A resilience framework: Sexual health trajectories of youth with maltreatment histories

Sexual Self-Concept After Child Maltreatment: The Role of Resilient Coping and Sexual Experience Among U.S. Young Adults

Evidence supports sexual experience as normative and health-promoting for many, but this picture is less clear for people with histories of adversity. Amazon Mechanical Turk (MTurk) was used to garner data from a sample of 362 young adults (aged 18-25) wherein 44.5% (n = 161) identified as women. We assessed longitudinal associations between child maltreatment and sexual self-concept, as mediated by sexual behaviors and sexual partners, and whether resilient coping moderated these associations using structural equation modeling. Although both child maltreatment and resilient coping were directly associated with aspects of sexual experience, only resilient coping was directly associated with sexual self-concept. In addition, we found support for sexual experience as a mediator between child maltreatment/resilient coping and sexual self-concept. Specifically, cumulative maltreatment was associated with more sexual partners, which was associated with higher sexual self-monitoring. Resilient coping was associated with more sexual partners and more sexual behaviors, which was associated with higher sexual self-monitoring and higher sexual self-consciousness, sexual assertiveness, sexual self-esteem, and sexual motivation, respectively. Thus, sexual behaviors and sexual partners operated independently. Findings contrast messaging that sexual experience is universally risky regardless of maltreatment history. Rather, sexual experience may foster positive sexual self-concept for some. Sexual health advocates must attend to differences between sexual behaviors and sexual partners in relation to sexual well-being, and support resilience in the sexual domain.

Impulsivity Drives Adolescents to Smoke and Drink: Gender Differences in the Mediating Effects of Resilience and Depression

High and rising rates of smoking and drinking among Chinese adolescents are contributing to increasingly serious physical and mental health issues. While impulsivity has been demonstrated to be significantly related to adolescent cigarette and alcohol use, little is known about the mechanisms behind this association. The current study focused on resilience and depressive symptoms as potential mediators of this link, exploring the indirect pathways connecting impulsivity to teenage tobacco and alcohol use. Possible gender differences in this indirect pathway were also explored. Participants were secondary school students from southern China (N = 3466; 49.2% were female; Mage = 14.18; SDage = 1.57). Results revealed that adolescents who were more impulsive used cigarettes and alcohol more frequently, and that this effect was partially mediated by lower resilience and more depressive symptoms. It is noteworthy that there were gender differences in this mediating effect, with the effect of impulsivity on cigarette use for girls being mediated by resilience and depressive symptoms, whereas this statistically significant association was not identified for boys. These findings show how adolescents' impulsivity drives them to smoke and drink, and also emphasize gender as a crucial consideration for intervening with adolescents' drinking and smoking behaviors.

Early childhood maltreatment and profiles of resilience among child welfare-involved children

Given the high burden of child maltreatment, there is an urgent need to know more about resilient functioning among those who have experienced maltreatment. The aims of the study were to: 1) identify distinct profiles of resilience across cognitive, emotional, behavioral, and social domains in young children involved in the child welfare system; and 2) examine maltreatment characteristics and family protective factors in relation to the identified resilience profiles. A secondary analysis was conducted using data from the National Survey of Child and Adolescent Well-Being (NSCAW-II). Latent profile analysis was performed on a sample of 827 children aged 3-5 years (46% girls, Mean age = 3.96). Three distinct resilience profiles were identified: 1) low cognitive resilience (24%); 2) low emotional and behavioral resilience (20%); and 3) multidomain resilience (56%). Caregiver cognitive stimulation, no out-of-home placement, higher caregiver education level, older child age, and being a girl were associated with the multidomain resilience profile. The findings provide empirical support for the multifaceted nature of resilience and suggest that practitioners need to help children achieve optimal and balanced development by assessing, identifying, and targeting those domains in which children struggle to obtain competence.

Child Maltreatment and Couples' Sexual Health: A Systematic Review

INTRODUCTION

Childhood maltreatment (CM) is an interpersonal trauma reported by 35% to 40% of individuals in population-based studies in North America. It refers to physical, sexual, and emotional abuse, as well as physical and emotional neglect. Although there is a growing body of cross-sectional work focusing on associations between CM and sexual health, most studies have ignored the broader relationship context in which sexuality is experienced.

OBJECTIVES

The current review sought to systematically and critically appraise all studies that reported on the association between CM and couples' sexual health, to inform clinical care and recommendations for research.

