The Impact of Abuse History and Trauma Symptoms on Successful Completion of a Prostitution-exiting Program

This study examines the trauma symptoms and life experiences of 49 women in a residential prostitution-exiting program and identifies differences among women who complete 90 days of the program and women who drop out of the program prior to completing 90 days. The majority of the women reported childhood abuse, adult abusive relationships, and victimization. Women who completed 90 days of treatment were found to be older than the non-completers. Non-completers were more likely to report clinically significant trauma symptoms including dissociation, poor coping behaviors, sex-related issues, and dysfunctional sexual behavior than completers. These findings suggest the importance of incorporating trauma-focused intervention early in the services provided in the exiting programs as well as the need to address the traumatic symptoms related to childhood and adult trauma histories. Findings also indicate the importance of clinically addressing trauma-related sexual issues, concerns, and behavior.     

The Effects of Childhood Sexual Abuse and Other Trauma on Drug Court Participants

Within the context of a larger study of drug court participants, this study examined the impact of traumatic experiences on psychiatric distress and on court outcomes. In the analyses, the participants (n = 229) were separated into 3 groups: childhood sexual abuse (CSA; n = 18), other trauma (n = 134), and no trauma (n = 77). The CSA group had higher mean scores on depression, anxiety, panic disorder, social phobia, somatization, and posttraumatic stress disorder than the other trauma group. Path analyses suggest that a history of trauma is a positive predictor of psychiatric distress and negative court events (positive urine screens, sanctions, etc.), with indirect effects on substance abuse severity, and failure in the drug court. These results suggest a need for the initial assessment procedure in drug courts to include a screening for trauma history, including CSA. They also suggest a need for trauma-informed care within drug courts.     

Acute Stress Disorder Symptoms Among Female Sexual Abuse Survivors Seeking Treatment

ABSTRACT

This exploratory study examined relationships between acute stress disorder (ASD) symptoms and sexual abuse history, distress, and social support among sexual abuse survivors seeking treatment. Participants were 32 women recruited for a pilot study of group treatment for sexual abuse survivors who completed self-report and interview measures. Many participants (37.5%) met criteria for all ASD symptoms. Also, ASD symptoms were significantly related to seeing the self as the causal locus of the abuse, forgetting the abuse for a period of time, and the number of abusers, the distress of a recent life event, other forms of distress, and poor social support, Acute stress disorder may occur among many sexual abuse survivors seeking treatment, requiring special intervention to help these patients to manage their reactions to ongoing stresses.     

Predictors of Attrition from an Expressive Writing Intervention for Sexual Abuse Survivors

This study examined predictors of attrition from a clinical trial examining the effects of an expressive writing intervention for sexual problems among female survivors of child sexual abuse. Participants were 124 women all reporting sexual difficulties, who were randomized to a trauma-focused condition (n?=?45), an experimental sexual schema-focused condition (n?=?37), or a control condition (n?=?42). Thirty-five women (28%) dropped out before completing posttreatment assessments. Younger age, less education, and increased use of positive coping strategies were each independently associated with dropout. Results have implications for both researchers and clinicians working with this population, and it is hoped that these data can help bolster retention of those who are more likely to discontinue treatment.     

Predictors of Job Satisfaction and Burnout in Child Abuse Professionals: Coping,Cognition, and Victimization History

ABSTRACT

This study investigated coping style, work-related cognition, and victimization history as predictors of job satisfaction and burnout in child abuse professionals. Subjects were 215 participants in a conference on sexual abuse victim treatment. We developed a questionnaire assessing a variety of cognitions related to work with human services clients. One of the findings was that job satisfaction showed no relation to items portraying simple optimism or pessimism about helping clients, but satisfaction was related to a number of cognitions that combined realism and hope in a distinctive fashion. The coping strategies of Planful Problem Solving, Positive Reappraisal, and Seeking Social Support were associated with positive work experience, and the coping mechanisms of Confrontive Coping, Escape/Avoidance, and Accepting Responsibility were associated with negative work experience. Job satisfaction was higher in subjects reporting a childhood history of sexual abuse or neglect.     

