Sexual Harassment and Posttraumatic Stress Disorder: Damages Beyond Prior Abuse

This study examined the extent to which harassment experiences correlate with posttraumatic stress disorder (PTSD) symptoms, and whether diagnosable PTSD on the basis of sexual harassment occurs after accounting for prior PTSD, prior sexual abuse, and prior psychological dysfunction. The sample consisted of a two-wave panel of 445 women who had received a domestic violence protective order from a Kentucky court. Hierarchical linear and logistic analyses confirmed that sexual harassment experiences were significantly correlated with PTSD symptoms after controlling for an extensive set of trauma variables measured in both the baseline and follow up interviews. Our findings lend further evidence that claims of PTSD from sexual harassment may be credible even if claimants have been victims of other forms of trauma.     

The Relationships Between Childhood Sexual Abuse,Social Anxiety,and Symptoms of Posttraumatic Stress Disorder in Women

The relationships between childhood sexual abuse, social anxiety, and symptoms of posttraumatic stress disorder were examined in a sample of 313 undergraduate women. Thirty-one percent of the women reported some form of sexual abuse in childhood. Women with a history of sexual abuse reported more symptoms of anxiety, distress in social situations, and posttraumatic stress disorder than other women. Women who experienced attempted or actual intercourse reported more avoidance than women with no history of abuse and women with exposure only, and more PTSD symptoms than all other groups of women. Women who experienced fondling reported more PTSD symptoms than women with no history of abuse. Pressure, age of onset of abuse, abuse by a family friend, and abuse by other perpetrators were all significant abuse characteristics in predicting adult social anxiety. Implications of these results for research and interventions are discussed.     

Scale 8 Elevations on the MMPI-2 among Women Survivors of Childhood Sexual Abuse: Evaluating Posttraumatic Stress, Depression, and Dissociation as Predictors

This paper investigated elevations on Scale 8 of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) in women survivors of childhood sexual abuse (CSA) in order to assess whether symptoms of posttraumatic stress disorder, depression, or dissociation account for such elevations. Participants were 73 women seeking outpatient treatment for CSA after-effects at a university-based community mental health center. A stepwise multiple regression analysis was conducted, including measures of commonly reported symptoms in CSA survivors: depression, posttraumatic stress, and dissociation. Regression analyses revealed that the Beck Depression Inventory (BDI) and Dissociative Experiences Scale (DES) accounted for the most variance in Scale 8 scores (59%), with the BDI as the best predictor. The Impact of Event Scale (IES) did not predict Scale 8 scores significantly above that achieved by the model above. Cross-validation results indicated good generalizability. Results suggest that depression and dissociation contribute most to scores on Scale 8. Implications of these findings for the clinical and empirical use of the MMPI-2 with CSA survivors are discussed.     

Relationship to Perpetrator and Posttraumatic Symptomatology Among Sexual Abuse Survivors

This study investigated the association of several dimensions of relationship to perpetrator of childhood sexual abuse to posttraumatic symptomatology in adulthood. A structured clinical interview, the Impact of Event Scale, and the TSC-40 were administered to 67 women survivors seeking psychotherapy. The t-tests for significant differences indicated that subjects whose perpetrators were not caretakers experienced higher levels of posttraumatic symptomatology (PTS) in adulthood than those abused by caretakers. No significant differences were found in traumatic symptomatology between those whose perpetrators were family members and those whose perpetrators were not or between those abused by someone in the home and those abused by someone outside the household. Implications for future research and clinical practice are explored.     

Romantic Attachment as a Moderator of the Association Between Childhood Abuse and Posttraumatic Stress Disorder Symptoms

Childhood abuse can have significant negative effects on survivors that often last into adulthood. The purpose of this study was to explore the role of romantic attachment in understanding the relationship between childhood abuse and posttraumatic stress disorder (PTSD) symptoms in adulthood. Data for this study were taken from the first wave of a five-wave longitudinal study. The sample included 120 mothers in their third trimester of pregnancy. Regression analyses were conducted in order to examine adult romantic attachment as a possible protective or vulnerability factor. Main effects of attachment anxiety and attachment avoidance on PTSD symptoms were found, such that higher levels of attachment anxiety and attachment avoidance were related to more PTSD symptoms. Attachment avoidance moderated this relationship, such that child abuse was significantly related to greater PTSD symptoms in those with high attachment avoidance. Implications for attachment-based interventions are discussed.     

