Heterogeneity of Individuals with a History of Child Sexual Abuse: An Examination of Children Presenting to Treatment

The current study examined children and families who presented for treatment through Project SAFE (Sexual Abuse Family Education) following childhood sexual abuse. Pretreatment assessment data were used to develop clusters of participants with significantly differing presentation of symptom outcome following abuse. Four clusters were discovered: (a) a Highly Distressed group, whose members had clinically elevated scores on all self- and parent-report measures; (b) a Problem Behaviors group, whose members had scores within the normal range for self-report measures and elevated scores on all parent-report measures; (c) a Subclinical group, whose participants had scores below the mean and below cutoff scores for all self- and parent-report measures; and (d) a Self-reported Distress group, whose members had elevated scores on self-report measures and scores below clinical cutoffs for all parent-report measures.     

Anxiety and depression among college students with attention-deficit/hyperactivity disorder (ADHD): Cross-informant,sex, and subtype differences

Objective: This study examined symptoms of anxiety and depression among college students with attention-deficit/hyperactivity disorder (ADHD). Participants: Data were collected between March 2011 and March 2016 from 150 college students with ADHD and 150 college students without ADHD. Method: Participants with ADHD were compared to a sex- and ethnicity-matched control group. For the ADHD group, parent and self-report of anxiety and depression were also compared. Results: College students with ADHD self-reported significantly higher anxiety and depressive symptoms than did students without ADHD. Scores on parent-report measures of anxiety and depressive symptoms were significantly higher than scores on self-report measures. Significant sex differences were found for participants with ADHD, with females showing higher depressive and anxiety symptoms than males. Parent-reported anxiety symptoms were higher for those with inattentive type ADHD compared to combined type ADHD. Conclusion: The current study highlights the importance of multi-informant assessment in ADHD evaluations for college-aged adults.     

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.     

Practical Ways Psychotherapy Can Support Physical Healthcare Experiences for Male Survivors of Childhood Sexual Abuse

This pilot study was conducted to examine older child molestation victims' self-report of their long-term psychological adjustment at least 12 months after the date of their initial clinic evaluation. Female participants were assesed using the Piers-Harris Children's Self-Concept Scale, Children's Depression Inventory, and the Hopelessness Scale which were also administered during their first evaluation. T-ratios revealed that scores on all measures, including five of the six Piers-Harris subscales showed significant improvement. The high rate of noncompliance associated with this population is also discussed in terms of removal from the home, type of abuse, and age of the perpetrator.     

Using social media-based drama therapy and family counselling to treat symptoms of postpartum depression among women

This study examines the impact of social media-based drama therapy and family counselling in reducing symptoms of postpartum depression (PPD) in women aged 18–34. The researchers used a quasi-experimental design and randomly assigned the participants (n = 303) to the control, drama therapy, and family counselling groups. The key findings of the study are as follows. First, at baseline, women not only showed more symptoms of PPD than their male counterparts, but men also reached the PPD threshold of 12/13. Second, the difference between women and men regarding their PPD scores achieved statistical significance (p = 0.004). However, during the post-intervention assessment, men who received drama therapy intervention reported a significant drop in their PPD below the threshold of 12/13. Only women whose spouses received family counselling on spousal support reported a significant drop in their PPD. However, those whose partners did not receive family counselling on spousal support still reported PPD scores within the threshold. In both instances, women in the control group still had high PPD scores. Finally, during the 6-month follow-up assessment, even men in the control group did not have significant symptoms of PPD as their scores dropped below the threshold. On the contrary, women in the control group still had high PPD, indicating that PPD lasted more in women than in men. Also, women whose husbands received family counselling on spousal support reported PPD scores below the threshold. However, women whose husbands did not receive spousal counselling still had PPD scores at the threshold, even though their scores marginally dropped.     

