Differences in Family Functioning of Sexually Abused vs. Nonabused Enuretics

The present study examined self-reported maternal depression, children's somatic complaints, and perception of family functioning in sexually abused and nonabused enuretics. Forty children with primary nocturnal enuresis served as subjects. Half had documented histories of sexual abuse while the other half did not report a history of victimization. Results indicated that those children with a history of sexual abuse perceived and rated their families as significantly more conflictual and rigid than their nonabused counterparts. Variables such as type of abuse (intrafamilial vs. extrafamilial) and perpetrator did not affect the outcome. However, there were no significant differences in child somatic complaints or maternal depression between the two groups. These results suggest that primary nocturnal enuresis may manifest itself differently in families of sexually abused children than nonabused children. Implications of these findings with respect to intervention are discussed.     

Predictors of trauma symptomatology in sexually abused adolescents: a 6-month follow-up study

This study examines the natural course of trauma-specific symptoms 6 months after disclosure. Furthermore, this study investigates whether severity and type of abuse (intrafamilial or extrafamilial sexual abuse), negative appraisals, coping strategies, and crisis support measured at time of disclosure can be predictive of trauma symptoms 6 months later. Sixty-five sexually abused Flemish adolescents are reassessed 6 months after disclosure. Information from the participants is obtained through self-report questionnaires. Forty-six percent of the adolescents report clinically significant trauma symptoms. Although internalizing symptoms significantly decreases after 6 months, externalizing symptoms persist. Type or severity of the abuse does not account for differences in symptomatology. Two predictors of ongoing trauma symptomatology are identified: postdisclosure trauma symptomatology and a lack of initial crisis support. Information on the victims' postdisclosure symptomatology as well as information on the initial received social support is critical in understanding which abused adolescents are most at risk for poor outcomes in the long term.     

Adolescent Physical Abuse: Age at Time of Abuse and Adolescent Perception of Family Functioning

The relationship between physical abuse and family functioning was investigated in a comparative study of victims of adolescent physical abuse. The sample consisted of 99 physically abused adolescents and 99 nonabused adolescents who were administered the Parental Bonding Instrument (PBI) and Family Adaptability and Cohesion Evaluation Scale (FACES III). These measures assess family functioning in terms of adolescents' perception of their family's cohesiveness, flexibility, and the degree to which their parents provide care and protection. The relationship between family functioning and physical abuse, severity of abuse, and date of abuse onset was investigated. Abused adolescents perceived their families as significantly less adaptable, less cohesive, and less balanced than the comparison adolescents. Fathers and mothers of abused adolescents were viewed as less caring; abuse group fathers were also viewed as more overprotective. Family functioning was not different when childhood-onset abuse was compared to adolescent-onset abuse. Severity of abuse also did not differ in the childhood and adolescent onset groups. It was concluded that physically abused adolescents view their families as rigid, and their parents as emotionally unavailable. Treatment needs and intervention strategies for these families are outlined.     

Do parents blame or doubt their child more when sexually abused by adolescents versus adults?

Although the importance of parental support for child sexual abuse victims is well documented, the nature of parental support for victims sexually abused by adolescents is less understood. In this exploratory study, we examine whether parents differ in their levels of blame or doubt for their child when sexually abused by adolescents versus adults. Data included 161 reports of child sexual abuse. Parental blame toward their child was higher when sexually abused by an adolescent versus an adult suspect. In the bivariate and multivariate analysis, parental blame was significantly higher as victim age increased, for Black, non-Hispanic children, and when there was an adolescent suspect. Practitioners need to recognize that high levels of blame and doubt could exist for adolescent victims of sexual abuse and when children are sexually abused by adolescents.     

Childhood sexual abuse, gender, and depression among incarcerated youth

This study examined whether sexual abuse was related to higher levels of psychological distress among incarcerated youth and if the effects were invariant across gender. Participants were male and female adolescents, aged 11 to 20 years, incarcerated in six juvenile correctional institutions in five states. Using data from a national study of juveniles confined to secure institutions, this study assessed the relationship between gender, sexual abuse, and depression. Adolescents who were sexually abused during childhood compared to adolescents who were not report higher levels of depression. Sexually abused girls and boys report higher levels of depression compared to boys not sexually abused. These findings suggest the importance of understanding the relationship between childhood sexual abuse and depressive symptoms among incarcerated youth. Additionally, the findings suggest that the effects of childhood sexual abuse are similar for males and females among a high-risk sample of institutionalized juvenile delinquents. Implications for treatment of incarcerated youth are discussed.     

Type and Severity of Abuse as Predictors of Psychiatric Symptoms in Adolescence

There has been little previous research about histories of child maltreatment and psychological symptoms in adolescent psychiatric patients. This study investigated whether type and characteristics of child physical and/or sexual abuse predicted individual differences in symptoms. Participants were 187 patients in day or residential treatment facilities. Abuse was assessed using structured interviews with the adolescent, the therapist, and the caseworker. Participants completed a standardized, self-report measure of internalizing and externalizing symptoms. Adolescents with histories of dual abuse (i.e., sexual and physical abuse) had elevated depression and anxiety compared with nonabused patients. Histories of any type of abuse were associated with elevated posttraumatic symptoms. Among physically abused patients, severity and duration of abuse predicted individual differences in depression and anxiety, whereas severity and concomitant sexual abuse predicted elevated posttraumatic symptoms. Among sexually abused patients, the characteristics of sexual abuse did not predict individual differences in symptoms. Thus, child abuse, particularly dual abuse and severe physical abuse, predicted elevated internalizing symptoms, even in comparison with other adolescent psychiatric patients. The need for replication is discussed.     