An Investigation of Posttraumatic Stress Disorder and Depressive Symptomatology among Female Victimsof Interpersonal Trauma

This study examined factors associated with PTSD-depression comorbidity among a sample of 162 adult female rape or assault victims with PTSD, as well as potential differential predictors of PTSD and depression severity. PTSD-only participants reported higher levels of childhood sexual abuse than those with comorbid PTSD and depression, and the PTSD/MDD group reported relatively more distorted trauma-related beliefs, dissociation, PTSD severity, and depression severity. Distorted trauma-related beliefs and dissociation were the strongest unique predictors of higher PTSD and depressive symptoms. Rates of PTSD and depression comorbidity did not appear to be a function of symptom overlap. Study findings suggest possible explanations for the high PTSD and depression comorbidity rates commonly found among victims of interpersonal violence. This research was supported in part by a grant to Patricia A. Resick from the National Institute of Mental Health (R02-MH51509).     

Degrees of Memory of Childhood Sexual Abuse Among Women Survivors in Therapy

Past and current memory for childhood sexual abuse reported by a clinical sample of 160 women survivors was assessed utilizing a structured clinical interview. Response alternatives for memory were ordered along a continuum. To minimize treatment effects, participants were interviewed as early in therapy as possible. Fairly complete recollection both in the past and currently was reported by 26.3% of the sample, 36.9% apparently lost and subsequently recovered sexual abuse memories, and 36.9% endorsed intermediate degrees of memory. Only 2.5% indicated a decrease in degree of recollection over time. Age at onset was the only abuse characteristic found to differentiate participants with fairly complete memory from the rest of the sample. Findings are interpreted as illustrating that conclusions about memory for abuse are highly dependent on the way inquiries are conceptualized and worded.     

Forms of Social Support That Moderate PTSD in Childhood Sexual Abuse Survivors

Although social support has been found to attenuate psychological symptoms in victims of sexual abuse, literature does not identify the specific forms of social support that mitigate maladjustment following a sexual abuse experience. This study sought to distinguish the specific types of perceived social support that buffer the development of post-traumatic stress disorder (PTSD) in victims of childhood sexual abuse (CSA). One hundred and seventy-two adult females reporting CSA were administered the Interpersonal Support Evaluation List (ISEL) and the Impact of Events Scale (IES). The ISEL measures the perceived availability of 4 support types. The IES measures core PTSD symptoms of intrusion and avoidance. Regression analysis indicated that social support significantly buffered PTSD development. The best model was one which contained self-esteem and appraisal support. Tangible and belonging support added little to prediction. Further, self-esteem support was identified as the most important variable in preventing PTSD development.     

Trauma and Posttraumatic Stress Disorder Among Substance-Using Women Entering Cook County Jail

In the United States, the number of incarcerated women continues to rise each year, with African American women having the highest incarceration rates. Many women enter prisons and jails with an extensive trauma history, though little is known about the percentage of these individuals suffering from posttraumatic stress disorder (PTSD) and specific trauma exposures they have had based on factors such as homelessness, degree of substance problems, and race. The present study examines a largely African American substance-using population of incarcerated women to determine the impact of various factors on specific traumas reported. We found that individuals reporting symptoms meeting criteria for PTSD had experienced the highest average number of traumas, and those who had ever been homeless also experienced many and varied trauma exposures compared with those who had never been homeless. Higher substance problems were also associated with more trauma exposure. Fewer than 10 percent of the sample met full criteria for PTSD, though those reporting having ever been homeless and those with higher substance problems were significantly more likely to meet all criteria. Results indicate a need to assess previous homelessness as a method for identifying additional trauma exposures and guiding treatment to women's specific needs and trauma profiles.     

Predictors of Maladaptive Coping in Incarcerated Women Who are Survivors of Childhood Sexual Abuse

Women’s rates of incarceration have increased notably in the past two decades. Concurrently, research with female offenders has identified a high incidence of experiences of childhood sexual abuse (CSA), a potential risk factor for negative psychosocial outcomes. Structural equation modeling was used to test a model examining associations among CSA, emotion regulation, posttraumatic stress, and coping in a sample of 224 incarcerated women. The relationships between CSA and difficulties with emotion regulation and posttraumatic stress were mediated by self-blame, and the relationship between self-blame and maladaptive coping was mediated by both difficulties with emotion regulation and posttraumatic stress. These findings have implications for identifying treatment needs of incarcerated women and suggest potential targets for intervention.     