Shame and Guilt in Men Exposed to Childhood Sexual Abuse: A Qualitative Investigation

This study examined the experiences of shame and guilt in adult males sexually abused as children. Seven participants attending a service for male sexual abuse completed measures of shame, guilt, dissociation, and childhood trauma history and subsequently participated in a focus group. All participants experienced childhood sexual abuse in the “severe” range and showed elevated scores for shame, guilt, and dissociation. Four superordinate themes with associated subordinate themes emerged: (a) self-as-shame (foundations of self-as-shame, fear of exposure, temporary antidote: connection), (b) pervasiveness and power of doubt and denial (from others, from self, consequences of incredulity), (c) uncontrollability (of problems after disclosure, of rage, of intrusions and emotional pain), and (d) dissociation. Results are discussed with reference to the existing literature and the emerging “self-as-shame” construct, which appeared to encapsulate participants’ view of themselves.     

Heterogeneous Symptom Patterns of Sexually Abused Children in Treatment: Understanding the Complexity of the Problem

A major challenge for clinicians and researchers is the heterogeneity of the severity and type of symptoms presented by sexually abused youth, including those who are subclinical on traditional clinical measures but still present to treatment. Most research continues to treat sexually abused youth as a single population and has not assessed the outcomes or symptom trajectories of various groups of sexually abused youth. Participants included 107 sexually abused children and their nonoffending parents presenting to a cognitive-behavioral group treatment. A cluster analysis using child- and parent-report measures revealed four profiles, including Subclinical, Highly Distressed, Problem Behaviors, and Self-Reported Distress clusters. Hierarchical linear modeling was used to create separate child- and parent-report models of weekly symptomatology to examine differential change over the course of treatment. Contrary to expectation, there was little variation in the weekly rates of change for the different symptom groups; however, all groups evidenced a decrease in symptoms over the course of treatment, including the Subclinical cluster.     

Shame and guilt in men exposed to childhood sexual abuse: a qualitative investigation

This study examined the experiences of shame and guilt in adult males sexually abused as children. Seven participants attending a service for male sexual abuse completed measures of shame, guilt, dissociation, and childhood trauma history and subsequently participated in a focus group. All participants experienced childhood sexual abuse in the "severe" range and showed elevated scores for shame, guilt, and dissociation. Four superordinate themes with associated subordinate themes emerged: (a) self-as-shame (foundations of self-as-shame, fear of exposure, temporary antidote: connection), (b) pervasiveness and power of doubt and denial (from others, from self, consequences of incredulity), (c) uncontrollability (of problems after disclosure, of rage, of intrusions and emotional pain), and (d) dissociation. Results are discussed with reference to the existing literature and the emerging "self-as-shame" construct, which appeared to encapsulate participants' view of themselves.     

An Evaluation of Group Intervention Programs for Violent and Abusive Men

Using the Abusive Behaviour Inventory and Rosenberg's Self Esteem Questionnaire, we assessed the efficacy of six group intervention programs for abusive and violent men. We predicted that both physical and psychological abuse levels would be significantly lower and that self-esteem would increase significantly post-treatment. The six group programs, involving forty-five male participants overall, were conducted over ten to fourteen weeks in the Melbourne metropolitan area. Sixteen non-abusive male subjects were used as a comparison group. Results indicated that the programs were more effective than no treatment in significantly reducing psychological (but not physical) abuse and had no effect on self-esteem. No post-program differences were found between the comparison and treatment groups. We concluded that the programs had positive effects on the participants, particularly in the reduced levels of psychological abuse, and that self-esteem was not a meaningful factor in level of abusive behaviour. The relatively low mean preprogram score on the physical abuse sub-scale for the program groups may explain the lack of significant differences between the physical abuse pre-program and post-program scores.     

Psychological Distress as an Indicator of Co-Occurring Psychopathology among Treatment-Seeking Disordered Gamblers

Disordered gamblers frequently present with concurrent anxiety, depressive, personality, and substance use disorders, which may complicate treatment. Although there is a need for a thorough assessment, some questionnaires may prove lengthy for clients and clinicians. Thus, there is a need for brief screens for identifying co-occurring psychopathology. The present study sought to examine whether a brief, self-report measure of psychological distress could indicate the presence of co-occurring psychopathology among an outpatient sample of disordered gamblers. At intake, 69 participants completed self-report measures of distress and gambling symptomatology, a personality inventory, and a structured interview for the diagnostic criteria for disordered gambling. Gamblers with greater elevations of psychological distress evidenced greater severity of gambling pathology. Clinically significant elevations were present for symptoms of depression, deviancy, and anxiety, but not substance abuse. Greater scores of psychological distress significantly predicted elevations of depression, deviancy, and anxiety. Sensitivity and specificity were evaluated and the findings supported that an average psychological distress score of 16 corresponded with the presence of co-occurring psychopathology. Clinicians treating disordered gamblers should consider screening for co-occurring psychopathology with brief, self-report measures of psychological distress.     

