Prior childhood sexual abuse in mothers of sexually abused children

A Scoping Study of Parents With a History of Childhood Sexual Abuse and a Theoretical Framework for Future Research

Transitioning to a parenting role is a complex psychological process that can be stressful for a parent with a history of childhood sexual abuse (CSA). Over the past decade, important advances have been made in identifying the effects of childhood trauma on parents' relationships with their children. This article presents a new theoretical framework that emerged from a scoping study of parenting experiences among adults who experienced CSA. The methods of Arksey and O'Malley were used to conduct the scoping study, and the guidelines for theory construction and model building developed by Jaccard and Jacoby were adopted. Only peer-reviewed published journal articles in English that studied exclusively CSA and its effects on parenting among individuals aged 18 years or older were included. Three resources for collecting data were used: (1) internet databases including PsycINFO and PubMed, (2) reference lists of review articles, and (3) the citation index functionality of Google Scholar for review articles. Forty-six articles were included in the scoping study. These studies mainly focused on mothers and their relationships with their children. No articles considered the age(s) at which parents experienced CSA and potential effects on parenting outcomes. In addition, there is limited knowledge about fathers with a history of CSA and their relationship with their children. The development of a theoretical framework designed through a methodologically driven identification of gaps in the body of knowledge provides a foundation for future research in this area.

Intergenerational Cycles of Maltreatment: A Scoping Review of Psychosocial Risk and Protective Factors

Child maltreatment tends to show intergenerational continuity. However, a significant proportion of maltreated parents break these cycles. Since several studies have investigated risk and protective factors associated with the intergenerational continuity of child maltreatment over the past decades, and no systematic review of the literature is available, this scoping review aimed to summarize studies documenting associated psychosocial risk and protective factors. A secondary objective was to document the prevalence of this phenomenon. A search in six major databases (PsycINFO, Scopus, Medline, Social Work Abstracts, ProQuest Dissertations/Theses, and Web of Science) was conducted. Studies involving human participants, presenting original findings, written in French or English, and of any type of design were included. There was no limit regarding the date of publication, except for theses/dissertations (5 years). A final sample of 51 papers was retained, 33 providing data on risk and protective factors and 18 providing only prevalence data. Results indicate that parents' individual characteristics (e.g., mental health, age), childhood adversity (e.g., multiple forms of adversity), relational (e.g., couples' adjustment, attachment, social support), and contextual factors (e.g., disadvantage, community violence) are relevant to the intergenerational continuity of child maltreatment. Prevalence rates of continuity ranged from 7% to 88%. Major limitations of reviewed studies are discussed. Continued efforts to uncover the mechanisms associated with the intergenerational continuity of child maltreatment using strong methodological designs are necessary. Knowledge in this area could lead to the development of effective prevention strategies (e.g., mental health services for parents, family/dyadic interventions) to break harmful intergenerational cycles of violence.

The Relationship between Childhood Traumas and Crime in Male Prisoners

OBJECTIVE

It is known that the negative impact of childhood traumas on the mental health of the individual is significant and leads to the emergence of many psychiatric conditions. The aim of this study was to determine the relationship between childhood trauma, violence tendency, and crime among male prisoners and inmates in prison.

METHODS

The study group consisted of 313 male prisoners who have been convicted of drug crimes, sexual crimes, deliberate manslaughter, and theft crimes in Mersin Anamur T type closed-open prison. Sociodemographic forms prepared by researchers, Childhood Trauma Questionnaire (CTQ), and the Violence Tendency Scale (VTS) were used for measuring variables.

RESULTS

It was observed that there is a relationship between childhood traumas and criminal behavior in prisoners and detainees and that criminal behavior is affected by sociodemographic variables. In addition, there is a relationship between childhood traumas and violent tendencies. As the scores of individuals on emotional abuse, physical abuse, physical neglect, sexual abuse, and childhood trauma scales increased, the scores of individuals on VTS increased as well. CTQ predicts 11% of the variance of violence tendency.

CONCLUSION

If psychiatric conditions and violence tendency of individuals with childhood trauma are detected, it will be possible for preventive actions to be taken before these people become prisoners or detainees.

