Relationships of Sexual,Physical, and Emotional Abuse to Emotional and Behavioral Problems Among Incarcerated Adolescents

ABSTRACT

This study examined the relationships of sexual, physical and emotional abuse to emotional (internalizing) and behavioral (externalizing) problems among incarcerated girls and boys. Participants were youth who were remanded to the correctional facilities within a statewide juvenile correctional system in a southern state in the United States of America. Each participant completed a structured interview regarding abuse history, emotional and behavioral difficulties, and demographic characteristics. Multiple regression analyses indicated that girls were more likely than boys to internalize their problems. The only abuse variable that was positively and significantly associated with emotional problems was emotional abuse. Greater behavioral problems were significantly related to youths being younger in age, white ethnicity, history of sexual abuse, and history of physical abuse. There were overall gender differences for internalizing problems, but not for externalizing problems among incarcerated adolescents. Furthermore, physical and sexual abuses were related to externalizing problems but not to internalizing problems. Thus, different types of abuse appear to have different effects on adolescent behavior. Implications for future research and practice are discussed.     

Gender Roles, Externalizing Behaviors, and Substance Use Among Mexican-American Adolescents

A sample of 60 male and 91 female Mexican-American adolescents (age 13-18) were administered measures of positive (i.e., assertive masculinity, affective femininity) and negative (i.e., aggressive masculinity, submissive femininity) gender roles, internalizing and externalizing problem behaviors, peer substance use, and own substance use (alcohol, cigarettes, marijuana). Negative gender roles were significantly correlated with internalizing and externalizing problems for both boys and girls, with aggressive masculinity also predicting peer substance use for both genders. Assertive masculinity significantly predicted lower alcohol use in boys, and this effect was not mediated by internalizing problems, externalizing problems, or peer substance use. Negative gender roles significantly predicted higher alcohol use in girls, but this effect was almost completely mediated by internalizing problems, externalizing problems, and peer substance use. Results are discussed in terms of gender role socialization among Mexican Americans.     

Changes in Externalizing and Internalizing Problems of Adolescents in Foster Care

Using a developmental psychopathology framework, this study aimed to examine changes in externalizing and internalizing problems of adolescents in foster care and to determine whether type of maltreatment, gender, and age influenced trajectories. Authors used 3 waves of data from the National Survey of Child and Adolescent Well‐Being. Growth‐curve analyses of 106 adolescents aged 13–16 in foster care revealed that externalizing and internalizing problems decreased over time. Adolescents, particularly boys, placed in foster care as a result of sexual abuse, physical abuse, or neglect demonstrated faster decreases in externalizing problems and, similarly but to a weaker degree, internalizing problems than did those placed in foster care as a result of other forms of maltreatment.     

The mediational effect of affect regulation on the relationship between attachment and internalizing/externalizing behaviors in adolescent males who have sexually offended

Research has shown that adults who sexually offend frequently report perpetrating a sexual offense for the first time during childhood/adolescence; therefore in this preliminary study, we examine the possible covariates related to offending sexually in adolescents. For this study, 62 incarcerated adolescents at a correctional facility in Alabama completed self-report questionnaires regarding demographic information, internalizing/externalizing behavior problems, attachment, and affect regulation. The results of this study indicate that attachment is related to internalizing and externalizing behaviors, as well as, both adaptive affect regulation and maladaptive affect regulation. Through path analyses, this study was the first to test and find that affect regulation ability mediated the relationship between attachment and externalizing behavior; however, it did not mediate the relationship between attachment and internalizing behavior. Interestingly, maladaptive affect regulation appeared to have a stronger influence on problem behaviors than adaptive affect regulation for these adolescents. The findings from this study could help professionals identify more successful therapeutic interventions for these adolescents and consequently prevent later sexual offending and further negative, individual or societal outcomes.     

Relationships between maternal adult attachment security, child perceptions of maternal support, and maternal perceptions of child responses to sexual abuse

This study assessed the relationships between maternal adult attachment style, children's perceptions of maternal support following disclosure of sexual abuse, and maternal perceptions of children's behavioral and emotional responses to sexual abuse among African-American child sexual abuse victims aged 4 to 12 (n=96) and a comparison group of non-abused subjects (n=100). Mothers with insecure attachment styles reported significantly higher rates of internalizing behaviors in their sexually abused children than did securely attached mothers. Among mothers of non-abused children, those with insecure adult attachment styles reported significantly higher rates of externalizing behaviors shown by their children in comparison with mothers with a secure adult attachment style. Mothers with insecure adult attachment styles also reported higher rates of overall behavior problems in their non-abused children that approached statistical significance. Sexually abused children's perceptions of maternal support were not related to maternal attachment style nor to child functioning. Contrary to our prediction, mothers of sexually abused children did not show lower rates of secure attachments when compared to mothers of non-sexually abused children. Our findings indicate that fostering parent- child attachment is important in order to decrease the risk for behavior problems and symptomatology in sexually abused children.     

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.     