Posttraumatic Stress Disorder: Protective and Risk Factors in 18 Survivors of a Plane Crash

The aim of this study is to identify protective and risk factors related to the development of posttraumatic stress disorder (PTSD) on a sample of survivors from a single plane crash. Eighteen survivors were examined 6 months following the event. The subjects all underwent psychiatric interviews, Clinician‐Administered PTSD Scale structured interviews, personality and cognitive tests. Only 38.9% of them presented with all of the symptoms of PTSD; 22.2% showed no symptoms for PTSD; remaining survivors exhibited emotional/affective symptoms related to the event. In addition to the severity of the traumatic event itself, other risk factors identified were the loss of a relative, the manifestation of depressive symptoms, and the severity of physical injuries sustained. Low levels of hostility and high levels of self‐efficacy represented protective factors against developing PTSD.     

Relationship Abuse and Victims’ Posttraumatic Stress Disorder Symptoms: Associations with Child Behavior Problems

This study examined associations among male-to-female physical and psychological relationship aggression, female partners’ PTSD symptoms, and behavior problems among the children (n = 62) of men enrolled in a treatment program for relationship abuse perpetration. Psychological aggression was a stronger predictor of child behavior problems than physical assault. Restrictive engulfment and hostile withdrawal behaviors evidenced the strongest bivariate associations with child behavior problems, and were the strongest predictors of this outcome when considering four distinct forms of psychological aggression together. Victim PTSD symptoms largely mediated the effects of psychological aggression on child behavior. Findings suggest that male-to-female psychological aggression and victim PTSD symptoms play an important role in understanding behavior problems among children living with male relationship abuse perpetrators. Portions of this work were presented at the annual convention of the Association for the Advancement of Behavior Therapy, New Orleans, Louisiana, November, 2004.     

Relationship Between Childhood Sexual Abuse Characteristics and Dissociation Among Women in Therapy

This study investigated the relationship between 10 characteristics of childhood sexual abuse and dissociation in adulthood. A structured clinical interview, the Dissociative Experiences Scale, and the Dissociation Subscale of the Symptom Checklist 90 - Revised were administered to 118 women survivors seeking psychotherapy. Separate stepwise multiple regression analyses were conducted for each dissociation scale to determine which abuse characteristics were predictive of dissociation. In both analyses, the same four variables were significantly related to dissociation: age at onset, coercive sexual acts, objectifying sexual acts, and concurrent multiple perpetrators. Implications of findings for future research and clinical practice are explored.     

Ethnicity and Sexual Orientation as PTSD Mitigators in Child Sexual Abuse Survivors

Purpose and Potential benefits: Research, to our knowledge, has not examined the effect of demographic variables on PTSD symptoms among adult survivors of childhood sexual abuse (CSA). This study explores the relationship between demographic variables and scores of CSA survivors on the Impact of Scale (IES). Participants were 257 women CSA survivors entering outpatient treatment at a university-based mental health center. All participants reported a CSA history and presented with psychological difficulties associated with CSA. The demographic variables investigated were relationship status, religious affiliation, ethnicity, educational level, spousal educational level income, and sexual orientation. Significance tests were used to examine each variable and scores on the Total IES and Avoidance and Intrusion Subscales. Total IES and Intrusion scores differed for sexual orientation and ethnicity in accord with conventional standards of significance ( < .05). Self-reported asexuals indicated fewer intrusive and total PTSD symptoms than heterosexuals, lesbians, and bisexuals. Likewise, Hispanics reported less intrusive PTSD symptoms than Non-Hispanic Caucasians. Our findings invite further exploration of the relationship between ethnicity and sexual orientation and the long-term effects of CSA. A question for empirical investigation is whether asexuality shields against the triggering of CSA memories by a sexual relationship. Another possible area of inquiry is whether particular characteristics of Hispanic culture as a whole serve to moderate the detrimental effects of CSA.     

Exploring the Relationship Between Childhood Sexual Abuse and Adult Sexual Perpetration

Empirical findings indicate that many adult sexual offenders experienced sexual abuse during childhood. It has been suggested that characteristics of offenders' sexual perpetrating behaviors may resemble their own victimization experiences, although there has been minimal empirical investigation in this area. The purpose of the present study was to provide preliminary data on the relationship between childhood sexual abuse and characteristics of sexual offending behavior. A sample of adult male sexual offenders with histories of sexual abuse completed the Sexual Victimization Survey as well as a measure on their sexual offenses. Such characteristics as the nature of sexual activities, duration and frequency of experiences, and age and relationship of participants were examined. Results showed trends in the hypothesized direction and revealed a variety of similarities between childhood sexual abuse and adult sexual perpetration. Findings of this exploratory study suggest the importance of addressing the nature of victimization in the treatment of sexually abused boys and offenders with histories of sexual abuse.     

