Group therapy for women sexually abused as children: mental health before and after group therapy

Forty-five female outpatients sexually abused in childhood were offered a 2-year phase-divided group therapy. Before and after treatment and at 12 months follow-up, they answered questionnaires designed to elicit responses concerning psychological symptoms (Symptom Checklist; SCL-90) and sense of coherence (SOC). Symptoms for posttraumatic stress disorder (PTSD) were assessed before and after treatment. Inpatient days and sick listing days were assessed during 2 years before and 2 years after treatment. The psychological and PTSD symptoms were significantly reduced after treatment, and the SOC was increased as well. Inpatient days were decreased, and sick listing days increased but not significantly. Compared to a similar short-term focused therapy group and a waiting-list group there were no significant differences between the groups. Trauma-focused group therapy for women who were sexually abused in childhood seems to have promising effects on mental health, both concerning long-term and short-term approaches.     

Social-cognitive skills training with a sexually abused and abusive child psychiatric inpatient: Training,generalization, and follow-up

This paper describes the clinical application of a social-cognitive skills training program for an 11 1/2-year-old child psychiatric inpatient with a history of sexual abuse and neglect who was referred for hospitalization after sexually molesting a neighborhood girl. The content and procedures of the program are outlined in detail to facilitate replication. Results indicated that improvements were found on analogue role-play scenarios administered during training-which then generalized to several specific and general measures of social adjustment/competence on the inpatient unit. A 1-year follow-up assessment revealed the maintenance of these therapeutic gains. The implications of this therapeutic approach with maltreated children and need for more rigorous empirical outcome studies are discussed.     

Medical/health histories and physical evaluation of physically and sexually abused child psychiatric patients: A controlled study

This study examines findings from a pediatric health history and child physical examination conducted for 105 outpatient and 105 inpatient children who were classified on the basis of their history of physical and sexual abuse. Based on multivariate and univariate analyses, physically abused children had more early developmental delays, neurologic soft signs, serious physical injuries, skin markings and scars, and stimulant drug use than their non-physically abused peers. Sexually abused children were reported to exhibit higher levels of sexual activity and stimulant drug use, and had more physical signs of genital manipulation than non-sexually abused children. These data highlight the need to further examine the impact of medical and developmental aberrations, the nature and origins of recurrent physical injuries in this population, and the extent of risk-taking in understanding the differences between physical and sexual child maltreatment.     

Beyond PTSD: mental health consequences of violence against women: a response to Briere and Jordan

This article proposes that we move beyond posttraumatic stress disorder (PTSD) in our conceptualization of traumatic stress responses of victimized women exposed to serial forms of unrelenting violence, such as intimate partner violence and stalking. It is argued that the traditional PTSD framework is ill fitting in the context of some forms of violence against women (VAW), and these limits have consequences for developing appropriate interventions for some victimized women. The article further suggests going beyond PTSD by developing a more nuanced understanding of the ways in which PTSD and other mental health symptoms contribute to the vast array of deleterious personal, societal, and economic costs of VAW.     

Relationships among abuse characteristics, coping strategies, and abused women's psychological health: a path model

We examined relationships between abuse, coping, and psychological health among 143 women who had experienced abuse in adult relationships. Measures included characteristics of the abuse, problem-focused and emotion-focused coping, Sense of Coherence, and four measures of psychological wellbeing--the SF-36 Mental Component Scale, the General Health Questionnaire, Center for Epidemiologic Studies Depression scale, and a measure of perceived negative effects of the abuse. Problem-focused coping was not related to psychological health, and the influence of emotion-focused coping on psychological health was indirect. Sense of coherence had significant direct effects on psychological health. Both emotion-focused coping and sense of coherence were related to aspects of the abusive experience. The concept of sense of coherence has parallels with the recently proposed concept of meaning-focused coping, and the data suggest that finding meaning in adverse events such as abuse is associated with better psychological well-being.     