Physical, Emotional, and Sexual Victimization Across Three Generations: a Cross-Sectional Study

Using data gathered from grandparents (G1), parents (G2), and young adults (G3), this study examines the continuity of intergenerational victimization (physical, emotional, and sexual) across three generations. The study included data from 168 participants within three generations: grandparents, G1 (19.2% male, 80.8% female, M = 78.13 years old); parents, G2 (25.5% male, 74.5% female, M = 50.13 years old); and young adults, G3 (40% male, 60% female, M = 21.10 years old). The data is analyzed at two levels: (1) bivariate analyses to address relationships between the variables studied by Spearman's correlations, and (2) a path model to examine the intergenerational abuse simultaneously considering all variables. Overall, path modeling showed that experienced abuse demonstrated continuity from G1 to G2 and from G2 to G3. Specifically, findings indicated that grandparents' physical and psychological victimization has a direct effect on parents' sexual and physical abuse victimization, respectively. Additionally, parents' physical victimization has a direct effect on young adults' psychological and sexual victimization, while parents' psychological victimization has a direct effect on young adults' physical and sexual victimization. These findings highlight the need for preventive interventions focused on breaking intergenerational cycles of abuse.

Testing the cycle of maltreatment hypothesis: Meta-analytic evidence of the intergenerational transmission of child maltreatment

It has long been claimed that "maltreatment begets maltreatment," that is, a parent's history of maltreatment increases the risk that his or her child will also suffer maltreatment. However, significant methodological concerns have been raised regarding evidence supporting this assertion, with some arguing that the association weakens in samples with higher methodological rigor. In the current study, the intergenerational transmission of maltreatment hypothesis is examined in 142 studies (149 samples; 227,918 dyads) that underwent a methodological quality review, as well as data extraction on a number of potential moderator variables. Results reveal a modest association of intergenerational maltreatment (k = 80; d = 0.45, 95% confidence interval; CI [0.37, 0.54]). Support for the intergenerational transmission of specific maltreatment types was also observed (neglect: k = 13, d = 0.24, 95% CI [0.11, 0.37]; physical abuse: k = 61, d = 0.41, 95% CI [0.33, 0.49]; emotional abuse: k = 18, d = 0.57, 95% CI [0.43, 0.71]; sexual abuse: k = 18, d = 0.39, 95% CI [0.24, 0.55]). Methodological quality only emerged as a significant moderator of the intergenerational transmission of physical abuse, with a weakening of effect sizes as methodological rigor increased. Evidence from this meta-analysis confirms the cycle of maltreatment hypothesis, although effect sizes were modest. Future research should focus on deepening understanding of mechanisms of transmission, as well as identifying protective factors that can effectively break the cycle of maltreatment.

Maternal and Child Sexual Abuse History: An Intergenerational Exploration of Children's Adjustment and Maternal Trauma-Reflective Functioning

Objective: The aim of the current study was to investigate associations, unique and interactive, between mothers’ and children’s histories of childhood sexual abuse (CSA) and children’s psychiatric outcomes using an intergenerational perspective. Further, we were particularly interested in examining whether maternal reflective functioning about their own trauma (T-RF) was associated with a lower likelihood of children’s abuse exposure (among children of CSA-exposed mothers).

Methods: One hundred and eleven children (M_age = 9.53 years; 43 sexual abuse victims) and their mothers (M_age = 37.99; 63 sexual abuse victims) participated in this study. Mothers completed the Parent Development Interview (PDI), which yielded assessments of RF regarding their own experiences of abuse, and also reported on their children’s internalizing and externalizing symptoms.

Results: Children of CSA-exposed mothers were more likely to have experienced CSA. A key result was that among CSA-exposed mothers, higher maternal T-RF regarding their own abuse was associated with lower likelihood of child CSA-exposure. Mothers’ and children’s CSA histories predicted children’s internalizing and externalizing symptoms, such that CSA exposure for mother or child was associated with greater symptomatology in children.

Conclusion: The findings show that the presence of either maternal or child CSA is associated with more child psychological difficulties. Importantly in terms of identifying potential protective factors, maternal T-RF is associated with lower likelihood of CSA exposure in children of CSA-exposed mothers. We discuss these findings in the context of the need for treatments focusing on increasing T-RF in mothers and children in the context of abuse to facilitate adaptation and reduce the intergenerational risk.

