Disclosure and Psychological Well-Being of Sexually Abused Adolescents in Hong Kong

The role of disclosure on psychological well-being of adolescents with child sexual abuse experience was investigated in a subsample of 74 disclosers among 800 adolescents recruited in the community in Hong Kong. The results supported that CSA experiences have differential impact on adolescents’ psychological well-being. Family characteristics of the disclosers accounted for only a small amount of the variance in an array of psychological well-being measures. CSA characteristics were robust predictors of disclosers’ sexual eroticism and externalizing behavioral symptoms. Disclosers’ cognitive appraisal of CSA experience and quality of parental attachment were strong predictors of their self-esteem and internalizing behavioral problems. After controlling for the aforementioned factors, negative disclosure experience still significantly predicted lower self-esteem, higher sexual anxiety, more internalizing behavior, and more severe post-traumatic stress disorder responses. Research to understand the factors that generate negative disclosure experiences is needed for developing effective intervention strategies to mitigate the negative consequences of disclosure.     

An Exploratory Study of Group Therapy for Sexually Abused Adolescents and Nonoffending Guardians

ABSTRACT

Adolescent survivors of sexual abuse frequently report severe trauma, depression, anxiety, and low self-esteem. While cognitive-behavioral group interventions show promise, interpreting efficacy is problematic due to commonly high attrition. This article reports promising exploratory study findings relating to a 12-week multimodal abuse-specific group intervention with a nonoffending parent/caregiver component. Participants (aged 11–16 years) consisted of six adolescents with severe abuse histories, and their caregivers. Participants completed pre-, post-, and 1-month follow-up measures. The results were consistent with the possibility that the program produced clinically meaningful reductions in abuse-related psychological sequelae, the program had excellent face validity with participants, and there were no dropouts.     

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.     

Lesbian,Gay, Bisexual,Sexual-Orientation Questioning Adolescents Seeking Mental Health Services

Summary

Lesbian, gay, bisexual, and sexual-orientation questioning (LGBQ) adolescents have many of the same health needs as straight adolescents. In addition, they must learn to manage a stigmatized identity that may create confusion, anxiety, and emotional turbulence for them. Beyond stigma, LGBQ youth are often found to be at higher risk for substance abuse, violence, depression, suicide, and sexual health problems. Based on responses given by urban adolescents seeking mental health services to a clinical self-assessment questionnaire (Adquest), this article examines the relationship between sexual identity and risk factors related to safety, health, sex, substance use, family and friends, worries, and their desire to talk about these in counseling. Findings indicate that LGBQ youth are at higher risk than straights, and express greater desire to talk about substance use, health, their personal lives, and their friends. Mental health practitioners working with these young persons must properly assess and address their risks by creating a sense of community and safe environment for open discussion.     

Cocaine Abusing Women Who Report Sexual Abuse: Implications for Treatment

ABSTRACT

Four hundred seventy-three substance-abusing women were assessed for histories of sexual abuse. The results of bivariate analysis indicated that Sexual Abuse Survivors (SAS) had higher levels of depression, anxiety, and psychological distress. A greater number of SAS reported histories of emotional and physical abuse. They also had greater severity on ASI scales of alcohol, drug, medical, and family/social difficulty. Logistic regression analysis indicated that women who were survivors of sexual abuse were more likely to have histories of emotional and physical abuse, higher levels of addiction severity, and more family members who used drugs. Implications for research and treatment are discussed.     

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.     

Psychological Symptoms in a Sample of Latino Abused Children

SUMMARY

This study compared Latino children who were victims of child abuse with similar children who were not abused on measures of depression, anxiety, behavior problems, and dissociation. Abused children were found to have higher levels of symptoms on the majority of symptom measures. There were differences in the evaluation of distress levels on the self report versus parent/guardian report measures. Mean scores of the abused children on the self report measures were not in the clinical range, although a substantial number of children had high levels of distress. In contrast, the results of the parent/guardian measures revealed mean scores in the clinical range of problems. Implications for research and practice are included.     

