Trauma and Adolescents Who Engage in Sexually Abusive Behavior: A Review of the Literature

ABSTRACT

While recent research has established the abuse and victimization histories of youth who engage in sexually abusive behavior, there is still debate regarding the significance of trauma and abuse as developmental antecedents to sexual offending in adolescence. Moreover, research has not conclusively identified the types, context, and timing of adverse experiences that act as catalysts for subsequent sexual perpetration. The present comprehensive literature review has one primary aim: Explore the adverse childhood experiences of youth who engage in sexually abusive behavior, considering whether trauma may be a consistent developmental antecedent to offending. Search method, inclusion criteria, and screening protocol are described, and the articles included in the review (N = 13) are qualitatively analyzed using thematic coding. Findings indicate that traumatic experiences and symptoms may be of developmental and etiological significance for subsequent sexually abusive behavior in adolescence. Implications for research, treatment, and policy are discussed, with the hope the findings will act as impetus to develop and deliver targeted treatment and prevention programs to sexually abusive youth who have histories of victimization.     

A review of literature: An examination of the correlation between attachment styles and adolescent girls’ sexual behaviors

ABSTRACT

This literature review examines eight studies of parental attachment styles, sexual behavior, and health outcomes among adolescent girls. The review focuses on studies that analyzed the perceived relationships between parents and their adolescent daughters and whether instabilities of life experiences correlated with risky sexual behaviors and if high-risk sexual behaviors were associated with an increase of sexually transmitted infections, unplanned pregnancies, and other poor health outcomes in adolescent girls. Findings show adolescent girls with insecure parental attachment styles were at a higher risk of sexual behaviors, early pregnancies, and transmission of sexually transmitted infections (STI’s). The most common finding in the studies reviewed was the significant association of how higher parental communication and monitoring may prevent risky sexual behaviors at an earlier age. Recommendations for mental and health care providers include the development of treatment programs to address the importance of parent-attachment relationships and multifaceted health needs of adolescents girls. Programs can be strengthened by involving other family members, improving parent-daughter communication and relationships and emphasizing system-level change (policy, procedure, practice). Adding these elements may ultimately lead to sustained improvements over time. Future research on other family social factors (e.g., divorce and separation of attachment figure, poverty, and single-parent homes) associated with attachment and high-risk behaviors is warranted. More research is needed to exam how secure attachments among adolescent girls may prevent earlier sexual encounters, unplanned pregnancies, and STI’s.     

Psychological Adaptation and Adjustment to Acquired Immune Deficiency Syndrome

Early reports of the psychological ramifications of acquired immune deficiency syndrome (AIDS) emerged shortly after the first incidence of the isease was officially reported in this country in 1981. These preliminary reports were based on clinical observations and anecdotal information which showed that the psychological reactions of AIDS patients were similar to those stages of death and dying described by Kubler-Ross (1969) although they appeared to be intensified and compounded by other issues related to the stigmatized status of most carriers of this disease. Two specific models of the staging of these psychological reactions are outlined. The psychological problems most commonly requiring therapeutic intervention are discussed with attention paid to the importance of distinguishing between those whose etiology is functional versus organic. The suspected pathogenesis, symptomatology and progression of the most common form of organic neurological disorder associated with AIDS, AIDS dementia complex, is summarized. Finally, a model of integrated treatment for the psychological aspects of adaptation to AIDS is described.     

Predicting Human Papillomavirus Vaccine Intentions of College-Aged Males: An Examination of Parents’ and Son's Perceptions

Abstract

Objective: To examine male students’ and their parents’ human papillomavirus (HPV) vaccine communication in relation to males’ willingness to discuss the vaccine with their health care provider and the likelihood of being vaccinated. Participants: Dyads (n = 111) of students and parents. Methods: Participants completed a HPV vaccine survey based on the risk perception attitude framework in 2009. Results: Male students’ perceived susceptibility for HPV and self-efficacy to talk to their provider were directly related to their intention to discuss the HPV vaccine, and their intention was directly related to their likelihood of being vaccinated. Parents’ perceived self-efficacy to talk to their son and response efficacy of the vaccine were directly related to their intention to talk to their son; however, parents’ intention was not related to the likelihood of their son being vaccinated. Conclusions: College males may benefit from HPV vaccine educational programs that include communication skills training to discuss the HPV vaccine with their parents.     

Relative Efficacy of a Pregnancy,Sexually Transmitted Infection,or Human Immunodeficiency Virus Prevention–Focused Intervention on Changing Sexual Risk Behavior Among Young Adults

Abstract

Objectives: Despite findings suggesting that young adults are more concerned about experiencing an unplanned pregnancy or contracting a sexually transmitted infection (STI) than becoming human immunodeficiency virus (HIV) infected, no empirical work has investigated whether the specific focus of an intervention may be more or less efficacious at changing sexual behavior. Participants: Participants were 198 college students randomized to 1 of 4 conditions: pregnancy intervention, STI intervention, HIV intervention, or a control condition during 2008–2009. Methods: The authors compared the efficacy of 3 theory-based, sexual risk–reduction interventions that were exactly the same except for an exclusive focus on preventing pregnancy, STI, or HIV. Condom use and risky sexual behavior were assessed at baseline and 4-week and 8-week follow-up. Results: Participants exposed to the pregnancy or STI interventions reported greater condom use and less risky sexual behavior than those exposed to the HIV intervention. Conclusions: The focus of sexual risk–reduction interventions may lead to differential behavior change among young adults.     

