Differentiating Children with and without a History of Repeated Problematic Sexual Behavior

Although the issue of dissociative amnesia in adult survivors of child sexual abuse has been contentious, many research studies have shown that there is a subset of child sexual abuse survivors who have forgotten their abuse and later remembered it. Child sexual abuse survivors with dissociative amnesia histories have different formative and therapeutic issues than survivors of child sexual abuse who have had continuous memory of their abuse. This article first discusses those differences in terms of the moderating risk factors for developing dissociative amnesia (e.g., age, ethnicity, gender, etc.) and then mediating risk factors (e.g., social support, trait dissociativity, etc.). The differences between the two types of survivors are then explored in terms of treatment issues.     

Examining Outpatient Treatment Dropout in Adolescents: A Literature Review

This literature review explores the research to date on adolescent mental health treatment drop out. As many as one in five adolescents in the United States has been diagnosed with an Axis-I psychiatric disorder. Adolescents with Axis-I psychiatric disorders face significant short- and long-term consequences if they do not obtain mental health treatment. However, treatment dropout research has focused on child and adult populations with little focus on the unique issues that are likely to impact adolescents. The theoretical underpinnings for understanding adolescent mental health treatment are explored in relation to adolescent psychological development and the therapeutic alliance. The review concludes with suggestions for future research to extend our understanding of adolescent treatment drop out.     

Confronting abusers: the opinions of clinicians and survivors

Confrontation of an abuser is often regarded as a powerful process in clinical work with adult survivors of childhood sexual abuse. This paper explores direct and symbolic forms of survivors confronting their abusers via a review of the current literature and the self-report of 12 female survivors, post-therapy. Six of the survivors had chosen to directly confront their abusers and six had not. Their experiences and opinions are presented together with a discussion of important issues within this area and the need for further research.     

THE "ALIENATED" PARTNER: RESPONSES TO TRADITIONAL THERAPIES FOR ADULT SEX ABUSE SURVIVORS

Childhood sexual abuse affects both survivors and partners; however, the common therapy modalities for survivors (individual and individual group therapy exclude their partners. In-depth interviews with the husbands of survivors were used to examine partner issues around the survivor's therapy. Several thems, both positive and negative, emerged from the qualitative analysis of the in-depth interviews. The authors suggest that therapists should consider integration conjoint couple therapy as an adjunct to, not a replacement for the traditional modalities of individual and individual group therapy for adult survivors.     

Wherefore the Oedipus Complex in Adolescence? Its Relevance,Evolution, and Appearance in Treatment

This article is a critique of the frequent and reflexive use of the Oedipus complex in clinical discussions as a constellation that refers specifically to experiences of young children. A more fluid concept of the Oedipus complex is described in which it is seen as a constellation of issues that derives from early childhood and recurs throughout development. The adolescent Oedipus complex is described in detail and is seen as the more probable form that occurs in treatment when adult patients are describing their sexual and gender-based lives.     

Male Survivors of Childhood Sexual Abuse: A Qualitative Study and Issues for Clinical Consideration

ABSTRACT

This qualitative study explored the effects of childhood sexual abuse with 10 adult male survivors. The men who participated in the research were largely motivated by their perception that North American society does not acknowledge the sexual abuse of boys. They described the abuse as having significantly affected their sexual identity, as well as their emotional and sexual relationships as adults. The implications of these issues for clinical intervention are described.     

Service Patterns of Adult Survivors of Childhood Versus Adult Sexual Assault/Abuse

This analysis compared the characteristics and service patterns of adult survivors of childhood sexual assault/abuse and adult survivors of adult sexual assault/abuse. Utilizing data from sexual assault crisis centers serving survivors in a Midwestern state over a six year period and controlling for revictimization, we describe and compare the demographic characteristics, referral sources, and service patterns of the two groups. Results indicate that paths into service differ for the two groups. Furthermore, adult survivors of childhood sexual assault/abuse obtain significantly more hours of service and service contacts on average than adult survivors of adult sexual assault/abuse. Implications for policy and practice are discussed.     