Neurobiological Causes of Addiction

Abstract

Neurobiology and molecular genetics are contributing heavily to a new understanding of the causes of chemical dependence (“addiction”). Willful chemical abuse is a problem that continues to produce significant societal costs including accidents, medical expenses, and family suffering. Pathological chemical dependence, on the other hand, is being recognized as a true medical disease that is also devastating, but in different ways. There is strong evidence in animals and humans that chemical dependence involves a dysregulation of the pleasure pathway (the “medial forebrain bundle”), located in the mesolimbic portion of the brain. Dopamine is one of the medial forebrain bundle's major neurotransmitters. In this paper, we provide a research-based model for the causes of chemical dependence and its treatment, and integrate this information with classic Twelve Step treatment programs.     

Perceived Loss of Social Contact and Trauma Symptoms among Adolescents Who Have Experienced Sexual Abuse

ABSTRACT

Child sexual abuse (CSA) is a robust predictor of trauma symptoms. Past research has identified many correlates of trauma symptoms following disclosure of CSA. Theory suggests that loss of social contact may be another important contributor to adolescents’ trauma symptoms following CSA. A clinical sample of 166 adolescents (95% female) between 11 and 19 years (M = 13.80, SD = 1.87) reported on perceived loss of social contact, the extent to which the CSA was coercive, appraisals of self-blame for the abuse, supportiveness of a primary non-abusing caregiver, and trauma symptoms. The adolescent’s relationship to the abuser, abuse severity and duration were coded from forensic interviews. Results indicated that greater perceived loss of social contact was associated with higher levels of trauma symptoms, even after controlling for other correlates of trauma symptoms and demographic variables. These findings suggest that perceived loss of social contact may be an important variable to consider in assessing and intervening with adolescents who have been sexually abused.     

Internet Use,Abuse, and Dependence Among Students at a Southeastern Regional University

Objective: To assess Internet use, abuse, and dependence. Participants: 411 undergraduate students. Results: Ninety percent of participants reported daily Internet use. Approximately half of the sample met criteria for Internet abuse, and one-quarter met criteria for Internet dependence. Men and women did not differ on the mean amount of time accessing the Internet each day; however, the reasons for accessing the Internet differed between the 2 groups. Depression was correlated with more frequent use of the Internet to meet people, socially experiment, and participate in chat rooms, and with less frequent face-to-face socialization. In addition, individuals meeting criteria for Internet abuse and dependence endorsed more depressive symptoms, more time online, and less face-to-face socialization than did those not meeting the criteria. Conclusions: Mental health and student affairs professionals should be alert to the problems associated with Internet overuse, especially as computers become an integral part of college life.     

Building Trauma Informed Practice: Appreciating the Impact of Trauma in the Lives of Women with Substance Abuse and Mental Health Problems

ABSTRACT

This paper examines the lifetime interpersonal abuse experienced by a substance abuse treatment sample of 1,955 women with co-occurring disorders. Substantial rates of intimate and community-based interpersonal abuse and other life stressors are documented. Regression analysis shows that while trauma severity is significantly related to trauma distress, its impact on psychological symptom distress and drug severity is quite modest. The implementation of a trauma informed approach featuring trauma-specific treatment, service integration and consumer empowerment is described as a promising practice model for assisting women seeking help in substance abuse treatment programs.     

Integrative Intensive Retreats for Veteran Couples and Families: A Pilot Study Assessing Change in Relationship Adjustment,Posttraumatic Growth,and Trauma Symptoms

We assessed a brief, systemic retreat‐style intervention that was developed to address concerns about the utilization of services for veterans coping with traumatic stress. A total of 76 dyads (N = 152) were assessed before and after a 4‐day retreat, which included psychoeducation, group and conjoint therapeutic sessions, and recreational relaxation components. Overall, participants reported a reduction in trauma symptoms, but only support persons experienced a significant increase in posttraumatic growth from pretest to posttest. Both veterans and their romantic partners reported an increase in relationship adjustment after the retreat. Opportunities to address the needs of this population by removing barriers to treatment and reducing feelings of isolation, as well as implications for similar treatments are discussed.     

