Childhood sexual abuse, sexual motives, and adolescent sexual risk-taking among males and females receiving child welfare services

Traumatized Sexuality: Understanding and Predicting Profiles of Sexual Behaviors Using Childhood Abuse and Trauma Measures

In the current study we sought to identify sexual behavior profiles and examine the levels of childhood abuse history and trauma measures in each profile. The study was conducted among a large non-clinical sample of men and women (n = 806). Latent profile analysis was employed to identify distinct profiles of sexual behaviors and then childhood abuse, posttraumatic stress disorder (PTSD), depression, and anxiety, and motives for engaging in sex were assessed in each profile. Four distinct profiles of sexual behavior were identified: hyposexual individuals, hypersexual porn users, porn users, and within usual ranges (WURs). Hypersexual porn users had significantly more childhood trauma (emotional, physical, and sexual) than WURs, significantly greater PTSD symptom than WURs and hyposexual individuals, and significantly greater anxiety and depression as compared with all other groups. The hyposexual individuals had significantly lower scores on all motives for engaging in sex than did porn users or hypersexual porn users. Hypersexual porn users and porn users reported coping and peer-pressure as motives for engaging in sex more than did WURs or hyposexual individuals. Clinicians working with survivors of childhood abuse should consider directly targeting these different maladaptive sexual behaviors by addressing PTSD symptoms, affective disorders, and motives for engaging in sex.

Romantic Attachment, Sex Motives and Sexual Difficulties in Emerging Adults: The Role of Childhood Interpersonal Victimization

A growing body of research has revealed that many emerging adults (i.e., aged 18 to 25) experience sexual difficulties. Past studies have emphasized the need to examine sexual difficulties by accounting for sex motives (i.e., reasons for engaging in sex) and by using a trauma-focused or attachment-based framework. This study examined the role of sex motives in the associations among attachment insecurities (anxiety, avoidance) and sexual difficulties in emerging adults, and assessed whether these links varied on the basis of low or high exposure to childhood interpersonal victimization (CIV) (i.e., 0-3 different types of CIV or 4 or more types of CIV). A sample of 437 French-Canadian emerging adults completed validated questionnaires online. Path analyses revealed that participants with higher attachment anxiety were more likely to endorse the partner approval sex motive, which was related to more sexual difficulties. Participants with higher attachment avoidance were less likely to endorse the pleasure sex motive, which was associated with more sexual difficulties. Results indicated a significant effect of CIV showing that some indirect effects were significant only in participants who reported high CIV exposure. Results suggest that addressing sex motives using an attachment- and trauma-focused framework might help understand, prevent and treat sexual difficulties among emerging adults.

Sexual Victimization of Adolescents in Residential Care: Self-Reported and Other-Reported Prevalence

Adolescents in the child welfare system have been exposed to multiple forms of victimization, most notably sexual victimization, many times underreported and misreported. The main aim of this study was to explore the lifetime prevalence of sexual victimization among adolescents in residential care in Eastern Spain, contrasting self-reported information compared to the information reported by the professionals. Sexual abuse/assault characteristics and effects of gender and age were analyzed. Additionally, the association between sexual revictimization and the relationship with the aggressor as well as the age of the first episode of sexual abuse/assault was analyzed. The sample comprised 346 adolescents (34.1% females, 65.9% males) aged between 11 and 19 years old. The prevalence of sexual victimization reported by adolescents was 35.3%, more than double compared to the information reported by professionals (16.9%). Females experienced significantly more sexual victimization than males (OR = 0.23, 95% CI [0.14, 0.37]). The age of the victim at the first episode of sexual abuse/assault and the relationship with the aggressor were explanatory variables of revictimization. Research such as this is crucial to ascertain that these adolescents have very different needs that will influence the design of affective-sexual education initiatives, which are essential to ensure healthy sexual development.

Sexual Compulsivity Mediates the Association Between Childhood Sexual Abuse and Condom Use Resistance Among Men Who Have Sex with Men and Women

