Childhood physical and sexual abuse in China

In order to determine the prevalence and characteristics of childhood physical and sexual abuse in China, the authors conducted a survey in Shanghai. The Dissociative Disorders Interview Schedule was administered to 423 inpatients and 304 outpatients at Shanghai Mental Health Center, and to a non-clinical sample of 618 workers at a clothing factory. The results were compared to a previous sample of 502 respondents in the general population in Winnipeg, Canada. The identities of the perpetrators of physical and sexual abuse, and the types of sexual abuse reported were similar in the two countries; however, the rates of reported abuse were lower in China. Childhood sexual abuse appears to be far less common in the general population in Canada than in China.     

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.     

Exploring patterns of employee psychosocial outcomes among child welfare workers

Child welfare workers continue to suffer from increased levels of job stress and burnout, often resulting in an intention to leave. Although the literature on these psychosocial employee outcomes is extensive, much of it is limited in that it has failed to determine if variability exists across these constructs in a way that can be systematically categorized. This cross sectional exploratory study utilized a statewide purposive sample of respondents (N = 209) from a public child welfare organization in a Northeastern state. Two complementary cluster methods and discriminant function analysis were used to determine if subtypes of job stress, burnout, well-being, job satisfaction and intent to leave exist among public child welfare workers. Since the results yielded three different clusters of workers, an Analysis of Variance was used to identify significant group differences, while Scheffé post hoc tests were examined to determine which groups differed. Findings show that the all three clusters significantly vary from one another in terms of the adverse employee psychosocial outcomes. Our findings suggest that child welfare workers represent a heterogeneous group with dissimilar psychosocial needs. To meet those employee needs and maximize their work output, child welfare administrators should make a concerted effort to better understand the unique needs of this strained workforce.     

Trauma symptoms, sexual behaviors, and substance abuse: correlates of childhood sexual abuse and HIV risks among men who have sex with men

Childhood sexual abuse is associated with high-risk sexual behavior in men who have sex with men. This study examined psychological and behavioral correlates of HIV risk behavior associated with childhood sexual abuse in a sample of men who have sex with men. Men attending a large gay pride event (N = 647) completed anonymous surveys that assessed demographic characteristics, childhood sexual abuse history, symptoms of dissociation and trauma-related anxiety, borderline personality characteristics, substance use, and sexual risk behavior. Results indicated that men who have a history of childhood sexual abuse were more likely to: engage in high-risk sexual behavior (i.e., unprotected receptive anal intercourse), trade sex for money or drugs, report being HIV positive, and experience non-sexual relationship violence. Results of this study extend previous research to show that men who have sex with men and who have a history of child sexual abuse are more likely to be at high risk for HIV infection.     

Childhood and adult sexual abuse: relationships with alcohol and other psychoactive drug use

Questions concerning sexual abuse before and after the age of 16 years were included in a general population survey of a representative sample of 1052 UK women and 975 UK men. A total of 12.5% of women reported experiencing some form of sexual abuse before the age of 16 years. The corresponding ?gures for men in this category were 11.7%. After the age of 16, the ?gure for women remained at this level. However, the proportion of men reporting these traumatic experiences dropped to 3.2%. Sexual abuse both pre and post age 16 was associated with being single or cohabiting, with higher levels of cigarette‐smoking, alcohol consumption, experience of alcohol‐related problems and use of illicit drugs. The relationship between drinking and other forms of psychoactive drug use and sexual abuse is complex. Some possible explanations for this connection and its therapeutic and practical implications are discussed. Copyright © 2004 John Wiley & Sons, Ltd.     

Childhood sexual experiences and adult health sequelae among gay and bisexual men: defining childhood sexual abuse

Gay and bisexual men carry the burden of HIV infections in the United States and have high rates of childhood sexual abuse that predict HIV and other health outcomes. This study examined differential effects of forced, consensual, and no childhood sexual experiences (CSE) on health outcomes among a probability sample of adult men who have sex with men (MSM). The forced sex group had the highest levels of psychological distress, substance use, and HIV risk. There were no differences in rates of depression and suicidal ideation between the consensual- and no-sex groups. The consensual- and forced-sex groups had higher rates of substance use and transmission risk than the no-sex group. The forced-sex group, however, had significantly higher rates of frequent drug use and high-risk sex than the consensual group. Findings suggest that forced CSEs result in a higher-risk profile than consensual or no childhood sexual experiences, the kind of risk pattern differs between forced and consensual childhood sexual experiences, and the underlying mechanisms that maintain risk patterns may vary. It is important to clarify risk patterns and mechanisms that maintain them differentially for forced and consensual sex groups so that interventions may be tailored to the specific trajectories related to each experience.     

