerns by researchers that childhood sexual abuse is neglected because researchers have an unwarranted perception about how fragile sexually abused subjects are as subjects.     

The Place of Culture and Religion in Patterns of Disclosure and Reporting Sexual Abuse of Males: A Case Study of Ultra Orthodox Male Victims

ABSTRACT

This article deals with reporting patterns of sexual abuse in males in a religious-cultural context through a case study of ultra-Orthodox Jewish (Haredi) men who were young victims of sexual abuse. The study is based on in-depth interviews with 40 Haredi men. The results indicate that sexual abuse involving ultra-Orthodox boys was and is underreported. Moreover, the results indicate that even when such incidents were reported, the avenues for disclosure were parents, educational-religious figures, and friends. It was also found that silencing in matters related to sexuality, viewing sexual abuse in boys as a serious sin and taboo, and encouraging blind obedience—all of which characterize Haredi society—were factors in the underreporting. The results also show a strong tendency to cover up incidents of sexual abuse on an individual level, on a family level, and at the community level. The findings indicate a linkage between the religious and cultural background of male victims of sexual abuse and their reporting patterns.     

The Role of Shame in Women's Recovery from Alcoholism

Abstract

This study compares the recovery experience of female members of Alcoholics Anonymous (AA) who reported a history of childhood sexual abuse (68%) with those who did not report experiencing childhood sexual abuse. A sample of 53 women was obtained from AA. A significant relationship was found between shame and two measures of difficulties in recovery-problems in social adjustment and relapse. Though the hypothesis that experiences of child sexual abuse predicted difficulty in recovery was not supported, these data suggest that shame may be an important variable in both the etiology and treatment of alcoholism in women.     

Puerto Rican drug users experiences of physical and sexual abuse: comparisons based on sexual identities

This study integrates the results of quantitative and qualitative methods to elucidate the association between sexual identity and physical and sexual abuse among Puerto Rican drug users. A structured questionnaire was administered to 800 subjects in New York and 399 in Puerto Rico. A total of 93 subjects (7.9%) self-identified as homosexual or bisexual. Gay males were significantly more likely than heterosexual males to report first occurrence of physical abuse by a family member in childhood. Both gay and bisexual males were more likely than their heterosexual counterparts to report first experiencing unwanted sex in childhood and intimate partner physical abuse later in life. Lesbians were more likely than female heterosexuals to report unwanted sex in childhood. Qualitative data were collected through in-depth life histories with 21 subjects and suggest that gay and lesbian subjects perceive antihomosexual prejudice on the part of family members as one cause of childhood physical and sexual abuse.     

Puerto rican drug users’ experiences of physical and sexual abuse: Comparisons based on sexual identities

This study integrates the results of quantitative and qualitative methods to elucidate the association between sexual identity and physical and sexual abuse among Puerto Rican drug users. A structured questionnaire was administered to 800 subjects in New York and 399 in Puerto Rico. A total of 93 subjects (7.9%) self‐identified as homosexual or bisexual. Gay males were significantly more likely than heterosexual males to report first occurrence of physical abuse by a family member in childhood. Both gay and bisexual males were more likely than their heterosexual counterparts to report first experiencing unwanted sex in childhood and intimate partner physical abuse later in life. Lesbians were more likely than female heterosexuals to report unwanted sex in childhood. Qualitative data were collected through in‐depth life histories with 21 subjects and suggest that gay and lesbian subjects perceive antihomosexual prejudice on the part of family members as one cause of childhood physical and sexual abuse.     

Are Males and Females Sexually Abused As Children Socially Anxious Adults?

It is well documented that childhood sexual abuse is associated with deleterious outcomes in the areas of anxiety, depression, and sexual functioning. However, very little research has been conducted to specifically investigate childhood sexual abuse's relationship to adult social anxiety in both males and females. Participants included 250 undergraduate students from a large metropolitan university. Results indicated that almost one-third of males and a little over a third of females reported being sexually abused as a child or adolescent. Although a large portion of the sample exhibited socially anxious symptomology, childhood sexual abuse did not place males and females at increased risk for social anxiety. The use of a nonclinical, college student sample may provide researchers the opportunity to investigate resiliency in individuals with a history of childhood sexual abuse.     

Prevalence of Childhood Sexual Abuse in China: A Meta-Analysis

The objective of the current study was to explore the estimated prevalence of childhood sexual abuse in China. We conducted a meta-analysis that used the data from 36 articles. A total of 125 independent samples and 131,734 participants were included. The results revealed no significant difference in the prevalence of childhood sexual abuse between Chinese men (9.1%) and women (8.9%). The prevalence of childhood sexual abuse in studies from mainland areas was significantly higher than that from Hong Kong/Taiwan. The estimated prevalence of childhood sexual abuse in China also differed according to the definition of child sexual abuse, data collection method, year of data collection, and the mean age of participants at the time of assessment.     

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.     

The Influence of Trauma History and Relationship Power on Latinas’ Sexual Risk for HIV/STIs

ABSTRACT

A community sample of Latinas completed surveys that included measures of sexual abuse and intimate partner violence history, relationship power, negotiating power regarding condom use, perceived HIV/sexually transmitted infection (STI) risk for sexual partner, and sexual behavior. More than half of the women reported a history of intimate partner violence in the past year and/or sexual abuse in their lifetime. Intimate partner violence was correlated with lower overall sexual relationship power scores, while sexual abuse was correlated with lower condom-use negotiating power. More extensive intimate partner violence had the strongest association with higher HIV/STI risk, while controlling for relationship status, sexual abuse, and relationship power.     

Factors related to childhood sexual abuse among gay/bisexual male Internet escorts

This exploratory investigation examined the relationship between childhood sexual abuse (CSA) and related psychosocial characteristics and sexual behaviors among 46 gay/bisexual male escorts who advertise via the Internet. More than a quarter of men (28.3%) reported some history of CSA. Men reporting CSA were more likely to be from an ethnic minority group, identify as bisexual, have a primary male partner, and were less likely to identify an anal receptive ("bottom") sexual role preference. Men with a history of CSA were more likely to report unprotected sex with work-related partners, increased internalized homophobia, and decreased adolescent isolation. Interventions designed for male escorts with a history of CSA should emphasize safer sex strategies with work partners and reducing internalized homophobia.