Despite the continued prevalence of HIV and condoms' proven effectiveness in HIV prevention, many young men continue to engage in condom use resistance (CUR). Research shows that sexual compulsivity and childhood sexual abuse (CSA) victimization are risk factors for CUR. Given that sexual activity between men is the most common method through which HIV is transmitted, and that men who have sex with men and women (MSMW) are up to five times as likely to contract or transmit HIV as men who have sex with women only (MSWO), understanding the CUR behaviors of MSMW is uniquely important. Young, single men who had had sex with a woman in the past year (N = 623) completed questionnaires assessing their previous sexual experiences with men and women, history of CSA, sexual compulsivity, and CUR to determine how MSMW classification may moderate the associations between these variables. Results revealed full, moderated mediation, such that CSA was significantly associated with sexual compulsivity among MSMW, but not MSWO. Furthermore, sexual compulsivity was subsequently associated with CUR, in a model accounting for 5.35% of CUR variance. Such findings suggest that exposure to CSA may render MSMW especially susceptible to maladaptive, sexually compulsive desires and behaviors. As a result, MSMW may be more likely to disregard the inherent risks associated with condomless sexual activity and engage in CUR. Thus, intervention programs seeking to reduce the transmission of HIV and other STIs should prioritize targeting MSMW who experienced CSA to reduce sexual compulsivity and increase condom use.

The Indirect Effect of Avoidant Motives for Sex on the Pathways From Childhood Maltreatment to Risky Sex Behaviors

Literature supports a strong link between engagement in risky sex and childhood maltreatment, with engagement in risky sexual behavior proposed as a manifestation of avoidant coping. Sex motives refer to underlying motivations for engaging in sex such as increased intimacy, or peer pressure. Limited research has examined the role of sex motives on the relationship between childhood maltreatment and risky sex. This study sought to examine this path between childhood maltreatment types and later engagement in risky sex through sex motivations that seek to avoid or reduce negative affect (i.e., sex to cope and sex to affirm self-esteem). A sample of sexually active undergraduate women (n = 551) completed a series of questionnaires on childhood maltreatment, risky sexual behavior, and motivations for sexual intercourse as part of a larger parent study on revictimization. Path analysis was conducted to examine differential indirect effects of childhood maltreatment on risky sex (i.e., sex with a stranger and hookup behaviors). Results suggested sex to cope with negative affect mediated the relationship between emotional abuse, sexual abuse, physical neglect, and hookup behavior. Only an indirect path between childhood emotional abuse and sex with a stranger was identified through sex to cope. Emotional abuse was the only maltreatment to predict sex to affirm, but sex to affirm did not predict risky sex outcomes. Findings provide support for differential pathways from various forms of childhood maltreatment, specifically sexual abuse, emotional abuse, and physical neglect, to increased risky sex as a manifestation of avoidant coping. Furthermore, results support the call for more inclusion of nonsexual forms of childhood maltreatment in studies of risky sex and avoidant coping as a potential intervention target for risky sexual behavior regardless of childhood maltreatment type.

Cumulative childhood trauma, sex motives and sexual satisfaction among emerging adults

BACKGROUND

To better understand sexual satisfaction in emerging adults, previous research has emphasized the importance of considering the role of developmental experiences, such as cumulative childhood trauma (CCT; the number of different forms of abuse and neglect sustained during childhood). However, the mechanisms by which CCT and sexual satisfaction are related remain unknown. Sex motives are suggested as an explanatory mechanism given the previously found associations between sex motives and both sexual satisfaction and CCT.

OBJECTIVE

This study examined the direct associations between CCT and sexual satisfaction, as well as indirect associations through sex motives, in emerging adults.

PARTICIPANTS AND SETTING

A sample of 437 French Canadian emerging adults (76 % women, mean age of 2.3) were recruited.

METHODS

Participants completed online self-reported validated questionnaires assessing CCT, sex motives and sexual satisfaction.

RESULTS

Results from a path analysis revealed that CCT was associated with a higher endorsement of the self-affirmation sex motive (β = 0.25, p < .001) which was linked to lower sexual satisfaction (β = -0.13, p < .001). CCT was also associated with a higher endorsement of the coping (β = 0.25, p < .001) and partner approval (β = 0.09, p < .05) sex motives. A higher endorsement of the intimacy (β = 0.28, p < .001) and pleasure (β = 0.24, p < .001) sex motives, and a lower endorsement of the partner approval sex motive (β =  -0.13, p < .001) were linked to greater sexual satisfaction.

CONCLUSIONS

Results suggest education and intervention targets to improve emerging adults' sexuality.

Assessment of Child Sexual Abuse in Victimized Women

Child sexual abuse (CSA) is a frequent phenomenon, and women who report it are at a higher risk of mental disorders and sexual dysfunction. The application of a brief questionnaire could help gynecologists assessment of CSA history in women. This study was carried out including women (n = 593) who had been victims of CSA before the age of 18 years. We used the Early Trauma Inventory Self Report-Short Form (ETISR-SF) Part 4, the Female Sexual Function Index (FSFI), the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7), the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), and a semi-structured instrument to assess CSA. Among the 593 women included, 77 agreed to answer the questionnaires, 62(80.5%) had traumatic sexual events, 53(68.8%) had a total FSFI score ≤ 26.55, and 64(84.2%) considered themselves victims of CSA. There was an association regarding the belief that CSA influenced their sex life and their being at risk for GAD (p = 0.001), PTSD (p = 0.02), and sexual abuse by a family member (p = 0.01). The risk factors were the presence of risk for GAD (OR = 5.88[1.3-27.03]) and CSA by a family member (OR = 5.78[1.57-21.28]). This methodology can assist gynecologists in assessing a patient's history of CSA.

