Correlates of comorbid PTSD and polysubstance use in sexual assault victims

A diverse sample of community-residing women in a large metropolitan area who had experienced adult sexual assault was surveyed using standardized measures in an NIAAA-funded study (2003-2004). Four groups (N = 503) of victims: (1) post-traumatic stress disorder (PTSD)-only, (2) PTSD and illicit drug use, (3) PTSD and drinking problems, and (4) PTSD and polysubstance use were compared using bivariate analyses. Victims with PTSD/polysubstance use had lower socioeconomic status, more extensive trauma histories, worse current psychological functioning, more problematic post-assault psychosocial experiences, and more sexual revictimization at follow-up than those with PTSD only. Implications for future research are discussed.     

Impact of Traumatic Events on Posttraumatic Stress Disorder among Danish Survivors of Sexual Abuse in Childhood

Childhood sexual abuse can be extremely traumatic and lead to lifelong symptomatology. The present study examined the impact of several demographic, abuse, and psychosocial variables on posttraumatic stress disorder severity among a consecutive sample of treatment-seeking, adult child sexual abuse survivors (N = 480). The child sexual abuse sample was characterized by severe trauma exposure, insecure attachment, and significant traumatization, with an estimated 77% suffering from posttraumatic stress disorder, more than twice the level of the comparison group. Regression analyses revealed risk factors associated with the development of posttraumatic stress disorder in which the strongest predictors being additional traumas, negative affectivity, and somatization. The findings add to existing research confirming the stressful nature of child sexual abuse and the variables that contribute to the development and severity of posttraumatic stress disorder.     

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.     

Substance use during sexual and physical assault in HIV-infected persons

Data from the HIV-Alcohol Longitudinal Cohort was used to determine the prevalence of substance use by victims and assailants during physical and sexual assault against HIV-infected persons and whether these findings differed by gender. Of the sexually assaulted participants, 31% of victims and 70% of assailant(s) had used drugs/alcohol during sexual assault. Compared with men, women had higher odds of substance use during sexual assault (adjusted odds ratio [OR] 3.8, 95% confidence interval [CI] 1.6 to 8.7) and of substance use by their assailant(s) during sexual assault (adjusted OR 5.9, 95% CI 1.7 to 20.6) in adjusted analysis. Of the physically assaulted participants, 66% of victims and 85% of assailants used drugs/alcohol during physical assault; these results did not differ by gender.     

The prevalence and correlates of psychological distress following physical and sexual assault in a young adult cohort

Among a birth cohort of New Zealand's 21-year-olds, 41% experienced physical or sexual assault in the previous 12 months. The level of psychological distress experienced by the 374 victims was determined in interviews assessing for symptoms indicative of posttraumatic stress disorder and ratings of impairment in activities of daily living. Of the 141 women victims, 32.6% were identified as experiencing psychological distress as were 9.9% of the 233 men. For men, bivariate analyses showed psychological distress was significantly associated with factors indicative of increased assault severity, and for women an increased likelihood of distress was associated with the location of assault and the relationship to the assailant. Positive indicators of social support were not significantly associated with less adverse psychological outcomes. However, for both men and women, resisting the assailant was associated with a reduced likelihood of psychological distress. Multivariate analyses revealed that for both women and men, unemployment uniquely predicted variance in distress, over and above that accounted for by characteristics of the assault.     

Post Traumatic Stress Disorder Symptomatology in Sexually Abused Children

No abstract available for this article.     

Body-Related Emotions in Posttraumatic Stress Disorder Following Childhood Sexual Abuse

Traumatic experiences are associated with emotions such as anxiety, shame, guilt, disgust, and anger. For patients who have experienced child sexual abuse, these emotions might be triggered by perceptions of their own body. The aim of this study was to investigate the extent of the association of the body to traumatic experiences and to discern the emotions linked to trauma-associated body areas. Ninety-seven female participants were assigned to four groups: post-traumatic stress disorder following child sexual abuse with co-occurring borderline personality disorder, post-traumatic stress disorder following child sexual abuse without co-occurring borderline personality disorder, borderline personality disorder without post-traumatic stress disorder, and healthy controls. Participants rated 26 body areas regarding their association with trauma and 7 emotions. Emotions were assessed by questionnaires. Results suggest that specific areas of the body are associated with trauma and linked to highly aversive emotions. In post-traumatic stress disorder patients, the areas associated with highly negative emotions were the pubic region and inner thighs. Thus, the patient’s body may act as a trigger for traumatic memories.     

