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Lurie I, Yalon S, Levi-Belz Y. Sexual Trauma and Mental Distress among Former Ultra-Orthodox Jewish Individuals. J Trauma Dissociation 2025:1-20. [PMID: 40393054 DOI: 10.1080/15299732.2025.2507901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2024] [Accepted: 05/06/2025] [Indexed: 05/22/2025]
Abstract
BACKGROUND Disaffiliating from an ultra-Orthodox society is a risk factor for psychological distress, depression, and suicide ideation because the process involves encountering culture shock, education gaps, and disconnection from familiar surroundings. Traumatic experiences such as sexual abuse may augment distress among ex-ultra-Orthodox individuals (ex-ULTOIs). OBJECTIVE This study examined the prevalence of past sexual trauma among ex-ULTOIs, and assessed the contribution of experiences of sexual trauma to psychopathology among this population. METHODS In an online cross-sectional survey among ex-ULTOIs (N = 724, aged 19-54, 47.9% women), anonymously completed questionnaires concerning prior sexual trauma, psychopathology, depression, anxiety, and posttraumatic stress disorder (PTSD) symptoms, and suicide ideation and behavior. RESULTS Sexual trauma was reported by 252 (34.8%) of the respondents, of whom 150 (20.7%) reported being sexually assaulted by a family member. Sexual trauma was associated with increased levels of emotional distress, including a higher probability of depression, anxiety, PTSD, and suicide risk. CONCLUSIONS Sexually traumatic experiences are prevalent among ex-ULTOIs. Sexual trauma was found to be associated with an increased risk of emotional distress and psychopathology. Bearing in mind that this population is, by definition, vulnerable to high levels of emotional distress, the study results highlight the importance of screening for sexual trauma in order to identify and treat ex-ULTOIs who have experienced sexual abuse. Moreover, therapeutic programs specifically focusing on this vulnerable population are warranted.
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Affiliation(s)
- Ido Lurie
- Shalvata Mental Health Center, Hod Hasharon, Israel
- Department of Psychiatry, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shachar Yalon
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel
| | - Yossi Levi-Belz
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel
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Calanni JS, Pasquini LA, Dieguez HH, Aguirre NB, Berardino BG, Dorfman D, Rosenstein RE. Microglial depletion prevents visual deficits and retinal ganglion cell loss induced by early life stress in adult animals. Sci Rep 2025; 15:17143. [PMID: 40382377 PMCID: PMC12085643 DOI: 10.1038/s41598-025-01526-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2024] [Accepted: 05/06/2025] [Indexed: 05/20/2025] Open
Abstract
Early life stress (ELS), a prenatal/early postnatal period of severe trauma, social deprivation, or neglect, among other adversities, constitutes a risk factor for developing psychopathologies and different health complications in adulthood. Maternal separation with early weaning (MSEW) induces long-term consequences in mouse retinal function and structure. We analyzed microglia involvement in adult retina ELS-induced sequelae. C57Bl/6 J mice were separated from the dams at postnatal days (PND) 4-6, 7-9, 10-12, and 13-16, for 2 h, 3 h, 4 h, and 6 h, respectively, and were weaned at PND 17. Control pups were left undisturbed and weaned at PND 21. At PND 45, MSEW induced microgliosis and decreased retinal ganglion cell (RGC) function, followed by RGC loss at PND 60. Microglial phenotypic alterations correlated with a pro-inflammatory profile (i.e., increase in the nuclear levels of nuclear factor kappa B -subunit p65, and C3-, nitric oxide synthase-2, and interleukin-1β-immunoreactivity in Iba-1 ( +) cells). Depleting microglia between PND 35 and 60 did not affect the retina from naïve mice. However, in early stressed mice, it preserved RGC function and number, visually mediated behavior, and contrast sensitivity. Therefore, microglial reactivity could be one of the key factors linking progressive alterations provoked by ELS in adult mice retinal function and structure.
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Affiliation(s)
- Juan S Calanni
- Laboratory of Retinal Neurochemistry and Experimental Ophthalmology, Department of Biological Chemistry/IQUIBICEN, School of Science, University of Buenos Aires/CONICET, Ciudad Autónoma de Buenos Aires (C1428EHA) Argentina, Av. Int. Güiraldes 2620, Pabellón II, 2º Piso, Ciudad Autónoma de Buenos Aires, Argentina
| | - Laura A Pasquini
- Department of Biological Chemistry and Institute of Chemistry and Biological Physicochemistry, IQUIFIB, School of Pharmacy and Biochemistry, University of Buenos Aires/CONICET, Ciudad Autónoma de Buenos Aires, Argentina
| | - Hernán H Dieguez
- Laboratory of Retinal Neurochemistry and Experimental Ophthalmology, Department of Human Biochemistry, School of Medicine/CEFYBO, University of Buenos Aires/CONICET, Ciudad Autónoma de Buenos Aires, Argentina
| | - Nathaly Bernal Aguirre
- Laboratory of Retinal Neurochemistry and Experimental Ophthalmology, Department of Human Biochemistry, School of Medicine/CEFYBO, University of Buenos Aires/CONICET, Ciudad Autónoma de Buenos Aires, Argentina
| | - Bruno G Berardino
- Neuroepigenetics Laboratory, Department of Biological Chemistry/IQUIBICEN, School of Science, University of Buenos Aires/CONICET, Ciudad Autónoma de Buenos Aires, Argentina
| | - Damian Dorfman
- Laboratory of Retinal Neurochemistry and Experimental Ophthalmology, Department of Human Biochemistry, School of Medicine/CEFYBO, University of Buenos Aires/CONICET, Ciudad Autónoma de Buenos Aires, Argentina
| | - Ruth E Rosenstein
- Laboratory of Retinal Neurochemistry and Experimental Ophthalmology, Department of Biological Chemistry/IQUIBICEN, School of Science, University of Buenos Aires/CONICET, Ciudad Autónoma de Buenos Aires (C1428EHA) Argentina, Av. Int. Güiraldes 2620, Pabellón II, 2º Piso, Ciudad Autónoma de Buenos Aires, Argentina.
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Chauviré-Geib K, Gerke J, Fegert JM, Rassenhofer M. The Digital Dimension: Victim's Experiences of Technology's Impact on Penetrative Child Sexual Abuse. JOURNAL OF CHILD SEXUAL ABUSE 2025:1-21. [PMID: 40293357 DOI: 10.1080/10538712.2025.2497286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2024] [Revised: 03/20/2025] [Accepted: 04/05/2025] [Indexed: 04/30/2025]
Abstract
Research comparing penetrative technology-assisted child sexual abuse (TA-CSA) and penetrative child sexual abuse (CSA) is limited. Existing studies indicate similarities among victims and the consequences of their abuse. This study investigates the experiences of victims of penetrative TA-CSA and penetrative CSA, examining their sociodemographic characteristics, the nature of the abuse, and mental health and psychosocial consequences. Data was derived from the German Sexual Abuse Telephone Helpline between 2020 and 2023, with information gathered anonymously during calls with the caller's consent. The sample consisted of N = 302 callers reporting experiences of penetrative CSA or penetrative TA-CSA. Exact Chi-Square tests and Mann-Whitney-U tests were used to compare both groups in terms of demographics, characteristics of the abuse, and reported consequences. Logistic regression analyses were performed to explore the relationship between consequences and technology use. Results show that penetrative TA-CSA is objectively associated with more severe abuse circumstances, including multiple perpetrators, higher frequency of abuse, and earlier age of onset. The latter contributed to the specific consequences being reported by victims. No differences in terms of gender, living environment, or education were found between both groups. While the involvement of technology in penetrative abuse is related to its severity, it does not directly affect reported consequences. Future research should further examine the nuanced impact of technology use.
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Affiliation(s)
- Katrin Chauviré-Geib
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Ulm, Ulm, Germany
- German Enter for Mental Health (DZPG), Partner Site Mannheim-Heidelberg-Ulm, Ulm, Germany
| | - Jelena Gerke
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Ulm, Ulm, Germany
- German Enter for Mental Health (DZPG), Partner Site Mannheim-Heidelberg-Ulm, Ulm, Germany
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Ulm, Ulm, Germany
- German Enter for Mental Health (DZPG), Partner Site Mannheim-Heidelberg-Ulm, Ulm, Germany
| | - Miriam Rassenhofer
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Ulm, Ulm, Germany
- German Enter for Mental Health (DZPG), Partner Site Mannheim-Heidelberg-Ulm, Ulm, Germany
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4
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Durkin J, Zordan R, Bullen M, Pavich N, Thomas PTB, Lethborg C, Holder W, Jolly M, Dreise D, Fleming D. The impact of clergy sexual abuse on spirituality and health: A systematic scoping review of the literature. PLoS One 2025; 20:e0317821. [PMID: 40238787 PMCID: PMC12002452 DOI: 10.1371/journal.pone.0317821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2024] [Accepted: 11/29/2024] [Indexed: 04/18/2025] Open
Abstract
Sexual abuse perpetrated by clergy or other Church leaders can cause harm to the spirituality of people who are subject to this abuse, which also has impacts on their overall health. We conducted a systematic scoping review to examine how Spiritual Harm in this context is operationalized in the literature with specific reference to the Catholic Church. Literature searches were conducted across Academic Search Complete, Informit Database, ProQuest, Web of Science and Google Scholar in 2022 and updated throughout 2023. Eligible studies were published between 2002-2022 and included peer reviewed empirical research, systematic reviews, discussion, or perspective papers that explored spiritual and/or religious harm and sexual abuse in a church context, and the psychological, emotional, and spiritual impact of the abuse. The review included 12 research articles. Data were analysed using qualitative approaches and presented as a narrative summary. Reporting follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for scoping reviews. Spiritual Harm in people who are subject to clerical sexual abuse is understood as a distinct condition or phenomena, comprising of complex spiritual, emotional and psychological components. However, it is not consistently defined. Understanding Spiritual Harm in a more comprehensive and consistent way is important in order to be able to adequately respond to the needs of victims, survivors, their families and wider communities.
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Affiliation(s)
- Joanne Durkin
- St Vincent’s Health Australia, Melbourne, Victoria, Australia
| | - Rachel Zordan
- St Vincent’s Hospital Melbourne, Melbourne, Victoria, Australia
- School of Health University of Melbourne, Melbourne, Victoria, Australia
| | - Matthew Bullen
- Private Consultancy, Mountain Stillness Listening Spaces, Sydney, New South Wales, Australia
| | - Nadia Pavich
- St Vincent’s Health Australia, Melbourne, Victoria, Australia
| | | | - Carolyn Lethborg
- Health Equity Research, St Vincent’s Hospital Melbourne, Melbourne, Victoria, Australia
- Centre for Rural Health, College of Health & Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Wendy Holder
- Private Consultancy, Wendy Holder Psychologist, Launceston, Tasmania, Australia
| | - Melinda Jolly
- Pastoral Care St Vincent’s Private Hospital Sydney, Sydney, New South Wales, Australia
| | - Darlene Dreise
- St Vincent’s Health Australia, Melbourne, Victoria, Australia
| | - Daniel Fleming
- St Vincent’s Health Australia, Melbourne, Victoria, Australia
- School of Medicine, The University of Notre Dame Australia, Melbourne, Victoria, Australia
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5
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Scoglio AA, Chen YL, Huang KJ, Borgogna NC, Potenza MN, Blycker GR, Kraus SW. Sexual trauma and compulsive sexual behavior in young men and women: A network analysis involving two samples. J Behav Addict 2025; 14:166-177. [PMID: 39841161 PMCID: PMC11974438 DOI: 10.1556/2006.2024.00074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2024] [Revised: 11/06/2024] [Accepted: 12/07/2024] [Indexed: 01/23/2025] Open
Abstract
Background and aims Sexual trauma is associated with multiple negative health and social conditions, including compulsive sexual behavior. The present study examined network structures involving sexual trauma history, psychological distress (defined as depression and/or anxiety symptoms), substance use, transactional sex, and compulsive sexual behavior. Prior network analysis work in this area is limited. Methods We drew upon two samples of young adults (Sample 1: n = 1,884, 69.3% women; Sample 2: n = 2,337, 69.7% women) recruited from universities in the United States in 2020-2022. Results Findings support relationships between sexual trauma and compulsive sexual behavior. Relationships between elements of compulsive sexual behavior, timing of trauma, psychological distress, substance use, engagement in transactional sex, and gender differences were identified. Significant edge strength differences between men and women were observed; distress was a more central node for men, trauma was a more central node for women (Sample 1). When examining elements of CSB, significant gender differences in edge strength were also observed (e.g. connections between dissatisfaction and relapse for men, dissatisfaction and negative consequences for women). Discussion and conclusions Specific aspects of CSB closely related to sexual trauma history (e.g., dissatisfaction) and co-occurring psychopathology or clinical concerns (e.g., depression, anxiety, substance use, and engagement in transactional sex) and warrant further attention and study.