Differential Profiles of Sexually Abused Adolescent Boys

Victims of child sexual abuse (CSA) are a heterogeneous population. Several characteristics may influence the outcomes associated with this adverse childhood experience, including personal (e.g. age) and CSA characteristics (e.g. relationship to the perpetrator). This study relied on a person-centered approach to account for this heterogeneity and focused on adolescent boys, an understudied population. Data were drawn from a representative sample of high school students aged 14 to 18 years old in Quebec, Canada. A total of 3.9% (n = 138) of boys reported CSA. Various CSA characteristics (severity, relationship to the perpetrator, and number of events) were used as indicators to derive classes. A four-class solution emerged from the latent class analysis: CSA in a sports context (6%), intrafamilial CSA (8%), extrafamilial CSA (52%) and multiple CSA (34%). The multiple CSA profile included boys who were sexually abused in multiple situations by different perpetrators and who were victims of acts involving penetration. The exploration of correlates associated with class membership revealed that adolescent boys included in the multiple CSA profile were distinguished by higher rates of delinquent behaviors and alcohol and drug use. They were more likely than members of other latent classes to belong to sexual minorities. This exploratory study sheds light on sexually victimized adolescent boys and the deleterious consequences that may affect them, particularly boys who have experienced multiple CSA events. We conclude that prevention efforts should focus on the demystification of sexual trauma among boys and on using trauma-informed care approaches for adolescent externalizing behaviors.

Associations between Conflict Negotiation Strategies, Sexual Comfort, and Sexual Satisfaction in Adolescent Romantic Relationships

Achieving healthy and satisfying sexual relationships is a major developmental task in adolescence, but factors promoting sexual satisfaction among adolescent romantic relationships remain underexplored. Since sexuality is shaped by relational experiences, strategies mobilized to negotiate conflicts in romantic relationships could be related to sexual satisfaction through comfort in negotiating sexual experiences. Sexual comfort refers to the ease of discussing sexuality, and feeling comfortable with one's own sexual life and with others' sexual behaviors. This cross-sectional dyadic study examined the mediating role of sexual comfort in the associations between perceived conflict negotiation strategies and sexual satisfaction among adolescent romantic dyads. The actor-partner interdependence model guided the analyses of self-reported questionnaires from 104 mixed- and same-sex dyads (M_age = 18.99 years, SD = 1.51). An adolescent's higher compromise and lower submission were related to their own higher sexual satisfaction via their own higher sexual comfort. The results also revealed a direct association between an adolescent's higher domination and their own lower sexual satisfaction. These findings underscore the importance of considering conflict negotiation strategies and sexual comfort as key factors related to adolescents' sexual satisfaction.

Childhood Sexual Abuse, Intellectual Disability, and Subsequent Physical and Mental Health Disorders: A Matched Cohort Study

This study assesses whether children with intellectual disability (ID) are more at risk of sexual abuse and whether they have similar consultation rates for physical and mental health disorders than children without ID. The matched-cohort design study uses administrative databases of children who had a sexual abuse report corroborated by a child protection agency and a matched group from the general population. Children with ID were 3.5 times more likely to have a corroborated sexual abuse report when compared to their peers without ID and a higher post-abuse number of medical consultations for physical and mental health disorders. Children with ID are more at risk of sexual abuse and physical and mental health disorders and may also be more vulnerable to the effects of abuse.

The Effects of Childhood Sexual Abuse, Mental Health, and Motives for Sex on Sexual Risk-Taking Among United States Men Who Have Sex with Women

This study assessed the role of mental health symptoms and motives for sex in the association between childhood sexual abuse (CSA) and sexual risk-taking among men who have sex with women (MSW). The sample consisted of young adult (ages 21 to 30), non-monogamous MSW (N = 532) who reported having condomless sex at least once in the past year. Due to alcohol-related aims from two larger studies from which the data were analyzed, participation was excluded to men who regularly consumed alcohol (3 to 35 weekly drinks) and reported no symptoms of alcohol use disorder. Participants answered background questionnaires in lab and then completed a six-week, follow-up survey assessing the number of sex partners and condom use during the prior six weeks. CSA survivors reported greater mental health symptoms and sex motives related to coping, self-affirmation, and partner approval relative to non-survivors. CSA, sex for partner approval, and sex to enhance motives were positively associated with the number of sex partners. Participants endorsing self-affirmation sex motives reported higher condom use than those who did not. CSA contributes to long-term mental and sexual health outcomes among MSW. Identifying and treating depressive and anxiety symptoms and motives for sex may improve sexual health among CSA survivors.

