Psychosocial adjustment and psychopathology of men sexually abused during childhood

The purpose of this study was to evaluate psychosocial adjustment and psychopathology among men sexually abused during their childhood and arrive at a better understanding of the reasons for which, following such sexual experiences, some adult males manifest greater distress than others. In total, 64 participants were interviewed and completed eight questionnaires covering various aspects of childhood and adult life. Results suggest the existence of three types of sexual abuse scenarios. Participants in each of these three groups presented with an adult-specific adjustment. However, the methodology and multivariate analyses used in this study suggest that some of these problems were not only associated with the sexual contacts but also with other childhood experiences and with the participant's cognitive, affective, and psychological resources.     

Betrayal trauma: associations with psychological and physical symptoms in young adults

Betrayal trauma, or trauma perpetrated by someone with whom a victim is close, is strongly associated with a range of negative psychological and physical health outcomes. However, few studies have examined associations between different forms of trauma and emotional and physical symptoms. The present study compared betrayal trauma to other forms of trauma as predictors of young adults' psychological and physical symptoms, and explored potential mediators. A total of 185 university undergraduate students completed the Brief Betrayal Trauma Survey, the Trauma Symptom Checklist, the Toronto Alexithymia Scale, and the Pennebaker Inventory of Limbic Languidness. For each set of symptoms, simultaneous multiple regressions assessed the relative contributions of low versus high betrayal trauma to psychological and physical health reports. Structural equation models examined traumatic stress symptoms and alexithymia as mediators of the relationship between betrayal trauma and physical health symptoms. A total of 151 participants (82%) reported exposure to at least 1 of 11 forms of trauma queried (M = 2.08, SD = 1.94); 96 participants (51.9%) reported at least 1 betrayal trauma. Traumas characterized by high betrayal predicted alexithymia, anxiety, depression, dissociation, physical health complaints, and the number of days students reported being sick during the past month, whereas other traumas did not. Structural equation modeling revealed that traumatic stress symptoms and alexithymia mediated the association between betrayal trauma and physical health complaints. These results indicate that betrayal trauma is associated with young adults' physical and mental health difficulties to a greater extent than are other forms of trauma. Results may inform assessment, intervention, and prevention efforts.     

Isolating Adult Psychological Correlates of Witnessing Parental Violence: Findings from a Predominantly Latina Sample

This study examined the relationship between childhood exposure to parental violence and adult psychological functioning in a sample of predominantly Mexican American participants. Questionnaires assessing childhood maltreatment, family environment, and current psychological symptomatology were completed by 142 female undergraduates. Findings revealed that witnessing parental violence in childhood was associated with depressive symptoms, low self-esteem, and trauma symptoms in adulthood, even after controlling for child physical and sexual abuse. However, in subsequent analyses, also controlling for levels of nonphysical family conflict, previous associations between exposure to parental violence and adult symptomatology were reduced, such that trauma-related symptoms remained the sole outcome still predicted by a history of witnessing parental violence. Implications of these findings, issues related to the use of statistical control procedures in abuse effects research, and directions for future investigation are discussed.     

Adolescent Girls’ Use of Avoidant and Approach Coping as Moderators Between Trauma Exposure and Trauma Symptoms

High rates of child maltreatment demand attention, as exposure to child maltreatment substantially increases the risk of developing PTSD. Some evidence exists that the presence of coping skills may reduce the likelihood that victims of childhood maltreatment will develop PTSD (Agaibi & Wilson, Trauma Violence Abuse 6:195–216, 2005). This study examined whether avoidant and/or approach coping skills moderated the relationship between childhood trauma exposure and trauma symptoms among adolescent females with a history of complex trauma. Results suggest that the use of avoidant coping moderates the relationship between trauma exposure and trauma symptoms. More specifically, girls with higher levels of trauma exposure demonstrated lower levels of trauma symptoms if they reported using higher levels of avoidant coping. Clinical implications for these results are discussed.     