Risk of physical assault against school educators with histories of occupational and other violence: a case-control study

A case-control study design was used to investigate risks of work-related physical assault (PA) associated with a history of violent victimization among educators. A total of 6,469 state-licensed educators (Kindergarten - Grade 12) worked in the previous 12~months and were eligible to participate. Exposure data were collected from cases (reporting a PA event in previous 12 months, n=290) for the month before PA, and from controls (no work-related PA in previous 12 months; n=867) for a randomly selected working month. Odds ratios and 95% confidence intervals identified increased risks for educators with any prior history of work-related (17.3, 11.4-26.3) or non-work-related PA (2.0, 1.2-3.5). In addition, PA risk in the previous twelve months increased with the number of previous victimizations, and risk also increased for educators with histories of non-physical violence (work- and non work-related). The results present a compelling case for targeted interventions and further research.     

Concurrent reductions in psychotropic medication,assault, and physical restraint in two residential treatment programs for youth

Over the past decade, the level of clinical needs of youth in residential treatment has increased significantly. Youth in out-of-home settings typically experience higher levels of psychotropic medication use than their peers living at home, even when controlling for the severity of clinical issues. The purpose of the current study was to examine the effects of an approach to clinically reassess psychotropic medication utilization for youth residing in residential treatment settings while also observing the impact on the youth's need for physical containment. Medication changes were based on a data-informed process, using input from a multi-disciplinary treatment team. Data for 531 youth who were consecutively admitted to one of two non-affiliated intensive residential treatment programs, one in the Midwest and one in New England, was analyzed. Over half of these youth (n = 292, 55%) had their medications reduced during their stay and only 14% (n = 76) were prescribed more medication at discharge than they had been taking at admission. The remainder either saw no change during their stay (n = 104, 20%) or were never on medication at any time (n = 59, 11%). From admission to discharge there was a 62% decrease in the number of assaultive incidents as well as a 72% decrease in the use of physical restraints. These results support the view that residential treatment can provide a treatment milieu that allows for thoughtful reassessment of the clinical basis for behavioral disorders in children that can achieve the dual goals of medication reduction and behavioral stabilization.     

Common correlates of suicidal ideation and physical assault among male and female university students in Hong Kong

This study examined prevalence and correlates of suicidal ideation and dating partner violence in a cohort of 651 university students in social sciences classes at three universities in Hong Kong. A standard questionnaire was completed within one class period to examine the rates of occurrence of physical assault perpetration and suicidal ideation. Separate rates are presented for male and female perpetrators and for severe and overall levels of violence. The differences between subjects having suicidal ideation are compared using t tests. Logistic regression is used to predict the presence or absence of physical assault in the preceding year of reporting and suicidal ideation based on the variables such as Personal Relationship Profile, age, relationship length, and socioeconomic status. Results showed that 55% of suicidal persons had a history of violence, whereas 39% of violent people had a history of suicidal ideation. Logistic regression showed that physical assault shared a total of seven associated factors with suicidal ideation. Suicidal ideation seems to have no direct relation to physical and sexual assault, but they do share some common associated factors that are essential for the development of suicide prevention.     

Post-Traumatic Stress Disorder and Quality of Life in Sexually Abused Australian Children

The study used publicly available data on post-traumatic stress disorder in a sample of the Australian population with a history of sexual abuse to demonstrate how this evidence can inform economic analyses. The 2007 Australian Mental Health Survey revealed that 8.3% of 993 adolescents experienced childhood sexual abuse, of which 40.2% were diagnosed with post-traumatic stress disorder. Post-traumatic stress disorder diagnosis corresponded to a significant loss of quality of life. Survival analysis was used to estimate the lifetime persistence of post-traumatic stress disorder symptoms. The average time between post-traumatic stress disorder onset and remission was 11.4 years. Results suggest that successful treatment of post-traumatic stress disorder will save 2.05 quality adjusted life years per child or adolescent with post-traumatic stress disorder.     