Psychosocial distress,physical illness,and social behaviour of close relatives to people with substance use disorders

ABSTRACT

This study explores how a family member with substance use disorder (SUD) affects the psychosocial, behavioral, and physical states of other family members. Sixteen in-depth interviews with relatives of Icelandic individuals afflicted with SUD were performed. The interviewees were selected from a pool of Icelandic families whose members included one or more chronic SUD users. They represented different relations to the user (spouses, parents, children, and siblings) and both genders. All participants except for siblings expressed that SUD had negatively affected their mental health by inducing depression, anxiety, and stress-related physical illness. All had experienced physical violence, mental abuse and financial loss. Parents indicated that the SUD of the family member had isolating psychosocial impacts on their children and caused a loss of connection among their family members. All participants, except the siblings, regarded their workplace as a shelter. The study’s findings can help social professionals to better understand the effects of SUD on families, family systems, and public health in general.     

Relationship among grip strength,functional outcomes,and work performance following hand trauma

This study examined the relationship among the recovery grip strength, functional outcomes, and work performance following occupational therapy intervention for hand trauma. This study had a sample size of 15 participants whose recovery grip strength was measured using a Jamar dynamometer, whose satisfaction with outcomes was measured by the Michigan Hand Outcomes Questionnaire (MHQ), and whose compliance with the home therapy program was measured by a visual analog scale (VAS). A Pearson r correlation demonstrated a significant relationship between recovery grip strength and two MHQ subset scores: overall hand function (r = 0.59, p = 0.019) and activities of daily living (ADL) performance (r = 0.61, p = 0.016). The participants' self-rating of compliance did not predict or influence either recovery grip strength or MHQ scores. A moderate positive correlation approaching significance (r = 0.51, p = 0.052) was found between grip strength and overall MHQ scores. The researchers concluded that a recovery grip strength measure should be used along with functional measures to appropriately assess overall hand function following hand trauma.     

The relationships among childhood abuse, borderline personality, and self-harm behavior in psychiatric inpatients

The current study was undertaken to explore the relationships among childhood abuse subtypes (sexual, physical, and emotional abuse; witnessing violence), three diagnostic screenings for borderline personality disorder (BPD), and self-harm behavior. Psychiatric inpatients (N = 77) were evaluated for childhood abuse histories through a survey. Participants also underwent assessment for BPD using a self-report measure, clinical diagnosis, and a DSM-IV checklist. Finally, each was assessed for self-harm behavior using the 22-item Self-Harm Inventory (SHI). Compared with non-abused participants, those with abuse histories (with the exception of witnessing violence) had a significantly greater number of BPD confirmations (i.e., self-report, clinical diagnosis, DSM-IV checklist) as well as self-harm behaviors. When examining the total number of endorsed abuse subtypes, there was a significant correlation with the number of self-harm behaviors, but not the number of BPD diagnoses. Among psychiatric inpatients, childhood abuse demonstrates a complex relationship to BPD diagnoses and self-harm behavior.     

Purpose and life satisfaction during adolescence: the role of meaning in life,social support,and problematic digital use

This study examined the characteristics of youth with different types of purpose in life, as well as the associations between adolescents’ life satisfaction, purpose in life, meaning in life, social support, and problematic digital use. The sample included 193 participants aged 14–18 who completed self-report questionnaires on life satisfaction, purpose in life, meaning in life, social support, and problematic digital use. The following purpose in life clusters were found: (1) other-oriented goals (n?=?33); (2) self-oriented goals (n?=?42); and (3) both other- and self-oriented goals (n?=?107). Adolescents with both self- and other-oriented goals had significantly higher life satisfaction, meaning in life, and social support compared to the other groups. Meaning in life and greater support from parents and teachers were significantly associated with greater life satisfaction. In addition, having other-oriented goals was associated with lower life satisfaction. Finally, support from parents (p?=?0.05) mediated the association between problematic digital use and life satisfaction. Findings are discussed in light of previous research and the theoretical and practical implications are examined.     