Adult Survivors of Childhood Abuse: An Analysis of Coping Mechanisms Used for Stressful Childhood Memories and Current Stressors

Coping mechanisms used to deal with stressful childhood memories and current stressors were assessed for 196 women in each of 4 groups: no abuse history, sexual abuse history, physical abuse history, and both sexual and physical abuse history. Current psychological adjustment was also examined. Discriminant function analyses revealed a variety of significant differences between the groups in use of strategies for coping with memories of abuse or another childhood stressor. There was no relationship between childhood history of abuse and the manner in which women coped with a current stressor. Women with an abuse history reported significantly poorer adult adjustment than did nonabused women, and different coping strategies were predictive of adjustment for abused and nonabused women.     

Posttraumatic Stress Disorder Symptoms,Relationship Adjustment,and Relationship Aggression in a Sample of Female Flood Victims

This study tested a model examining the interrelationships among posttraumatic stress disorder (PTSD) symptoms, intimate relationship adjustment, and intimate relationship aggression in a sample of 205 adult female flood victims. At the bivariate level, higher PTSD symptoms were associated with higher physical and psychological aggression victimization, poorer relationship adjustment, and higher physical and psychological aggression perpetration. Results from structural equation modeling (SEM) analyses indicated that relationship aggression victimization influenced aggression perpetration directly, and in the case of physical aggression, indirectly through its relationship with PTSD symptoms and relationship adjustment. The influence of PTSD symptoms on physical aggression perpetration was fully explained by poorer relationship adjustment. These findings extend prior work from other traumatized populations documenting associations between variables reflecting PTSD symptomatology and indices of relationship functioning, and indicate a need for further investigation in this area of inquiry. This research was supported in part by a grant to Patricia A. Resick from the National Institute of Mental Health (1-R01-MH55542).     

Child sexual abuse and adult romantic adjustment: comparison of single- and multiple-indicator measures

This study compared the usefulness of single- and multiple-indicator strategies in a model examining the role of child sexual abuse (CSA) to predict later marital satisfaction through attachment and psychological distress. The sample included 1,092 women and men from a nonclinical population in cohabiting or marital relationships. The single-item measure assessed the presence or absence of CSA. The multiple-indicator measure included items relating to level of force, relationship with perpetrator, number of abusive experiences, and nature of assault. Structural equation modeling indicated that, for research purposes, a dichotomized item provided as much information as a complex measure to predict the relationship between sexual abuse and marital adjustment through attachment representations and psychological distress. However, when analyses were conducted strictly within the CSA victims group, no correlation was found between abuse severity and psychosocial measures. The present results show that in a community sample, CSA may be an important risk factor that develops couple difficulties, regardless of the severity of the trauma.     

Attachment as a Mediator between Childhood Maltreatment and Adult Symptomatology

This study examined the mediating role of attachment in the relationship between childhood maltreatment perpetrated by parents and adult symptomatology. Young adults (N = 803), with and without a history of abuse, were recruited from a local university to complete a series of questionnaires inquiring about past maltreatment experiences, adult attachment in current close relationships, and psychological symptomatology. While attachment was found to be a mediator for all three types of abuse when they were looked at individually, a more robust mediated effect was found in the case of psychological abuse. When all three types of parental maltreatment (psychological, physical, and exposure to family violence) were considered simultaneously, attachment mediated the relationship between only psychological abuse and symptomatology. Parallel meditated effects were observed across two measures of symptomatology: trauma-related symptomatology and externalizing and internalizing symptomatology. The results of this study further our understanding of psychological maltreatment and its intra-individual correlates.     

Childhood Sexual Abuse,Other Childhood Factors,and Pathways to Survivors’ Adult Relationship Quality

We were interested in understanding how the effects of childhood sexual abuse, in concert with other negative childhood experiences, were carried forward into adult romantic relationships. Data from 15,831 married or cohabitating individuals were gathered via the RELATE Questionnaire. Empirical research, attachment theory, and a general model of adult relationship quality suggested that the path from negative childhood events to adult relationship quality was mediated by a number of individual and relational affect-laden variables. Results showed that childhood abuse and other family-of-origin variables work primarily through the adult survivor’s perceptions of the events of his or her childhood. This “current impact” variable, along with the current level of depression, work through an emotion-laden relationship variable—level of emotional flooding during couple conflict—to influence the relationship quality outcome variable. Treatment implications are discussed.     