Mothers' History of Child Sexual Abuse and Child Behavior Problems: The Mediating Role of Mothers' Helpless State of Mind

This investigation evaluated a theoretically specified model of associations among mothers' history of child sexual abuse (CSA), a helpless state of mind (SOM) with regard to the mother-child relationship, and increased behavior problems in the next generation. Moreover, we evaluated the moderating influence of child gender on predicted relations between mothers' CSA severity and helpless SOM (i.e., moderated mediation). Participants were 225 biological mother-preschooler dyads (48% female; 46.4% Latinx) drawn from an ongoing, longitudinal study of representation and regulation in child development. Mothers' history of CSA was assessed when their children were 4 years old and emerged as a prominent risk factor in this diverse, high-risk community sample with 40% of mothers reporting contact-based sexual abuse prior to age 18. Mediation analyses revealed a significant indirect pathway from a continuous rating of mothers' CSA severity to increased externalizing behavior problems from ages 4 to 8 in the next generation via mothers' helpless SOM at age 6. Further, this indirect path was significant for mother-daughter dyads, but not for mother-son dyads. This investigation contributes to the neophyte literature on intergenerational CSA effects by revealing the impact of a mother's CSA history on her SOM regarding the mother-child relationship, particularly when parenting daughters. Clinical interventions that enhance survivors' awareness of and reflection on their SOM regarding the parent-child relationship may attenuate intergenerational CSA effects on child adaptation.

Clinical characteristics of children presenting with a suspicion or allegation of historic sexual abuse

INTRODUCTION

Police-recorded sexual offences against children and young people (CYP) increased 85% in the UK between 2010/2011 and 2014/2015. Many children delay disclosure, but little data are available regarding characteristics of CYP presenting with historic child sexual abuse (CSA).

AIM

To identify the clinical and CSA-related characteristics of CYP presenting with a suspicion or allegation of historic CSA.

METHOD

Data were collected on all CYP<17 years presenting with suspected or alleged historic CSA (ie, >3 days since last sexual assault in prepubertal children, >7 days pubertal girls) between October 2009 and November 2014.

DATA COLLECTED

source and indication for referral, alleged perpetrator, physical findings. Findings supportive of CSA were peer reviewed for consensus agreement.

ANALYSIS

χ² test, Fisher's exact test and logistic regression.

RESULTS

Among 249 CYP, presentation with physical/behavioural symptoms was associated with age <13 years (p<0.01), and alleged penetration with ages 13-17 years (p<0.01). Where known, time since alleged CSA ranged from 1 week to 13 months. Anogenital findings supportive of CSA were present in 7% of examined children (16/233), significantly associated with alleged penetration (p<0.01) and more likely with increasing age (OR 1.46, 95% CI 1.23 to 1.72). Additionally, where tested, sexually transmitted infections (STI) were detected in 2.6% CYP (3/116). Alleged perpetrators were intrafamilial in 66% (126/190). No associations were identified between perpetrator type and gender (p=1.0), age (p=0.7) or indication for referral (p=0.35).

CONCLUSIONS

Despite significant time delay since the alleged CSA, this study highlights the persistence of anogenital findings supportive of CSA in 7% and STIs in 2.6% of CYP.

Screening for potential child maltreatment in parents of a newborn baby: The predictive validity of an Instrument for early identification of Parents At Risk for child Abuse and Neglect (IPARAN)

For preventive purposes it is important to be able to identify families with a high risk of child maltreatment at an early stage. Therefore we developed an actuarial instrument for screening families with a newborn baby, the Instrument for identification of Parents At Risk for child Abuse and Neglect (IPARAN). The aim of this study was to assess the predictive validity of the IPARAN and to examine whether combining actuarial and clinical methods leads to an improvement of the predictive validity. We examined the predictive validity by calculating several performance indicators (i.e., sensitivity, specificity and the Area Under the receiver operating characteristic Curve [AUC]) in a sample of 4692 Dutch families with newborns. The outcome measure was a report of child maltreatment at Child Protection Services during a follow-up of 3 years. For 17 children (.4%) a report of maltreatment was registered. The predictive validity of the IPARAN was significantly better than chance (AUC=.700, 95% CI [.567-.832]), in contrast to a low value for clinical judgement of nurses of the Youth Health Care Centers (AUC=.591, 95% CI [.422-.759]). The combination of the IPARAN and clinical judgement resulted in the highest predictive validity (AUC=.720, 95% CI [.593-.847]), however, the difference between the methods did not reach statistical significance. The good predictive validity of the IPARAN in combination with clinical judgment of the nurse enables professionals to assess risks at an early stage and to make referrals to early intervention programs.