METHODS

The electronic literature search was conducted using PubMed, PsycNET (PsycINFO, PsychArticles), Medline, CINAHL, and Eric for peer-reviewed journal articles published before September 2021. Eligible studies had to report on the association between any form of CM and any dimension of sexual health in couples or individuals in a romantic relationship.

RESULTS

In total, 13 studies (18 articles) were included in this systematic review: 4 studies pertained to clinical couples and 9, to community couples; 2 studies used a longitudinal design and 11, a cross-sectional design; 3 studies examined CM as a whole, 2 studies examined multiple subtypes of CM separately, 1 study examined both CM as a whole and its subtypes separately, whereas the other 7 studies focused on childhood sexual abuse. Results indicated that studies using valid measures of sexual health outcomes found significant associations between CM and worse outcomes - including declines over time - in both clinical and community samples. Mediators and moderators of these associations were also identified.

CONCLUSIONS

Findings provide preliminary support for the role of CM in couples' sexual health. There is a need for future longitudinal studies involving both members of the couple, valid and multidimensional measures of sexual health, and potential mediators and moderators. Bergeron S, Bigras N, Vaillancourt-Morel M-P. Child Maltreatment and Couples' Sexual Health: A Systematic Review. Sex Med Rev 2022;XX:XXX-XXX.

Profiles of Resilience among Children Exposed to Non-Maltreatment Adverse Childhood Experiences

Considering the high prevalence and negative consequences of non-maltreatment adverse childhood experiences (NM-ACEs), it is critical to understand their impacts on the resilient functioning of young children. This study sought to examine heterogeneity in resilience among first-grade children who were exposed to NM-ACEs during kindergarten and explore demographic and adversity characteristics that distinguish between resilience profiles. Latent profile analysis (LPA) was conducted on 4929 children drawn from the Early Childhood Longitudinal Study-Kindergarten (ECLS-K). The results of the LPA revealed four distinct resilience profiles: (1) low cognitive and executive functioning (4%); (2) low social and behavioral functioning (14%); (3) low average functioning (31%); and (4) multi-domain resilience (51%). Female children and those in families characterized by older maternal age, higher parental education level, household income above 200% federal poverty level, not receiving welfare benefits, and races other than Black were more likely to be in the multi-domain resilience profile. The findings highlight heterogeneity in resilience among children exposed to NM-ACEs and point to the need for a comprehensive, multi-domain assessment of child functioning to support optimal resilience development in this population.

What is sexual wellbeing and why does it matter for public health?

Sexual health has provided a guiding framework for addressing sexuality in public health for several decades. Although the WHO definition of sexual health is revolutionary in acknowledging positive sexuality, public health approaches remain focused on risk and adverse outcomes. The long-standing conflation of sexual health and sexual wellbeing has affected our ability to address everyday sexual issues. This Viewpoint provides a way forward to resolve this impasse. We propose sexual wellbeing as a distinct and revolutionary concept that can be operationalised as a seven-domain model. We situate sexual wellbeing alongside sexual health, sexual justice, and sexual pleasure as one of four pillars of public health enquiry. We argue that sexual wellbeing is imperative to public health as a marker of health equity, a meaningful population indicator of wellbeing, a means to capture population trends distinct from sexual health, and an opportunity to refocus the ethics, form, and practices of public health.

Resilience Following Child Maltreatment: Definitional Considerations and Developmental Variations

Resilience following childhood maltreatment has received substantial empirical attention, with the number of studies on this construct growing exponentially in the past decade. While there is ample interest, inconsistencies remain about how to conceptualize and assess resilience. Further, there is a lack of consensus on how developmental stage influences resilience and how protective factors affect its expression. The current systematic review uses a developmental lens to synthesize findings on resilience following child maltreatment. Specifically, this article consolidates the body of empirical literature in a developmentally oriented review, with the intention of inclusively assessing three key areas-the conceptualization of resilience, assessment of resilience, and factors associated with resilience in maltreatment research. A total of 67 peer-reviewed, quantitative empirical articles that examined child maltreatment and resilience were included in this review. Results indicate that some inconsistencies in the literature may be addressed by utilizing a developmental lens and considering the individual's life stage when selecting a definition of resilience and associated measurement tool. The findings also support developmental variations in factors associated with resilience, with different individual, relational, and community protective factors emerging based on life stage. Implications for practice, policy, and research are incorporated throughout this review.