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Affiliation(s)
- Arielle A.J. Scoglio
- Department of Natural and Applied Sciences, Bentley University, Waltham, MA, USA
| | | | - Kuan-Ju Huang
- Graduate School of Human and Environmental Studies, Kyoto University, Japan
| | - Nicholas C. Borgogna
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
| | - Marc N. Potenza
- Departments of Psychiatry and Neuroscience and the Child Study Center, Yale University School of Medicine, New Haven, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | | | - Shane W. Kraus
- Department of Psychology, University of Nevada Las Vegas, Las Vegas, NV, USA
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Raza HF, Amédée LM, Domond P, Orri M, Côté S, Hébert M. Personal, Family, and Environmental Factors Associated with Somatic Complaints in School-Aged Child Victims of Sexual Abuse. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2025; 18:229-242. [PMID: 40098789 PMCID: PMC11910453 DOI: 10.1007/s40653-024-00665-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/06/2024] [Indexed: 03/19/2025]
Abstract
Little is known about somatic complaints in school-aged child victims of sexual abuse and the associated risk factors. Given that somatic symptoms can lead to functional impairment and decreased health-related quality of life, identifying associated factors in the child's environment is essential. This study aimed to identify personal, family, and environmental factors associated with somatic complaints among child victims of sexual abuse. The sample included 654 children (68.8% girls; M = 8.96 years, SD = 1.88) seeking services after disclosure of child sexual abuse. Hierarchical linear regression models were used to investigate the associations between personal, family, and environmental factors, and somatic symptoms. Sex differences in the associations between risk factors and the level of somatic symptoms were systematically tested. Most children (58%) had at least one somatic symptom (M girls = 1.37, SD = 1.44 and M boys = 1.04, SD = 1.38). After controlling for sex and age, stress related to sexual abuse disclosure (β = 0.16, 95% CI [0.08, 0.23]), parental distress (β = 0.18, 95% CI [0.10, 0.26]), the number of stressful life events experienced (β = 0.12, 95% CI [0.05, 0.20]) and neighborhood social deprivation (β = 0.21, 95% CI [0.01, 0.42]) were independently associated with greater level of somatic complaints. Stress related to sexual abuse disclosure, parental distress, the number of stressful life events, and neighborhood social deprivation were associated with higher levels of somatic complaints in this population. Supplementary Information The online version contains supplementary material available at 10.1007/s40653-024-00665-y.
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Affiliation(s)
| | | | | | | | | | - Martine Hébert
- Université du Québec à Montréal, Montréal, Québec H3C 3P8 Canada
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7
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Kiss L, Iuliano A, Portella AP, Paiva H, Pires M, Leurent B. Growing up without violence (GWV): Study protocol for a cluster randomised trial and process evaluation of a school-based intervention preventing adolescent sexual exploitation in Brazil. Contemp Clin Trials 2025; 150:107802. [PMID: 39800276 DOI: 10.1016/j.cct.2024.107802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2024] [Revised: 11/15/2024] [Accepted: 12/29/2024] [Indexed: 01/15/2025]
Abstract
BACKGROUND Sexual exploitation of children and adolescents (SECA) is a mostly invisible phenomenon, having negative impacts on adolescents' health and well-being. There is increasing awarenessof preventative strategies to reduce sexual exploitation of children and adolescents, but limited evidence on their effectiveness and mechanisms. This project addresses this gap through the impact and process evaluation of 'Growing Up Without Violence' (GWV), the largest intervention in Brazil tackling SECA. METHODS We will conduct a two-arm cluster randomised trial (CRT) with parallel assignment in the municipalities of Cabo de Santo Agostinho and Jaboatão dos Guararapes, in Brazil. We will randomly allocate 30 schools to intervention and 30 to wait-list control arms. In each of these schools, we will randomly select independent samples of fifty students (aged 12 to 17) to participate in baseline and endline surveys. We will invite students to self-complete pre-programmed questionnaires in a private school space, under the supervision of trained researchers. Our main analysis is a cross-sectional comparison between control and intervention schools of students' levels of basic knowledge for identifying appropriate and inappropriate sexual advances and acts (primary outcome). Secondary outcomes include knowledge of risks of online sexual exploitation, willingness to report incidents of sexual abuse and exploitation, and recall of exposure SECA preventive training content. DISCUSSION To our knowledge, this is the first large-scale rigorous evaluation of an intervention to prevent SECA in Brazil. Findings will inform our strategies and future interventions to prevent SECA.
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Affiliation(s)
- Ligia Kiss
- Institute for Global Health, University College London, 3rd floor, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
| | - Agnese Iuliano
- Institute for Global Health, University College London, 3rd floor, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
| | - Ana Paula Portella
- Research consultant, Catholic University of Pernambuco, R. do Príncipe, 526 - Boa Vista, Recife, PE 50050-900, Brazil
| | - Heloína Paiva
- Research consultant, Catholic University of Pernambuco, R. do Príncipe, 526 - Boa Vista, Recife, PE 50050-900, Brazil
| | - Malini Pires
- Institute for Global Health, University College London, 3rd floor, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
| | - Baptiste Leurent
- Department of Statistical Science, University College London, Room 120, 1-19 Torrington Pl, London WC1E 7HB, UK.
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Guastaferro K, Shipe SL, Connell CM, Zadzora KM, Noll JG. Applying an Implementation Framework to the Dissemination of a School-Based Child Sexual Abuse Prevention Program. Health Promot Pract 2025; 26:352-361. [PMID: 37815083 DOI: 10.1177/15248399231201537] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
Since the 1980s, school-based child sexual abuse (CSA) prevention programs have been the prevailing prevention strategy in the United States. Despite demonstrated effectiveness, there is a lack of infrastructure and educational policy ensuring all students receive these programs. A pragmatic application of the RE-AIM implementation framework, this study provides an overview of a multi-county implementation effort of the school-based CSA prevention program, Safe Touches. Implementation efforts across five counties in a Mid-Atlantic state are described at three levels: organizational (school districts), child, and program facilitator. Children's CSA-related knowledge was measured at four time points: pre-workshop, immediately post-workshop, and then 6 and 12 months post-workshop. Facilitators completed an anonymous survey post-implementation. Over the course of one and a half academic years, Safe Touches was implemented in 718 public school districts, reaching in total 14,235 second-grade students. Students' significantly increased knowledge from pre- to post-workshop and gains were maintained at 6 and 12 months (ps <.001). A total of 29 disclosures of maltreatment were made by students to facilitators during or after the workshop. Facilitators generally adopted Safe Touches and attested to the feasibility and benefits of its large-scale implementation as well as the negligible negative impacts for children. When implemented systematically, school-based CSA prevention is able to reach a high number of students, effectively increase CSA-related knowledge, and facilitates disclosures. To maximize the potential public health impact, it is suggested that state funds be allocated to support the implementation of such programs as part of standard education costs.
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Affiliation(s)
- Kate Guastaferro
- New York University, New York City, NY, USA
- The Pennsylvania State University, University Park, PA, USA
| | - Stacey L Shipe
- The Pennsylvania State University, University Park, PA, USA
- Binghamton University, Binghamton, NY, USA
| | | | | | - Jennie G Noll
- The Pennsylvania State University, University Park, PA, USA
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Akinyemi O, Ogundare T, Fasokun M, Ogunyankin F, Ugochukwu N, Ajisafe W, Ikugbayigbe S, Eze O, Hughes K, Michael M. The long-term impact of childhood sexual assault on depression and self-reported mental and physical health. Front Psychiatry 2025; 15:1528914. [PMID: 39917377 PMCID: PMC11799268 DOI: 10.3389/fpsyt.2024.1528914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2024] [Accepted: 12/31/2024] [Indexed: 02/09/2025] Open
Abstract
Background Childhood trauma, including sexual assault (CSA), is a known risk factor for adverse mental health outcomes. This study quantifies the impact of CSA on the likelihood of being diagnosed with depression in adulthood, as well as its influence on poor mental and physical health days. Methods We analyzed data from the Behavioral Risk Factor Surveillance System (BRFSS) (2016-2023), comprising 321,106 respondents. The primary exposure was self-reported CSA, while the main outcomes were depression diagnosis, poor mental health days, and poor physical health days. Covariates included race, gender, marital status, employment, age, education, state, year, language spoken at home, metropolitan status, and urban residence. We employed Inverse Probability Weighting (IPW) to estimate the Average Treatment Effect (ATE), controlling for confounders and incorporating state and year fixed effects. Sampling weights ensured national representativeness, and robust standard errors accounted for clustering by state. Results In a matched cohort of 15,150 individuals with CSA and 15,150 controls, the CSA group had an average age of 50.3 ± 16.3 years, with most being White (69.3%) and female (76.7%). CSA was significantly associated with an increased risk of depression diagnosis, with a 22.1 percentage-point increase for those with one CSA experience (ATE = 0.221, 95% CI: 0.192-0.250, p < 0.001) and a 24.4 percentage-point increase for those with multiple CSA experiences (ATE = 0.244, 95% CI: 0.222-0.266, p < 0.001). CSA also impacted mental health. Those with a single CSA exposure reported 2.8 more days of poor mental health per month (ATE = 2.829, 95% CI: 2.096-3.398, p < 0.001), while those with multiple exposures reported 4.2 more days (ATE = 4.175, 95% CI: 3.609-4.740, p < 0.001) compared to controls. Regarding physical health, individuals with one CSA exposure reported 1.5 additional poor physical health days (ATE = 1.538, 95% CI: 0.788-2.289), while those with multiple exposures experienced 2.6 additional days (ATE = 2.587, 95% CI: 1.941-3.232). Conclusion This study provides robust evidence that CSA significantly increases the likelihood of depression in adulthood and leads to more poor mental and physical health days. The findings underscore the cumulative impact of multiple CSA exposures on health outcomes and emphasize the need for trauma-informed healthcare, early intervention, and public health strategies to mitigate the long-term consequences of CSA.
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Affiliation(s)
| | - Temitope Ogundare
- Chobanian & Avedisian School of Medicine, Boston University, Boston, MA, United States
| | - Mojisola Fasokun
- Epidemiology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Fadeke Ogunyankin
- Research Data Science and Analytics, Cook Children’s Health Care System, Fort Wort, TX, United States
| | | | - Walia Ajisafe
- College of Medicine, Howard University, Washington, DC, United States
| | - Seun Ikugbayigbe
- Biological Sciences, Eastern Illinois University, Charleston, IL, United States
| | | | - Kakra Hughes
- College of Medicine, Howard University, Washington, DC, United States
| | - Miriam Michael
- College of Medicine, Howard University, Washington, DC, United States
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10
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Munro-Kramer ML, Beck DC, Ball M, Pardee M. Finding the beat: A partnership to address the relationship between a music program and health among youth who have experienced trauma. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2025; 17:20-28. [PMID: 39207433 PMCID: PMC11925203 DOI: 10.1037/tra0001776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
OBJECTIVE Expertise on treating trauma and traumatic stress sequelae has been siloed in the mental health professions, although somatic psychotherapies and adjuncts to treatment are gaining attention. Alternative and accessible interventions are needed, especially for youth who have experienced trauma. Lost Voices is a community-based group providing trauma-informed music therapy to youth who have experienced trauma in southern Michigan. The purpose of this program evaluation was to use a community-based participatory research approach to create a thoughtful partnership between an academic partner and a nonprofit organization in order to evaluate the outcomes of a music therapy intervention currently being delivered by professional musicians to youth who have experienced trauma. METHOD This program evaluation used semistructured interviews with 19 key stakeholders (e.g., youth participants, facility staff, musicians) from two residential youth programs in southern Michigan. RESULTS A total of four themes were identified from the interviews, including (a) processing emotion, (b) building trust, (c) self-expression, and (d) future orientation. Subthemes included individual story and coping within the theme processing emotion, a focus on outside role models and peer connection within the theme building trust, the fun aspect of the intervention and confidence as part of the theme self-expression, and future orientation encompassed the motivation that youth participants gained as well as forward thinking. CONCLUSIONS This program evaluation provides data to help build the evidence for alternative mental health treatments that specifically reach those impacted by a lack of access and availability of treatments due to social determinants of health. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
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Affiliation(s)
| | - Dana C Beck
- School of Nursing, University of California, Los Angeles
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11
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Cañaveras P, Burgués-Freitas A, Joanpere M. The Role of the MeToo Route in Improving the Health of Gender-Based Violence and Isolating Gender Violence Survivors. Healthcare (Basel) 2024; 12:2480. [PMID: 39685102 DOI: 10.3390/healthcare12232480] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2024] [Revised: 12/02/2024] [Accepted: 12/06/2024] [Indexed: 12/18/2024] Open
Abstract
Background/Objectives: The scientific literature has provided evidence on the negative health effects experienced by those who suffer gender-based violence (GBV) and isolating gender violence (IGV), the latter being a form of retaliation against those who support GBV victims. However, less attention has been paid to the potential health improvements following the initial support received by victims. Methods: This study examines the positive health outcomes among survivors of GBV and IGV after they engaged with the "MeToo route," an initiative of the MeToo movement aimed at raising awareness about gender violence and fostering solidarity through support networks that traveled through 13 Spanish universities through more than 20 events in September 2022. Results: Using communicative methodology, survivors shared how their health, previously harmed by their experiences of violence, improved as a result of the support provided after knowing the MeToo support network. Conclusions: The findings highlight the crucial role of solidarity networks in alleviating the health impacts of GBV and IGV and underscore the importance of effective support systems for recovery.