Characteristics of Sexually Abused Children and Their Nonoffending Mothers Followed by Child Welfare Services: The Role of a Maternal History of Child Sexual Abuse

Considering the importance of mother's support in the adaptation of a sexually abused child, it is relevant to determine if the mothers and children involved in an intergenerational cycle of child sexual victimization differ from dyads in which only the child has been abused. The purpose of this study was to compare mother-child dyads with sexually abused children according to whether the mother had herself been victim of child sexual abuse. The sample included 87 dyads with sexually abused children aged 3-18 years old and their mothers (44 reporting maternal and child abuse), followed by social welfare services of the province of Quebec (Canada). The two groups of mothers were compared on their past family abuse experiences and past family relations, their mental health history, their current psychological distress, their parenting behaviors, and their current levels of family functioning. Children were compared on their adaptation. Multivariate analyses indicated that mothers reporting child sexual abuse were more likely to report more other maltreatments in their childhood and greater prevalence of lifetime history of alcohol abuse disorders, dysthymia, and panic disorder compared with mothers who had not experienced CSA. Compared to children whose mothers had not experienced CSA, those whose mothers had experienced CSA showed higher rates of problems behaviors and were more likely to report having been sexually abused by a trusted person. These results highlight the specific clinical needs for the assessment and treatment for sexually abused children whose mothers experienced child sexual abuse.

Caregiver Needs Following Disclosure of Child Sexual Abuse

Caregiver support is vital in improving outcomes for child sexual abuse victims; however, the disclosure can significantly affect caregivers, thus impacting their ability to meet their children's needs. To maximize the support from caregivers, their own needs following disclosure need to be met. This study investigated the impact of child sexual abuse disclosure and associated needs as identified by caregivers. Sixty needs assessment forms were collected from families who accessed a parenting support pilot program run in New Zealand. These forms were completed by nonoffending caregivers during an assessment session with their counselor and consisted of both open-ended and Likert scale questions focusing on both the needs of the child and the family. Caregivers identified a range of impacts of the disclosure on their children, themselves, and other families members and the related support that may be needed. In particular, caregivers identified that they needed support with child behavior management and with their own coping. The findings suggest that interventions with caregivers following disclosure of child sexual abuse may be a valuable adjunct to therapy provided directly to the child.

Mothers who were sexually abused during childhood are more likely to have a child victim of sexual violence

INTRODUCTION

Recurrent exposure to childhood sexual abuse (CSA) seems to be higher among victims of sexual abuse. In this sense, experiences related to sexual violence can perpetuate within the family context itself in various ways. Here, we investigate the association between being exposed to CSA and having a child victim of sexual abuse.

METHOD

We used a sample with 123 mothers, who were divided into 2 groups: one consisting of 41 mothers of sexually abused children and another consisting of 82 mothers of non-sexually abused children. History of exposure to CSA was evaluated by means of the Childhood Trauma Questionnaire - Short Form (CTQ) and we used a logistic regression model to estimate the prediction values regarding having or not a child exposed to sexual violence.

RESULTS

Mothers of sexually abused children had significantly higher scores on CTQ, especially on the sexual abuse subscale (SA). According to our logistic regression model, higher scores on the CTQ significantly predicted the status of being a mother of children exposed to sexual violence in our sample (Wald = 7.074; p = 0.008; Exp(B) = 1.681). Years of formal education reduced the likelihood of having a child victim of sexual violence (Wald = 18.994; p = 0.001; Exp(B) = 0.497).

CONCLUSION

Our findings highlight the importance of a possible intergenerational effect of sexual abuse. Family intervention and prevention against childhood maltreatment should take this issue in account.

Does maltreatment beget maltreatment? A systematic review of the intergenerational literature

In this article, the authors critically review the literature testing the cycle of maltreatment hypothesis which posits continuity in maltreatment across adjacent generations. That is, the authors examine whether a history of maltreatment victimization is a significant risk factor for the later perpetration of maltreatment. The authors begin by establishing 11 methodological criteria that studies testing this hypothesis should meet. They include such basic standards as using representative samples, valid and reliable measures, prospective designs, and different reporters for each generation. The authors identify 47 studies that investigated this issue and then evaluate them with regard to the 11 methodological criteria. Overall, most of these studies report findings consistent with the cycle of maltreatment hypothesis. Unfortunately, at the same time, few of them satisfy the basic methodological criteria that the authors established; indeed, even the stronger studies in this area only meet about half of them. Moreover, the methodologically stronger studies present mixed support for the hypothesis. As a result, the positive association often reported in the literature appears to be based largely on the methodologically weaker designs. Based on this systematic methodological review, the authors conclude that this small and methodologically weak body of literature does not provide a definitive test of the cycle of maltreatment hypothesis. The authors conclude that it is imperative to develop more robust and methodologically adequate assessments of this hypothesis to more accurately inform the development of prevention and treatment programs.