Negative reactions to the sexually abused victims,withdrawing the complaint and outcomes of the litigation: the first data from Turkey

In order to provide psychosocial services to children with sexual abuse (SA) histories, their needs and problems should be initially identified. In this study, it is intended to determine the psychosocial problems of victims. Participants were 73 victims between aged between 16 and 21. A telephone interview form was used to collect the study data. It is found that there were several problems noted by victims, including underage marriage (15.1%), teenage pregnancy (6.9%), revictimization (13.7%), need for psychiatric support (21.9%) as well as negative social reaction (84.4%) and not being supported by family (41.1%). One-third of the victims (30.1%) had withdrawn the complaint for reasons such as SA being heard among social circle, the negative effect of court process on psychological well-being, make a new beginning and reasons related to the suspects. Finally, it was found out that 21.9% of the parents did not know the outcome of the litigation, 34.2% of them were satisfied with the case result, 43.8% of them were not satisfied with the penalty, 43.8% of the litigation process was ended in favor of the suspect and 43.9% of the suspects were punished. This study shows the need for prevention and intervention studies to solve the problems of SA victims, and it is essential to make the justice system child-friendly.     

Physical health and crime among low-income urban women: An application of general strain theory

Purpose

Although studies of General Strain Theory (GST) typically include measures of physical health in multi-item indices of strain, no work has investigated the independent influence of physical health on criminal offending. The current research explores the relationship between physical health and criminal offending among low-income women living in disadvantaged neighborhoods.

Methods

Using data from the Welfare, Children, and Families (WCF) project, criminal behavior is predicted over two years with measures of physical health, depression, anxiety, competing strain, and relevant background factors.

Results

Poorer physical health at baseline and declines in physical health increase the odds of offending onset among previous non-offenders and reduce the odds of decreased offending among previous offenders. In offending onset models, higher levels of anxiety and depression at baseline and increases in these symptoms partially mediate the effect of poorer baseline health and fully mediate the effect of the loss of physical health. In decreased offending models, increases in anxiety and depression fully mediate the effect of poorer baseline health and partially mediate the effect of the loss of physical health.

Conclusions

The data suggest that poor health and declines in physical health influence both offending onset and offending escalation directly and indirectly through increases in anxiety and depression.     

Sexual victimization and health-risk behaviors: a prospective analysis of college women

The present study utilizes the National College Health Risk Behavior Survey to examine the relationship between health-risk behaviors and sexual victimization among a sample of college women. A prospective design is utilized to examine the relationship between health-risk behaviors as measured at baseline and sexual victimization during a 3-month follow-up period. After controlling for age and parents' education, a history of adolescent sexual victimization was associated with the following health-risk behaviors as measured at pretest: increased likelihood of cigarette smoking, marijuana use, suicidal ideation, experience of physical violence within a dating relationship, use of diet pills and vomiting or laxatives to lose weight, multiple sexual partners, and early sexual intercourse. Prospectively, women's history of adolescent sexual victimization was the strongest predictor of sexual victimization during the 3-month follow-up. Implications of univariate associations between early sexual intercourse, suicidal ideation, and problematic weight loss behaviors and subsequent experience of sexual victimization are discussed.     

Cranial thickness in relation to age, sex and general body build in a Danish forensic sample

The cranial thickness was measured in 64 individuals (43 males, 21 females) autopsied at our institute. The thickness was measured by taking a biopsy with a trephine at four specific locations on the skull. Complete medical records and pathologic autopsy results were available. While none of the individuals had suffered from diseases affecting bone or bone metabolism as such, a large sub group consisted of individuals with a history of, and autopsy finds consistent with, chronic substance and alcohol abuse. There was no statistically significant difference in cranial thickness measures between this group and the rest of the material. Subsequent analyses failed to reveal any correlations between the cranial thickness and sex and age and height and weight of the individual. This is in accordance with most earlier studies, which likewise show no correlation, or only very faint trends, between cranial thickness and these parameters. This study, thus, adds to other studies showing that cranial thickness cannot be used in aging or sexing human remains. Likewise, in a forensic pathological setting, cranial thickness cannot be inferred from the individuals stature and build, which may be an issue in cases of interpersonal violence with cranial trauma.     