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Affiliation(s)
- Paula Cañaveras
- Department of Sociology, Faculty of Economics and Business, University of Barcelona, 08007 Barcelona, Spain
| | - Ana Burgués-Freitas
- Department of Sociology, Faculty of Political Science and Sociology, University of Granada, 18071 Granada, Spain
| | - Mar Joanpere
- Department of Business Management, Faculty of Business and Economics, Universitat Rovira i Virgili, 43204 Reus, Spain
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12
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Zych I, Marín‐López I. PROTOCOL: Risk and protective factors for child sexual abuse and interventions against child sexual abuse: An umbrella review. CAMPBELL SYSTEMATIC REVIEWS 2024; 20:e70000. [PMID: 39502162 PMCID: PMC11534711 DOI: 10.1002/cl2.70000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 08/19/2024] [Accepted: 10/01/2024] [Indexed: 11/08/2024]
Abstract
This is the protocol for a Campbell Collaboration systematic review. Our objective is to conduct an umbrella review to synthesize published and unpublished systematic reviews focused on risk and protective factors for child sexual abuse and effectiveness of interventions against child sexual abuse perpetration and victimization. Specific research questions are: (i) what are the risk and protective factors for child sexual abuse victimization, and what are their relative strength and/or magnitude for predicting child sexual abuse victimization? (ii) what are the risk and protective factors for child sexual abuse perpetration, and what are their relative strength and/or magnitude for predicting child sexual abuse perpetration? (iii) are interventions aimed at reducing and/or preventing child sexual abuse effective? (iv) what are the moderators that increase or decrease effectiveness of the interventions? Efforts to decrease child sexual abuse need to be based on research, but more accessible evidence regarding the breadth of risk and protective factors and effectiveness of interventions to reduce child sexual abuse needs to be provided to policymakers. This will be the first umbrella review that comprehensively synthesizes findings of the previous systematic reviews that focus on risk and protective factors for child sexual abuse and interventions to prevent or reduce child sexual abuse. The results will be able to inform enhanced prevention policy and programs, and regulatory measures for specific contexts of child sexual abuse.
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Affiliation(s)
- Izabela Zych
- Department of PsychologyUniversidad de CordobaCordobaSpain
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13
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Antonikowski AA, Malhotra K, Allen JS, Galbraith D, Gerber MR. Trauma-Informed Health Care Practice in the Adolescent Well Visit. Prim Care 2024; 51:561-570. [PMID: 39448093 DOI: 10.1016/j.pop.2024.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2024]
Abstract
Trauma-informed care (TIC) is a patient-centered, strength-based approach to caring for and empowering patients. The adolescent well visit is an opportune moment to assess and address the impact of trauma. Given the well-documented impact of trauma exposure on adolescent health, and the relationship present between social determinants of health and trauma, physicians and advanced practice practitioners are well positioned to utilize TIC in the medical visit. This article will explore tools to incorporate trauma-informed practices in adolescent well visits in the context of medical care, mental health screening, and in promoting health equity.
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Affiliation(s)
- Angela Adger Antonikowski
- Division of Community Outreach & Medical Education, Department of Psychiatry, Office of Medical Education, Albany Medical College, 43 New Scotland Avenue, Albany, NY 12208, USA.
| | - Krithika Malhotra
- Department of Family and Community Medicine, Feinberg School of Medicine, Northwestern University, 1475 East Belvidere Road, Grayslake, IL 60030, USA
| | - Jay-Sheree Allen
- Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA
| | - D'Nea Galbraith
- Division of Community Outreach & Medical Education, Office of Medical Education, Albany Medical College, 43 New Scotland Avenue, Albany, NY 12208, USA
| | - Megan R Gerber
- Department of Medicine, Albany Medical College, 43 New Scotland Avenue, Albany, NY 12208, USA
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14
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Kachaner A, Lemogne C, Ranque B. [Psychocorporal approach to functional somatic disorders]. Rev Med Interne 2024; 45:634-640. [PMID: 38876948 DOI: 10.1016/j.revmed.2024.05.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 04/25/2024] [Accepted: 05/25/2024] [Indexed: 06/16/2024]
Abstract
Functional somatic disorders (FSD) are common conditions that result in a significant deterioration of the quality of life. Their origin is multifactorial and poorly understood, and their management is often inadequately defined. Medications typically show limited effectiveness, while mind-body approaches play a central role, guided by three key principles: establishing an empathetic, respectful, and sincere doctor-patient relationship; promoting regular and gradual physical activity; and implementing cognitive behavioral therapy (CBT). Special attention must be devoted to establishing a trustworthy relationship between the physician and the patient. Recognizing the reality and severity of symptoms and providing a positive diagnosis as well as an explanatory model to account for them rationally are fundamental aspects of patient management. Cognitive and behavioral maintenance factors should be investigated and constitute therapeutic targets. Cognitive factors include focused attention on body functioning and catastrophizing. Patients frequently display avoidance behaviors, particularly in relation to physical exertion, and it is crucial to motivate them to reintroduce gradual physical activity customized to their abilities. This approach has demonstrated efficacy in improving fatigue, pain, and the physical and mental quality of life for patients with FSD. Among psychotherapeutic approaches, the benefit of CBT is well-established. The combination of gradual physical activity and CBT appears to be complementary. Other mind-body approaches such as mindfulness meditation might help although their level of evidence is weaker. Given the prevalence of FSD in the general population, it seems necessary for all physicians to be trained in managing this condition.
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Affiliation(s)
- A Kachaner
- Service de médecine interne, hôpital européen Georges-Pompidou, AP-HP, Paris, France; Inserm, UMS 011 « Population-based Cohorts Unit », Paris-Saclay University, UVSQ, Paris, France.
| | - C Lemogne
- Inserm, INRAE, Center for Research in Epidemiology and Statistics (CRESS), université Paris-Cité, université Sorbonne-Paris-Nord, Paris, France; Service de psychiatrie de l'adulte, hôpital Hôtel-Dieu, AP-HP, Paris, France
| | - B Ranque
- Service de médecine interne, hôpital européen Georges-Pompidou, AP-HP, Paris, France; Inserm, INRAE, Center for Research in Epidemiology and Statistics (CRESS), université Paris-Cité, université Sorbonne-Paris-Nord, Paris, France; Unité CASPer, hôpital Hôtel-Dieu, AP-HP, Paris, France
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15
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Amiri S, Mahmood N, Yusuf R, Ghenimi N, Javaid SF, Khan MAB. Adverse Childhood Experiences and Risk of Abnormal Body Mass Index: A Global Systematic Review and Meta-Analysis. CHILDREN (BASEL, SWITZERLAND) 2024; 11:1015. [PMID: 39201949 PMCID: PMC11352292 DOI: 10.3390/children11081015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2024] [Revised: 07/23/2024] [Accepted: 08/12/2024] [Indexed: 09/03/2024]
Abstract
(1) Objectives: The impact of abnormal body mass index (BMI) on health is extensive, and various risk factors contribute to its effects. This study aimed to examine the association between adverse childhood experiences (ACEs) and BMI categories, including underweight, overweight, obesity, severe obesity, and morbid obesity; (2) Methods: Three databases were searched: Web of Science, PubMed, and Scopus. Manual searches were conducted using Google Scholar and ResearchGate. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the association between ACEs and BMI. A random-effects model was used to combine the ORs and CIs across studies; (3) Results: This meta-analysis included 71 studies. The pooled ORs for the relationship between ACEs and obesity was 1.42 (95% CI: 1.24-1.63, Z = 4.96, p < 0.001), indicating a significant association. ACEs showed a positive association with overweight (OR = 1.16, 95% CI: 1.06-1.27, Z = 3.24, p = 0.001). Specifically, ACEs ≥ 4 were strongly associated with obesity (OR = 2.06, 95% CI: 1.27-3.36, Z = 2.90, p = 0.004). Sexual abuse was also found to be significantly associated with obesity (OR = 1.46, 95% CI: 1.29-1.65, Z = 5.98, p < 0.001); (4) Conclusion: This study finds that individuals who have experienced ACEs are more likely to have a higher BMI in adulthood. Therefore, ACEs should be considered a factor associated with abnormal BMI.
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Affiliation(s)
- Sohrab Amiri
- Medicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran 17166, Iran;
| | - Nailah Mahmood
- Division of Health Research, Lancaster University, Lancaster LA1 4YW, UK;
| | - Rahemeen Yusuf
- Emirates Center for Happiness Research, United Arab Emirates University, Al-Ain 15551, United Arab Emirates;
| | - Nadirah Ghenimi
- Health and Wellness Research Group, Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain 15551, United Arab Emirates;
| | - Syed Fahad Javaid
- Health and Wellness Research Group, Department of Psychiatry and Behavioral Sciences, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain 15551, United Arab Emirates
| | - Moien AB Khan
- Health and Wellness Research Group, Department of Psychiatry and Behavioral Sciences, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain 15551, United Arab Emirates
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16
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Miggantz EL, Prince JR, Walter KH, Jackson E, Ray TN, Hollingsworth JC, Zong ZY, Meza-Lopez R, Gilmore AK, Orchowski LM, Davis KC. Sexual Assault Research in the Military: Is Oversampling Necessary for Representativeness? Mil Med 2024; 189:298-305. [PMID: 39160860 DOI: 10.1093/milmed/usae098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 02/07/2024] [Accepted: 03/05/2024] [Indexed: 08/21/2024] Open
Abstract
INTRODUCTION Sexual assault in the U.S. Military is a serious concern. Recruiting representative samples of service members to participate in sexual assault research is essential for understanding the scope of the problem and generating data that can inform prevention and intervention efforts. Accordingly, the current study aims to examine response and completion rates of an anonymous survey of sexual assault and alcohol use among active duty sailors aged 18 to 24 with the overarching goal of achieving a representative sample and informing future recruitment efforts. MATERIALS AND METHODS This study was approved by the Institutional Review Board at the Naval Health Research Center. The study involved an anonymous survey of sexual assault and alcohol use among 612 active duty sailors aged 18 to 24. Since 79.6% of Navy service members are men and 20.4% are women, women were oversampled to achieve sufficient representation. Survey invitations were emailed to 12,031 active duty sailors: 64.3% (n = 7,738) men and 35.7% (n = 4,293) women. RESULTS Response rates were disproportionate, with 3.0% (n = 234) of male and 8.8% (n = 377) of female sailors responding to the study invitation. Survey completion rates, however, were similar between male and female sailors (81.2% and 80.1% for male and female personnel, respectively). CONCLUSION Results demonstrated that female sailors were significantly more likely than male sailors to participate in a study of sexual assault and alcohol use. However, once enrolled in the study, male and female sailors completed the 234-item questionnaire at a similar rate. Study findings highlight the challenges of engaging male service members in sexual assault-related research. Despite the disproportionately high representation of men in the military, sexual assault researchers may need to sample according to the overall distribution of gender in the military or perhaps even oversample men to achieve a representative sample.
