Lifetime Abuse, Mental Health, and African American Women

This study examined the relationship between lifetime abuse and mental health among 126 African American women and 365 White women from a primary health care setting who participated in a telephone interview as part of a larger study. Seven types of childhood and adult intimate partner abuse were measured. Consistent with hypotheses, (1) lifetime abuse was associated with elevated levels of anxiety and depression, and (2) women who experienced childhood abuse were more likely to report adult partner abuse. African American and White women showed more similarities than differences in the associations between most abuse experiences and depression and anxiety, as well as types of childhood abuse. African American abused women reported more excessive jealousy by partners. Nonabused African American women reported higher levels of depression and anxiety than their White counterparts. Results are interpreted and discussed taking into account relevant social and cultural factors.     

Characteristics of victims of sexual abuse by gender and race in a community corrections population

The purpose of this study was to examine how victims of sexual abuse in a community corrections population differ as a result of their sex and race. Of the 19,422 participants, a total of 1,298 (6.7%) reported a history of sexual abuse and were compared with nonabused participants. The sample was analyzed by race-gender groups (White men, White women, African American men, and African American women) using univariate and logistic regression analyses, which were conducted separately for each group. White women were the most likely to report a history of sexual abuse (26.5%), followed by African American women (16.0%), White men (4.0%), and African American men (1.1%). For all groups, histories of suicidal ideation and suicide attempts were associated with a history of sexual abuse. Sexual abuse was associated with substance abuse problems for women but not the men. Cannabis dependence was associated with sexual abuse for the White women while cocaine dependence was associated with sexual abuse for the African American women. Several other variables were associated with sexual abuse for women but not men, including lower education (White women only), a history of violent offenses (White women only), and living in a shelter (African American women only). African American men tended to have higher levels of education; this was the only variable uniquely associated with either male group. Receiving psychiatric medications was associated with sexual abuse for all groups except African American men and a history of sex for drugs was associated with sexual abuse for all groups except White men. Consistent with national sample, women, particularly White women, were more likely to be victims of sexual abuse. The gender-race differences for the sociodemographic factors associated with sexual abuse, particularly the risk of substance abuse for women, suggest the need for tailored interventions for sexual abuse prevention and treatment.     

African American Caregivers and Substance Abuse in Child Welfare: Identification of Multiple Risk Profiles

Despite the strong correlation between caregiver substance abuse and child maltreatment, little information exists to understand the typology of African American caregivers with substance abuse problems in the child welfare system. Research shows African American caregivers contend with multiple problems stemming from substance abuse. Unfortunately, we do not yet know how to best tailor resources to be responsive to varying groups of African American caregivers. Using data from the National Survey of Child and Adolescent Well-being (NSCAW), this investigation tested for distinct multivariate profiles among a subset of African American caregivers with substance abuse problems (n=258). Latent Class Analysis (LCA) was used to classify caregivers, and five classes were identified among this high risk sample - each with distinct risk profiles. Based on these findings, we discuss implications for tailored practices to enhance the safety and stability of children involved with child welfare.     

Association of sexual revictimization with sexuality and psychological function

This study explores the associations of sexual revictimization (experiencing sexual abuse in childhood and adulthood) in a sample of 230 African American women who are low-income. Data indicate that women who experience sexual revictimization are more at risk for emotional stress and psychological pathology than women with no history of abuse. In addition, women who are revictimized appear to be at greater risk for emotional problems than women sexually abused only as a child or sexually assaulted only as adults. Revictimization also appears to be associated with an increased probability of engaging in prostitution, even higher than women with childhood- or adult-only victimization, who showed increased probability when compared to women never abused. Finally, women who are revictimized showed increased HIV risk, in that they were 4 times less likely than other women to consistently use condoms, but no more likely to be in monogamous relationships or less likely to have multiple partners.     

Social Support Choices for Help with Abusive Relationships: Perceptions of African American Women

A recent national telephone study of the African American community found that over 90% of respondents would feel comfortable talking to a family member or friend who was being abused about the abuse, with the majority advising she get help from a domestic violence program. The purpose of this study was to understand how comfortable abused women would feel talking to members of her support system about the abuse and how comfortable women who have not experienced partner abuse would feel if they were abused. Over 70% of women who have experienced abuse reported at least some comfort getting assistance for abuse from a friend, clergy/spiritual leader, Black community member, family member their age, or physician. Women who reported never experiencing physical or sexual partner violence were less likely to perceive feeling comfortable getting assistance from their social support systems (both formal and informal) if they were abused. Implications of these findings are discussed.     