Comparing the prevalence of sexual behaviors and victimization among adolescents based on child welfare system involvement

OBJECTIVE

Sexual behavior presents risks, particularly among vulnerable groups such as adolescents with child welfare system involvement. This study compares the prevalence of sexual behaviors and victimization among adolescents in Los Angeles County with and without child welfare system involvement. It examines associations between online and offline sexual behaviors and victimization.

METHODS

The sample included middle and high school students (N = 2365) and high school students only (N = 1068) participating in the 2015 Los Angeles Youth Risk Behavior Survey (YRBS). Measures included child welfare system involvement with or without foster care placement, demographics (race, ethnicity, gender, age), in-person sexual behaviors (e.g., unsafe sex), online sexual behaviors (e.g., sent/received sext), and sexual victimization (forced sex, dating physical violence, dating sexual assault). Logistic regressions examined variability in sexual behaviors and victimization based on child welfare involvement, net of demographics. Path analyses associated online sexual behaviors with victimization and offline risk.

RESULTS

Greater reported sexual behavior and victimization among foster care youths was found, relative to youths without child welfare system involvement (maximum OR = 9.8). Youth with child welfare system involvement but not placed in foster care reported more unsafe sex, sexting because of pressure, finding a sex partner online, having sex with a partner met online, and forced sex (maximum OR = 10.4). Sexting was associated with forced sex and dating sexual assault, finding a sexual partner online, and physical violence.

CONCLUSIONS

Targeted prevention is needed for online and offline sexual risks and victimization among youth with child welfare system involvement.

Adapting Adolescent Dating Violence Prevention Interventions to Victims of Child Sexual Abuse

Considering the increased risk of revictimization, adolescents who have experienced child sexual abuse (CSA) are a priority subpopulation for the prevention of dating violence. Yet, intervention programs often focus on psychological symptomology associated with CSA; few tackle issues specific to relational violence. Addressing the relational traumatization of adolescents with a history of CSA is essential to prevent their revictimization. Given specific CSA sequelae related to intimacy and engagement in sexual behaviors, there is a need for tailoring interventions to boy and girl survivors. A case study of a group intervention designed for adolescent girls with a history of CSA was conducted. The context adaptation, based on intervention mapping proposed by Bartholomew and colleagues, served as a theoretical framework. Four steps were taken to ensure that the intervention addressed CSA youth needs: (a) needs assessment, (b) analysis of the conceptual framework of the original program, (c) selection of interventions and developing new interventions, and (d) validation with a committee of practitioners. This approach provided an understanding of risk factors and intervention priorities using the problem logic model. The original program was enhanced by adding four interventions addressing the prevention of dating violence. These interventions were then validated by practitioners before implementation in the setting. The approach underscores the relevance of understanding the needs of the clientele and of adopting a collaborative approach to ensure the proposed interventions are relevant.

Adverse Childhood Experiences and Their Relationship with Poor Sexual Health Outcomes: Results from Four Cross-Sectional Surveys

Improving understanding of risk factors for risky sexual behaviour is fundamental to achieve better population sexual health. Exposure to adverse childhood experiences (ACEs) can increase the risk of poor sexual health outcomes, but most research is US-based. This study explored associations between ACEs and poor sexual health outcomes in the UK. Data from four cross-sectional ACE surveys with adult general populations in different regions of the UK from 2013−2015 (n = 12,788) were analysed. Data included participants’ demographics, ACE exposure, and four sexual health outcomes: having early sex (<16 years), having an accidental teenage pregnancy, becoming a teenage parent, or having a lifetime diagnosis of a sexually transmitted infection. ACE count was a consistent and significant predictor of all four sexual health outcomes for both males and females, with odds of these outcomes between three and seven times higher for those with 4+ ACEs compared to those with no ACEs. Increased risks of some, but not all, sexual health outcomes were also found with higher residential deprivation, younger age, being of white ethnicity, and being born to a teenage mother. Findings highlight the need for effective interventions to prevent and ameliorate the lifelong effects of ACEs. Trauma-informed relationships and sex education, sexual health services, and antenatal/postnatal services, particularly for teenagers and young parents, could provide opportunities to prevent ACEs and support those affected. Ensuring that those living in deprived areas have access to services and that barriers to uptake are addressed is also key.