Sexual offenders’ parental and adult attachments and preferences for therapists’ interpersonal qualities

ABSTRACT

This study explored sex offenders' parental and adult attachment difficulties and assessed the extent to which these were associated with preferences for therapists' interpersonal qualities. One-hundred and twelve adult male child sexual offenders were invited to provide self-report data on their attachment histories, adult attachments and preferences for therapists' interpersonal qualities. A weak relationship between childhood and adulthood secure attachment was found, suggesting that attachment at the time of offending may be more relevant than childhood attachment to the aetiology of sexual offending. Participants valued a range of therapists' qualities previously identified as important for positive treatment change. Therapist trust and genuineness were perceived as particularly important by those with attachment difficulties, demonstrating the need for these qualities in offender programmes where attachment difficulties would be expected. There were some differences in the preferences for therapists' qualities between participants with different adult attachment types, highlighting the importance of responsivity factors in treatment.     

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.     

Life Constraints and Psychological Well-Being of Domestic Violence Shelter Graduates

Psychosocial adjustment and life constraints of 81 domestic violence shelter graduates were examined via field interviews in the community, assessing womens current life status, satisfaction with core life domains, and violence experience, pre- and post-shelter. Psychometric scales for depression and trauma symptoms were also administered. Participants had received extensive services in either an emergency or a transitional living shelter. Although fairly satisfied across life domains, many had serious post-shelter financial hardships. Most importantly, they reported remarkably little post-shelter violence exposure, either within or outside of romantic relationships. Despite now living independently, 43% and 75% reported clinical levels of depression and trauma symptoms, respectively. In hierarchical stepwise regressions, depression was related to womens childhood sexual abuse, dissatisfaction with housing and their own parenting, and experience of financial difficulties conjoined with public assistance. Trauma symptoms were associated with childhood sexual abuse and post-shelter financial difficulties. The impaired psychosocial functioning and life difficulties of these predominantly successful domestic violence survivors highlights the need for specialized shelter intervention and continuity of care in the community.     

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.     

Positive Resolution of Childhood Sexual Abuse Experiences: The Role of Coping,Benefit-Finding and Meaning-Making

Resolution of the trauma of childhood sexual abuse (CSA), and the current adjustment of 60 adult female CSA survivors were explored through qualitative and quantitative analyses of their coping strategies, perceived benefits, and meaning-making attempts. While the majority of the women (87%) perceived at least some benefit resulting from coping with the CSA experience, many (29%) found it impossible to make any meaning of their trauma. Specific benefits that were associated with various aspects of positive adjustment (marital satisfaction, better physical health, less isolation) included improved relationships with others, religious or spiritual growth, and improved parenting skills. Some perceived benefits were actually associated with a negative outcome. Increased knowledge of sexual abuse was associated with more isolation and lower marital satisfaction. When positive meaning could be derived from the coping process, the women reported less isolation. Avoidant coping was strongly associated with more depressive symptoms and poorer resolution of abuse issues. Results highlight the importance of considering coping strategies and cognitive restructuring efforts in designing therapeutic interventions with this population. Portions of this paper were presented at the annual meeting of the Midwest Psychological Association, May 2004, Chicago, IL.     

PTSD Symptom Trajectories among Mothers Reporting Interpersonal Trauma: Protective Factors and Parenting Outcomes

The childbearing years are further complicated when experiences of interpersonal trauma from childhood and/or adulthood lead to symptoms of posttraumatic stress disorder (PTSD). Maternal symptoms of PTSD over time were examined in relation to supportive adult relationships and parenting experiences. Ninety-five primarily economically disadvantaged mothers reporting exposure to childhood maltreatment and/or intimate partner violence were assessed from pregnancy through 2-years postpartum. Latent class growth analysis of PTSD symptoms indicated a 2-group model: stable low (82%) and moderate dysfunction (18%). The stable low group reported higher levels of support from romantic partners and family members, but not friends, and lower levels of parenting distress compared to the moderate dysfunction group. Results highlight individual variability in adaptation after violence exposure; current support from romantic partners and family members may have helped maintain lower PTSD symptoms for some trauma-exposed mothers. Psychological interventions aimed at reducing the impact of trauma exposure on parenting should consider promoting ongoing social support.     