Pathways to adult sexual revictimization: direct and indirect behavioral risk factors across the lifespan

The purpose of this study is to investigate direct and indirect social and behavioral risk factors for adult sexual revictimization. Participants include 147 adult, predominantly African American (88%) women, 59% of whom had a documented history of child sexual abuse. Participants are interviewed in adulthood about adolescent and adult sexual victimization as well as other background and lifestyle characteristics. Structural equation modeling indicates that the relationship between child and adolescent sexual victimization is indirect, mediated by adolescent risk-taking behavior. The relationship between adolescent and adult sexual victimization is also indirect, mediated by risky sexual behavior. The residual effects of early childhood family environment and childhood physical abuse also indirectly predict sexual revictimization. Results provide empirical support for the general supposition that the relationship between child and adult sexual victimization is complex and that many intermediary factors differentially affect risk for a heightened vulnerability to sexual revictimization.     

Partner Abuse and HIV Infection: Implications for Psychosocial Adjustment in African American Women

A prospective study of the effects of partner abuse among HIV-infected and noninfected African American women (N = 137) revealed that there were both concurrent and longitudinal effects of abuse on several indices of psychosocial adjustment. Specifically, higher levels of both verbal and physical abuse were found among the HIV-infected group. In addition, the effects of abuse on suicidal ideation were significantly stronger among the HIV-infected group (n = 53) than among their demographically similar noninfected counterparts (n = 84), resulting in significant HIV status by partner abuse interactions. The findings of this study advance our understanding of intimate relationships with regard to partner abuse by examining a group of women at high-risk for abuse, yet understudied in both the HIV/AIDS and relationship literatures.     

Childhood Abuse,Intrapersonal Strength,and Suicide Resilience in African American Females who Attempted Suicide

There is a significant association between childhood abuse and suicidal behavior in low-income African American women with a recent suicide attempt. Increasingly, empirical focus is shifting toward including suicide resilience, which mitigates against suicidal behavior. This cross-sectional study examines childhood abuse, intrapersonal strengths, and suicide resilience in 121 African American women, average age of 36.07 years (SD?=?11.03) with recent exposure to intimate partner violence and a suicide attempt. To address the hypothesis that childhood abuse will be negatively related to suicide resilience and that this effect will be mediated by intrapersonal strengths that serve as protective factors, structural equation modeling examined the relations among three latent variables: childhood abuse (measured via physical, sexual, and emotional abuse), intrapersonal strengths (assessed by self-efficacy and spiritual well-being), and suicide resilience (operationalized via the three components of suicide resilience—internal protective, external protective, and emotional stability). The initial measurement model and the structural model both indicated excellent fit. Results indicated that childhood abuse was negatively associated with intrapersonal strengths and suicide resilience, intrapersonal strengths were positively associated with suicide resilience, and intrapersonal strengths fully mediated the association between childhood abuse and suicide resilience. Thus, the results suggest a positive and protective influence of intrapersonal strengths on suicide resilience in the face of childhood abuse in suicidal African American women. The clinical implications and directions for future research that emerge from these findings are discussed.     

Child Abuse,Social Support,and Social Functioning in African American Children

This study examined the relationship among child abuse (physical, emotional, and sexual), social support from friends and family, and social functioning in a sample of low-income African American children (N?=?152). With the exception of the association between sexual abuse and peer support, all of the correlations among study variables were significant. The relationship between child physical and emotional abuse and social functioning were mediated by both family and peer support; however, only family (not peer) support was a significant mediator in the sexual abuse-social functioning link. Additionally, there was no difference found in the strength of mediation via family support versus peer support. Results suggest that mental health professionals should inquire about and attempt to increase children’s levels of social support from family and peers when working with abused youth in order to promote healthy psychological and psychosocial outcomes.     

A media campaign prevention program for child sexual abuse: community members' perspectives

This study examines the face validity and feasibility of materials included in a multimedia child sexual abuse (CSA) prevention campaign. A quantitative survey method assessed participants' comfort level, knowledge gain, and likelihood of behavioral change in response to the media campaign. Furthermore, a focus group method explored participants' attitudes and opinions regarding the campaign and the unique effects of ethnic or cultural norms on participants' acceptance of the media materials. Six groups, established based on participant ethnicity (i.e., three Caucasian groups, two African American groups, one Hispanic group), met at two sites in the Charleston, South Carolina, area. Quantitative data suggest that participants reported increased CSA knowledge and low levels of discomfort or anxiety related to exposure to the materials. Focus group results suggest that study participants, regardless of ethnic background, agreed that the media campaign can have a positive impact on public knowledge of CSA. Implications and directions for future research are discussed.     