The Voices of Victims: Surviving Child Sexual Abuse

This exploratory project had two goals: (1) to ask child and adolescent sexual abuse victims/survivors what they believed counseling and/or therapy designed to help them should entail; and (2) to learn from survivors how others (e.g., parents, social service workers, law enforcement, siblings, etc.) may have helped them deal with the negative impact of child sexual abuse victimization. A focus group methodology, using thematic analysis, was used to learn about how child and adolescent sexual abuse survivors saw these matters and to evaluate the usefulness of focus groups with this population.     

Does Adolescent Affect Impact Adult Social Integration? Evidence from the British 1946 Birth Cohort

Using data from the MRC National Survey of Health and Development (the British 1946 birth cohort), we take a life course approach with a sociology of mental health framework to examine the relationship between adolescent affect and adult social integration. The results suggest that being observed as anxious or sad in adolescence has long-term effect on adult social integration. These associations are not explained by adult mental health or socioeconomic status, for the most part. The results demonstrate support for social selection processes between adolescent mental health and adult social outcomes and suggest a disparate effect of type of adolescent affect on adult social outcomes.     

Adolescent Loneliness and Health in Early Adulthood

The health consequence of loneliness in the early life course is an understudied topic in the sociological literature. Using data from Waves 1–3 of the National Longitudinal Study of Adolescent Health, we examine pre‐disease pathways in the relationship between adolescent loneliness and early adult health. Our results indicate that loneliness during adolescence is associated with diagnosed depression, poorer adult self‐rated health, and metabolic risk factors related to cardiovascular disease. High depressive symptoms and parent support are important pathways through which the health consequences of loneliness are exacerbated or offset. There is also evidence that lonely youth remain at higher risk for experiencing adult depression and poor self‐rated health even in the presence of equivalent levels of parental support relative to non‐lonely adolescents. Furthermore, lonely adolescent females are more vulnerable to reporting poor adult self‐rated health and being overweight or obese in adulthood. In sum, our study demonstrates the importance of adolescent loneliness for elevating the risk of poor health outcomes in adulthood.     

Maternal Sexual Abuse of Males

This article presents one aspect of the findings of a qualitative research study which explored the impact of childhood sexual abuse on the lives of a non-clinical sample of 25 adult males who responded to advertisements for adult male survivors of childhood sexual abuse. The author conducted in-depth interviews with the men to discover how their experiences of childhood sexual abuse had influenced their psychosocial development. Thirteen of the 25 men were abused by females. This article focuses on seven men who were abused by their mothers and describes how definition, prevalence and outcomes of maternal sexual abuse are affected by male socialization, creating additional difficulties for these men. The author describes some of the psychological defence mechanisms used by this sample of men, explores some of the reasons for maternal abuse and issues to be considered by practitioners. © 1997 John Wiley & Sons, Ltd.     

Assessing the Traumatic Impact of Child Sexual Abuse

A sample of 531 self-identitied adult and adolescent survivors of sexual abuse were sent or given a 686 item Post-Traumatic Stress Questionnaire. Each respondent described between 1-3 different sexually abusive experiences with different perpetrators, in detail, for a total of 1140 experiences. A series of statistical analyses examined the correlations and relationships between aspects of the abuse (including perceived severe impact, duration, frequency, type of abuse, use of force, age of onset) and scores on a variety of standardized instruments. Results of these analyses of the Impact of Events Scale, the Trauma Symptom Checklist-33, and the MMPI-PTSD scale revealed that the cognitive variable of perceived severity of impact accounted for the most variance in scores on the instruments. Other variables which influenced higher scores were greater number of abusers, greater intrusiveness of abuse with force, and greater intrusiveness of abuse without force.     

Trauma Related Critical Incident Debriefing for Adolescents

Events like the tragedy at Columbine High School and the terrorists attacks on New York City in 2001 have highlighted the need for mental health practitioners to become familiar with interventions that are designed to assist young people who have survived extremely stressful events. Mental health professionals often see people who have experienced car accidents, severe abuse, rape, or other victimization, as well as survivors of natural and man-made disasters during the first critical stages of the recovery period. This article describes the process of critical incident de-briefing and provides a step-by-step primer for its application. The process is short-term (four sessions or less) and provides an intervention designed to reduce the frequency and severity of post-traumatic stress symptoms. Adolescents are particularly at risk because of issues surrounding identity formation, self- esteem, and developmental differences in coping mechanisms. Therefore, those who work with an adolescent cohort should be familiar with debriefing methods and how to apply them to the teenager.     