Clinical correlates and repetition of self-harming behaviors among female adolescent victims of sexual abuse

This study investigated self-harming behaviors in 149 female adolescent victims of sexual abuse, first, by determining the rates of nine types of self-mutilating behavior at intake and nine months later and, second, by investigating comorbidity of clinical correlates associated with these behaviors. The adolescents were divided into three groups according to level of self-mutilating behavior and then compared on symptom self-reports; 62.1% of the adolescents engaged in at least one self-mutilating behavior. A graded relation was observed between level of self-mutilating behavior and rate, and total number of clinical disorders. At nine month follow-up, one in four teenagers still reported a moderate or high level of self-harm. The need for systematic assessment and intervention of self-mutilating behaviors is discussed.     

Childhood sexual abuse and psychosomatic symptoms in irritable bowel syndrome

Irritable bowel syndrome is characterized by chronic gastrointestinal symptoms without a demonstrable physical cause. In a subgroup of patients, irritable bowel syndrome may be part of a cluster of psychosomatic symptoms related to childhood sexual abuse. To investigate this possibility, the Dissociative Disorders Interview Schedule (DDIS), the Dissociative Experiences Scale (DES) and the Symptom Checklist-90 (SCL-90) were administered to 105 subjects with either irritable bowel syndrome, inflammatory bowel disease (Crohn's disease or ulcerative colitis), or other gastrointestinal disorders. The subjects in the three groups did not differ on the DES, the SCL-90 or most sections of the DDIS. However, subjects with irritable bowel syndrome reported much higher rates of childhood sexual abuse and psychosomatic symptoms.     

Sex differences in psychosocial consequences of alcohol and drug abuse

This paper reports analyses of the 1985 National Household Survey on Drug Abuse to evaluate three perspectives on sex differences in the relationship of psychosocial problems to levels of substance use. The results are more consistent with a styles of deviance perspective than with either the generalized feminine vulnerability or the convergence theses. Compared to women, men report higher levels of alcohol and drug abuse during the past year and are more likely than women to have experienced each of 17 psychosocial problems resulting from alcohol or drug use. Significant sex by substance use interaction tests for problem indices and for individual problems suggest that substance abuse is related more strongly to intrapsychic problems among women and to problems in social functioning among men. Decompositions of the sex differences in mean levels of psychological and social/behavioral problems suggest that most of the differences can be explained by males' greater frequency of intoxication and drug use.     

Association between child sexual abuse and sexual revictimization in adulthood among women sex partners of injection drug users

Community-recruited women (n = 1490) were interviewed about their early and adult sexual victimization histories to determine whether there was an association between child sexual abuse and adult revictimization by sex partners and strangers/nonsex partners. Adolescent sexual abuse, lifetime sex-trading, drug treatment, and mental health treatment were examined as mediating variables. One-fourth of the women had been revictimized (i.e., experienced child sexual abuse and at least one instance of adult sexual victimization). Child sexual abuse was associated with both rape and other sexual victimization by a sex partner in adulthood, as well as adult rape by a stranger/nonsex partner. Drug and mental health treatments reduced abused women's chances of being raped by a sex partner; drug treatment also decreased the likelihood of other sexual victimization by a sex partner. Sex-trading increased abused women's likelihood of rape by a stranger or nonsex partner. Intervention--including drug treatment--can help women with child sexual abuse histories overcome some of the abuse-related sequelae that make them vulnerable to adult revictimization.     

Childhood sexual experiences and the perception of abuse among Latino men who have sex with men

There is a lack of consensus on how to define childhood sexual abuse (CSA). In this study we explore the perceptions of CSA among men who had such experiences. One hundred Latino men (predominately gay) who had childhood sexual experiences with an older partner (CSEOP) were asked whether they considered their experiences sexual abuse (41 said no; 59 said yes). Those who felt abused were younger when the events happened and were more likely to have been physically forced, physically hurt, threatened, and emotionally hurt. Negative correlates of CSEOP in adulthood were also explored. Men who considered themselves the victims of CSA differed from those without CSEOP in having more alcohol use, unprotected anal sex, and male sex partners.     

Childhood sexual experiences and the perception of abuse among latino men who have sex with men

There is a lack of consensus on how to define childhood sexual abuse (CSA). In this study we explore the perceptions of CSA among men who had such experiences. One hundred Latino men (predominately gay) who had childhood sexual experiences with an older partner (CSEOP) were asked whether they considered their experiences sexual abuse (41 said no; 59 said yes). Those who felt abused were younger when the events happened and were more likely to have been physically forced, physically hurt, threatened, and emotionally hurt. Negative correlates of CSEOP in adulthood were also explored. Men who considered themselves the victims of CSA differed from those without CSEOP in having more alcohol use, unprotected anal sex, and male sex partners.     