Evaluating the Reliability of Expert Evidence in Compensation Procedures: Are Diagnosticians Influenced by the Narrative Fallacy when Assessing the Psychological Injuries of Trauma Victims?

The current study investigated whether mental health practitioners are influenced by the narrative fallacy when assessing the psychological injuries of trauma victims. The narrative fallacy is associated with our tendency to establish logical links between different facts. In psychodiagnostic assessments, this tendency may result in overdiagnosis of mental disorders when psychological symptoms can be attributed to a traumatic event. Consequently, legal decision makers may be at risk of awarding compensation for psychological injuries which are not severe enough to justify financial reimbursement. To explore this topic, we asked Dutch mental health practitioners whether they would assign a diagnosis of mental disorder to fictitious symptoms of psychological injury. Each participant was presented with two vignettes. The first vignette described symptoms in terms of a generalized anxiety disorder; the second in terms of a major depressive episode. The vignettes varied in the cause (trauma versus cause not specified) and severity (near threshold of DSM diagnosis versus below threshold of DSM diagnosis) of the symptoms. Results indicated that participants more often assigned a diagnosis of mental disorder if the psychological symptoms had been caused by a traumatic event than if that had not been the case. Further analysis of the data suggested that this difference was due to the high numbers of assigned diagnoses of posttraumatic stress and acute stress disorder in the trauma conditions. It was speculated that participants filled in missing information to justify the assignment of such diagnoses, for example by imagining symptoms of intrusion and avoidance.     

Childhood Physical and Verbal Mistreatment,Psychological Symptoms,and Substance Use: Sex Differences and the Moderating Role of Attachment

Sex differences in sequelae associated with levels of childhood physical mistreatment and verbal mistreatment were examined in a non-clinical sample of 272 university students. We predicted and found that both forms of mistreatment are related to attachment difficulties as well as various adverse psychological symptoms. We hypothesized, based on attachment theory, that the strength of a child’s attachment to one parent would moderate adverse emotional sequelae of mistreatment by the other parent. This prediction was only partially supported. Strength of the mother-daughter attachment moderated several of the adverse psychological symptoms in response to mistreatment by fathers, but mother-son attachment did not so moderate. Strength of the father-son attachment also did not moderate the symptoms associated with mistreatment perpetrated by mothers, nor did the father-daughter attachment. These results suggest that, among other relevant factors, sex differences should also be taken into account in treatment and prevention efforts.     

Sexual Trauma and Psychological Injuries: What Experts Need to Know

This article was written to introduce readers to the bodies of work that inform experts who conduct evaluations of plaintiffs or offer generic testimony in cases involving claims of psychological injuries in the aftermath of sexual trauma, including childhood sexual abuse, adult sexual assault, and sexual harassment. In addition to summarizing the research literatures on those three areas of maltreatment, it reviews what mental health experts should know about our laws, about professional standards for evaluations, and about other relevant areas of research, such as assessment of posttraumatic stress symptoms, disclosures by young children, “normal” childhood sexual behaviors, “repressed” or “recovered” memories, memory and trauma, memory distortions, and resilience.     

Adult female victims of child sexual abuse: multitype maltreatment and disclosure characteristics related to subjective health

This study examined the impact of child sexual abuse and disclosure characteristics on adult psychological and psychosomatic symptoms. Data on abuse characteristics, disclosure-related events, and subjective health were collected through semistructured interviews and questionnaires from 123 adult women reporting having been sexually abused in childhood by someone close. The results indicate that disclosure-related events have a stronger relation than abuse characteristics to long-term consequences of childhood sexual abuse. In particular, a positive reaction from a partner was related to fewer symptoms. Of the abuse characteristics, exposure also to physical abuse was strongly associated to psychological sequelae.