Treating Sexual Dysfunctions Among Survivors of Child Sexual Abuse: An Overview of Empirical Research

Sexual problems are very prevalent among survivors of child sexual abuse (CSA). Yet, various approaches to therapy do not seem to address this issue when treating these individuals. Traditional sex therapy may also not suit the experiences of CSA survivors, as CSA was not considered when the most well-known and frequently used techniques were developed. The present review sought to identify (1) theory-based therapeutic approaches that address sexual problems among CSA survivors and offer treatment protocols (including an outline of specific therapy stages, sessions, or techniques) to treat these sexual problems and (2) identify therapeutic approaches that include a protocol for treating sexual problems among CSA survivors that was empirically tested and validated. In total, six approaches for treating sexual dysfunctions among CSA survivors that provide detailed guidelines for implementing the approach within sex therapy for CSA survivors were identified in the literature. Only two of the studies conducted a randomized controlled trial to test the intervention. This overview concludes with important issues to address when treating sexual problems among CSA survivors and a call for additional evidence-based practices for treating sexual problems among survivors of CSA.

Child Maltreatment and the Child Welfare System as Environmental Factors in the International Classification of Functioning

The WHO defines child maltreatment as any form of neglect, exploitation, and physical, emotional, or sexual abuse, committed against children under the age of 18. Youth involved in the child welfare system report more maltreatment experiences and environmental turbulence (e.g., number of moves, caseworkers), placing them at greater risk for poorer physical and mental health. The International Classification of Functioning, Disability, and Health (ICF) provides a framework to describe health conditions and severity of disabilities for an individual and/or group in the context of environmental factors. The Maltreatment and Adolescent Pathways (MAP) study is a longitudinal study, assessing self-reports on variables (e.g., child maltreatment history, trauma symptoms, dating violence, and substance use) of youth in an urban child protection service system. This study focuses on 11 of the 24 MAP publications that pertain to health and functioning, which can be considered applicable to the ICF framework, following established linking rules. The purpose of this study is to analyze these MAP sub-studies, with maltreatment and involvement in the child welfare system as environmental factors that impact the functioning of child welfare-involved youth. Findings indicate significant relationships across environmental factors (i.e., child maltreatment histories, child welfare system involvement), health conditions (i.e., trauma symptomatology, psychological distress, intellectual disabilities), and functioning problems (i.e., substance use, adolescent dating violence, sexual risk-taking, coping motives, sleep problems). The interrelated nature of these factors in the MAP sub-studies suggests the value of the ICF model to a holistic health view of use to practitioners supporting system-involved youth, clarifying unattended environmental factors in guiding service provision for foster care and/or maltreated youth.

Relationship between childhood sexual abuse and attitudes toward premarital sexual permissiveness among middle school students in Luzhou, China

BACKGROUND

In recent years, the number of adolescents engaging in premarital sex has increased, and an increasing number of childhood sexual abuse (CSA) cases have been reported in China. Many studies have indicated that CSA has a well-established association with risky sexual activities. However, only a limited number of studies have explored possible reasons for this association among middle school students, a population that may engage in premarital sex, which is critical for the development of interventions to prevent risky sexual behavior. Based on random samples of middle school students from a Chinese city, this article investigated the relationship between CSA and students' premarital sexual permissiveness (PSP).

METHODS

In a cross-sectional study conducted between 2016 and 2017 in Luzhou, China, 2292 middle school and high school students aged 12-18 years were recruited by multistage random sampling. All students were administered anonymous questionnaires. Multiple linear regression and binary logistic regression analyses were conducted to analyze the relationship between CSA and PSP.

RESULTS

The prevalence of CSA was 15.4% (354/2292; 95% CI: 14-16.9%). A higher percentage of male respondents (18.2%) than female respondents (12.9%) had experienced CSA. A positive association between CSA and PSP was found among students. Respondents who had suffered CSA exhibited greater PSP, and this relationship was observed in the male sample, female sample and the total student sample in Luzhou (β = - 3.76, P < 0.05; β = - 2.79, P < 0.05; and β = - 2.84, P < 0.05, respectively). Respondents who had suffered CSA were also more likely to express a double standard about premarital sex (odds ratio [OR] =1.41, P < 0.05), especially among male students (odds ratio [OR] =1.63, P < 0.05).