Culturally Competent Substance Abuse Treatment for Asian/Pacific Islander Women

Summary

In response to the urgent need for substance abuse treatment among pregnant and postpartum Asian/Pacific Islander (A/PI) women, heath care and social service providers in a rural community of Hawaii established a culturally based, women-centered residential treatment program. The program was designed to address barriers that often prevent A/PI women from engaging and completing treatment. Treatment included Hawaiian healing practices or deep cultural therapy, provision for newborns to live with their mothers, infant health-care services, parent education, and infant-mother bonding guided by kupu-na (elders) of the community.

Analysis of twenty-one in-depth interviews revealed factors that A/ PI women participants found vital to their treatment process: having their children with them in a non-punitive, mutually respectful treatment milieu; working with consistent, competent residential staff and culturally-sensitive interdisciplinary professionals; and involvement in a range of substance abuse interventions, including cultural healing practices.

Findings underscore the importance of learning about and affirming women's lived-experiences and cultural contexts in the development of culturally competent practice models, interventions, research procedures, and policies that focus on the complex needs of chemically dependent pregnant and parenting women (Brindis & Theidon, 1997).     

Efficacy of a Web-Based,Tailored, Alcohol Prevention/Intervention Program for College Students: Initial Findings

Abstract

Objective: Reduce college student at-risk drinking (ARD) using a Web-based brief motivational alcohol prevention/intervention called Michigan Prevention and Alcohol Safety for Students (M-PASS). Participants: Participants included 1,137 randomly sampled first-year college students, including 59% female, 80% white, and averaged age 18.1 years. Methods: Intervention group participants (n = 616) attended 4 online M-PASS sessions, receiving feedback tailored to individual drinking patterns and concepts from 4 behavior change theories. Control group participants (n = 521) completed a mid-phase survey, and both groups were surveyed at baseline and posttest. Results: Evidence of M-PASS's efficacy was found. The intervention was associated with advanced stage of change, lower tolerance of drinking and drink/driving, fewer reasons to drink, and use of more strategies to avoid ARD. Preliminary evidence of behavioral change was also found. Efficacy was greater for women than men. Conclusions: Web-based programs may be useful in reducing alcohol-related risk among college students. Further evaluation is needed.     

Three Types of Memory for Childhood Sexual Abuse: Relationships to Characteristics of Abuse and Psychological Symptoms∗

ABSTRACT

Data from a clinical sample (N?=?88) reporting childhood sexual abuse was compared by types of memory, abuse characteristics, and psychological symptoms. Three types of memory were identified from a questionnaire (“Always” n?=?27 [31%], “Recovered” n?=?41 [46%], and “Both” n?=?20 [23%]). When compared with narrative reports from a subset (n?=?30) of the sample, the lines between “Always,” “Recovered,” and “Both” types of memory were ambiguous. Consistency across reports, however, was 83%. Memories classified as either “Recovered” or “Both” were associated with earlier age-at-onset and more severe psychological symptoms compared to those who “Always” remembered CSA. No significant differences were found between the “Both” and “Recovered” groups.     

The Indirect Effect of Child Maltreatment Severity on Adult PTSD Symptoms through Anxiety Sensitivity

Although the rate of posttraumatic stress disorder (PTSD) among survivors of child maltreatment is high, individuals differ in symptom severity and many do not experience clinically significant levels of psychopathology. The present study tested the indirect effects of child maltreatment severity on adult PTSD, suicidal ideations, and alcohol dependence via anxiety sensitivity. A sample of 336 participants (mean age of 22.81 years, SD = 8.93; 70.2% female) completed an online survey of child abuse and neglect, anxiety sensitivity, PTSD symptom severity, suicidal ideation severity, and alcohol dependence severity. The results revealed significant indirect effects of child maltreatment on PTSD symptom severity through cognitive and social concerns, but not physical concerns. No direct or indirect effects were demonstrated for suicidal ideations or alcohol dependence severity. These findings elucidate mechanisms in the robust relationship between child maltreatment and adult PTSD symptoms and can potentially inform future research on mechanisms of change in psychotherapy.     