Parental efficacy, self-control, and delinquency: A test of a general theory of crime on a nationally representative sample of youth

Criminologists have recently begun examining Gottfredson and Hirschi's (1990) proposition that parenting is the primary influence on children's levels of self-control. The few existing studies on the subject, however, have typically been based on small, nonrandom samples. The current study examines the relationships between parental efficacy, self-control, and delinquent behavior using data from a nationally representative sample of adolescents (the National Longitudinal Study of Adolescent Health). The results indicate that although parental efficacy is an important precursor to self-control, contrary to Gottfredson and Hirschi's proposition, self-control does not completely mediate the relationship between parental efficacy and delinquency. The implications for future research and theoretical development are discussed.     

The relationship of stress, impulsivity, and beliefs to drug use severity in a sample of women prison inmates

There is a paucity of research examining substance abuse issues among women prisoners. This study explored relationships between perceived stress, impulsivity, and beliefs in the efficacy of drugs as these variables pertain to self-reported drug use severity. Women prisoners (N = 100) participated in structured face-to-face interviews based on established research instruments. Although there was no significant correlation between demographic characteristics and substance use severity, positive relationships were found between substance use severity, perceived stress, impulsivity, and beliefs. A multiple linear model was estimated regressing drug use severity on beliefs, impulsivity, and perceived stress. Only the measures of beliefs and impulsivity were significant correlates of drug use severity. Implications are discussed for prison substance abuse programming and future research.     

Pathway to terrorist behaviors: The role of childhood experiences,personality traits,and ideological motivations in a sample of Iraqi prisoners

Radicalization to terrorism is a multifaceted process with no single theory or approach to explain it. Although research has focused on understanding the process, there is still a dearth of studies that examine an empirically driven pathway to terrorism behavior. This study examines a cross-sectional sample of incarcerated men convicted of terrorism in Iraq (N = 160). A questionnaire-guided interview included adverse childhood experiences (ACEs), conduct disorder (CD), antisocial personality disorder (ASPD), religious and political ideology, views about causes of terrorism, and the severity of terrorist acts. Path analysis was employed to examine the relationships between these factors and to identify the model with the best fit. After adjusting for age, employment, and location, results indicated that ACEs positively impacted CD, ASPD, religious guidance, and terrorism attitudes. ASPD positively affected political commitment and terrorism attitudes, but inversely affected current religious commitment. Political commitment inversely influenced terrorism attitudes. Religious commitment positively influenced the prioritization of religion in life, which subsequently impacted terrorism attitudes and behavior severity. Additionally, attitudes toward terrorism directly affected the severity of terrorism behavior. All paths in the final model were statistically significant at p < 0.05. Although these findings may be limited in generalizability due to the unique sample, results support the complex and interdependent nature of childhood and adult experiences on the development of both terrorism attitudes and the severity of terrorism behavior.     

Intimate partner violence and long-term psychosocial functioning in a national sample of American women

Using a nationally representative sample of American married or cohabiting women, this prospective study examined women who reported or denied intimate partner violence (IPV) at wave 1 and compared them on a range of psychosocial outcomes at a 5-year follow-up. This study also examined the rate of divorce or separation during the 5-year interval among women who reported IPV at wave 1 and explored whether certain predictors were related to ending an abusive relationship with an intimate partner during the period. Women with IPV at wave 1, compared to women without IPV, were significantly more likely to experience a greater degree of depressive symptoms and functional impairment and less self-esteem and life satisfaction at the 5-year follow-up. Also, nearly half of the women in an abusive relationship left the relationship within the period. Leaving the abusive relationship was associated with lower individual income and more social support at wave 1.     