Maternal Childhood Sexual Trauma and Child Conduct Problems

This study examines multiple pathways by which maternal childhood sexual trauma may be related to the behavioral development of children. Propensity score matching procedures were used to create matched groups (total n?=?204) of mothers who retroactively did and did not self-report childhood sexual trauma in a longitudinal sample of families living in poor, rural communities. Using structural equation modeling, maternal characteristics and behaviors were examined as potential mediators of the relationship between maternal histories of childhood sexual trauma and children’s conduct problems. After controlling for numerous socio-demographic factors, analyses indicate that maternal depressive symptoms, intimate partner violence, and maternal parenting were significant mediators and highlight the lasting impact of childhood sexual trauma on victims and their children.     

Symptom Overreporting and Recovered Memories of Childhood Sexual Abuse

The authenticity of recovered memories is a much debated issue. Surprisingly, no study has systematically looked at symptom overreporting in people claiming recovered memories of childhood sexual abuse (CSA). In a first sample we administered the Structured Inventory of Malingered Symptomatology (SIMS) to individuals who said they had recovered CSA memories (n=66), individuals who said their CSA had always been accessible (continuous CSA memory group; n=119), and controls who said they had no CSA experiences (n=83). In a second sample individuals reporting recovered (n=45) or continuous (n=45) CSA memories completed the Morel Emotional Numbing Test (MENT). Our aim was to compare these groups with regard to their tendency to overreport symptoms. The results indicate that people with recovered memories do not score higher on the SIMS and the MENT than other CSA survivors suggesting that symptom overreporting is not typical for people reporting recovered memories.     

Posttraumatic Stress Disorder: Current Concepts and Controversies

The diagnosis of posttraumatic stress disorder (PTSD) sometimes is raised in compensation claims, in tort settings, and in other medical–legal settings. Accordingly, health-care and legal professionals working in these areas need to be familiar with the current findings and controversies concerning the disorder. The purpose of this article is twofold. First, we review the most important findings concerning the clinical features, etiology, and treatment of PTSD. Second, we examine six major controversies concerning the disorder that are relevant to psychologists and other medical–legal practitioners: (a) the issue of what qualifies as a traumatic stressor, (b) the question of whether traumatic stress causes brain damage, (c) the validity of the concept of delayed-onset PTSD, (d) the recovered memory controversy, (e) the question of whether PTSD can arise when the person has no memory of the trauma (e.g., due to concussion), and (f) issues concerning PTSD malingering. Throughout this article we offer recommendations for psychological and other medical–legal practice in relation to the evaluation of PTSD claims.     

Neuropsychological and Psychological Aspects of Malingered Posttraumatic Stress Disorder

Posttraumatic stress disorder (PTSD) is an anxiety disorder that is frequently encountered in litigation, and as such, there is an increased risk for poor effort on cognitive tests, symptom exaggeration, or frank malingering. These are particularly problematic for accurate diagnosis. This article is divided into four sections. First, we address why individuals malinger PTSD as well as the challenges in detecting an invalid PTSD symptom presentation. Second, we discuss issues of cognitive functioning in PTSD and then the prevalence of and common patterns of poor effort on neuropsychological testing among individuals feigning PTSD. Third, we discuss psychological functioning in PTSD and then the prevalence and patterns of functioning on psychological measures of malingering in this population. Finally, recommendations for detecting invalid PTSD symptom presentations are provided.     

Parental Sociopathy as a Predictor of Childhood Sexual Abuse

Research on childhood sexual abuse has often examined, in isolation of one another, such highly correlated risk factors as parental substance abuse, domestic violence, and pathological family functioning. Investigating comorbid antecedents separately does not allow accurate specification of the predictors of abuse. Moreover, sexual trauma research has tended to neglect parental sociopathy as a risk factor. Given the limitations of past research, the present study examined the relationships among parental sociopathy, parental substance use, marital violence, poor family functioning, and childhood sexual abuse. We administered a battery of questionnaires to a nonclinical sample of 130 college women and replicated previous findings by showing that parental substance use predicted sexual abuse when examined in isolation. However, when parental sociopathy and the other risk factors were included in a regression model, parental sociopathy was the only significant predictor. Mother's and father's sociopathy predicted sexual abuse independently and when combined.