Reducing depression among mothers in a residential treatment setting: building evidence for the PST4PPD intervention

ABSTRACT

Objective

The prevalence of postpartum depression (PPD) nearly doubles among low-income mothers in the United States compared to the general population. Problem Solving Therapy (PST) is an effective treatment for populations of low-income women and more accessible than costly, long term interventions. This study aimed to assess the feasibility of implementing a problem-solving-focused intervention originally designed for home visits. Method: This study was conducted in a residential treatment facility (RTF). A chemical dependency counselor delivered the 5-session intervention named “PST4PPD”. A one-group pretest/posttest design was adopted. The standardized tools: Edinburgh Postnatal Depression Scale (EPDS) and Patient Health Questionnaire (PHQ-9) were used to assess depressive symptoms. The New General Self-Efficacy Scale (NGSE) was used to measure self-efficacy. Results: Among the 41 eligible women, 90% (n = 37) completed the intervention. The research found statistically significant decreases in depression (EPDS t(36) = 6.70, p <.001; PHQ-9 t(36) = 4.67, p <.001) and increases in self-efficacy (NGSE t(36) = ?2.41, p =.02). Conclusions: This pilot study finds positive results and feasibility of “PST4PPD”, a community-based, affordable intervention to lower symptoms of postpartum depression. Recommendations for future research and practice, including suggestions for engaging and retaining low-income mothers in PPD interventions, are discussed.     

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.     

Best Practices in the Treatment of Substance-Abusing Women in the Child Welfare System

ABSTRACT

This paper reviews the literature on women's chemical dependency and its effects on their children. Many risk factors (e.g., a history of traumatic exposure) and consequences (interference with parenting) of substance abuse are unique for women, giving rise to special treatment needs of substance-abusing women with children. Substance-abusing mothers also experience unique barriers to receiving the services they need to recover, such as absence of child care and lack of gender-specific treatment in their communities. Model programs are described and recommendations are offered for best treatment practices for women with chemical dependency who present in the child welfare system.     

Prevalence of Sexual Trauma History Using Behaviorally Specific Methods of Assessment in First Year College Students

There are several challenges associated with evaluating the prevalence of sexual trauma, including child sexual abuse and adult sexual assault. The aim of this study was to assess sexual trauma prevalence rates among first year college students (N = 954) using behaviorally specific questions and a more representative recruitment sample that did not rely on self-selection. Participants completed a list of sexual trauma questions, including general questions containing labels such as “rape” or “abuse” as well as behaviorally specific questions that describe specific behaviors that qualify as sexual trauma without labels. Results indicated that 6.7% of the sample reported at least one incident of child sexual abuse, with similar rates for men and women. Women were more likely to report a history of adult sexual assault, which was reported by 12.4% of the total sample. Participants were also more likely to endorse a history of sexual trauma when answering behaviorally specific rather than general “label” questions. Women survivors in particular were more likely than men to identify their experiences as abuse/assault (66.7% versus 21.1% for child sexual abuse), which may help explain prevalence differences between men and women in prior research. Men may be less likely than women to label their experiences as abuse and may be underidentified in sexual trauma research without the use of behaviorally specific questions. Overall, the results of this study suggest that the prevalence of sexual trauma is better assessed using behaviorally specific questions and that this is an important topic of study among both men and women.     

Exploring the Relations Among the Nature of the Abuse,Perceived Parental Support,and Child's Self-Concept and Trauma Symptoms Among Sexually Abused Children

ABSTRACT

This study examined two resiliency factors: self-concept and perceived parental support, in conjunction with abuse factors that impact psychological functioning. Data were collected on 61 sexually abused children prior to treatment. Findings indicate that a child's self-concept was associated with all the trauma symptoms except sexual concerns and did account for a significant amount of variance in relation to trauma symptomatology. Parental support was only associated with the Dissociation and was not found to account for variance in relation to trauma symptoms. Factors specific to the sexual abuse found that when a child endured a lengthy abuse period, their self-concept was more negative.     

A Follow-up Study of Homeless Women

This article presents an in-depth analysis of the changes observed in 25 homeless women with drug and alcohol abuse problems participating in a case management program. Participation in the program ranged from 6 to 44 months. Thirty-two percent of all participants’ situations were considered to have improved, while 20% remained stable. Less improvement was noted in the situations of women followed for 3 years or more (14.3% improved, 28.6% stable). Domains showing the most improvement were housing, financial situation, and substance abuse. Deterioration was primarily attributable to physical and mental health problems. These findings could indicate that although a case management program can initially contribute to improving the living conditions of its clients, acquisitions are difficult to maintain over an extended period. Health and substance abuse play a crucial role in the deterioration process.