Parental Attachment Among Korean–American Adolescents

The present study examined the relationship between parental care and control perceived by Korean–American adolescents, and further investigated the relationships between parental attachment styles and mental health measures including self-esteem, depression, and social support. The relationship between parental care and parental control resulted in a significantly negative correlation. Parental care showed significantly positive correlations with self-esteem and social support, and a negative correlation with depression. Parental control showed a significantly negative correlation with self-esteem, and a significantly positive correlation with depression. The analysis demonstrated that optimal parenting showed significantly higher self-esteem, lower depression, and higher social support than the other groups.     

The Role of Dissociation in Self-Injurious Behavior among Female Adolescents Who Were Sexually Abused

The study aimed to examine the role of dissociation (persistent versus peritraumatic) in self-injurious behavior among at-risk Israeli female adolescents. In addition, the relationship between childhood sexual abuse, depression, dissociation, and potency was investigated. A convenience sample of 93 female adolescents aged 12 years to 18 years were recruited from institutions for at-risk adolescent girls in Israel. Participants were administered an anonymous self-report questionnaire that included six measures: Demographics, Dissociative Experiences Scale, Center for Epidemiologic Studies Depression Scale, the Peritraumatic Dissociative Experiences Questionnaire, the Traumatic Events Questionnaire, and the Potency Scale. Results indicated that childhood sexual abuse increases the risk for self-injurious behavior more than threefold. Higher levels of persistent dissociation were found among girls who reported child sexual abuse compared to those who did not. Self-injurious behavior was predicted by persistent dissociation. Girls who engaged in self-injurious behavior had lower potency and higher depression levels, regardless of childhood sexual abuse history.     

Self-Esteem Among Vietnamese American Adolescents

Abstract

This prospective study examined whether interdependent self-construal (collectivism), independent self-construal (individualism), family cohesion, and social support would predict levels of self-esteem among Vietnamese American adolescents. Standardized self-report measures of family cohesion, social support, and self-esteem, as well as a measure of self-construal, were administered to 152 Vietnamese American adolescents. The results indicated that independent self-construal, family cohesion, and social support were significantly related to self-esteem. Interdependent self-construal was also found to positively affect self-esteem via family cohesion and social support. The implications of these findings are discussed.     

Attachment Insecurities and Women's Sexual Function and Satisfaction: The Mediating Roles of Sexual Self-Esteem,Sexual Anxiety,and Sexual Assertiveness

We examined the potential role of three mediators—sexual self-esteem, sexual anxiety, and sexual assertiveness—of the association between romantic attachment insecurities (anxiety and avoidance) and two aspects of women's sexual functioning: sexual function and sexual satisfaction. A sample of 556 women aged 18 to 30 agreed to complete an online series of validated questionnaires assessing attachment insecurities and several aspects of sexual functioning. Lower sexual self-esteem and higher sexual anxiety mediated the associations between attachment anxiety and lower sexual function and satisfaction. Lower sexual self-esteem and higher sexual anxiety also partially mediated the links between attachment-related avoidance and the two sexual functioning variables. Sexual assertiveness, however, did not mediate these associations. A significant interaction between attachment anxiety and avoidance was also found to predict sexual satisfaction, with women high in avoidance and low in anxiety being the least satisfied. Results are discussed in terms of theoretical and clinical implications.     

Family environment and adult attachment as predictors of psychopathology and personality dysfunction among inpatient abuse survivors

The current study explored the role of early family environment and adult attachment style in explaining long-term outcomes among child abuse survivors. Adult patients (N = 80) in a trauma treatment program were assessed for clinical diagnosis and administered a multiscale questionnaire. Hierarchical regression analyses were significant for dissociative identity disorder (DID), substance abuse, anxiety disorder, posttraumatic stress, somatization, and six personality disorder dimensions. Adult attachment styles were significant predictors of most outcome variables. Of particular note was the strong contribution of attachment avoidance to DID. Five family environment scales (Independence, Organization, Control, Conflict, Expressiveness) also contributed to various psychopathological outcomes. Evidence emerged supporting a mediating role for attachment style in the link between family independence and five personality disorder dimensions.     