The long-term effects of child sexual abuse by female perpetrators: a qualitative study of male and female victims

Although the long-term effects of sexual abuse by men have been studied extensively, minimal research has explored the effects of sexual abuse by women. This qualitative study explores the experience and long-term impact of sexual abuse by women. The data were derived from in-depth interviews with 14 adult victims (7 men, 7 women) of child sexual abuse by females. Most respondents reported severe sexual abuse by their mothers. The vast majority of participants reported that the experience of female-perpetrated sexual abuse was harmful and damaging. As a result of the sexual abuse, male and female respondents reported long-term difficulties with substance abuse, self-injury, suicide, depression, rage, strained relationships with women, self-concept and identity issues, and a discomfort with sex. In light of the popular and professional perceptions that sexual abuse by women is relatively harmless as compared to sexual abuse by men, the implications of these long-term effects are discussed, particularly in relation to professionals working in the area of child sexual abuse.     

Relational outcomes of childhood sexual trauma in female survivors: a longitudinal study

This longitudinal study examines the effects of childhood sexual abuse (CSA) on the intimate and marital relationships of adult survivors from a sample composed primarily of African American women. In addition, the authors explore the protective role of maternal support. Interview data are collected on 136 women with documented histories of CSA who indicate the quality and nature of their current marital relationships and other interpersonal connections. Results suggest that CSA survivors with poor maternal attachment are more likely to enter into marital or cohabiting relationships. However, more severe sexual trauma in childhood correlates with greater marital dissatisfaction. Good maternal attachment during childhood has a negative main effect on adult interpersonal problems and a buffering effect on the relationship between abuse and marital dissatisfaction. These data can help guide future research on the adult relational outcomes of female CSA survivors, especially among minority populations.     

Ethnicity and risk for symptoms of posttraumatic stress following intimate partner violence: prevalence and predictors in European American and African American women

The present study uses a feminist theoretical framework to explore risk factors for the development of posttraumatic stress symptoms following intimate partner violence, with a community sample of 120 low-income European American and African American women. Hierarchical regression analyses were used to examine demographic, violence, and mental health variables that predict posttraumatic stress symptoms. The data reveal that African American women report lower levels of posttraumatic stress symptoms than do their European American peers. This difference was observed despite the presence of more empirically identified risk factors for African American women. Regression analyses show that symptoms of depression increase risk for posttraumatic stress for both groups. However, a difference was observed such that past victimization increase risk for only European American women, whereas amount of psychological violence in the previous year increases risk for only African American women. Potential explanations for observed ethnic differences are offered.     

Intimate Partner Violence,Psychological Distress,and Suicidality: A Path Model Using Data from African American Women Seeking Care in an Urban Emergency Department

Intimate partner violence (IPV) and suicidal behavior are major public health problems in the African American community. This study investigated whether or not IPV and suicidal ideation are correlated in urban African American women, and if the IPV–suicidal ideation link is explained by symptoms of depression and posttraumatic stress disorder (PTSD). With 323 abused African American females, path analysis revealed that: (1) IPV → depressive symptoms → suicidal ideation, and (2) IPV → PTSD symptoms → depressive symptoms → suicidal ideation. When evaluating abused women, depressive and PTSD symptoms and suicidal thoughts must be assessed. Interventions for reducing suicidal behavior in abused, low income African American women should reduce symptoms of depression and PTSD.     

Drug Abuse and Partner Violence among Women in Methadone Treatment

This study aims to (1) describe rates of lifetime and current partner abuse among women on methadone; (2) examine the relationship between partner violence and demographics, substance abuse, and drug risk behaviors; and (3) explore the association between a victim's current use of crack/cocaine, heroin, marijuana, and drug risk behavior after controlling for demographics, household composition, history of victimization and sex trading. Approximately three-fourths of the women ever experienced physical, sexual, or life-threatening abuse and slightly less than one-third experienced at least one type of abuse during the previous year. A history of childhood victimization was reported by more than half of the women and one-third witnessed her mother being abused. Risk of partner violence was associated with victim's current drug and alcohol use, visiting shooting galleries, and living with someone with drug or alcohol problems. The study discusses the implications of the findings for research and intervention.     