Sex-typed role in male adolescent sexual abuse survivors

Confusion and conflicts regarding sexual identity have been identified by clinicians as sequelae of sexual abuse in male adolescents. The empirical evidence supporting this assertion is limited, however. The purpose of this study was to examine the relationship between sexual abuse of male adolescents and their sexual self-concept in comparison to other clinical and nonclinical adolescent populations. The Bem Sex-Role Inventory (BSRI) was administered to 31 sexually abused male adolescents, 14 nonabused, psychiatrically treated male adolescents, and 35 nonabused, nonpsychiatric male adolescents. A significant difference in sex-typed roles was found between sexually abused male adolescents and nonabused, nonpsychiatric male adolescents.     

Behavior Problems in Sexually Abused Children of Depressed Versus Nondepressed Mothers

Children's psychological adjustment following stressors, such as sexual abuse, is impacted by environmental variables. One such factor is parental support, which can be hampered when a caregiver suffers from psychopathology. The purpose of this study was to determine whether maternal depression would impact the children's adjustment to sexual abuse. It was hypothesized that depressed mothers would report more behavior difficulties for their sexually abused children than nondepressed mothers. Participants were 58 children (and their mothers) who were referred for trauma symptoms related to sexual abuse. Mothers completed the Beck Depression Inventory as a measure of their depression and rated their children's behaviors on the Revised Behavior Problem Checklist. The children completed the Children's Depression Inventory and the Revised Children's Manifest Anxiety Scale. Results revealed that depressed mothers reported more conduct problems, inattention/immaturity, and psychotic behavior than nondepressed mothers. Differences were not observed for mothers' report of depressive or anxious behaviors across groups. The children of depressed mothers reported increased levels of depression, but not anxiety, when compared to children of nondepressed mothers. Although both groups of mothers reported symptoms to be clinically significant, the children did not endorse their symptoms in clinically significant ranges.     

Type and extent of child abuse as predictors of adult functioning

Child abuse is associated with a variety of difficulties later in life. However, it is unclear to what extent these outcomes are related to the type and combinations of abuse (i.e., sexual versus physical) rather than the variable characteristics within each type. Information regarding child abuse histories as well as current functioning was gathered from a community sample of 259 working women. Incest and severe physical abuse were each associated with similar symptoms, with people who were more severely abused showing worse outcomes. Those women who were both physically and sexually abused had less favorable outcomes than those abused in only one manner. The effects of abuse could not be understood without taking combinations of different types and severities into account. The implications of the similarities of the outcomes of severe sexual and physical abuse were discussed.     

The associations between abuse characteristics in child sexual abuse: a meta-analysis

Child sexual abuse (CSA) is a general term describing a wide range of events that vary in characteristics such as the victim’s age of onset, relationship to the perpetrator, abuse quantity, degree of contact, and use of force. To investigate correlations and provide information on the clustering of these characteristics, the present meta-analysis included data from 14,494 sexually abused individuals from 62 empirical peer-reviewed studies and doctoral theses. The results showed that victims of intrafamilial abuse were younger than victims of extrafamilial abuse. More force was used in abuse including higher degrees of physical contact. Intrafamilial abuse and early onset of abuse showed no statistically significant associations with either use of force or closer physical contact. Abuse was more frequent and/or committed over a longer time period when it (a) featured more contact or force, (b) involved a relative as a perpetrator, or (c) commenced when the child was younger. The associations were weak to moderate in strength.     

Interpersonal barriers to stopping animal abuse: exploring the role of adolescent friendship norms and breeches

Research into bystander apathy has focused on the barriers to intervening when the perpetrators and witnesses of violence are strangers. Although violence also occurs in the presence of friends, family, and other close ties, it is unclear how these affiliations constrain the behavior of bystanders in these situations. To explore this question, qualitative interviews were conducted with 25 adolescents who were bystanders to animal abuse committed and/or witnessed by family members, friends, or known others. Most interviewees claimed that, despite feeling disturbed by the animal abuse, they did little if anything to stop the abuse and did not report it to adult authority figures. Friendship norms and breeches presented most interviewees with significant barriers that either stopped or tempered their interventions. Implications of these findings are discussed for educating adolescents to intervene on behalf of abused animals.     

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.     