Attachment representations and anxiety: differential relationships among mothers of sexually abused and comparison girls

The present study sought to document an example of how childhood sexual abuse and attachment representation interact while contributing to the trait anxiety of nonoffending mothers following the disclosure of their daughters' sexual abuse. The study sample consisted of 57 ethnically diverse mothers of sexually abused girls aged 6 to 16 and 47 mothers of comparison girls who were matched with the abused girls on age, socioeconomic status, and family constellation. Results indicate that the mothers' representations of past attachment relationships with their own fathers were differentially related to their current attachment styles, depending on their daughters' childhood sexual abuse status. The representation of past attachment relationships with peers had both main and protective effects on the mothers' trait anxiety symptoms. The relevance of attachment perspectives to adjustment among these mothers and intergenerational process in childhood sexual abuse are discussed, and implications for future research and clinical practices are identified.

Childhood experiences of sexual abuse and later parenting practices among non-offending mothers of sexually abused and comparison girls

OBJECTIVE

The primary goal of this study was to explore the relationship between childhood sexual abuse and parenting practices among non-offending mothers of sexually abused girls. Guided by a developmental-ecological perspective of parenting, several models with different potential pathways starting from the mothers' childhood experiences of sexual abuse and culminating in their parenting practices (e.g., direct, spurious, indirect effect) were hypothesized and explored in the context of the mothers' past and current psychosocial risks and resources. Two dimensions of parenting were considered: providing positive structure (i.e., ratings of how consistent, fair, easygoing), and using punitive discipline.

METHODS

This study utilized a sample from a longitudinal, multigenerational study in which sexually abused girls, demographically similar comparison girls, and the mothers of both groups of girls participated. For the current study, the data regarding the mothers of the two groups of girls was of primary importance.

RESULTS

The results from a series of model comparison tests supported the spurious effect of mothers' childhood sexual abuse on the positive structure dimension. A direct, inverse relationship was found as the most accurate model with the punitive discipline dimension. Overall, childhood experience of punitive discipline, current dissociative symptoms, and satisfaction with social support were indicated as possible correlates of parenting practices among the mothers.

CONCLUSIONS

The significance of these findings is discussed in the context of theories concerning childhood trauma and parenting, as well as the intergenerational process of child maltreatment. Practice implications of the findings are also presented and discussed in terms of intervention programs for families where intrafamilial child sexual abuse occurs.

Compreendendo as mães de crianças vítimas de abuso sexual: ciclos de violência

O objetivo deste artigo é discutir as características de mães de crianças vítimas de abuso sexual, considerando aspectos como ajustamento emocional, multigeracionalidade e reações maternas frente à revelação. O abuso sexual infantil é considerado um problema de saúde pública e suas conseqüências têm sido foco de interesse de pesquisadores. Entretanto, poucos estudos têm se dedicado a explorar as características maternas envolvidas nesse complexo ciclo de violência. De modo geral, mães de crianças abusadas sexualmente não se configuram como as perpetradoras do abuso, mas de alguma forma encontram-se envolvidas, seja como vítimas ou testemunhas desta situação. Por outro lado, vários fatores influenciam as reações maternas frente à revelação do abuso, tais como a percepção de rede de apoio social e as características de personalidade da mãe, entre outros. Pesquisas têm demonstrado a continuidade da violência entre as gerações, apontando a necessidade de estudos longitudinais sobre o abuso sexual infantil.

Psychosocial characteristics of nonoffending mothers of sexually abused girls: findings from a prospective, multigenerational study

This study examined psychosocial characteristics of nonoffending mothers of sexually abused girls. The sample consisted of 72 ethnically diverse mothers of sexually abused girls aged 6 to 16 years, and 55 mothers of girls who were demographically similar with the abused girls on age, socioeconomic status, and family constellation. The variables examined included measures of the mothers' childhood developmental histories and current functioning (e.g., depression, parenting), as well as their current family environment. The specific questions addressed were (a) whether mothers of sexually abused girls could be distinguished from mothers of comparison girls on various psychosocial characteristics and (b) whether three subgroups of mothers (i.e., mother and daughter sexually abused, daughter-only abused, neither mother nor daughter abused) would exhibit different patterns of psychosocial characteristics. Results show that nonoffending mothers of sexually abused girls may confront considerable psychosocial challenges following the disclosure of their daughters' sexual abuse and that mother's own childhood abuse experiences may be an important factor to understand these challenges.