CONCLUSIONS

Sex differences in CSA and the relationship between CSA and PSP were significant among this large sample of middle school students in Luzhou (China). The findings suggest that experiencing CSA may be closely related to youth attitudes toward premarital sex, especially among males. Therefore, it is important to emphasize the prevention of CSA and provide adolescent reproductive health programs to reduce the impact of CSA on sexual cognition and attitude, prevent premarital sex and promote positive attitudes toward sexual equality for middle school students.

The Development and Initial Validation of the Youth Sexual Intention Scale: Indonesian Version

Interventions for the early sexual problem in adolescents require proper measurement of sexual intentions. The adolescent sexual intention scales have been widely used by researchers in the West. However, those scales are not very suitable for adolescents in eastern cultures such as Indonesia. As a religious society, Indonesian people have different sexual expectations from liberal western society. Religious teachings and societal norms shape sexual beliefs that reflect semi-restrictive sexual socialization. Thus, sexual intention measurement that represents the sexual beliefs of the subject under study becomes important. Therefore, this two-steps study aims to develop and validate the Youth Sexual Intention Scale (YSIS). In the first step, qualitative elaboration resulted in 27 themes of adolescent sexual beliefs, which turned into 31 items according to the Theory of Planned Behavior (TPB). In the second step, we selected 396 students using the cluster random sampling technique. We investigated 2 methods of validity, content validity using CVI and construct validity using confirmatory factor analysis (CFA). The content validity examination proved that all scale items had high validity (CVI = .93). Meanwhile, the CFA showed that the data was fit for the model (Chi-square 819,420, P <.001, RMSEA = .056, CFI = .978, TLI = .972). The CFA groups items into 4 dimensions, namely, sexual attitudes, subjective norms, perceived behavioral control, and sexual intentions. The reliability test shows an Alpha coefficient of .854. We conclude that 26-items YSIS is a valid and reliable instrument to measure belief-based youth sexual intentions (15–18 years) in religious culture.

Childhood Sexual Abuse and Sexual Motivations - The Role of Dissociation

The present study sought to examine the relations between a history of childhood sexual abuse (CSA) and sexual motivations and to explore the moderating role of dissociation within these relations. The study was conducted among 889 men and women (ages 18-70). Results indicated a history of CSA was significantly related to higher scores on self-affirmation, coping, partner approval and peer pressure sexual motivations. Interactions between CSA and gender in explaining sexual motivations, were not significant. Among participants with a history of CSA (n = 365), dissociation was significantly related to sexual motivations, so that participants who had dissociation scores above the cutoff (reporting high levels of dissociation) scored higher on intimacy, self-affirmation, coping, and partner approval than did those with a history of CSA who reported low levels of dissociation. Analyzes revealed significant moderating effects for dissociation within the relations between CSA and intimacy, coping, and partner approval sexual motivations. The present study suggests CSA survivors and those who report high levels of dissociation in particular, utilize sex for intimacy, for coping with negative emotions, and for partner approval. Therapists working with CSA survivors should be aware of the potential effects the abuse has on the survivor's reasons to engage in sex.

Gender, rights and responsibilities: The need for a global analysis of the sexual exploitation of boys

The United Nations Convention on the Rights of the Child confirmed child and youth rights globally. Their right to participation is a critical driver for the 2030 Sustainable Development Goals (SDGs). Youth prioritize the need to end violence against them, charging adults with safeguarding, and identify gender inequality as an underlying cause of child sexual exploitation (CSE). SDG 5 includes targets for ending sexual exploitation of girls; however, it is critical to review whether we are supporting both boys and girls adequately. Based on recent research, it is clear that male victims of CSE are prevalent, yet they have been relatively excluded in policy, research, and interventions. The aim is not to minimize the importance of understanding and eliminating CSE of girls, but to acknowledge that vulnerable sub-groups of boys exist in community (street-connected boys, refugees, sexual minorities) and service systems (justice, child welfare, humanitarian aid). Gender-based challenges persist in protection, disclosure, help-seeking, professional recognition, programming and prevention. In this discussion article, we outline responsibilities in human rights law to understand and address boys' CSE and overview key literature on its impact on boys. It is argued that gender-, trauma-, and violence-informed approaches are expanded to address the contribution of harmful gender norms, and to target prevention in the adolescent years for sexually transmitted infections, mental health, and substance abuse and violence problems. This discussion advances a pressing need for a global analysis of CSE among boys.