Child Medical Evaluation Program: a statewide system for the medical and mental health evaluation of abused and neglected children

The Child Medical Evaluation Program examines 1500 children per year suspected by county social service departments of having subtle physical evidence of abuse or neglect. The program utilizes private practitioners, primarily pediatricians, in a systematic manner and provides consultation, direction, and quality control. The system is a unique, cooperative effort between private practitioners and county departments of social service. It is administered from a state university department of pediatrics. The cost is low, government involvement minimal, and the service extensive. The system is recommended to other states.     

Gambling, substance use, and other problem behaviors among youth: A test of general deviance models

Understanding the relationships between youthful gambling, substance use, and other problem behaviors is of interest to researchers studying deviance and to policymakers developing improved prevention strategies. This study used first-order and second-order factor models to test the hypothesis that gambling, alcohol misuse, other drug use, and delinquency were manifestations of a single general deviance construct. Respondents were seventeen to twenty-one year-old youth who were interviewed in two separate general population studies. Contrary to the hypothesis, the second-order model with a single deviance construct did not fit as well as a model specifying only correlations among all first-order factors. A single latent variable representing general deviant behavior did not explain deviance as well as distinct types of problem behaviors. This was true for overall samples and for gender-specific subgroups. Thus, while problem behaviors were related, there also must be uncorrelated antecedents predicting distinct types of youthful problem behaviors.     

Self-harming behaviors in prison: a comparison of suicidal processes,self-injurious behaviors,and mixed events

Self-harming behaviors occurring in prison disproportionately consume resources and cause considerable disruption. To date, theoretical paradigms have explained self-injurious behaviors and suicidal processes either via a continuum or dichotomy of self-harm. This current study examines all documented acts of self-harm (n = 1,158) occurring in South Carolina’s 28 prisons over a 50-month period. We test and find support for a tripartite schema of self-harm; differentiated with regard to suicidal processes, self-injurious behaviors, and a ‘mixed group‘ of self-harming behaviors. These groups of behaviors were distinct with regard to situational variables (i.e. body part targeted, injury severity) as well as institutional responses (i.e., medical treatment needed, employment of suicide protocols). Findings indicate that self-injurious behaviors are likely to result in physical injury and/or hospitalizations.     

Healthy, wealthy, and wise: Incorporating health issues as a source of strain in Agnew's general strain theory

The current study uses Agnew's general strain theory (GST) as a foundation to argue that poor health may lead to delinquency. Those who suffer frequently from minor health problems and lack resources to afford proper medical care are expected to experience elevated levels of health-related strain, negative emotional affect, and report engaging in more delinquent acts. Using longitudinal data from the National Longitudinal Study of Adolescent Health (Add Health), negative binomial regression models were estimated and show that health strains increase the subsequent frequency of non-violent delinquency even when controlling for important demographic and theoretically derived variables. Health strain's influence on non-violent delinquency was not conditioned by anger, depression, self-esteem, low constraint, or religiosity. Implications for GST are discussed and a modest research agenda for investigating health strain is identified.     

Mental health, quality of life, and health functioning in women veterans: differential outcomes associated with military and civilian sexual assault

The present study examined psychiatric, physical, and quality-of-life functioning in a sample of 270 women veterans receiving outpatient treatment at a Veterans Affairs medical center. Participants were interviewed regarding their civilian (CSA) and military sexual assault (MSA) histories, and data regarding quality of life and health outcomes were obtained through structured interviews and questionnaires. Women veterans with CSA histories reported significantly poorer physical, psychiatric, and quality-of-life functioning compared to those without a history of sexual assault. Furthermore, women veterans with an MSA history demonstrated additional negative consequences above and beyond the effects of CSA. The study sample was comparable to a national random sample of women veterans who access care in the Veterans Affairs healthcare system, increasing the generalizibility of the results.