Violence exposure and health related risk among African American adolescent female detainees: A strategy for reducing recidivism

Juvenile crime and violent victimization continue to be significant social problems (Fitzpatrick, Piko, Wright, & LaGory, 2005); in that, adolescents, females in particular, are likely to participate in health related risk behaviors as result of having been victimized or exposed to a violent environment. Specifically, abuse, neglect, sexual molestation, poverty, and witnessing violence are well known risk factors for the development of trauma-related psychopathology and poor outcomes relative to delinquency, drug and alcohol abuse, and HIV risk behaviors (Steiner, Garcia, & Matthews, 1997). HIV infection is a common public health concern disproportionally affecting adolescent African American female detainees. This unique population has a serious history of violence exposure, which subsequently tends to lead to engaging in risky sexual behaviors, mental health problems, and abusing substances. Also, as a result of little to no intervention, this population is recidivating at an alarming rate, a problem that may further exacerbate the expression of health-related risk behaviors among African American adolescent female detainees. The authors briefly describe a pilot program to be implemented in the juvenile justice system that is based on the Model of Accumulated Risk (Garbarino, 1996), Bronfenbrenner's Ecological Model (1994), and the Positive Youth Justice Model (Butts, Bazemore, & Meroe, 2009). The program proposes to reduce risky sexual behaviors, teach alternatives to abusing substances, treat mental health concerns, and reduce the rate of recidivism through "positive youth development", PYD (Butts, Bazemore, & Meroe, 2009). Tying elements of wraparound services and reeducation together, this program addresses salient concerns that may have an impact on an adolescent detainees' success following their release from prison in a holistic manner.     

Coparenting Conflict and Parenting Behavior in Economically Disadvantaged Single Parent African American Families: The Role of Maternal Psychological Distress

Substantial research has focused on the negative associations between coparenting conflict, parental psychological functioning, and parenting behavior in European American, middle-income, families. However, less attention has been given to ethnic minority families and to families that are nontraditionally structured. In an effort to address this gap, the current longitudinal study examines the relation between conflict with the mother-identified primary co-caregiver and parenting practices in single parent, economically disadvantaged African American families. Participants included 234 mother–child dyads. It was hypothesized that conflict would relate to less utilization of positive parenting practices and that this association would be mediated, at least in part, by maternal psychological distress. Hypotheses were examined using structural equation modeling (Lisrel 8.3): Conflict with a co-caregiver was significantly related to parenting both directly and indirectly through maternal psychological distress. Implications of the findings are discussed.

Child abuse and chronic pain in a community survey of women

This study examined the relationship between a self-reported history of child physical and sexual abuse and chronic pain among women (N = 3,381) in a provincewide community sample. Chronic pain was significantly associated with physical abuse, education, and age of the respondents and was unrelated to child sexual abuse alone or in combination with physical abuse, mental disorder (anxiety, depression, or substance abuse), or low income. Number of health problems and mental health disorders did not mediate the relationship between physical abuse and chronic pain. Despite considerable evidence from the clinical literature linking exposure to child maltreatment and chronic pain in adulthood, this may well be the first population-based study to investigate this relationship for child physical and sexual abuse independently. The significant association between childhood history of physical abuse and pain in adulthood calls for a greater awareness of the potential for chronic pain problems associated with this type of maltreatment. Further research is needed to understand the mechanism for this complex relationship.     

Postshelter adjustment of children from violent families

Few studies have examined the adjustment of battered women and their children after exiting domestic violence shelters. Participants were 62 women who had endured severe partner abuse, completed a shelter program with their children, and resided in the community for at least 6 months. Field interviews concerned mothers' and children's abuse histories and included measures of maternal depression, maternal trauma, and child behavior problems. Nearly all women had lived violence free since shelter exit. Child internalizing behaviors were associated with direct abuse, maternal depression, and shelter program. Externalizing behaviors were related to maternal depression and shelter program. Neither severity of interparental violence nor maternal trauma symptoms was related to child behavior problems. Mothers' family of-origin abuse predicted current satisfaction with child functioning, beyond the effects of maternal depression and child behavioral problems. Findings suggest a need for postshelter therapeutic services and further research addressing the adjustment of such families.