The Association of Childhood Sexual Abuse With Non-Paraphilic and Paraphilic Sexual Behaviors Among Adolescents Who Have Sexually Offended

A history of childhood sexual victimization (CSV) is one of the most commonly examined factors in research on male adolescent sexual offending. Although CSV has been extensively researched in relation to the onset and maintenance of adolescent sexual offending, few studies have investigated the association of CSV with domains of adolescent sexuality outside of sexual offending. Understanding how CSV may be associated with the non-paraphilic, and paraphilic, sexual behaviors of adolescent males who commit sexual offenses has important implications for promoting healthy sexuality among this population. In a sample of 162 male adolescents (M age = 15.2 years, SD = 1.3) adjudicated for a sexual offense, we tested the association of CSV with a range of non-paraphilic (e.g., age of first consensual sex) and paraphilic (e.g., use of paraphilic pornography) sexual behavior variables. The results indicated CSV was associated with greater engagement in risky non-paraphilic sexual behaviors, as well as paraphilic sexual behaviors. CSV was also associated with specific offense characteristics, replicating previous research findings. The current study is a first step toward understanding the broader sexual context of adolescents who commit sexual offenses.

Physical Abuse and Adolescent Sexual Behaviors: Moderating Effects of Mental Health Disorders and Substance Use

The purpose of the current study was to examine the direct effects of child physical abuse on sexual behaviors and whether mental health problems and substance use moderated the associations between exposure to child physical abuse and sexual behavioral practices among adolescents who participated in the National Comorbidity Survey-Adolescent Supplement (NCS-A). The data show statistically significant relationships between physical abuse and risky sexual behaviors for youth who met the clinical criteria for lifetime Posttraumatic Stress Disorder (PTSD) and reported marijuana use. Data from future studies can inform sexual health practice development with adolescents and emerging adults with a history of physical abuse, marijuana use/abuse and PTSD. These findings underscore the importance of exploring presence of symptoms associated with PTSD and marijuana use as part of a comprehensive biopsychosocial assessment for physically abused adolescents and emerging adults to determine if they are engaging in risky sexual behaviors.

Effect of child abuse and neglect on risk behaviors in inner-city minority female adolescents and young adults

BACKGROUND

Over six million children each year are referred to child protective services for child abuse (sexual, physical and emotional) and neglect (physical and emotional).

OBJECTIVE

While the relationship between child sexual abuse and sexually transmitted infections has been documented, there has been little research regarding the effects of other forms of maltreatment.

PARTICIPANTS AND SETTING

882 inner-city females aged 12-20 years of age seen at a large adolescent and young adult (AYA) health center in New York City between 2012-2017.

METHODS

History of maltreatment was assessed using the Childhood Trauma Questionnaire. Associations with depressive symptoms, antisocial behavior, peer deviancy, drug/alcohol use, and risky sexual behaviors were assessed.

RESULTS

History of maltreatment was common in our cohort of inner-city AYA females, with 59.6 % reporting any type of maltreatment, including sexual abuse (17.5 %), physical abuse (19.5 %) or neglect (26.2 %), and emotional abuse (30.7 %) or neglect (40.4 %). We observed significant associations between all forms of maltreatment and risk of depression, drug/alcohol use, antisocial behaviors, peer deviancy, and risky sexual risk behaviors (including having a higher number of sexual partners, having a sexual partner 5+ years older, and anal sex). Physical and emotional abuse were associated with having unprotected sex while under the influence of drugs/alcohol.

CONCLUSIONS AND RELEVANCE

Reporting a history of maltreatment was associated with an increased likelihood of engaging in risky sexual and antisocial behaviors, as well as depression in inner-city female youth. These data highlight the broad, lingering repercussions of all types of child maltreatment.

The Relationship between Childhood Maltreatment and Risky Sexual Behaviors: A Meta-Analysis

Childhood maltreatment is associated with risky sexual behaviors (RSBs). Previous systematic reviews and meta-analysis focused only on the relationship between childhood sexual abuse and RSBs, thus the association between childhood maltreatment and RSBs has yet to be systematically and quantitatively reviewed. We aimed to provide a systematic meta-analysis exploring the effect of childhood maltreatment and its subtypes on subsequent RSBs in adolescence and adulthood. PubMed, Google Scholar, EMBASE, Medline were searched for qualified articles up to April 2019. We calculated the pooled risk estimates using either the random-effect model or fixed-effect model. The potential heterogeneity moderators were identified by subgroup and sensitivity analysis. Overall, childhood maltreatment was significantly associated with an early sexual debut (odds ratio (OR) = 2.22; 95% confidence interval (CI): 1.64–3.00), multiple sexual partners (OR = 2.22; 95% CI: 1.78–2.76), transactional sex (OR = 3.05; 95% CI: 1.92–4.86) and unprotected sex (OR = 1.59; 95% CI: 1.22-2.09). Additionally, different types of childhood maltreatment were also significantly associated with higher risk of RSBs. Relevant heterogeneity moderators have been identified by subgroup analysis. Sensitivity analysis yielded consistent results. Childhood maltreatment is significantly associated with risky sexual behaviors. The current meta-analysis indicates it is vital to protect children from any types of maltreatment and provide health education and support for maltreated individuals.