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Affiliation(s)
- Erin L Miggantz
- Leidos, Inc., 4161 Campus Point Court, San Diego, CA 92121, USA
- Psychological Health and Readiness Department, Naval Health Research Center, San Diego, CA 92106, USA
| | - Jessica R Prince
- Department of Psychology, Georgia State University, Atlanta, GA 30302-5010, USA
| | - Kristen H Walter
- Psychological Health and Readiness Department, Naval Health Research Center, San Diego, CA 92106, USA
| | - Elaine Jackson
- Department of Psychology, Georgia State University, Atlanta, GA 30302-5010, USA
| | - Travis N Ray
- Leidos, Inc., 4161 Campus Point Court, San Diego, CA 92121, USA
- Psychological Health and Readiness Department, Naval Health Research Center, San Diego, CA 92106, USA
| | - Julia C Hollingsworth
- Leidos, Inc., 4161 Campus Point Court, San Diego, CA 92121, USA
- Psychological Health and Readiness Department, Naval Health Research Center, San Diego, CA 92106, USA
| | - Zoe Y Zong
- Department of Psychiatry and Behavioral Health, Rhode Island Hospital, Providence, RI 02904, USA
| | - Richard Meza-Lopez
- Department of Psychiatry and Behavioral Health, Rhode Island Hospital, Providence, RI 02904, USA
| | - Amanda K Gilmore
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA 30302-3995, USA
| | - Lindsay M Orchowski
- Department of Psychiatry and Behavioral Health, Rhode Island Hospital, Providence, RI 02904, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI 02904, USA
| | - Kelly Cue Davis
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ 85004, USA
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Schneider J, Rukundo-Zeller AC, Bambonyé M, Lust S, Mugisha H, Muhoza JA, Ndayikengurukiye T, Nitanga L, Rushoza AA, Crombach A. The impact of parental acceptance and childhood maltreatment on mental health and physical pain in Burundian survivors of childhood sexual abuse. CHILD ABUSE & NEGLECT 2024; 154:106906. [PMID: 38917765 DOI: 10.1016/j.chiabu.2024.106906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 05/13/2024] [Accepted: 06/07/2024] [Indexed: 06/27/2024]
Abstract
BACKGROUND Parental support has been suggested to mitigate mental and physical consequences following childhood sexual abuse (CSA). However, many CSA survivors experience parental rejection post-CSA. OBJECTIVE We aimed to understand the impact of abuse-specific parental acceptance on post-traumatic stress disorder (PTSD) and physical pain in Burundian CSA-survivors. We further assessed the significance of parental acceptance among known risk factors for predicting PTSD. METHODS, PARTICIPANTS, AND SETTINGS Participants (N = 131, 80.9 % female, mean age 16.21 years) were recruited via primary health care centers for survivors of sexual violence which survivors approached post-CSA. Survivors reported on PTSD symptoms, daytime/nighttime pain, and adverse childhood experiences in semi-structured interviews. Parental acceptance levels were categorized (acceptance, no acceptance, no contact) for mothers and fathers separately. Kruskal-Wallis tests assessed group differences. Conditional random forests (CRF) evaluated the significance of parental acceptance in predicting PTSD symptom severity. RESULTS No significant differences regarding PTSD symptoms and physical pain between levels of maternal acceptance were obtained. Pairwise comparisons revealed significant differences in PTSD symptom severity between paternal acceptance and no acceptance (d = 1.04) and paternal acceptance and no contact (d = 0.81). The CRF identified paternal acceptance as important variable for the prediction of PTSD symptom severity. Even though results were less conclusive, medium effect sizes hint at less pain perception within the paternal acceptance group. CONCLUSIONS The results highlight paternal acceptance as a potential risk or protective factor regarding psychological and possibly physical well-being in the aftermath of CSA, even in the context of other known risk factors.
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Affiliation(s)
- Julia Schneider
- Saarland University, Psychology, Clinical Psychology and Psychotherapy for Children and Adolescents, Saarbrücken, Germany.
| | - Anja C Rukundo-Zeller
- University of Konstanz, Psychology, Clinical Psychology and Clinical Neuropsychology, Konstanz, Germany; Non-Governmental Organization Psychologues sans Frontières Burundi, Bujumbura, Burundi; Non-Governmental Organization vivo international e.V., Konstanz, Germany
| | - Manassé Bambonyé
- Université Lumière de Bujumbura, Clinical Psychology, Bujumbura, Burundi; Non-Governmental Organization Psychologues sans Frontières Burundi, Bujumbura, Burundi
| | - Sarah Lust
- University of Konstanz, Psychology, Clinical Psychology and Clinical Neuropsychology, Konstanz, Germany
| | - Hervé Mugisha
- Non-Governmental Organization Psychologues sans Frontières Burundi, Bujumbura, Burundi
| | - Jean-Arnaud Muhoza
- Non-Governmental Organization Psychologues sans Frontières Burundi, Bujumbura, Burundi
| | | | - Lydia Nitanga
- Non-Governmental Organization Psychologues sans Frontières Burundi, Bujumbura, Burundi
| | - Amini Ahmed Rushoza
- Non-Governmental Organization Psychologues sans Frontières Burundi, Bujumbura, Burundi
| | - Anselm Crombach
- Saarland University, Psychology, Clinical Psychology and Psychotherapy for Children and Adolescents, Saarbrücken, Germany; Non-Governmental Organization Psychologues sans Frontières Burundi, Bujumbura, Burundi; Non-Governmental Organization vivo international e.V., Konstanz, Germany
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van Hemert MTC, de Jong PM, Vanaerschot G, Brouwer TR, Zoon JS, Gunst E. Posttraumatic stress disorder following childhood sexual and physical abuse: a study protocol for an 11-week randomised controlled trial comparing imaginal exposure and imagery rescripting. Eur J Psychotraumatol 2024; 15:2358683. [PMID: 39076139 PMCID: PMC11290290 DOI: 10.1080/20008066.2024.2358683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 04/30/2024] [Accepted: 04/30/2024] [Indexed: 07/31/2024] Open
Abstract
Background: There is a vast amount of evidence supporting the effectiveness of trauma-focused cognitive-behavioral therapy in treating posttraumatic stress disorder (PTSD). However, it remains unclear which specific treatment is most effective for patients with PTSD following childhood sexual and physical abuse (CSPA). Although Imaginal Exposure (IE) has proven highly effective in treating PTSD and is widely acknowledged as a standard method, Imagery Rescripting (IR) may be more suitable for CSPA-related PTSD. IR not only addresses fear but also targets other emotions and cognitions associated with childhood maladaptive schemas. Preliminary findings suggest lower drop-out rates for IR compared to IE, but no Randomized Controlled Trial (RCT) currently assesses the effectiveness of IR for CSPA-related PTSD.Objective: This article presents a study protocol designed to investigate the optimal treatment (IE or IR) for individuals with CSPA-related PTSD and explore predictors of treatment success.Method: In our study protocol, we suggest the inclusion of 173 patients (N = 64 in IR, N = 64 in IE, and N = 45 in the waitlist condition). The therapy procedures for both IE and IR will consist of 16 sessions lasting 90 min each, with treatment durations of 11 weeks. Measurements take place at baseline, at start of treatment, 11 weeks after the start of treatment (after 16 sessions) and at follow-up at 26 weeks after the last session. A mixed regression will be used to compare the three active conditions before and after measurement.Results: This article serves as a study protocol. The results are not yet available but they will be presented in a subsequent article.Conclusion: This study protocol outlines a RCT which will be the first to provide information on the effectiveness of IR versus IE versus a control group in CSPA-related PTSD.Trial registration: Netherlands Trial Register NTR 4817. Registered 26 September 2014.
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Affiliation(s)
| | - Paula M. de Jong
- Psychotherapy & Movement, Mental Health Care Practice, Amsterdam, The Netherlands
| | - Greet Vanaerschot
- Collaborative Antwerp Psychiatric Research Institute (CAPRI) Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Tessa R. Brouwer
- Psychotherapy & Movement, Mental Health Care Practice, Amsterdam, The Netherlands
| | - Joeri S. Zoon
- Psychotherapy & Movement, Mental Health Care Practice, Amsterdam, The Netherlands
- Amsterdam UMC, and GGZ Ingeest, Amsterdam, The Netherlands
| | - Ellen Gunst
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Belgium
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19
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Fitzgerald M, Hall H. Childhood sexual abuse and cholesterol risk: Testing body mass index as a mediator across gender in a national sample of adults. CHILD ABUSE & NEGLECT 2024; 153:106848. [PMID: 38820954 DOI: 10.1016/j.chiabu.2024.106848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/28/2024] [Accepted: 05/07/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND Childhood sexual abuse (CSA) is associated with health problems, including cardiometabolic outcomes. Findings directly linking CSA to cholesterol levels are mixed, and identifying mediating pathways is the next logical step. Body mass index (BMI) is one possible mediator, given its association with both CSA and cardiometabolic outcomes. Gendered effects of CSA indicates that BMI may operate differently in men and women. OBJECTIVE We tested BMI as a mediator linking CSA to high-density lipoprotein (HDL) and low-density lipoprotein (LDL) using a multiple group structural equation model stratified across gender to test the indirect effects. PARTICIPANTS AND SETTING We utilized a sample of 1054 adults (54.7 % women) from the study of Midlife Development in the United States, who were drawn from the general population. METHODS Using two waves of data, participants responded to a questionnaire assessing CSA, provided measurements from which to calculate BMI, and a fasting blood sample from which cholesterol levels were measured. RESULTS The indirect effects in the overall sample yielded a significant effect from CSA to HDL via BMI (β = -0.03, 95 % CI [-0.050, -0.010]), but not LDL (β = 0.006, 95 % CI [-0.002, 0.014]). The indirect effect from CSA to HDL cholesterol was significant among women (β = -0.04, 95 % CI [-0.066, -0.012]) only. Indirect effects to LDL among both genders were both non-significant. CONCLUSIONS BMI appears to be a possible mediator linking CSA to lower HDL cholesterol among women suggesting BMI could be a point of trauma-informed prevention and intervention especially impactful.
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Affiliation(s)
| | - Haley Hall
- Oklahoma State University, United States of America
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20
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Tsur N, Talmon A, Shemesh N. Peritraumatic Pain in Child Maltreatment: A Systematic Literature Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:1725-1736. [PMID: 37655587 PMCID: PMC11155214 DOI: 10.1177/15248380231194069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Extensive research has been conducted on the link between trauma, child maltreatment (CM), and chronic pain. Although the risk of suffering from chronic pain among CM survivors has been established, much less is known about the experience of pain during CM incidents or whether such peritraumatic pain sensations are associated with later chronic pain. This scoping review was conducted to synthesize the existing literature on pain during and a short time following CM (i.e., peritraumatic pain). Utilizing the preferred reporting items for systematic reviews and meta-analyses guidelines, the current review included 11 manuscripts, which met the following criteria: (a) refer to physical pain experienced during or a short time after CM, (b) were published in peer-reviewed journals, and (c) were written in English. The review demonstrated that most of the included studies were not intentionally focused on peritraumatic pain, the majority used qualitative research methods, and all were cross-sectional. Furthermore, although validated questionnaires are available, most of the studies did not utilize such measures. Those that intentionally reported pain demonstrated its high intensity and prevalence in CM incidents, indicating that pain is inherently embedded in the experience of maltreatment. The findings spotlight an underdeveloped research realm on a phenomenon that may hold significant empirical, clinical, and legal implications. Research endeavors should initiate interdisciplinary bodies of knowledge to establish well-validated research methodologies that properly quantify peritraumatic pain in trauma and CM.
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Affiliation(s)
- Noga Tsur
- Tel Aviv University, Tel Aviv, Israel
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21
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Dubé V, Amédée LM, Raza H, Hébert M. Somatic Problems in Children Disclosing Sexual Abuse: The Mediating Role of Alexithymia and Dissociation. JOURNAL OF CHILD SEXUAL ABUSE 2024; 33:608-626. [PMID: 39291891 DOI: 10.1080/10538712.2024.2403999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 06/03/2024] [Accepted: 08/13/2024] [Indexed: 09/19/2024]
Abstract
Child sexual abuse (CSA) is linked to heightened levels of medically unexplained symptoms. Research indicates that victims of CSA display alexithymia and dissociation symptoms. Alexithymia and dissociation may potentially contribute to developing somatic complaints in CSA victims. They represent mechanisms through which psychological distress is avoided and could then manifest as physical symptoms like somatic problems (e.g. headaches, nausea, stomachache, etc.). This study aimed to investigate if alexithymia and dissociation are mechanisms explaining the link between CSA and somatic complaints. The sample included 245 children who had disclosed child sexual abuse and 100 non-abused children aged 6-12 years old. Results of a sequential mediation model revealed that the CSA-somatic complaints relationship was mediated by alexithymia and dissociation. This study suggests that intense negative emotion leads children to focus on external stimuli to reduce psychological suffering. To mitigate somatic problems in victims of CSA, treatment should target overregulation of affect, namely alexithymia, and dissociation. In the long term, this could prevent unnecessary diagnostic testing and delay in appropriate interventions.