Childhood sexual abuse, dissociation, and adult self-destructive behavior

Female college students reporting a history of childhood sexual abuse (N=175) and not reporting a history of childhood sexual abuse (N=260) were compared on indices of six self-destructive behaviors, including drug use, alcohol abuse, binge eating, self-mutilation, risky sex, and suicidality. The samples were also compared on two measures of dissociation, the Trauma Symptom Checklist dissociation subscale and the Dissociative Experiences Scale. The CSA group had significantly higher mean scores on all the indices of self-destructive behavior except self-mutilation (where the mean difference approached significance), and on both measures of dissociation. One or both dissociation measures were related significantly to each index of self-destructive behavior except binge eating. Multiple regression mediation analyses provided support for the hypothesis that dissociation mediates the relationships between CSA and both drug use and alcohol abuse. Dissociation also explained significant variability when added to the regressions of risky sex and suicidality on CSA.     

Evaluation of the impact of the Webster‐Stratton Parent‐Child Videotape Series on participants in a Midlands town in 2001–2002

Small groups of parents experiencing problems in managing the behaviour of young children took part in parenting programmes in a Midlands city in 2001–2002 based on the Webster Stratton Parent‐Child Videotape Series. Programmes were evaluated using standardised measures and qualitative data. Most participants who completed the programme (N = 29) in this small scale study had improved scores on all measures. The largest (positive) effects were in reductions in mean total parenting stress levels. Qualitative data confirmed high participant ratings for the facilitators and appreciation for group support; and indicated that partners' views were an important variable. Further research is needed about programme impact on non‐completers (including fathers and minority ethnic participants) and about the influence of non‐participating partners.     

Childhood sexual abuse severity reconsidered: a factor structure of CSA characteristics

To address the lack of empirically grounded measures of childhood sexual abuse severity, a survey of self-report items was developed following a thorough review of the childhood sexual abuse literature. An exploratory factor analysis was conducted using data collected from a convenience sample of college students that included 275 females and males with a history of childhood sexual abuse. The solution produced seven factors interpreted as the following: (a) less intrusive forms of childhood sexual abuse (e.g., sexual invitations, kissing), (b) more intrusive forms of childhood sexual abuse (e.g., oral sex, intercourse), (c) humiliation/fear, (d) childhood sexual abuse involving photography, (e) familiarity with the perpetrator, (f) physical force/rape, and (g) active digital penetration. Correlations among these factors further suggested the existence of two relatively independent second-order factors, one based on the levels of physical intrusiveness and the other composed of the psychological/emotional factors. While arguably the most common measurement of severity, physical intrusiveness had little association with critical factors such as humiliation, fear, and association with the perpetrator. Consequently, physical intrusiveness appears to be an inadequate stand-alone measure of childhood sexual abuse severity. These results are proposed to lay the groundwork for an improved, more comprehensive measure of childhood sexual abuse severity.     

Childhood Sexual Abuse Severity Reconsidered: A Factor Structure of CSA Characteristics

To address the lack of empirically grounded measures of childhood sexual abuse severity, a survey of self-report items was developed following a thorough review of the childhood sexual abuse literature. An exploratory factor analysis was conducted using data collected from a convenience sample of college students that included 275 females and males with a history of childhood sexual abuse. The solution produced seven factors interpreted as the following: (a) less intrusive forms of childhood sexual abuse (e.g., sexual invitations, kissing), (b) more intrusive forms of childhood sexual abuse (e.g., oral sex, intercourse), (c) humiliation/fear, (d) childhood sexual abuse involving photography, (e) familiarity with the perpetrator, (f) physical force/rape, and (g) active digital penetration. Correlations among these factors further suggested the existence of two relatively independent second-order factors, one based on the levels of physical intrusiveness and the other composed of the psychological/emotional factors. While arguably the most common measurement of severity, physical intrusiveness had little association with critical factors such as humiliation, fear, and association with the perpetrator. Consequently, physical intrusiveness appears to be an inadequate stand-alone measure of childhood sexual abuse severity. These results are proposed to lay the groundwork for an improved, more comprehensive measure of childhood sexual abuse severity.     

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.     

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.