Function and well-being in ambulatory children with cerebral palsy

The purpose of this study was to determine whether there is a significant association between function and well-being in children with cerebral palsy. To determine this, the authors used validated measures of function (Gillette Functional Assessment Questionnaire, Gross Motor Function Classification System, Gross Motor Function Measure, and walking speed) and correlated them to health-related quality of life (HRQOL) measures (Pediatric Outcomes Data Collection Instrument, Pediatric Quality of Life instrument). In a cross-sectional study of ambulatory children with mild to moderate cerebral palsy aged 10.2 +/- 3.2 years, mild to moderate decreases in function were found when compared with normative data. As the assessment of HRQOL comprises both functional well-being and psychosocial well-being, the authors decided to specify the aspect of well-being to which they were referring. It was found that the child's function was not correlated to psychosocial well-being. The children with mild cerebral palsy had greater effects on their psychosocial well-being than would be predicted by their functional disability. Functional measures were good at predicting the functional well-being but were weak at predicting the psychosocial arm of well-being.

Non-abusive mothers of sexually abused children. The role of rumination in maternal outcomes

This study of 125 mothers examined the role of rumination in maternal emotional and behavioral outcomes subsequent to discovery of the sexual abuse of their children. Abuse severity, a maternal history of child abuse experiences, and life hassles were examined as predictors of negative outcomes. The central finding was that these factors, many of which are not controllable, were less likely to predict poor maternal outcomes than was rumination, a cognitive process that may be alterable. Rumination was the strongest correlate with each outcome. Further, the effects of most predictors on outcomes in this study were mediated by a ruminative cognitive style. Abuse severity, income, ethnicity, and education lacked significant relationships with maternal outcomes. This study asserts that rumination is a central component for understanding maternal outcomes in the post-discovery phase of sexual abuse cases. It recommends that rumination be routinely assessed both for research and treatment purposes.

"Speaking of mothers. . ."How does the literature portray mothers who have a history of child sexual abuse?

The tendency to cast mothers in a negative light has featured in much of the literature researching child sexual abuse. More recently however, this trend has become increasingly evident in any number of empirical discussions focusing on mothers who themselves have a history of child sexual abuse. This article presents a detailed thematic analysis of the ways in which the literature presents these mothers, particularly concentrating on research examining their parenting post disclosure of their child's sexual abuse. A critical reading of the literature supports commentary on methodological problems in research design as well as assumptions made about mothering, the nature of support, and the focus on the effects of childhood sexual abuse to the exclusion of the influence of other childhood experiences and difficulties.

The role of depression and dissociation in the link between childhood sexual abuse and later parental practices

Research has yielded contradictory results on the relationship between childhood sexual abuse and later parental functioning. This study was undertaken to specify the link between childhood sexual abuse and maternal parenting, while taking into account mothers' childhood physical and emotional traumas and current depressive and dissociative symptoms. Data were collected through self-report measures completed by 93 French-speaking Canadian mothers of children aged 6 to 11 years referred to Youth Protection Services. Parental behaviors examined included involvement with the child, use of positive reinforcement, lack of monitoring and supervision of the child, inconsistency in applying discipline, and use of corporal punishment. Mothers' perception of the quality of the relationship with her child was also assessed. In addition, history of abuse and neglect, depression and dissociation were respectively measured with the Childhood Trauma Questionnaire, the Diagnostic Interview Schedule Simplified, and the Dissociative Experiences Scale. The short-form of the Marlowe-Crowne Social Desirability Scale was used to control for respondent bias aimed at minimizing their problems. Mothers' current depressive symptoms were not found to predict any of the parental dimensions measured. Results from multiple hierarchical regressions pointed to dissociative symptoms as the key predictor of parental practices and attitudes. More specifically, dissociative symptoms predicted the use of positive reinforcement, lack of monitoring and supervision of the child, inconsistency in applying discipline, and use of corporal punishment. Dissociation also mediated the association between childhood maltreatment (physical and emotional abuse and neglect) and inconsistency in applying discipline. Implications for research and practice are discussed.