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Affiliation(s)
- Valéry Dubé
- Université du Québec à Montréal, Montréal, Canada
| | | | - Hina Raza
- Brown University, Providence, RI, USA
| | - Martine Hébert
- Université du Québec à Montréal, Montréal, Canada
- Canada Research Chair in Interpersonal Traumas and Resilience, Montréal, Canada
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Furian G, Beier KM, Schwarz K, da Silva DC, Grundmann D, Lobato MIR. The Need for a Prevention Program for Child Sexual Abuse in Brazil: A Report of Shortfall Care to Pedophilia and its Critical Consequences. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2024; 17:671-675. [PMID: 38938962 PMCID: PMC11199424 DOI: 10.1007/s40653-023-00586-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/31/2023] [Indexed: 06/29/2024]
Abstract
From a case report of a person with pedophilic disorder, this paper focuses on the issue of pedophilia, child sexual abuse, and the need for specific prevention and treatment strategies in Brazil. It seems inevitable to increase awareness for this topic within the mental health care system to protect children and reduce the risk for sexual offense in individuals at-risk. This is a case report of an individual, known by medical-psychiatric and forensic facilities for a past history of patricide, who revealed his pedophilic fantasies and behavior belatedly. To assess a pedophilic disorder and screen for other paraphilic contents, a screening questionnaire and clinical interview were used during the patient hospitalization in 2020 for a proper evaluation of sexual history and past offending behaviors. A review of the literature on pedophilia prevention programs was also carried out. WW is a middle-aged man admitted to a psychiatric unit for a severe episode of major depressive disorder and at risk of suicide. During recovery, he reported pedophilic fantasies and behaviors in his life. Sexual fantasies involving children and actual sexual offenses have remained unknown to mental health professionals and unreported to legal authorities. WW's case alarmingly emphasizes the need for the training of health care professionals and for preventive strategies in Brazil for those who are at risk of engaging in offending sexual behaviors in a combined and intensive effort to protect children from sexual offense.
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Affiliation(s)
- Gabriel Furian
- Graduate Program in Medical Sciences: Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS Brazil
| | - Klaus Michael Beier
- Institute of Sexology and Sexual Medicine, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Karine Schwarz
- Gender Identity Program at Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul Brazil
- Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, Porto Alegre, 2350, Rio Grande do Sul 90035-903 Brazil
- Postgraduate Program in Medical Sciences: Endocrinology, Faculty of Medicine, UFRGS, porto alegre, Brazil
| | - Dhiordan Cardoso da Silva
- Graduate Program in Medical Sciences: Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS Brazil
| | - Dorit Grundmann
- Institute of Sexology and Sexual Medicine, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Maria Inês Rodrigues Lobato
- Graduate Program in Medical Sciences: Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS Brazil
- Gender Identity Program at Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul Brazil
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Basile KC, Chen J, Friar NW, Smith SG, Leemis RW. Association of Contact Sexual Violence Victimization and Health in the U.S. Am J Prev Med 2024; 66:860-869. [PMID: 38331115 PMCID: PMC11182425 DOI: 10.1016/j.amepre.2024.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 02/10/2024]
Abstract
INTRODUCTION Sexual violence victimization is related to negative impacts, including chronic health conditions. Less is known about possible confounders of this relationship. This study examines the association between lifetime experience of contact sexual violence (CSV) and health conditions by sex, controlling for demographics and other victimization. METHODS Data are from the 2016/2017 National Intimate Partner and Sexual Violence Survey, a nationally representative study of English- or Spanish-speaking adults. Ten health conditions (e.g., HIV/AIDS) and four activity limitations (e.g., difficulty dressing) were examined related to CSV victimization. Logistic regression models examined the association between CSV victimization and health controlling for demographics and other victimization experiences. Analyses were conducted in 2022 to 2023. RESULTS For women and men, many health conditions and activity limitations were significantly associated with CSV after controlling for demographics. Accounting for other victimization, female CSV victims had higher odds of experiencing difficulty sleeping (Adjusted Odds Ratio [AOR]=1.3); difficulty concentrating, remembering, or making decisions (AOR=1.7); and difficulty doing errands alone (AOR=1.4) than nonvictims. Male victims had higher odds than nonvictims of having HIV/AIDS (AOR=5.2); frequent headaches (AOR=1.5); chronic pain (AOR=1.5); difficulty sleeping (AOR=1.4); serious difficulty hearing (AOR=1.3); and difficulty concentrating, remembering, or making decisions (AOR=1.5). CONCLUSIONS CSV had a negative impact on health, although other types of victimization appear to also have an impact, especially for women. Demographic characteristics also aid the understanding of the relationship between CSV and health. Efforts to prevent CSV and other forms of violence can be coupled with healthcare- and population-level approaches to improve long-term health.
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Affiliation(s)
- Kathleen C Basile
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Jieru Chen
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Norah W Friar
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sharon G Smith
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ruth W Leemis
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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Mekonnen BD, Tsega SS. Child sexual abuse and its determinants among children in Addis Ababa Ethiopia: Systematic review and meta-analysis. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0001979. [PMID: 38569122 PMCID: PMC10990560 DOI: 10.1371/journal.pgph.0001979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 02/29/2024] [Indexed: 04/05/2024]
Abstract
Child sexual abuse is a significant public health concern and a breach of basic human rights affecting millions of children each year globally. It is typically not reported by victims, hence it remains usually concealed. Except for single studies with varying reports, there is no national studies conducted on child sexual abuse in Ethiopia. Therefore, this review determined the pooled magnitude and determinants of sexual abuse among children in Ethiopia. Potential articles were searched from PubMed, Science Direct, Scopus, and Web of science using relevant searching key terms. The Joanna Briggs Institute (JBI) critical appraisal checklist was used to evaluate the quality of all selected articles. Data were analyzed using STATA Version 14 software. Publication bias was checked using Egger's test and funnel plot. Cochran's chi-squared test and I2 values were used to assess heterogeneity. A random-effects model was applied during meta-analysis. The pooled prevalence of sexual abuse among 5,979 children in Ethiopia was 41.15% (95% CI: 24.44, 57.86). Sex of children (OR: 2.14, 95%CI: 1.12, 4.06), smoking (OR: 4.48, 95%CI: 1.26, 76.79), khat chewing (OR: 3.68, 95%CI: 1.62, 21.93), and alcohol use (OR: 4.77, 95%CI: 2.22, 10.25) were the determinants of child sexual abuse. The main perpetrators of sexual abuse against children were neighbors, boy/girlfriends, family members, school teachers, and stranger person. Child sexual abuse commonly took place in the victim's or perpetrator's home, school, and neighbor's home. This review revealed that the magnitude of child sexual abuse in Ethiopia was relatively high and multiple factors determined the likelihood of sexual violence against children. Thus, policy-makers and concerned stakeholders should strengthen comprehensive sexual and reproductive health education to reduce the magnitude and consequences of child sexual abuse. Moreover, support with special attention should be given to children with mental illness and physical disabilities.
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Affiliation(s)
| | - Sintayehu Simie Tsega
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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25
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Blaustein RB, Parker CA, Haefner HK, Reed BD, Haefner JK, Welch KC. Relationship Between Childhood Sexual Abuse, Obesity, and Vulvodynia in Adulthood. J Low Genit Tract Dis 2024; 28:160-163. [PMID: 38346428 DOI: 10.1097/lgt.0000000000000799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2024]
Abstract
OBJECTIVE The aim of the study is to assess the relationship between childhood sexual abuse, obesity, and vulvodynia among adult women participating in a population-based longitudinal vulvodynia study. MATERIALS AND METHODS Surveys assessed health status, diagnoses, risk factors, and screening test outcomes for women with vulvodynia. Associations between childhood sexual abuse (CSA) and obesity, CSA and vulvodynia, and obesity and vulvodynia were investigated. A multivariate model was used to determine if obesity mediates and/or modifies the relationship between CSA and vulvodynia. RESULTS Of 2,277 women participating in the study, 1,647 completed survey data on CSA at 18 months, body mass index at 24 months, and vulvodynia over the first 54 months of the survey. Mean age was 50.9 ± 15.8 years. Overall, race and ethnicity were 77.4% White, 15.7% Black, 2.4% Hispanic, and 4.5% other. Five hundred thirty-nine participants (32.7%) were obese (body mass index >30) and 468 (28.4%) were overweight. Physical CSA before age of 18 years was reported by 20.0% ( n = 329). During the study, 22.0% ( n = 362) screened positive for vulvodynia on one or more surveys. After controlling for demographic variables, both obesity and screening positive for vulvodynia were associated with a history of CSA before age of 18 years ( p = .013 and p < .001, respectively), but obesity was not associated with screening positive for vulvodynia ( p = .865). In addition, multivariate analysis indicated no mediation of the CSA/vulvodynia relationship by obesity. CONCLUSIONS Although obesity and vulvodynia were independently associated with a history of CSA, obesity did not mediate or modify the relationship between CSA and vulvodynia in adulthood.
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Affiliation(s)
| | | | - Hope K Haefner
- University of Michigan, Department of Obstetrics and Gynecology, Ann Arbor, MI
| | - Barbara D Reed
- University of Michigan, Department of Family Medicine, Ann Arbor, MI
| | - Jessica K Haefner
- University of Michigan, Department of Obstetrics and Gynecology, Ann Arbor, MI
| | - Kathryn C Welch
- University of Michigan, Department of Obstetrics and Gynecology, Ann Arbor, MI
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Bailey CM. (Un)safe Spaces: The Relationship Between Slavery and Sexual Victimization of Black Women. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:1543-1570. [PMID: 37902456 DOI: 10.1177/08862605231207622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
Research exploring the correlates of sexual victimization has found sexual victimization to be associated with both individual- and contextual-level factors, including age, gender, poverty, and size of the female population. However, to date, research has been limited in exploring how historical factors, such as slavery, may be associated with the contemporary prevalence of sexual victimization of women. Historical accounts have often suggested that enslaved women often experienced sexual victimization during their enslavement. Despite these accounts, research has been limited in empirically exploring the relationship between slavery and the sexual victimization of Black women. Using the 1860 U.S. Census and the 2019 National Incidence-Based Reporting System, multilevel logistic regression analyses are employed to explore whether slavery is consequential for contemporary instances of Black female sexual victimization. In line with the "legacy effect" framework, the findings from the current study suggest that Black women are significantly more likely to be sexually victimized in counties characterized by larger enslaved populations in 1860. These findings illuminate how historical institutions, despite being outlawed, have contemporary consequences, particularly for Black women. These findings, discussions, avenues for future research, and policy implications are discussed below.
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Gewirtz-Meydan A, Godbout N, Canivet C, Peleg-Sagy T, Lafortune D. The Complex Interplay between BDSM and Childhood Sexual Abuse: A Form of Repetition and Dissociation or a Path Toward Processing and Healing? JOURNAL OF SEX & MARITAL THERAPY 2024; 50:583-594. [PMID: 38544460 DOI: 10.1080/0092623x.2024.2332775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
In this theoretical paper the authors explore the connections between BDSM (i.e., practices involving bondage, discipline, dominance, submission, sadism, masochism) and CSA (childhood sexual abuse) in order to investigate the potential unconscious mechanisms at play and the therapeutic functions of BDSM practices among CSA victims. Drawing on the embodiment framework, the authors address how BDSM may serve as a form of unconscious repetition of traumatic experiences for certain CSA victims, with the aim of processing trauma and healing. A review of the empirical evidence regarding the links between BDSM and CSA trauma, along with the potential of BDSM to trigger trauma and elicit dissociation, guilt, or shame, is conducted. Finally, BDSM practices are reviewed through the concept of trauma-play, which involves deliberate rescripting. In short, the complex relationship between BDSM and CSA is highlighted, as well as its implications for understanding and potentially addressing trauma experiences in therapy.
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Affiliation(s)
- Ateret Gewirtz-Meydan
- School of Social Work, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel
| | - Natacha Godbout
- Department of Sexology, Université du Québec à Montréal, Montreal, Canada
| | - Cloé Canivet
- Department of Sexology, Université du Québec à Montréal, Montreal, Canada
| | - Tal Peleg-Sagy
- Department of Psychology, Ben Gurion University of the Negev, Beersheba, Israel
| | - David Lafortune
- Department of Sexology, Université du Québec à Montréal, Montreal, Canada
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Hemanth P, Fang L, Chong S, Tan LJ. Factors related to delayed disclosure among victims of child sexual abuse in Singapore. CHILD ABUSE & NEGLECT 2024; 149:106647. [PMID: 38281408 DOI: 10.1016/j.chiabu.2024.106647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 01/05/2024] [Accepted: 01/10/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND Delayed disclosure is a prevalent and serious issue among victims of child sexual abuse (CSA). Identifying the factors associated with delayed disclosure can identify the profile of children who are at risk of delaying disclosures and inform measures to facilitate timely disclosure. OBJECTIVE The current study represented a pioneering effort to investigate factors that are related to disclosure of CSA in Singapore. It examined the influence of various victim and abuse characteristics on the time taken for a victim to disclose CSA. PARTICIPANTS AND SETTING A total of 252 CSA cases that were referred to the psychology department of Singapore's Ministry of Social and Family Development (MSF) from 2017 to 2021 were analyzed. METHODS Cases were coded for the study variables and multivariate Cox regression was conducted to analyze the impact of each variable of interest on the time taken to disclose the abuse. RESULTS It was found that the following sub-populations of CSA victims were associated with delayed disclosure: younger victims, female victims (as compared to male victims), victims with higher severity of sexual abuse (e.g., forced intercourse), and victims who were abused by in-home caregivers (as compared to acquaintances). CONCLUSIONS The findings from the study generated practical implications to help reduce the time victims take to disclose CSA in the Singaporean context.