Persistent Complications of Child Sexual Abuse: Sexually Compulsive Behaviors,Attachment, and Emotions

ABSTRACT

Child sexual abuse has the potential to cause distress for the victim across the lifespan. Romantic relationships may be particularly difficult for victims of child sexual abuse. This retrospective study examined differences in adult romantic attachment, sexually compulsive behaviors, and emotion regulation by history of child sexual abuse in a large, nonclinical sample. Those with a history of child sexual abuse reported more attachment anxiety in romantic relationships and engaged in more sexually compulsive behaviors. Overall, males displayed more sexually compulsive behaviors than females regardless of history of sexual abuse. Males with a history of sexual abuse displayed the greatest number of sexually compulsive behaviors. Surprisingly, no differences were observed in emotion regulation or attachment avoidant behaviors by history of child sexual abuse. Future research should seek to replicate current findings and examine emotion regulation difficulties experienced as a result of trauma.     

An Evaluation of a Group Treatment for Sexually Abused Young Children

ABSTRACT

The present study measured outcomes of a group treatment for five-to eight-year-old sexually abused children. Although research completed in the last 10 years has produced some outcome studies on the effectiveness of group treatment for this population, no previous research has measured the effectiveness of psychoeducational interventions, such as the teaching of sexual information and abuse prevention strategies which are often included in this type of treatment. Also, the effects of different lengths of treatment have not been studied. The results of the current study found that children improved significantly from pre-treatment to mid-treatment on measures of problematic behavior, sexual information and abuse prevention. The children also made significant improvements from mid-treatment to post-treatment and from pre-treatment to post-treatment on all of the outcome measures with the exception of mid-treatment to post-treatment changes on the maternal acceptance self-esteem subscale. These results suggest that young children do benefit from a sexual abuse group treatment and that a longer treatment may be more beneficial.     

High Betrayal Adolescent Sexual Abuse and Nonsuicidal Self-Injury: The Role of Depersonalization in Emerging Adults

ABSTRACT

Adolescent sexual abuse can interfere with healthy development. Sexual abuse that is perpetrated by close other(s)—high betrayal—can be additionally harmful, with sexual abuse being linked with dissociation and nonsuicidal self-injury (NSSI). Depersonalization, a dissociative subtype characterized by disconnection between oneself and one’s body and/or thoughts, may further explain the role of dissociation in NSSI. The purpose of the current study was to: 1) isolate the impact of adolescent sexual abuse on NSSI; and 2) examine depersonalization as a pathway between high betrayal adolescent sexual abuse and NSSI. Participants (N = 192) were college students who completed online measures assessing sexual abuse, dissociation, and NSSI. While controlling for child sexual abuse and adult sexual abuse, adolescent sexual abuse predicted NSSI. Moreover, there was an indirect effect of high betrayal adolescent sexual abuse on NSSI through depersonalization, while controlling for child sexual abuse, adult sexual abuse, and medium betrayal (perpetrator: unclose other) adolescent sexual abuse. Findings from the current study have implications for relational cultural therapy as an evidence-informed treatment that highlights the relational harm of interpersonal trauma, while incorporating contextual elements, such as development of maladaptive coping strategies, into therapy.     

The Relationship Between Perceptions of Response to Disclosure of Childhood Sexual Abuse and Later Outcomes

This study assessed whether perceptions of others’ reactions to disclosure are related to psychological and physical outcomes among individuals with a history of child sexual abuse. Eighty-six female undergraduates completed a series of questionnaires assessing child sexual abuse, nonsexual trauma, depression, anxiety, posttraumatic stress disorder, somatic symptoms, disclosure, and social reactions to disclosure. Those who reported child sexual abuse endorsed higher levels of psychological and physical symptoms than those who reported a nonsexual traumatic event. Child sexual abuse survivors who reported more hurtful responses to disclosure had higher levels of posttraumatic stress disorder, anxiety, and physical symptoms than nonsexual trauma survivors. These findings suggest that many survivors of CSA may need psychological services, and an important focus of treatment may be assessing and strengthening social support.     