Effect of Environmental Risk and Externalizing Comorbidity on Internalizing Problems Among Economically Disadvantaged African American Youth

This study examined the effects of racial discrimination, community violence, and stressful life events on internalizing problems among African American youth from high‐poverty neighborhoods (N = 607; 293 boys; M_age = 16.0 years, SD = 1.44 years). Mediated effects via externalizing problems on these relations were also examined, given the high comorbidity rate between internalizing and externalizing problems. Externalizing problems partially mediated the effect of stressful life events on internalizing problems and fully mediated the effect of racial discrimination for boys but not for girls. Exposure to violence had a significant indirect effect on internalizing problems via externalizing problems. The findings call for greater attention to internalizing problems among African American youth and pathways to internalizing problems via externalizing problems.     

Gender and multiple forms of peer victimization: how do they influence adolescent psychosocial adjustment?

This study explores the relationship among multiple forms of peer victimization (e.g., direct physical/verbal, relational, and sexual harassment) and psychosocial adjustment among urban students and uses cluster analysis to identify subgroups of victims. Students in sixth, seventh, and eighth grade completed self-report surveys about their psychosocial adjustment, peer victimization experiences, and the gender of the other person involved. Results reveal that both physical/verbal victimization and sexual harassment were related to internalizing behavior, and sexual harassment was related to externalizing behavior. Cluster analysis revealed preliminary subgroups of victims. In addition, being victimized by a boy was more strongly related to behavior problems for both boys and girls than the experience of being victimized by a girl. Results suggest that the gender of perpetrators and victims should be considered, and there is a need to include sexual harassment in the study of peer victimization when developmentally appropriate.     

Game-Based Cognitive-Behavioral Therapy (GB-CBT) Group Program for Children Who Have Experienced Sexual Abuse: A Three-Month Follow-Up Investigation

This study examined the efficacy of a game-based cognitive-behavioral group therapy program for addressing problems typically found among elementary school-aged victims of child sexual abuse immediately after treatment and at three months following treatment. It was hypothesized that positive gains would be observed among the following domains: (a) internalizing symptoms (e.g., anxiety, depression, and trauma); (b) externalizing behaviors (e.g., oppositional behavior, disobedience, and conduct disordered behavior); and (c) sexually inappropriate behaviors. Improved knowledge of abuse and personal safety skills was also predicted. Results indicated that game-based cognitive-behavioral group therapy resulted in improvements in internalizing symptoms, externalizing behavioral problems, total behavioral problems, and personal safety skills both immediately after treatment and at three-month follow-up.     

The Association of Sexual Behavior with Externalizing Behaviors in a Community Sample of Prepubertal Children

Abstract

On the basis of the problem-behavior theory for adolescence, we hypothesized that already during childhood sexual behavior is associated with (non-sexual) externalizing behaviors and tested the hypothesis in a community sample. In the context of a postal questionnaire survey of 6-10 year old children, the parents of 349 girls and 326 boys completed the Child Behavior Checklist (CBCL). The CBCL Sex Problems scale did not differ between genders, ethnic groups, or age groups. For both girls and boys, the scores on the Sex Problems scale correlated significantly but modestly (maximum r = 0.35) with all other CBCL scales; only in boys did the correlations with externalizing behaviors exceed those with other scales. We conclude that children from a community sample who show sexual behavior as defined by the CBCL tend to be the ones with increased behavioral/emotional problems in general, with only modest specificity in symptomatology.     

Self-reported and case file maltreatment: Relations to psychosocial outcomes for youth in foster care

The aim of the current study was to explore the relation between maltreatment and psychosocial outcomes for youth in foster care, and how this relation differs according to reporter type (self-report or case file). Participants included 285 children and adolescents and their caregivers who completed self-report questionnaires about lifetime maltreatment and psychosocial adjustment. Youths' case files containing lifetime maltreatment reports were obtained from Division of Social Services (DSS), and were coded for physical and sexual abuse, emotional maltreatment, and neglect using the Modified Maltreatment Classification System (MMCS; English & LONGSCAN Investigators, 1997). Crosstabs analysis was used to summarize proportions of youth whose caregivers reported clinically significant internalizing and externalizing and average to high adaptive functioning within groups of youth who had a) neither self-reported nor case file maltreatment, b) only case file maltreatment, c) only self-reported maltreatment, and d) both case file and self-reported maltreatment for each maltreatment type (physical and sexual abuse, emotional maltreatment, and neglect). Results showed that externalizing symptoms differ according to reporter type for physical and sexual abuse, and that internalizing symptoms differ according to reporter type for sexual abuse. Implications for methodology in maltreatment research are discussed.     

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.     

Externalizing Behavior Among Adopted Boys with Preadoptive Histories of Child Sexual Abuse

This study examined the severity of externalizing symptomology among adopted boys with preadoptive histories of child sexual abuse, physical abuse, neglect/abandonment, or no abuse. The study was based on data collected across a three-year period from parents who adopted children from Florida's child welfare system. The sample consisted of 1,136 adopted boys aged 6 to 18 years. In repeated cross-sectional multivariate analyses, the results revealed that adopted boys with preadoptive child sexual abuse were prone to significantly higher levels and clinically severe externalizing symptomotology as compared to adopted boys without such histories. The findings highlight the need for postadoption services and empirically validated interventions for families adopting boys with preadoptive child sexual abuse.     