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Affiliation(s)
- Pooja Hemanth
- Clinical and Forensic Psychology Service, Ministry of Social and Family Development, Singapore.
| | - Lue Fang
- Clinical and Forensic Psychology Service, Ministry of Social and Family Development, Singapore
| | - Sophie Chong
- Clinical and Forensic Psychology Service, Ministry of Social and Family Development, Singapore
| | - Li Jen Tan
- Clinical and Forensic Psychology Service, Ministry of Social and Family Development, Singapore
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Guiney H, Caspi A, Ambler A, Belsky J, Kokaua J, Broadbent J, Cheyne K, Dickson N, Hancox RJ, Harrington H, Hogan S, Ramrakha S, Righarts A, Thomson WM, Moffitt TE, Poulton R. Childhood sexual abuse and pervasive problems across multiple life domains: Findings from a five-decade study. Dev Psychopathol 2024; 36:219-235. [PMID: 36562290 PMCID: PMC10287838 DOI: 10.1017/s0954579422001146] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The aim of this study was to use longitudinal population-based data to examine the associations between childhood sexual abuse (CSA) and risk for adverse outcomes in multiple life domains across adulthood. In 937 individuals followed from birth to age 45y, we assessed associations between CSA (retrospectively reported at age 26y) and the experience of 22 adverse outcomes in seven domains (physical, mental, sexual, interpersonal, economic, antisocial, multi-domain) from young adulthood to midlife (26 to 45y). Analyses controlled for sex, socioeconomic status, prospectively reported child harm and household dysfunction adverse childhood experiences, and adult sexual assault, and considered different definitions of CSA. After adjusting for confounders, CSA survivors were more likely than their peers to experience internalizing, externalizing, and thought disorders, suicide attempts, health risk behaviors, systemic inflammation, poor oral health, sexually transmitted diseases, high-conflict relationships, benefit use, financial difficulties, antisocial behavior, and cumulative problems across multiple domains in adulthood. In sum, CSA was associated with multiple persistent problems across adulthood, even after adjusting for confounding life stressors, and the risk for particular problems incremented with CSA severity. The higher risk for most specific problems was small to moderate, but the cumulative long-term effects across multiple domains reflect considerable individual and societal burden.
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Affiliation(s)
- Hayley Guiney
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Avshalom Caspi
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
- King’s College London, Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, & Neuroscience, London, UK
| | - Antony Ambler
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
- King’s College London, Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, & Neuroscience, London, UK
| | - Jay Belsky
- Robert M. and Natalie Reid Dorn Professor, Department of Human Ecology, University of California, Davis, CA, USA
| | - Jesse Kokaua
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
- Centre for Pacific Health, Va’a O Tautai, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | | | - Kirsten Cheyne
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Nigel Dickson
- Department of Preventive and Social Medicine, Otago Medical School, University of Otago, New Zealand
| | - Robert J. Hancox
- Department of Preventive and Social Medicine, Otago Medical School, University of Otago, New Zealand
| | - HonaLee Harrington
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Sean Hogan
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Sandhya Ramrakha
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Antoinette Righarts
- Department of Preventive and Social Medicine, Otago Medical School, University of Otago, New Zealand
| | | | - Terrie E. Moffitt
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
- King’s College London, Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, & Neuroscience, London, UK
| | - Richie Poulton
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
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Aşcı Ö, Bal MD, Koçoğlu F. The Impact of Childhood Sexual Abuse on Adult Female Sexual Function and Sexual Distress: A Systematic Review and Meta- Analysis. TURK PSIKIYATRI DERGISI = TURKISH JOURNAL OF PSYCHIATRY 2024; 35:63-74. [PMID: 38556938 PMCID: PMC11003369 DOI: 10.5080/u26991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 08/22/2022] [Indexed: 04/02/2024]
Abstract
OBJECTIVE In this study, it was aimed to examine the impacts of exposure to childhood sexual abuse (CSA) on women's sexual function and sexual distress. METHOD In this systematic review and meta-analysis study, eight international (EBSCO, Psyc-Info, Proquest, PubMed, Science Direct, Scopus, Ovid, Web of Science) and two national electronic databases (Dergipark and Thesis Database of the Turkish Council of Higher Education) were searched. Studies reporting outcomes of sexual function and sexual distress in women with and without a history of CSA were included. The data were synthesized by meta-analysis and narrative methods. RESULTS Two dissertations and five research articles published between 2010 and 2021 were included in the study. In some studies that were not included in the meta-analysis, it was reported that there was no difference in the prevalence of sexual dysfunction, and sexual satisfaction in women with and without a history of CSA. Meta-analysis results demonstrated lower sexual function (sexual arousal, MD: -0.83, p<0.001; sexual desire, MD: -0.55, p<0.001; lubrication, MD: -0.78, p<0.01; pain, MD: -0.52, p<0.001) and more sexual distress (SMD: -0.79, p<0.05) in women with CSA history. CONCLUSION This study showed that CSA negatively affects female sexual function and increases sexual distress. Healthcare professionals should be aware that women with a CSA history may have worse sexual functions and more sexual distress. More research is needed on the role of CSA in the etiology of sexual function problems and its possible mechanisms of action.
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Affiliation(s)
- Özlem Aşcı
- Assoc. Prof., Niğde Ömer Halisdemir University, Niğde Zübeyde Hanım Faculty of Health Sciences, Division of Midwifery, Niğde
| | - Meltem Demirgöz Bal
- Prof., Marmara University, Health Sciences Faculty, Midwifery Department, İstanbul
| | - Ferdane Koçoğlu
- Assis. Prof., Niğde Ömer Halisdemir University, Zübeyde Hanım Faculty of Health Sciences, Department of Public Health Nursing, Niğde, Turkey
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Bussières A, Hancock MJ, Elklit A, Ferreira ML, Ferreira PH, Stone LS, Wideman TH, Boruff JT, Al Zoubi F, Chaudhry F, Tolentino R, Hartvigsen J. Adverse childhood experience is associated with an increased risk of reporting chronic pain in adulthood: a stystematic review and meta-analysis. Eur J Psychotraumatol 2023; 14:2284025. [PMID: 38111090 PMCID: PMC10993817 DOI: 10.1080/20008066.2023.2284025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 08/22/2023] [Indexed: 12/20/2023] Open
Abstract
Background: Adverse childhood experiences (ACEs) have been shown to negatively affect health in adulthood. Estimates of associations between ACEs and chronic painful conditions are lacking.Objectives: This systematic review and meta-analysis aimed to evaluate associations between exposure to ACEs and chronic pain and pain-related disability in adults.Methods: We searched 10 electronic databases from inception to February 2023. We included observational studies assessing associations between direct ACEs (childhood sexual, physical, emotional abuse, or neglect) alone or in combination with indirect ACEs (witnessing domestic violence, household mental illness), and adult chronic pain (≥3 months duration) and pain-related disability (daily activities limited by chronic pain). Pairs of reviewers independently extracted data and assessed study risks of bias. Random-effect models were used to calculate pooled adjusted odds ratios [aOR]. Tau square [T2], 95% prediction intervals [95%PI] and I2 expressed the amount of heterogeneity, and meta-regressions and subgroup meta-analyses investigated sources of heterogeneity (PROSPERO: CRD42020150230).Results: We identified 85 studies including 826,452 adults of which 57 studies were included in meta-analyses. Study quality was generally good or fair (n = 70). The odds of reporting chronic pain in adulthood were significantly higher among individuals exposed to a direct ACE (aOR, 1.45, 95%CI, 1.38-1.53). Individuals reporting childhood physical abuse were significantly more likely to report both chronic pain (aOR, 1.50, 95CI, 1.39-1.64) and pain-related disability (1.46, 95CI, 1.03-2.08) during adulthood. Exposure to any ACEs alone or combined with indirect ACEs significantly increase the odds of adult chronic painful conditions (aOR, 1.53, 95%CI, 1.42-1.65) and pain-related disability (aOR, 1.29; 95%CI, 1.01-1.66). The risk of chronic pain in adulthood significantly increased from one ACE (aOR, 1.29, 95%CI, 1.22-1.37) to four or more ACEs (1.95, 95%CI, 1.73-2.19).Conclusions: Single and cumulative ACEs are significantly associated with reporting of chronic pain and pain-related disability as an adult.
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Affiliation(s)
- André Bussières
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
- Département Chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Mark J. Hancock
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Ask Elklit
- National Centre for Psychotraumatology, Department of Psychology, University of Southern DenmarkOdense, Denmark
| | - Manuela L. Ferreira
- Sydney Musculoskeletal Health, The Kolling Institute, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Paulo H. Ferreira
- Musculoskeletal Health, Faculty of Health Sciences, Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Laura S. Stone
- Faculty of Dentistry, McGill University, Montreal, Canada
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, Canada
- Department of Anesthesiology, Faculty of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Timothy H. Wideman
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, Canada
| | - Jill T. Boruff
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montreal, Canada
| | - Fadi Al Zoubi
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Fauzia Chaudhry
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - Raymond Tolentino
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal
| | - Jan Hartvigsen
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Chiropractic Knowledge Hub, Odense, Denmark
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Lathan EC, Selwyn CN, Gigler ME, Langhinrichsen-Rohling J, Gilmore AK. College Students' Trust, Betrayal, and Needs During and After Their Worst Nonassault-Related Healthcare Experiences Differ Based on Sexual Violence Exposure. VIOLENCE AND VICTIMS 2023; 38:858-878. [PMID: 37989528 DOI: 10.1891/vv-2022-0074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
The BITTEN theoretical framework conceptually links patient's past healthcare betrayal and trauma experiences with their current and future healthcare interactions. BITTEN was used to examine whether healthcare experiences, behaviors, and needs differ between those with and without a history of sexual violence exposure. College students at two public universities in the southeastern United States (n = 1,381; 59.5% White, 61.0% women) completed measures about their self-selected worst or most frightening but nonassault-related healthcare experience. Multivariate general linear and mediation models were used to test theory-derived hypotheses. Participants exposed to sexual violence reported greater healthcare institutional betrayal, lower trust, and greater need for tangible aid and trauma-informed care during their worst nonassault-related healthcare experience. They also reported greater current healthcare avoidance alongside increased utilization of more physical and mental healthcare appointments, even after accounting for gender and race differences. These results suggest that, with minimal information about past sexual violence exposure, healthcare providers could be better poised to predict and address vulnerable patients' healthcare needs.
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Affiliation(s)
- Emma C Lathan
- Department of Psychological Sciences, Auburn University, Auburn, AL, USA
| | - Candice N Selwyn
- Department of Community Mental Health Nursing, University of South Alabama, Mobile, AL, USA
| | - Margaret E Gigler
- Department of Psychological Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | | | - Amanda K Gilmore
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
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Kachaner A, Harim M, Combier A, Trouvin AP, Avouac J, Ranque B, Piot MA. Management perspectives from patients with fibromyalgia experiences with the healthcare pathway: a qualitative study. Front Med (Lausanne) 2023; 10:1231951. [PMID: 38105901 PMCID: PMC10722233 DOI: 10.3389/fmed.2023.1231951] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 11/08/2023] [Indexed: 12/19/2023] Open
Abstract
Background Fibromyalgia is a prevalent condition affecting 1-2% of the general population and can result in significant disability. Physicians and patients frequently encounter challenges in managing this condition. Aim The aim of this study was to explore novel management approaches through a qualitative analysis of the doctor-patient relationship. Design and setting Telephonic interviews were conducted with fibromyalgia patients to investigate their healthcare experiences. Methods Qualitative analysis was performed on patients' narratives using interpretative phenomenological analysis, a methodology that delves into each individual's subjectivity. Results A total of 19 adult patients with fibromyalgia, primarily middle-aged women (84% women, mean age 49.8 years), recruited from two university centers in Paris, were included in the study. The narratives of participants revealed substantial suffering and considerable functional impairment, which is paradoxical for a condition often considered benign. They reported an ongoing sense of loss of control, exacerbated by an imbalanced patient-doctor relationship. Patients constantly feared not being heard or believed, and they frequently sought attention from their caregivers. Most participants displayed significant ambivalence toward the nature of their condition and actively sought causal links. Patients' adaptive strategies sometimes worsened their symptoms, as in the case of muscular deconditioning. The healthcare system appeared deficient in managing these patients, characterized by a lack of health professional training, frequent inappropriate responses from healthcare providers, and stigmatization of psychological conditions. Conclusion Despite its perceived benign nature, fibromyalgia should be regarded as a severe condition due to its substantial long-term consequences. Participants reported a challenging experience with the doctor-patient relationship, marked by a strong sense of dependence and a lack of recognition. The care pathway for these patients appeared unsuitable and disorderly, potentially resulting in iatrogenic consequences. The management of patients with fibromyalgia should be enhanced and directed toward a patient-centered approach. The study provides practical recommendations regarding communication methods and patient care.