Mental health correlates of the victim-perpetrator relationship among interpersonally victimized adolescents

This research examines mental health correlates of different victim-perpetrator relationships among adolescent victims of interpersonal violence. A large and nationally representative sample of adolescents (N = 4,023) responded to structured telephone interviews concerning mental health functioning (posttraumatic stress disorder-PTSD, major depressive disorder, substance abuse/dependence, and delinquency). Those reporting histories of sexual (n = 321) and/or physical (n = 688) assault were queried about specific aspects of their assaults, including their relationship with the perpetrator. After controlling for demographic and assault-related risk factors, the victim-perpetrator relationship remained a significant risk factor for mental health problems. Adolescents sexually assaulted by nonstrangers were at increased risk for PTSD; those sexually assaulted by acquaintances or people they did not know well were at increased risk for delinquency. Adolescents who were physically assaulted by a family member were at increased risk for PTSD. Explanations for the findings and the need for consistent assessment methods across related studies are discussed.     

Detection

Sexually abused children who are not treated will likely commit violent crimes and will probably abuse or condone the abuse of their own children. But the best of treatment programs are of no use if the abused children are not found. Reporting laws adopted in recent years, even though of somewhat limited scope, have greatly increased the number of children found and brought to treatment, and each child treated not only improves that child's pursuit of happiness, it also breaks a cycle of abuse to his children. Reporting laws can be strengthened. They can help more children. They can cast a broader net of those who must report abuse and of those who are protected when they report. They can clarify the procedures to be taken and the agencies responsible when reports are made. They can provide for confidentiality and protective orders to save the family a second trauma during judicial and administrative procedures. They can identify public policy as to when to treat and when to punish if both cannot be done. They can encourage research for determining the truth of reports and for improving treatment methods. There is resistance to reporting laws. Physicians are well aware that if they report an abuse they may well lose not merely that family as patients but also their friends and relatives which can be a severe economic hardship. Lawyers and physicians resist intrusions into the confidentiality of their relations with their clients and patients. Foster homes and residential care facilities know that even a hint of impropriety may end their arrangements for payment by the public and insurance carriers. Families often resist reporting because of its embarrassment and potential impact on their jobs and on their relationships with friends. Children resist because of guilt feelings or for fear of losing a parent. Mothers resist because they fear the breakup of their homes and loss of a breadwinner. Compulsory reporting laws may be the best means of helping sexually abused children and of breaking the cycle of sexual abuse by those who were sexually abused and even of reducing violent crime. It is not a simple solution. But just as we can do nothing about child abuse unless it is reported, neither can we do anything about abuse unless the reports are managed efficiently, with prompt investigation and prompt action when appropriate. A report allowed to gather dust may have cost a physician a part of his practice without protecting or helping the child.     

Psychiatric aspects of sexual abuse

Sexual abuse of children and adolescents has become an increasingly publicized phenomenon. Psychiatrists and other mental health professionals are often called upon to evaluate and treat children and adolescents who may have been sexually abused, to provide counseling or treatment to the families of such children, and to provide reports and testimony for proceedings about such cases in the child protection system, the criminal justice system, and in custody disputes. Clarity regarding the medical, psychiatric, and legal aspects of sexual abuse is essential in carrying out such professional activities and in evaluating and formulating research on sexual abuse. In this paper current knowledge regarding these aspects of sexual abuse is summarized, and the role of psychiatrists in clinical and forensic work involving allegations of sexual abuse is 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.     

The Effects of Childhood Physical Abuse or Childhood Sexual Abuse in Battered Women's Coping Mechanisms: Obsessive-Compulsive Tendencies and Severe Depression

What role does childhood abuse have on the coping choices made by a battered woman? Ancillary to a depression study (Bailey, 1996) in 79 battered women from a Houston area women's shelter were compared for past abuse experiences and how the women were coping with abuse in adulthood. This study compared coping styles between two groups of battered women: those who experienced childhood physically abuse (CPA) (n=35), and those who did not experience childhood physically abuse (NCPA) in childhood (n=44). All of the women filled out a battery of questionnaires including The Brief Symptom Inventory (BSI), and a scale for learned helplessness. A t-test conducted on obsessive-compulsive tendencies (OCT) scale of the BSI found that women who were NPPA had significantly lower BSI-OCT scores t(77)=−2.05, p < .05 than women who were PPA. No statistically significant differences were found between groups for learned helplessness. Out of the 35 battered women who reported physical abuse in childhood were more likely to report sexual abuse as girls than battered women who were not physically abused, t(77)=−3.40, p < .001. Battered women who had been physically and sexually abused in childhood were more severely depressed. Battered women who were not abused in childhood had more obsessive compulsive tendencies. The ramifications of these findings for therapeutic treatment are discussed.     

Child-to-parent violence: Profile of abusive adolescents and their families

This study focused on parent abuse (PA), also known as child-to-parent violence. The main aim was to examine the psychological and family characteristics of adolescents who physically and/or verbally abuse their parents, and to study gender differences of perpetrators and victims of aggression. The authors analyzed the judicial proceedings of 103 adolescents in the court of Bilbao (Spain). These adolescents were divided into three groups: those with charges of PA, those with charges of PA and other kinds of charges (PA+), and those with only other types of charges (NotPA). Results showed a specific profile of adolescents who abused their parents (PA) (lower self-esteem and empathy, and more disciplinary problems at school), as well as differential characteristics of these families (economic situation and the type of household). Finally, the relation between this phenomenon and gender violence was discussed in detail.