Gender differences in correlates of recent physical assault among untreated rural and urban at-risk drinkers: role of depression

This study examined gender-specific correlates of past 6-month physical assault victimization among 468 men and 229 women at-risk drinkers recruited from both urban and rural settings. Both alcohol dependence and depression were associated with physical assault, but there were differences for women and men in the pattern of significant correlates. Specifically, for women the presence of alcohol dependence, depression or their comorbidity all were associated with physical assault. For men, depression by itself was not associated with physical assault, but alcohol dependence and especially alcohol dependence comorbid with depression were significant predictors. Further, there were stronger relationships between demographics and physical assault for men. The results have implications regarding identification of risk factors for physical assault victimization among at-risk drinkers. Overall, the results of this study suggest that screening and prevention interventions for physical assault among at-risk drinkers should target both alcohol use disorders and depression.     

Family Systemic Approaches for Borderline Personality Disorder in Acute Adult Mental Health Care Settings

This thematic literature review explores the contribution of family/systemic approaches in the treatment and care of people with borderline personality disorder (BPD) in acute adult mental health care settings. It recognises the importance of early childhood trauma, family dynamics, and relationships in the aetiology of BPD and outlines key benefits and constraints of a family systems approach. The article discusses institutional, cultural, and power structures that influence the diagnosis and treatment process for adult clients with BPD and the value of relational ethics in guiding or mediating care between the family, healthcare system, and community.     

Post-traumatic Stress Disorder in Childhood Sexual Abuse: A Synthesis and Analysis of Theoretical Models

The notion that post-traumatic stress disorder (PTSD) may be found in children who have experienced sexual abuse has become an important issue in research and clinical practice. To date however, there is a lack of consensus on what theoretical model(s), if any, best account for PTSD within this population. As a way of contributing to the existing body of literature pertaining to PTSD and its relationship to childhood sexual abuse, this paper synthesizes and presents a critical analysis of contemporary theoretical models.     

The influence of family visiting upon boys' behavior in a juvenile correctional institution

Parental visiting, already recognized as essential for children in foster care, has a direct beneficial effect upon the behavior of children in correctional placements.     

Relationship Help‐Seeking in a Danish Population Sample

Empirically supported couple interventions often transfer from the US to several other parts of the world yet we have little data on their final reach. This study investigated relationship help‐seeking in a random population sample of 1,371 individuals living with a partner in Denmark, a European high income – high divorce country. Only a small fraction of respondents had ever sought couple education (3%) or counseling/therapy (7%) with their partner. Among respondents experiencing a severe relationship crisis, individual types of help‐seeking were the most prevalent. Both women (38.9%) and men (27.8%) with a recent relationship crisis sought information online, and mostly women (19.4%) also sought individual therapy. Findings can inform strategies for increasing the reach of couples in new cultural contexts.     

Post-Traumatic Stress Disorder,Dissociation, and Neuropsychological Performance in Latina Victims of Childhood Sexual Abuse

This study compared the memory, attention/concentration, and executive functioning of 12 women with histories of child sexual abuse with a control group of 12 women without childhood abuse. Participants completed a neuropsychological test battery and various instruments assessing post-traumatic stress disorder and dissociation. The child sexual abuse group had lower performance than the control group on long- and short-term visual and verbal memory and presented more limited performance on executive functioning tasks. Functioning in these areas showed a negative correlation with post-traumatic stress disorder and dissociative symptoms. These findings suggest that child sexual abuse is associated with memory and executive functioning deficits and supports the idea that people with trauma histories and increased post-traumatic stress disorder and dissociation symptoms may have alterations in neuropsychological functioning.