Adolescent males' willingness to report masturbation

This paper compares contemporaneous and retrospective reports of adolescent masturbation experience, partnered sexual behavior, and nonsexual problem behavior. Analyses are based on data from 59 White males who were followed for 3 years in early adolescence and later reinterviewed as young adults. Comparisons of adolescent and adult reports about adolescent behavior indicated that adolescent masturbation, but not coitus and wet dreams, was more likely to be reported in young adulthood than in adolescence, even when confidential reporting techniques were used. In contrast, nonsexual problem behavior occurring during adolescence was more likely to be reported in adolescence than in early adulthood. These findings are consistent with other literature indicating that masturbation is a distinctly sensitive behavior that adolescent respondents may be particularly reluctant to report. These results suggest that adult retrospective reports may more accurately represent adolescent masturbation activity, but may underrepresent adolescent nonsexual problem behavior.     

Challenges in Isolating the Effect of College Attainment and Debt Accumulation on Young Adult Self‐Concept

Prior studies have found college attendance to boost self‐esteem and mastery in young adults. Yet, college attendance itself is likely influenced by self‐esteem and mastery levels experienced in adolescence. And both are likely influenced by adolescent cognitive ability and academic achievement. Using data from the NLSY79‐YA, we illustrate the difficulties in isolating the positive effect of college on young adult self‐concept. First, we estimate adolescent self‐concept trajectories for respondents and analyze whether these trajectories are predictive of college attendance and degree attainment. Second, we assess whether the inclusion of adolescent self‐concept trajectories significantly reduces the beneficial effect of college on young adult self‐esteem and mastery. We also investigate the complex temporal relationship between adolescent characteristics, debt accumulation, and young adult self‐concept. Our findings show that the positive effects of college attainment and debt accumulation on young adult self‐concept are significantly reduced when measures of adolescent self‐concept and cognitive ability are included. These results imply that the benefit of going to college or acquiring debt may be overstated when adolescent characteristics are not taken into consideration.     

Divorced parents and adolescent girls: The bouncing ball

In clinical work with divorced families and children, the continuing unfolding of developmental and familial issues has been observed over the spectrum of many years. While custody disputes soon after a divorce often reflect a playing out of control battles and ambivalence between the parents, changes in residence that occur during adolescence, years after a divorce, are seen as reflecting ongoing parental conflicts as well as phase specific adolescent developmental and divorce-related factors. Theoretical issues that deal with the resolution of adolescent developmental tasks in divorced families are explored and clinical experiences with these adolescent girls whose parents divorced during their earlier years are presented.     

Behaviour Exchange Systems Training: The ‘BEST’ Approach for Parents Stressed by Adolescent Drug Problems

Parents are challenged in the adolescent years by attempts to increase adolescent responsibility while also managing separation issues. Adolescent drug use can exacerbate parental concerns. Parental fears and anxieties surrounding adolescent drug use can undermine opportunities to respond effectively. This paper describes the theoretical rationale for, and early experience of delivering, a brief intervention program designed to assist parents coping with adolescent drug problems. The program emerges out of a hybrid of systems and behaviour therapy principles and has been designed to address issues associated with parenting characterised by a high level of emotional involvement and/or ineffective parental control. Group work encouraging more adolescent responsibility-taking can assist parents disabled by feelings of guilt and failure. As parents develop emotional independence from adolescent behaviour, an appropriate expectation for adolescent control is established.     

Assessment and collaboration: Key elements in comprehensive and cohesive transition planning

The relatively recent study of adolescent transitions into adulthood has compiled little consensus on exemplary practices or theoretical models. Despite this, transition planning teams are mandated to develop plans that result in successful achievement of adult roles. This task is predicated upon choosing appropriate assessments, and assembling them into a comprehensive and cohesive transition profile through collaboration among transition team members. States have provided broad guidelines or frameworks but few offer detailed listings of domains to address in the planning process. This article addresses some of the major issues team members face and identifies strategies for their successful resolution.     

Breaking the incest cycle: the group as a surrogate family

1. Adult women who are survivors of incest can work on healing issues during long-term group therapy sessions. 2. Group therapy sessions can assist survivors to deal with unresolved family issues. 3. Group therapy sessions can be facilitated by psychiatric nurses who are college faculty when a nursing center is affiliated with a college of nursing.