A Three-Generational Study of Transmission of Risk for Sexual Abuse

This intergenerational study investigates histories of both attachment relationships and abusive experiences and domains of current functioning that distinguish families of sexually abused children from families of nonabused children. The participants included (a) 199 nonoffending African American mothers of whom approximately half had children with documented sexual abuse histories and half had children with no documented abuse histories and (b) 106 maternal grandmothers of these children; approximately half had sexually abused grandchildren and half had grandchildren with no documented abuse. The children were 4 to 12 years old. Histories of abuse and attachment experiences and current functioning of the grandmother and mother were evaluated. Logistic regression analyses revealed that sexual abuse in a child was best predicted by 3 factors: maternal problems in adult functioning, a currently negative relationship between the grandmother and mother, and a disrupted pattern of caregiving during the mother's childhood. The findings underscore that troubled intergenerational attachment relationships in families can significantly heighten the risk of a child being sexually abused.

Vulnerability or resilience to intergenerational sexual abuse: the role of maternal factors

This study examined vulnerability or resilience to intergenerational sexual abuse. The sample included 196 African American mothers and their children of which 96 were sexually abused and 100 had no reported incidents of abuse. Four groups were formed based on maternal report of a history of childhood sexual abuse and the child's abuse status: (a) sexually abused mothers of children who were not sexually abused, (b) sexually abused mothers whose child was sexually abused, (c) mothers with no history of sexual abuse whose children had no history of sexual abuse, and (d) mothers with no history of sexual abuse who had a sexually abused child. The findings indicate that mothers who break the cycle of abuse were functioning as well as the nonsexually abused mothers in the study. Furthermore, sexually abused mothers with abused children evidenced significantly more disturbed functioning than the other three groups of mothers, particularly in their attachment relationships.

Protection, Dissociation, and Internal Roles: Modeling and Treating the Effects of Child Abuse

This article presents a theory of the long-term effects of child abuse that emphasizes the development of internal working models of protection. The theory proposes that abused children do not receive adequate caregiver protection and do not form internal representations of an effective protector. As a result, they have ongoing difficulty defending themselves against interpersonal aggression and internal self-criticism. The model integrates current research and theory in attachment behavior, developmental psychopathology, trauma, dissociation, and experiential psychotherapy. It accounts for many of the clinical symptoms presented by adult survivors of child abuse and suggests specific strategies for treatment. The author provides 3 examples of psychotherapy interventions derived from the model, distinguishes protection and “rescuing,” and suggests directions for future research.

The impact of complex trauma and depression on parenting: an exploration of mediating risk and protective factors

The current study examined (a) maternal depression as a mediator between mothers' complex trauma exposure and parenting difficulties and (b) protective factors within a sample of adult survivors of complex child and adult trauma. Participants were a sample of 152 women selected from 174 women interviewed in the third wave of a longitudinal study of a hospital sample of girls. The women in the current study represent a subsample that includes all participants who had given birth to a child. Measures included assessments of women's own trauma history and parenting outcomes. Higher rates of trauma exposure were related to decreased parenting satisfaction, reports of child neglect, use of physical punishment, and a history of protective service reports. These links were partially mediated by the relationship between trauma exposure and increased maternal depression. Exploratory analyses were also conducted to examine protective factors for fewer parenting problems within a further subsample of trauma survivors.

Parenting characteristics of women reporting a history of childhood sexual abuse

This article reviews research on the parenting characteristics of female survivors of childhood sexual abuse (CSA). Various aspects of parenting are considered, including (a) childbearing patterns, (b) the intergenerational transmission of CSA, (c) maternal reactions to child CSA disclosure, (d) parenting skills and behaviors, (e) parental violence toward children, (f) attitudes toward parenting, and (g) adjustment of survivors' children. Overall patterns suggest CSA survivors may experience difficulties with some aspects of parenting. Among the more consistent trends are findings that survivors may have difficulties establishing clear generational boundaries with their children, may be more permissive as parents, and may be more likely to use harsh physical discipline. Despite associations between CSA and parenting difficulties, the limited research addressing specific aspects of parenting, and limitations in study design, preclude causal inferences and make conclusions tentative at the present time. The clinical implications of this work and directions for future research are discussed.

[Current understanding about intergenerational transmission of child sexual abuse]

OBJECTIVE

The aim of this article is to review what is currently understood about intergenerational transmission of child sexual abuse (CSA).