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Affiliation(s)
| | - Magda Harim
- Service de réanimation, Hôpital Henri-Mondor, Créteil, France
| | - Alice Combier
- Université Paris Cité, Service de Rhumatologie, Hôpital Cochin, Paris, France
| | - Anne Priscille Trouvin
- Université Paris Cité, Centre d'Évaluation et de Traitement de la Douleur, Hôpital Cochin, Paris, France
| | - Jérôme Avouac
- Université Paris Cité, Service de Rhumatologie, Hôpital Cochin, Paris, France
| | - Brigitte Ranque
- Université Paris Cité, Service de Médecine Interne, Hôpital Européen Georges Pompidou, Paris, France
| | - Marie-Aude Piot
- Université Paris Cité, Hôpital Necker Enfants Maladies, AP-HP, Paris, France
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Ashida T, Fujiwara T, Kondo K. Association between adverse childhood experiences and social integration among older people in Japan: Results from the JAGES study. Arch Gerontol Geriatr 2023; 114:105099. [PMID: 37329767 DOI: 10.1016/j.archger.2023.105099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 05/30/2023] [Accepted: 06/07/2023] [Indexed: 06/19/2023]
Abstract
Social integration, network, and support are beneficial to health. However, there is little evidence of the association between adverse childhood experiences (ACEs) and social integration in later life. This study investigates the association between ACE history and social integration in older people. We used data from the Japan Gerontological Evaluation Study (JAGES) 2013, which conducted a self-reported survey of functionally independent people aged ≥ 65 years from 30 municipalities across Japan and yielded information on ACE history. We conducted a Poisson regression analysis with robust error variances to assess the association between ACE history and social integration, adjusting for sex, age, childhood economic hardship, adult socioeconomic status, health status, living status, and trust in others. The number of respondents with at least one incident of ACE was approximately 36.8%. The prevalence ratios for those who reported a history of ACEs were as follows: housebound 1.495 (95% confidence interval [CI]: 1.19-1.88), small network size 1.146 (95% CI: 1.10-1.19), low network contact 1.059 (95% CI: 1.00-1.059), non-membership sports group 1.038 (95% CI: 1.00-1.07), and non-membership hobby group 1.06 (95% CI: 1.03-1.09). Among older people in Japan, a history of ACEs is inversely associated with social integration. These findings support the life course approach and suggest that adverse events in early life may have an impact on social life in old age. In order to promote healthy aging, it is important to recognize the significant impact of early-life adversities that can extend into later life.
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Affiliation(s)
- Toyo Ashida
- Faculty of Economics, Keio University, Tokyo, Japan.
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
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Brown MJ, Amoatika D, Addo PNO, Kaur A, Haider MR, Merrell MA, Crouch E. Childhood Sexual Trauma and Subjective Cognitive Decline: An Assessment of Racial/Ethnic and Sexual Orientation Disparities. J Appl Gerontol 2023; 42:2129-2138. [PMID: 37218145 PMCID: PMC10523896 DOI: 10.1177/07334648231175299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023] Open
Abstract
Prior studies examining the association between childhood sexual abuse (CSA) and subjective cognitive decline (SCD) are limited. The aim of this study was to examine the racial/ethnic and sexual orientation disparities in the association between CSA and SCD. Using data from the 2019 Behavioral Risk Factor Surveillance System Survey, crude and multivariable logistic regression models were used to determine the association between CSA and SCD adjusting for sociodemographic characteristics, diabetes, hypertension, and depression. There were statistically significant differences in CSA status by age, gender, income, education, employment, and health status (depression). Black and Hispanic/Latine respondents had a stronger relationship between CSA and SCD compared to White populations. Also, sexual minority populations had a stronger relationship between CSA and SCD compared to heterosexual populations. Health disparities exist in the association between CSA and SCD. Trauma-informed interventions should be implemented among affected populations.
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Affiliation(s)
- Monique J. Brown
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- Office for the Study on Aging, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Daniel Amoatika
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Prince Nii Ossah Addo
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Amandeep Kaur
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Mohammad Rifat Haider
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, Georgia
| | - Melinda A. Merrell
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Elizabeth Crouch
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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Attrash-Najjar A, Tener D, Katz C. "One Day It Will Be Over, and You Will See Other Landscapes. . . You Are Not Alone": Adult Survivors' Messages to Children Undergoing Child Sexual Abuse. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:11138-11164. [PMID: 37431742 PMCID: PMC10466942 DOI: 10.1177/08862605231178496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
Child sexual abuse (CSA) has received considerable attention from scholars, contributing to policy, intervention, and prevention efforts worldwide. However, survivors' involvement in this research is limited. This study was designed to delve into the messages of adult CSA survivors to abused children. In all, 371 written testimonies were provided to the Israeli Independent Public Inquiry on CSA by survivors from diverse communities in Israel. The Inquiry aimed to promote change in policies related to CSA. The testimonies were analyzed using the qualitative thematic analysis method. The results revealed five main messages emphasized by survivors to children experiencing CSA: (a) transferring the responsibility and guilt from children to perpetrators and society; (b) turning toward the light and continuing on; (c) disclosure is essential; (d) a happy life is possible; and (e) together we can survive. The discussion emphasizes how various systems in survivors' lives have profound impacts following the abuse. Although survivors were from diverse backgrounds, their messages to abused children were consistent. Through their messages to the children, the survivors emphasized their wish to transfer responsibility and guilt from children experiencing abuse to the society that is supposed to see, listen, protect, and validate. Implications for practice are discussed, focusing on the importance of making room for survivors' voices and experiences in the processes of shaping policies in the area of CSA. Moreover, the survivors' desire to be there for the children emphasized the urgent need to promote the perception of survivors as key stakeholders in the field of child abuse and to integrate their experiences and perceptions into the formal and informal systems for children.
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Swaby H, Lievesley R. "Falling Through the Cracks": A Retrospective Exploration of the Barriers to Help-Seeking Among Men Convicted of Sexual Crimes. SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 2023; 35:812-841. [PMID: 36537848 DOI: 10.1177/10790632221146501] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The prevalence and impact of sexual abuse is of global concern, and the alarming rates of victimization have inspired a focus on its prevention. Whilst research has begun to explore the experiences of non-offending individuals to inform prevention initiatives, there is limited exploration of those who have struggled with their sexual interests and go on to commit sexual crime. Arguably these individuals hold key information about gaps in service provision, which may inform approaches to crime prevention. This study aimed to provide a phenomenological exploration of the pre-offense experiences of convicted individuals' beliefs about help-seeking, their desires for support, and any barriers that might have prevented them from coming forward for help. Semi-structured interviews were conducted with 14 individuals convicted of sexual offenses (n = 13 against children; n = 1 sexually motivated violence), and interpretative phenomenological analysis elicited three superordinate themes: Desperation, Barriers to Help-seeking and A Way Forward. The findings shed light on the distressing experience of living with sexual interests that are so openly rejected by society and the many ways participants attempted to cope with this, including multiple failed attempts to seek help. Implications and limitations are discussed.
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Amoatika DA, Brown MJ, Addo PNO, Kaur A. Coping strategies among older adults living with HIV/AIDS with history of childhood sexual abuse. Int J STD AIDS 2023; 34:687-693. [PMID: 37147925 DOI: 10.1177/09564624231173030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Background: Childhood sexual abuse (CSA) may be a risk factor for poor mental health in adulthood. Survivors may experience emotions detrimental to their social and mental wellbeing. Some of these emotions may include anger, fear, rage, helplessness, guilt, shame, which may impact their coping strategies. The aim of this study was to determine the association between CSA and coping among older adults living with HIV (OALH). Method: Data were obtained from 91 OALH via convenience sampling. The participants were recruited from an immunology clinic and were at least 50 years or older and living with HIV. CSA was operationalized using questions from the Adverse Childhood Experiences Questionnaire. Coping was assessed using the Brief COPE Inventory. Crude and adjusted linear regression models, controlling for age, sex, race, gender, and income were used to determine the association between CSA and each coping subscale. The analyses were conducted in SAS version 9.4. Results: Crude analyses showed statistically significant associations between CSA and specific coping strategies: humor (β = 1.244; p = 0.0018), religion (β = 1.122; p = 0.0291), Self-blame (β = 1.103; p = 0.0154), planning β = 1.197; p = 0.0196), venting (β = 1.218; p = 0.0063), substance use (β = 0.828; p = 0.0335) and instrumental support (β = 0.949; p = 0.0416) After adjusting for sociodemographic characteristics, there was a statistically significant association between CSA and humor (β = 1.321; p = 0.0048) and self-blame (β = 1.046; p = 0.0382). Conclusion: OALH with a history of CSA were more likely to use humor and self-blame as coping strategies. Trauma-informed interventions should be geared towards decreasing self-blame for OALH who are CSA survivors.
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Affiliation(s)
- Daniel A Amoatika
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Monique J Brown
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Office for the Study on Aging, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Prince N O Addo
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Amandeep Kaur
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Schiff M, Auslander WF, Gerke DR. Child Maltreatment, Mental Health, and Self-Reported Health Among Adolescent Girls in Child Welfare: Mediating Pathways. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:759-771. [PMID: 37593056 PMCID: PMC10427600 DOI: 10.1007/s40653-023-00545-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/06/2023] [Indexed: 08/19/2023]
Abstract
Child maltreatment is common in the US and has been shown to be associated with physical and psychological health problems in adolescence and adulthood. Based on the allostatic load theory, this study examined the association between different types of child maltreatment (emotional, physical, and sexual abuse, and physical neglect) and self-rated health, and the mediating roles of post-traumatic stress and depression in these relationships. Participants were 249 girls involved in the child welfare system, ages 12-19 years, the majority of whom were African American. A one item self-reported general health measure, the Child Trauma Questionnaire-Short Form (CTQ-SF), Child PTSD Symptom Scale (CPSS) and the Child Depression Inventory (CDI) measured self-reported health, child maltreatment, and posttraumatic and depression symptoms, respectively. Higher levels of emotional, physical, and sexual abuse, and physical neglect were significantly associated with poorer ratings of health. PTSD and depression were significant mediators between histories of childhood emotional, physical, and sexual abuse and physical health. In conclusion, results indicate that the pathways from child abuse to physical health problems in adolescents are through psychological distress. Trauma focused interventions to reduce symptoms of PTSD and depression among this vulnerable group of adolescents are essential to improve health.
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Affiliation(s)
- Miriam Schiff
- The Hebrew University of Jerusalem, Jerusalem, Israel
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Guastaferro K, Shipe SL, Connell CM, Letourneau EJ, Noll JG. Implementation of a Universal School-Based Child Sexual Abuse Prevention Program: A Longitudinal Cohort Study. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:8785-8802. [PMID: 36866594 PMCID: PMC10668535 DOI: 10.1177/08862605231158765] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Child sexual abuse (CSA) is a public health problem of considerable magnitude. The prevailing primary prevention strategies are universal, school-based CSA prevention programs, some of which have been designated as evidence-based, such as Safe Touches. However, to reach their public health impact potential, effective universal school-based CSA prevention programs require effective and efficient dissemination and implementation strategies. The purpose of this study was to demonstrate the reach and effectiveness of a school-based CSA prevention curriculum, Safe Touches, when implemented on a wide scale. Using a longitudinal cohort design, children in second grade classrooms in public elementary schools in five counties received the Safe Touches workshop and completed surveys designed to assess gains in knowledge at four timepoints (one week prior, immediately post-workshop, 6- and 12-months post-workshop). In total, the Safe Touches workshop was delivered in 718 classrooms in 92% of school districts, reaching ~14,235 second graders. Multilevel models (n = 3,673) revealed that Safe Touches significantly increased CSA-related knowledge, and that these gains were maintained 12-months post-workshop (ps < .001). There were some small but significant time-varying effects among participants in schools with a greater percentage of low income and minority students, but these effects largely disappeared 12-months post workshop. This study demonstrates that a single-session, universal school-based CSA prevention program can effectively increase children's knowledge when implemented and disseminated on a wide scale and knowledge gains can be retained 12-months post intervention.