Adverse Childhood Experiences, Early and Nonmarital Fertility, and Women's Health at Midlife

Adverse childhood experiences (ACEs) have powerful consequences for health and well-being throughout the life course. We draw on evidence that exposure to ACEs shapes developmental processes central to emotional regulation, impulsivity, and the formation of secure intimate ties to posit that ACEs shape the timing and context of childbearing, which in turn partially mediate the well-established effect of ACEs on women's later-life health. Analysis of 25 years of nationally representative panel data from the National Longitudinal Study of Youth (NLSY79; n = 3,893) indicates that adverse childhood experiences predict earlier age at first birth and greater odds of having a nonmarital first birth. Age and marital status at first birth partially mediate the effect of ACEs on women's health at midlife. Implications for public health and family policy aimed at improving maternal and child well-being are discussed.

Early Environmental Unpredictability: Implications for Youth's Perceptions and Social Functioning

According to an evolutionary perspective, early environmental unpredictability induces expectations in youth that their future is uncertain and increases their likelihood of engaging in opportunistic, impulsive, and aggressive behaviors. Although considerable evidence supports the links between environmental unpredictability and such behaviors, less is known about how youth growing up in volatile environments actually perceive their lives and how these perceptions relate to their behavior. In this study, two samples of 10-17 year-olds, one with a history of maltreatment and removal from home (n = 90; 52% female; 67% Hispanic-American) and one without (n = 80; 54% female; 69% Hispanic-American), reported on their perceptions of unpredictability and social functioning. Maltreated youth endorsed greater perceptions of unpredictability than non-maltreated youth. For both groups, greater perceptions of unpredictability were associated with increased aggression and conduct problems and decreased prosociality. Findings advance understanding of a developmental pathway contributing to opportunistic and risky social behavior in youth.

Maltreatment history, trauma symptoms and research reactivity among adolescents in child protection services

OBJECTIVE

There is a well-documented link between child maltreatment and poor health across the lifespan. This provides a strong case for ongoing research with youth involved in the child welfare system to reduce negative outcomes and support resilience while being inclusive of youth voices. However, detailed inquiries about maltreatment history and health consequences may cause re-experiencing of events and psychological distress for study participants. Data that accounts for different contexts, such as severity of maltreatment history and current trauma symptomatology, have been limited in considering the question of potential harms to youth who participate in research-especially longitudinal studies.

METHODS

This study compared self-reported impact of research participation against maltreatment history and current post-traumatic stress symptomatology among a randomly selected group of adolescents (< 18 years old) in the child protection service (CPS) system.

RESULTS

Adolescents who report more serious child maltreatment and current trauma symptom severity reported higher scores on distress questions from pre- to post-assessment participation. Critically, participants who were more negatively impacted by study involvement also reported greater benefit from study involvement.

CONCLUSION

The increase in both negative and positive impact does not shift the risk/reward ratio for participation, as risks alone do not increase for this vulnerable group of CPS involved youth. These results are consistent with previous findings from studies involving non-CPS populations and underlies the importance of empirical data to address the question of change in the risk/reward ratio and what factors might play a role in any change. This information can inform inclusion/exclusion criteria for future research with these vulnerable populations, thereby reducing the risk of distress among study participants.

Understanding Men's Self-Reported Sexual Interest in Children

A few studies have found that even in the general population, a minority of adults-men as well as women-report some sexual interest in a young age group. The purpose of the present study was to identify factors associated with self-reported sexual interest in children among a community-based sample of men. Using an online survey methodology, we examined the extent to which different types of childhood adversities (witnessing parental violence, sexual, physical, and emotional abuse), atypical childhood sexual experiences, and participants' self-reported likelihood of engaging in a variety of sexual behaviors (heightened sexual interest) were related to sexual interest in children (SIC) reported by a non-forensic/non-clinical sample of 173 men. Data were analyzed using hierarchical multiple regression. After controlling for physical and emotional abuse and witnessing parental violence, self-reported experiences of childhood sexual abuse (CSA) significantly increased the amount of variance explained in SIC scores. However, only early masturbation and current heightened sexual interests contributed significantly to the final model. Total variance explained by the model as a whole was 24% (adjusted R² = 20%). Early masturbation and heightened sexual interests significantly mediated the relationship between CSA and SIC scores. Findings add to the small but growing body of literature examining the etiology of pedophilic sexual interests in non-clinical samples.