Vaginal Douching Practices Among Women Attending a University in the Southern United States

Abstract

The authors assessed the frequency, characteristics, and motivational antecedents of vaginal douching practices among 125 White and 155 Black female college students. Overall, 40% of the students had ever douched and half of those women currently douche. Black women were most likely to be encouraged to douche by their mothers, whereas White women were more influenced by television advertisements. Among the sexually active women, being Black, using oral contraceptives, using spermicides, and being encouraged to douche by their mothers or by the media were independently associated with ever having douched. These associations were present among both Black and White women and were stronger when current douching was compared with never having douched. Women who were discouraged from douching by a physician or nurse were more likely to have stopped the practice. Douching is common, even among educated young women; nurses' and physicians' advice to stop douching appears to have a salutary effect.     

Group Treatment of Latency-Age Male Victims of Sexual Abuse

Researchers and clinicians across the country have documented increases in reports of sexual victimization of males. Awareness of the immediate and long-term needs of young male victims has highlighted the need for specialized, multi-modal treatment programs for these youngsters. Group therapy can be an important adjunct to individual and family unit therapy with this population. This article provides concrete suggestions for developing, implementing and evaluating a group therapy program for young male victims of sexual abuse. Specific areas addressed include: selection and preparation of group members; structure, phases, and salient tasks of the group; therapeutic group activities; co-leadership issues; managing transference and countertransference in the context of group; and, methods for evaluating the group's effectiveness.     

Policy Interventions Designed to Combat Sexual Violence: Community Notification and Civil Commitment

SUMMARY

Much attention has been given to the problem of sexual predators and the struggles of the legal-justice system to contain them. In response to public outcry over high-profile sex crimes, federal and state legislators have responded in the past decade with innovative but controversial public policy initiatives, called “sexually violent predator statutes.” In 1996 President Clinton signed “Megan's Law,” mandating all 50 states to develop requirements for convicted sex offenders to register with local law enforcement agencies and to notify communities when a sex offender lives in close proximity. Less publicized have been the civil commitment statutes introduced by 16 states which allow convicted sex offenders to be evaluated for involuntary and indefinite confinement in a psychiatric hospital following their release from prison. This article will review the literature regarding community notification and civil commitment as interventions designed to combat sexual violence. The history and context of each policy will be discussed, as will a review of available research evaluating the impact of each policy. Implications for future research and social policy will be examined.     

Multi-media campaign exposure effects on knowledge and use of condoms for STI and HIV/AIDS prevention in Uganda

This study examined the influences of behavior change communication (BCC) campaigns on knowledge and use of condoms for prevention of HIV/AIDS and other sexually transmitted infections in target areas of Uganda. Data were drawn from the 1997 and 1999 Delivery of Improved Services for Health (DISH) evaluation surveys, which collected information from representative samples of women and men of reproductive age in the districts served by the DISH project. Logistic regressions were used to assess the associations between BCC exposure and condom knowledge and use, controlling for individuals' background characteristics. Results indicated that BCC exposure was strongly associated with higher condom knowledge: women and men who reported being exposed to messages in the mass media were at least twice as likely as those with no exposure to know of condoms as a mean to avoid HIV/AIDS. A dose–response effect was observed, suggesting that campaigns using multiple media channels may be most effective in improving sexual health knowledge. At the same time, certain gender differences of the influences on condom use were found, with the channel and content of messages seemingly more important in terms of instilling safer sex practices. While there was some evidence of bias of self-report, exploratory analysis of the indirect effects of communications campaigns suggested that impacts may be compounded as overall awareness is increased at the community level eventually leading to behavior change among individuals.     

Psychometric and Faciometric Support for Observable Facial Feminization in Gay Men

ABSTRACT

Though male homosexuality appears to be evolutionarily paradoxical, phenotypic feminization has been offered as a route for three current models positing a genetic basis for male homosexuality. We tested whether facial feminization is observable in gay men in two studies. In Study 1, using two composite images of gay and of heterosexual men, naive participants (N = 308) rated the “gay” face more highly on stereotypically feminine traits and actual femininity and the “heterosexual” face more highly on stereotypically masculine traits and actual masculinity. In Study 2, faciometrics of 428 Internet images of gay (N = 219) and heterosexual men were analyzed along six sexually dimorphic ratios. The faciometrics of gay men were more feminine, both in gestalt terms and for five of the six individual traits. The studies offer objective support for a more feminized facial phenotype in gay males that is difficult to explain through cultural or behavioral cues.