METHOD

CSA transmission is discussed first from the point of view of men CSA survivors who become sexually abusive, and then from the perspective of mothers who survived CSA whose children have been sexually abused. Mechanisms that may help us understand how CSA is transmitted from one generation to another are described. More specifically, focus is given to those mechanisms that might differentiate CSA survivors who break the cycle of abuse from those who perpetuate it.

RESULTS

In light of the research reviewed, it seems that the transmission of CSA is far from inevitable, since one-third of sexually abusive men and half of sexually abused children's mothers mentioned having been sexually abused in their childhood. Because of the retrospective method used in many studies, causal links could not be established. However, some mechanisms have been proposed in order to better understand the phenomenon of CSA. Severity of abuse, attachment relationships with parental figures, as well as dissociative symptoms that follow the abuse were identified. Dissociative symptomatology appeared to be a determining factor in understanding the cycle of CSA.

CONCLUSIONS

More studies on CSA transmission are needed to understand the mechanisms that are involved in that cycle, as well as to develop effective strategies to treat and prevent CSA.

Interpersonal functioning among women reporting a history of childhood sexual abuse: empirical findings and methodological issues

A subset of research exploring the long-term impact of child sexual abuse (CSA) has examined the adult interpersonal functioning of female survivors. The present review discusses empirical findings and critical methodological issues related to this important but often overlooked aspect of adult adjustment. Though characterized by several methodological limitations, this literature, as a whole, suggests that early sexual abuse represents a risk factor for a range of interpersonal dysfunction among female survivors, including problems with intimate partner relations, disturbed sexual functioning, and difficulties in the parental role. Suggested methodological improvements for future research include new approaches to the measurement of CSA and interpersonal variables, the need for comprehensive assessment of significant third variables, and the use of more representative sampling strategies.

Influence of parental gender and self-reported health and illness on parent-reported child health

BACKGROUND

Although there is clear evidence of the influence of parental factors on child health outcomes, the influence of parental perceptions of their health and illness on the reporting of child health remains primarily unknown.

OBJECTIVES

To examine relationships between parents' reporting of their own health and illness with the reporting of their children's health and illness.

METHOD

We surveyed parents of a representative population-based sample of children aged 5 to 18 years. One parent of each child completed a written questionnaire including the Child Health Questionnaire, a subjective measure of functional health and well-being, and an assessment of self-reported parental health and illness. Logistic regression models were used to examine relationships between parent and child health and illness.

MAIN RESULTS

5340 parents responded (86% mothers, 14% fathers). After adjusting for confounding effects, parents self-reporting poor health had increased odds of reporting their children with poor health (odds ratio: 7.5), although the effect was modified by parent gender. There were increased odds of mothers with self-reporting poor global health reporting their children with poor global health and illness (odds ratio: 9.0 and 2.5, respectively) that were not observed for fathers.

CONCLUSIONS

A mother's self-reported health is strongly associated with her reporting of her child's health; this was not observed for fathers. These results suggest that parental gender should be considered as a mediating factor in the reporting of child health.

Reported anxieties concerning intimate parenting in women sexually abused as children

OBJECTIVE

The study had two aims: (1) To investigate whether mothers with a history of contact child sexual abuse were anxious about the intimate aspects of parenting compared with a clinical comparison group. (2) To determine if there was any relationship between the mother's anxieties and the kind of parenting they recalled receiving themselves.

METHOD

Two groups of mothers in mental health out-patient care were interviewed; 34 women with a history of contact child sexual abuse and 29 women with no history of sexual abuse. They completed the Intimate Aspects of Parenting Questionnaire, The Parenting Stress Index (Short form) The Parental Bonding Instrument and The General Health Questionnaire-28. The index group also completed a sexual abuse history questionnaire.

RESULTS

Mothers with a history of child sexual abuse were significantly more anxious about intimate aspects of parenting than the comparison group. They also reported significantly more overall stress as parents. The index group recalled that their own parents were significantly less caring and that their fathers more controlling than the comparison group. A low score on Father Care was significantly associated with concerns about intimate parenting, but not with total parenting stress. By contrast, a low score on Mother Care was significantly associated with higher stress experienced as a parent, but not as strongly with anxieties about intimate parenting.

CONCLUSIONS

Mothers with a history of contact child sexual abuse who attend mental health services are often worried that their normal parenting behaviors may be inappropriate or seen as such by other people. These anxieties seem associated with their history of childhood sexual abuse.