Program variation in treatment outcomes among women in residential drug treatment

Multilevel modeling was used to assess the program characteristics associated with treatment retention among 637 women in 16 residential drug treatment programs in the Drug Abuse Treatment Outcome Study. Women who were pregnant or had dependent children had higher rates of retention in programs in which there were higher percentages of other such women. Longer retention was associated with higher rates of posttreatment abstinence. Bivariate analyses showed that programs with higher proportions of pregnant and parenting women provided more services related to women's needs. The findings support the provision of specialized services and programs for women in order to improve outcomes of drug abuse treatment.     

Ritual,and child sexual abuse,but not ritual child sexual abuse

Central to the controversy over ritual (satanic) child sexual abuse have been claims concerning agency ‘diagnoses’ of cases. Specifically, it has been alleged that agency findings of ritual abuse have been erroneous and are the product of poor practice. There is, though, little systematic information regarding agency assessment of suspected ritual abuse cases. This paper presents two cases where there was evidence both of child sexual abuse and ‘ritual’ but where agencies adjudged that these aspects occurred independently of one another and were not indicative of ritual child sexual abuse. The existence of these cases underlines the need for a broader and more balanced debate in respect of ritual abuse in general and the agency handling of these cases in particular. Copyright © 2000 John Wiley & Sons, Ltd.     

Childhood sexual abuse, teenage pregnancy, and partnering with adult men: exploring the relationship

Although the mechanism by which early victimization, specifically sexual abuse, increases the risk of adolescent pregnancy is unclear, a relationship between previous victimization and adolescent pregnancy has been demonstrated. While partnering with an older man may initially offer the means necessary to escape a neglectful or violent family of origin, this protection be accompanied by an imbalance of power and control. Both adolescent mothers partnered with adult men and adolescent mothers partnered with male peers reported sexual abuse perpetrated by family members, family friends, strangers, and peers. Policies developed to protect young people from victimization, including mandatory reporting and statutory rape laws, should be evaluated for their consistent application to all children, regardless of age, race, gender, or pregnancy status.     

Neighborhood disadvantage, stress, and drug use among adults

This paper explores the relationships among neighborhood disadvantage, stress, and the likelihood of drug use in a sample of adults (N = 1,101). Using the 1995 Detroit Area Study in conjunction with tract-level data from the 1990 census, we find a positive relationship between neighborhood disadvantage and drug use, and this relationship remains statistically significant net of controls for individual-level socioeconomic status. Neighborhood disadvantage is moderately associated with drug related behaviors, indirectly through increased social stressors and higher levels of psychological distress among residents of disadvantaged neighborhoods. A residual effect of neighborhood disadvantage remains, net of a large number of socially relevant controls. Finally, results from interactive models suggest that the relationship between neighborhood disadvantage and drug use is most pronounced among individuals with lower incomes.     

Childhood adversity,sense of belonging and psychosocial outcomes in emerging adulthood: A test of mediated pathways

Childhood adversity is a complex issue with the potential for lasting effects over the developmental trajectory. Research has confirmed that people who experience significant adversity, hardship and trauma in early stages of development are at an increased risk of a range of negative outcomes at later stages of the life-course, including increased psychological distress and dysfunction, decreased likelihood of educational engagement and an increased risk of early parenthood. However, distal events exert their influence on later outcomes through various proximal mechanisms. One such postulated mechanism is a sense of belonging. This study investigated the role of sense of belonging as a mediator between experiences of adversity in childhood and psychosocial outcomes in emerging adulthood, amongst a sample of 254 young people receiving a range of social services throughout Australia. Results of three mediation analyses confirm that the path from childhood adversity to psychological distress and educational engagement is only weakly mediated by sense of belonging. No other statistically significant relationships were found. These results indicate that additional mediators are likely needed to more fully explain the effects of childhood adversity on psychosocial functioning in emerging adulthood. The paper concludes with a discussion of the relevance of belonging for practice in the field of child and youth welfare.     

Rural/Non-Rural differences in psychosocial risk factors among sexual minorities

The purpose of this study was to examine rural versus non-rural differences in the following risk factors among sexual minority adults: victimization/discrimination, fundamental religiosity, identification and involvement in the lesbian, gay, bisexual, and transgender (LGBT) community, social support, and level of comfort disclosing sexual identity to others. The study recruited sexual minority individuals via online communications to LGBT organizations. Of the total sample (N = 699), 23.3% resided in rural areas and 76.7% resided in non-rural areas. A MANCOVA was conducted to determine if there was a significant overall relation of rural versus non-rural location to the five risk factors of interests, while controlling for age, sex, race, relationship status, and sexual identity. Post hoc ANCOVAs were then conducted to explore the specific directionality of the significant differences. Results revealed rural sexual minorities reported greater identification with fundamental religious beliefs, less comfort in disclosing their sexual identity to others, more experiences of victimization and discrimination, less identification with and involvement in the LGBT community, and less perceived social support when compared to their non-rural counterparts. These findings suggest sexual minorities residing in rural areas may experience increased exposure to negative risk factors. Implications for mental health providers working with rural sexual minorities are discussed.