Factors Associated with Adolescents’ Disclosure of Sexual Abuse Experiences in Hong Kong

This research project is the first study conducted in Hong Kong using adolescent subjects to explore predictors of child sexual abuse disclosure. Eight-hundred male and female adolescents aged 13 to 16 years were recruited from the community while another 30 adolescents joined the study from a clinical setting. One hundred and seventy-seven adolescents acknowledged having a child sexual abuse experience. Results showed that the severity of sexual abuse activities and parent attachment were associated with disclosure in the clinical setting, while abuser’s gender and the adolescents’ disclosure tendency were associated with disclosure among participants in the community setting. Among the 104 participants who had disclosed their childhood sexual abuse, 70% of them had disclosed it within one month and 63% of them had disclosed to 2 to 5 people. The majority of the disclosers (81%) shared their child sexual abuse experience(s) with their friends. Participants from the clinical setting tended to reveal the experience more to adults than those from the community. The study suggested that when choosing a potential confidant, adolescents paid more attention to confidant characteristics than to anticipated confidant responses to their disclosure. Limitations and practical implications for increasing child sexual abuse disclosure rates are discussed.     

Adolescents in Treatment: Effects of Parental Substance Abuse on Treatment Entry Characteristics and Outcomes

SUMMARY

Research strongly supports an increased risk of substance use disorders among the adolescent children of addicted parents. However, little documentation exists of how these adolescents fare when they present for treatment. This article uses data taken from a two-state study on the effects of adolescent substance abuse treatment to examine the characteristics of adolescents with substance-abusing parents and their outcomes following an episode of outpatient treatment. Although such adolescents enter treatment with greater problem severity in a range of areas, outcomes appear similar to adolescents with no substance-abusing parents. The impact of family and individual counseling on outcomes was also examined, demonstrating mixed results for adolescents with substance-abusing parents.     

The Influence of Family Environment Factors on Self-Acceptance and Emotional Adjustment Among Gay,Lesbian, and Bisexual Adolescents

Abstract

The quality of an adolescent's family environment has been shown to contribute to their self-acceptance and emotional adjustment. Studies suggest that sexual minority adolescents face unique challenges while negotiating family relationships but few studies have specifically examined the relationships between these family environments and the adolescent's psychological adjustment. This study examined general aspects of family functioning (family cohesion, family expressiveness, family conflict, parental support) and parental attitudes toward homosexuality as predictors of self-acceptance of sexual orientation identity and emotional adjustment among 102 gay, lesbian, and bisexual adolescents ages 15 to 19 years. Family variables did not predict a significant amount of variance in self-acceptance of sexual orientation identity. However, measures of general family functioning and parental attitudes toward homosexuality accounted for significant amounts of variance in emotional adjustment.     

The Role of Early Maladaptive Schemas in the Appearance of Psychological Symptomatology in Adult Women Victims of Child Abuse

ABSTRACT

Child abuse affects people’s ways of thinking, feeling, and observing the world, resulting in dysfunctional beliefs and maladaptive schemas. Thus, consequences of child abuse may persist during adulthood. Therefore, the aim of this study was to analyze the psychological consequences (anxiety, phobic anxiety, depression, and hopelessness) of different types of maltreatment (physical, sexual, and emotional abuse and physical and emotional neglect) and to study the role of early maladaptive schemas in the onset of symptomatology in adult female victims of child abuse. The sample consisted of 75 women referred by associations for treatment of abuse and maltreatment in childhood. Sexual abuse was the type of maltreatment that was most strongly related to most dysfunctional symptomatology, followed by emotional abuse and physical abuse, whereas physical neglect was the least related. Also, early maladaptive schemas were found to correlate with child abuse and dysfunctional symptomatology. Finally, early maladaptive schemas mediated the relationship between sexual abuse and dysfunctional symptomatology when the effect of other types of abuse was controlled. These results may provide important guidance for clinical intervention.