A Dyadic Longitudinal Study of Child Maltreatment and Sexual Well-Being in Adult Couples: The Buffering Effect of a Satisfying Relationship

This study examined the contribution of child maltreatment (CM) to trajectories of couples' sexual well-being, and whether relationship satisfaction moderates these associations. Using a sample of 269 mixed-sex couples followed over one year, dyadic latent growth curve models showed both actor and partner effects. In terms of actor effects, women's emotional neglect was associated with lower initial levels of sexual satisfaction, and most types of women's CM were related to a sharper decrease over time in sexual satisfaction. Men and women's emotional abuse and neglect, and women's sexual abuse, were associated with lower initial levels of sexual function. Men and women's emotional neglect and women's emotional abuse were related to higher initial levels of sexual distress. Women's sexual abuse was associated with a steeper increase in sexual distress. In terms of partner effects, women's emotional neglect was associated with lower initial levels of partner sexual satisfaction, and women's emotional abuse and neglect, with lower initial levels of partner sexual function. Greater relationship satisfaction buffered some of these negative effects. Given that sexual well-being requires a context in which the individual feels safe, all forms of CM may affect sexual well-being, although a satisfying relationship may buffer some of these effects.

At risk and in love: A mixed methodexamination of the link between childhood maltreatment and youth relationships

INTRODUCTION

Research indicates that sexual and romantic relationships play an important role in youth well-being and development. This strengths-based perspective sits in tension with the documented risks that youth with histories of maltreatment face in sexual/romantic relationships. We conducted a U.S.-based mixed-method study to examine the connection between childhood maltreatment and youth relationships.

METHOD

We collected retrospective ratings of relationship quality and open-ended comments about those relationships using an online sexual life history calendar. Quantitative analyses drew on data from 98 participants (51 cisgender women, 47 cisgender men) between the ages of 18-25 (M_age = 22.51). Qualitative analyses compared demographically matched subsamples of 19 participants who reported multiple forms of child maltreatment and 20 who reported none.

RESULTS

Quantitative analyses indicated that ratings of relationship stability, intimacy, and pleasure were unrelated to prior abuse or neglect. Qualitative analyses showed the relationships of those with multiple maltreatment histories, compared to those without any maltreatment, to be more often intertwined with and complicated by other hardships (e.g., homelessness).

CONCLUSIONS

Quantitatively, childhood maltreatment appeared unrelated to youth sexual/romantic relationship quality, though we regard those findings with due caution. Complementing this was qualitative evidence of differences between participants based on trauma histories, with those who had experienced childhood maltreatment referring more often to surrounding circumstances and hardships in descriptions of their youth sexual/romantic relationships. These mixed method findings reinforce the importance of youth sexuality research, policy, and practice that takes the broader conditions of young people's lives into consideration.

Unwanted Sex Due to Intoxication among Australians Aged 16-69 Years

Intoxication can be a factor in unwanted sex, but research on the extent of the issue in both women and men is limited. We assessed the prevalence, correlates, and 10-year time-trends of unwanted sex due to intoxication among a representative sample of 4,279 women and 3,875 men aged 16-69 years in Australia and considered how these vary by gender. In 2012-13, 16% of women and 10% of men reported ever having had a sexual experience when they "did not want to because they were too drunk or high at the time." For both women and men, this was associated with younger age, bisexual activity, and reports of lifetime injection drug use, sexually transmitted infections, and forced sex. Among women only, it was associated with drinking above guideline levels and ever having terminated a pregnancy. Among men only, it was associated with current tobacco smoking, elevated psychosocial distress, and poor general health. Compared with 2001-02 data, fewer men reported unwanted intoxicated sex, while there were no changes for women as a whole. Interpreting these findings through an intersectional assemblage framework supports stronger understanding of the multiple factors influencing sexuality and substance use with implications for promoting equity, safety, and sexual health.

“The Power of Me”: The Role of Agency in the Resilience Processes of Adolescent African Girls Who Have Been Sexually Abused

In this article we explore how individual expressions of agency are shaped by structural factors and exercised by Black African girls with child sexual abuse (CSA) histories as they navigate resilience pathways. We employed a qualitative multiple instrumental case study design and purposefully recruited seven Black African girls, between the ages of 15 and 18 years, with a history of CSA. Participants were engaged in a range of participatory methods that included participatory diagramming (time lines), digital stories, and participatory videos. Data were analyzed using inductive thematic analysis. Findings highlight how agency, as a process of resilience, manifested as well as how these agentic expressions were activated, bound, and later reciprocated and sustained by the surrounding social structures.