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.     

Maltreatment history as persistent risk: An extension of Li and Godinet (2014)

Using individual growth curves with mixed models, this study examined the influence of maltreatment on the trajectories of both internalizing and externalizing behavioral problems from early childhood (age 4) to late adolescence/emerging adulthood (age 16) in the LONGSCAN samples of children with early maltreatment exposure or early risk for maltreatment. Maltreatment reports for each child were used to create a time-varying predictor, which was assessed on an ongoing basis in the LONGSCAN study. Child/youth emotional and behavioral problems were measured at ages 4, 6, 8, 10, 12, 14, and 16 using the Child Behavior Checklist. Maltreatment allegations significantly predicted subsequent trajectories of both internalizing and externalizing problems. For both types of problems, the effect of repeated maltreatment was on the rate of change (the trajectory), and in the case of externalizing problems, this effect grew more pronounced through age 16. Although behavioral problems may not be seen in younger children who experience maltreatment, these children are at ongoing risk for such problems as they grow older, and this risk is either maintained through adolescence (in the case of internalizing problems) or increases in strength through adolescence (in the case of externalizing problems). Maltreatment history is a persistent risk factor for child outcomes through adolescence. Assessment for recent maltreatment, as well as for earlier history of maltreatment, in adolescent children would improve treatment and service plans for children with behavioral and emotional problems through adolescence.     

Youth characteristics associated with behavioral and mental health problems during the transition to residential treatment centers: the Odyssey Project population

This study aimed to determine what youth characteristics were associated with emotional and behavioral problems exhibited within the first three months of placement in residential treatment centers (RTCs) in a sample of youth from 20 agencies in 13 states. Two primary research questions were addressed: 1) What characteristics were associated with behavior during the transition to care? 2) Were the characteristics associated with behavior during the transition the same for boys and girls? Data were drawn from the Time 1 phase of the longitudinal national Odyssey Project dataset developed by the Child Welfare League of America. Measures included an extensive child and family characteristics (CFC) form and the Achenbach Child Behavior Checklist (CBCL). The results revealed significant gender-specific patterns of associations between youth characteristics and behavior exhibited during the transition to RTC placement. Notably, a sexual abuse history was associated with Externalizing for girls and Internalizing for boys and entering on psychotropic medication was associated with Internalizing for girls and boys and Externalizing for boys only. Results suggest many avenues for refining practice.     

Sexual abuse: Effects of group therapy on pre-adolescent girls

This article describes the effectiveness of a group therapy program used at the University of Manitoba with pre-adolescent girls who have experienced sexual abuse. Thirty-five girls, ranging in age from 7 to 12, were referred to structured therapy groups of 9 to 12 weeks' duration. Issues addressed in weekly sessions included feelings about the offender, problem-solving, sex education, and prevention of further abuse. Measurements of self-esteem, anxiety, and internalizing and externalizing behaviour problems were taken for participating children prior to and following treatment at 1 and 9 to 12 month intervals. Parent- and child-reported social validity data were also collected following treatment. Comparison group data for self-esteem and anxiety were provided by a non-random sample of 35 girls with no known history of sexual abuse. Results indicated that following group therapy, self-esteem increased and anxiety and behaviour problems decreased. Comparison group data further supported the effectiveness of group treatment in improving the self-esteem of sexually abused girls. Social validity reports of children and parents also suggested that treatment was helpful and worthwhile. Implications of the findings are discussed as are difficulties encountered in conducting treatment outcome research with children who have been sexually abused.     

Predicting Well‐Being and Internalizing Symptoms in Late Adolescence From Trajectories of Externalizing Behavior Starting in Infancy

This study aimed to examine the long‐term prediction of well‐being and internalizing symptoms from trajectories of externalizing behavior problems in 921 children from a population‐based sample. We found that a high stable trajectory of externalizing behavior from infancy (age 1.5) to mid‐adolescence (age 14.5) predicted lower scores on life satisfaction and flourishing for both girls and boys (age 18.5). The high stable trajectory also predicted higher levels of depressive symptoms in boys and anxiety symptoms in girls (age 18.5). The findings are noteworthy as they document how a person‐oriented study of externalizing behavior problems starting in infancy can predict well‐being and internalizing in late adolescence. The findings underline the importance of early health promotion and problem intervention efforts.     

Coping while Incarcerated: A Study of Male Juvenile Offenders

The present study examines the associations between coping efforts and psychological (internalizing and externalizing symptoms) and behavioral adjustment in a sample of 373 male juvenile offenders (ages 14-17) during the first month of incarceration. Social support seeking was associated with a more rapid decline in internalizing symptoms and lower levels of externalizing symptoms. Acceptance had a stress-buffering effect with regard to internalizing symptoms, whereas denial predicted higher levels of these symptoms. The only coping variable related to violent behavior was active coping, which was associated with lower rates of violent offending among youth with any violent incidents. The importance of fostering coping skills and increasing positive coping options for incarcerated adolescents is discussed.