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Affiliation(s)
- Kate Guastaferro
- The Pennsylvania State University, University Park, USA
- New York University, USA
| | - Stacey L. Shipe
- The Pennsylvania State University, University Park, USA
- State University of New York – Binghamton University, USA
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Foti TR, Watson C, Adams SR, Rios N, Staunton M, Wei J, Sterling SA, Ridout KK, Young-Wolff KC. Associations between Adverse Childhood Experiences (ACEs) and Prenatal Mental Health and Substance Use. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6289. [PMID: 37444136 PMCID: PMC10341286 DOI: 10.3390/ijerph20136289] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023]
Abstract
Adverse childhood experiences (ACEs) are common and increase the risk of poor health outcomes. Resilience may offer protection against the impacts of ACEs. This study examined the association between maternal ACEs and mental/behavioral health outcomes during pregnancy overall and by resilience. The sample comprised pregnant patients in two pilot studies screened for eight ACEs and resilience during standard prenatal care in Kaiser Permanente Northern California from 1 March 2016 to 30 July 2016 (Study 1, medical centers A, B) and from 1 April 2018 to 31 March 2019 (Study 2, medical centers A, C). Early pregnancy outcomes included anxiety and depressive disorders, depression symptoms, intimate partner violence (IPV), and substance use. Multivariable logistic regression was used in this cross-sectional study to examine associations between maternal ACEs (0, 1-2, ≥3) and mental/behavioral health outcomes overall and among those with low and high resilience. Patients (n = 1084) averaged 30.8 years (SD 5.1); 41.7% were non-Hispanic White; 41.7% experienced ≥1 ACE, and 40.3% had low resilience. Patients with 1-2 ACEs or ≥3 ACEs (versus 0 ACEs) had higher odds of anxiety and depressive disorders, depressive symptoms, IPV, and any prenatal substance use (OR 1.44-4.40, p < 0.05). Each individual ACE was associated with ≥2 mental/behavioral health outcomes. In stratified analyses, having ≥1 ACE (vs. 0) was associated with a greater number of mental/behavioral health outcomes among patients with low versus high resilience. ACEs were associated with prenatal mental/behavioral health conditions, particularly in the context of low resilience, highlighting the importance of trauma-informed prenatal care and the need to study resilience-building interventions during pregnancy.
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Affiliation(s)
- Tara R. Foti
- College of Public Health, University of South Florida, Tampa, FL 33612, USA
| | - Carey Watson
- Obstetrics and Gynecology, Kaiser Permanente, Antioch Medical Center, Antioch, CA 94531, USA
| | - Sara R. Adams
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA (K.C.Y.-W.)
| | - Normelena Rios
- Obstetrics and Gynecology, Kaiser Permanente, Dublin Medical Center, Dublin, CA 94568, USA
| | - Mary Staunton
- Department of Psychiatry, Kaiser Permanente, Walnut Creek Medical Center, Walnut Creek, CA 94596, USA
| | - Julia Wei
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA (K.C.Y.-W.)
| | - Stacy A. Sterling
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA (K.C.Y.-W.)
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA
| | - Kathryn K. Ridout
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA (K.C.Y.-W.)
- Department of Psychiatry, Kaiser Permanente, Santa Rosa Medical Center, Santa Rosa, CA 95403, USA
| | - Kelly C. Young-Wolff
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA (K.C.Y.-W.)
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA
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Guastaferro K, Melchior M, Murphy-Costanzo AS, Anderson A, Melamed N, Madden S. Preventive Education Outreach on Social Media: The Quest to Enroll Community Members in a Child Sexual Prevention Workshop. JOURNAL OF CHILD SEXUAL ABUSE 2023; 32:963-978. [PMID: 37915237 DOI: 10.1080/10538712.2023.2274889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 10/10/2023] [Indexed: 11/03/2023]
Abstract
Social media is a frequently used tool in health promotion efforts although less so for the prevention of child sexual abuse (CSA). This is due, in part, to the lack of standardized branding guides for community-based efforts in how to craft messages related to CSA prevention. This study examined the use of Twitter (now "X") as a means of promoting participation in the adult-focused Stewards of Children CSA prevention workshop, prior to and following the implementation of a standardized branding guide. The exposure, reach, and engagement of the top tweets and top media tweets were examined over 24-months pre- and post-implementation of a five-point branding guide. Engagement was descriptively compared to the number of adults who enrolled in the Stewards of Children workshop. As evidenced by the increase in tweet impressions and the number of adults trained, it is likely the implementation of the branding guide was beneficial in promoting participation in the Stewards of Children workshop. Though participation in a program does not inherently suggest behavior change, getting participants to enroll is a crucial first step. The findings emphasize the potential of using social media to ultimately promote behavior change in the field of CSA prevention and beyond.
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Affiliation(s)
| | - Mia Melchior
- The Pennsylvania State University, University Park, PA, USA
| | | | | | - Nicole Melamed
- The Pennsylvania State University, University Park, PA, USA
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Kisely S, Siskind D, Scott JG, Najman JM. Self-reported child maltreatment and cardiometabolic risk in 30-year-old adults. Intern Med J 2023; 53:1121-1130. [PMID: 35607779 PMCID: PMC10947207 DOI: 10.1111/imj.15824] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 05/17/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Childhood maltreatment (CM) is associated with both dietary fat intake and obesity in later life. There is less information on associations with metabolic risk factors and specific types of CM such as physical, sexual and emotional abuse, as well as neglect. AIMS To assess the association between five types of self-reported CM and a range of obesity and metabolic indicators in a subsample of a birth cohort. METHODS This was a study of 1689 adults born in a major metropolitan maternity hospital in Australia and followed up 30 years later. Body mass index, bioimpedance and fasting lipid levels/insulin resistance were measured. Details on self-reported CM were collected using the Child Trauma Questionnaire. We adjusted for birth weight, parental income and relationship at participants' birth, as well as maternal age and alcohol or tobacco use. We also adjusted for participants' smoking, depression, educational level, marital and employment status at follow up. RESULTS One-fifth reported maltreatment (n = 362), most commonly emotional neglect (n = 175), followed by emotional abuse (n = 128), physical neglect (n = 123), sexual (n = 121) and physical abuse (n = 116). On adjusted analyses, there were significant associations for CM, particularly neglect or emotional abuse, and one or more of the following outcomes: obesity, the total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C) ratio and HDL levels. Results for other outcomes were more equivocal. CONCLUSIONS Of child maltreatment types, emotional abuse and neglect show the strongest associations with obesity and several cardiometabolic risk factors, therefore highlighting the public health importance of early intervention to reduce childhood adversity.
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Affiliation(s)
- Stephen Kisely
- Metro South Addiction and Mental Health ServiceBrisbaneQueenslandAustralia
- School of Clinical MedicineUniversity of QueenslandBrisbaneQueenslandAustralia
- Departments of Psychiatry, Community Health and EpidemiologyDalhousie UniversityHalifaxNova ScotiaCanada
| | - Dan Siskind
- Metro South Addiction and Mental Health ServiceBrisbaneQueenslandAustralia
- School of Clinical MedicineUniversity of QueenslandBrisbaneQueenslandAustralia
| | - James G. Scott
- Mental Health ProgramQIMR Berghofer Medical Research InstituteBrisbaneQueenslandAustralia
- Metro North Mental Health ServiceBrisbaneQueenslandAustralia
- School of Public HealthThe University of Queensland, Public Health BuildingBrisbaneQueenslandAustralia
| | - Jake M. Najman
- School of Public HealthThe University of Queensland, Public Health BuildingBrisbaneQueenslandAustralia
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DeMaria AL, Meier S, King H, Sidorowicz H, Seigfried-Spellar KC, Schwab-Reese LM. The role of community healthcare professionals in discussing sexual assault experiences during obstetrics and gynecological healthcare appointments. BMC Womens Health 2023; 23:263. [PMID: 37189119 PMCID: PMC10184971 DOI: 10.1186/s12905-023-02401-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 04/28/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Nearly half of adult women in the US report experiencing sexual assault, with almost one-fifth reporting rape. For many sexual assault survivors, healthcare professionals are the first point of contact and disclosure. This study aimed to understand how healthcare professionals working in community settings perceived their role in discussing sexual violence experiences with women during obstetrical and gynecological healthcare appointments. The secondary purpose was to compare healthcare professionals' perspectives with the patients' to determine how sexual violence conversations should occur in these environments. METHODS Data were collected in two phases. Phase 1 consisted of 6 focus groups (Sept-Dec, 2019) with women aged 18-45 (n = 22) living in Indiana who sought community-based or private healthcare for women's reproductive healthcare needs. Phase 2 included 20 key-informant interviews with non-physician healthcare professionals (i.e., NP, RN, CNM, doula, pharmacist, chiropractor) living in Indiana (September 2019-May 2020) who provided community-based women's reproductive healthcare. Focus groups and interviews were audio-recorded, transcribed, and analyzed using thematic analyses. HyperRESEARCH assisted in data management and organization. RESULTS There were three resulting themes: (1) healthcare professionals' approaches to screening for a history of sexual violence varied depending on how they ask, what setting they work in, and type of professional asking; (2) healthcare experiences can compound traumatic experiences and create distrust with survivors; and (3) sexual violence impacts patient healthcare experiences through what services they seek, how professionals may interact with them, and what professionals they are willing to utilize. CONCLUSIONS Findings offered insight into actionable and practical strategies for enhancing sexual violence screening and discussions in community-based women's reproductive health settings. The findings offer strategies to address barriers and facilitators among community healthcare professionals and the people they serve. Incorporating healthcare professional and patient experiences and preferences for violence-related discussions during obstetrical and gynecological healthcare appointments can assist in violence prevention efforts, improve patient-professional rapport, and yield better health outcomes.
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Affiliation(s)
- Andrea L DeMaria
- Department of Public Health, College of Health and Human Sciences, Purdue University, 812 West State Street, 47907, West Lafayette, IN, USA.
- Division of Consumer Science, College of Health and Human Sciences, Purdue University, West Lafayette, IN, USA.
| | - Stephanie Meier
- Division of Consumer Science, College of Health and Human Sciences, Purdue University, West Lafayette, IN, USA
| | - Hannah King
- Department of Public Health, College of Health and Human Sciences, Purdue University, 812 West State Street, 47907, West Lafayette, IN, USA
| | - Haley Sidorowicz
- Department of Biological Sciences, College of Science, Purdue University, West Lafayette, IN, USA
| | - Kathryn C Seigfried-Spellar
- Department of Computer and Information Technology, Polytechnic Institute, Purdue University, West Lafayette, IN, USA
| | - Laura M Schwab-Reese
- Department of Public Health, College of Health and Human Sciences, Purdue University, 812 West State Street, 47907, West Lafayette, IN, USA
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45
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Maleki Z, Damghanian M, Rad M, Farnam F. Knowledge, Skills, and Self-Disclosure Following a Sexual Abuse Prevention Program Among Iranian Preschoolers: A Cluster Quasi-Experimental Controlled Study. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:6346-6365. [PMID: 36331113 DOI: 10.1177/08862605221133306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Standard empirical studies are needed despite three decades of research on child sexual abuse prevention programs (CSAPPs). This study aimed to investigate the effects of CSAPP on the child's sexual safety. A multicenter, random cluster, quasi-experimental controlled survey was conducted in a 1:1 ratio in Tehran, Iran, from May to December 2019 in seventy 5- to 6-years-old children from 10 kindergartens. In groups of 7 to 8, the intervention group participated in four sessions of 45 minutes of face-to-face sexual self-care training, 3 to 4 days apart. The control groups received one session on accident safety. Knowledge, self-protective skills, fear, and self-disclosure were assessed respectively by the "Personal Safety Questionnaire (PSQ)," "What If Situation Test (WIST)," "Fear Assessment Thermometer Scale (FATS)," and researcher-made questions before and 8 weeks after the intervention. At the baseline, children obtained 70% of knowledge and 45% of protective skills scores. After the intervention, knowledge, protective skills, and detection of "appropriate requests" were significantly promoted (p < .001). Detecting "inappropriate requests" did not differ; however, all quadruple skills (Say, Do, Tell, and Report) improved significantly. "Girl sex" and "parents' education" were related factors promoting children's protective skills. Sexual abuse self-disclosure was 4.2% (n = 3), and one child reported child sexual abuse (CSA) only after the intervention. Despite the lack of formal education, children's basic knowledge reflects the importance of parents in preventing CSA. However, the CSAPP significantly improved children's skills and revealed one CSA case. CSAPP should not focus solely on risky scenarios because if children cannot distinguish between safe and unsafe situations, they will experience unnecessary anxiety. Even after recognizing the dangerous conditions, CSA prevention will practically fail without appropriate reactions such as escaping and reporting. CSAPP should emphasize individual rights such as body ownership and assertiveness skills and explain the "danger of known people" with detailed scenarios, especially in collectivistic and traditional societies.
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Affiliation(s)
| | | | - Maryam Rad
- Kerman University of Medical Sciences, Iran
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Winterstein TB, Avieli H, Gichaz M. Recovering the Lost Soul: Older Women's Reflections on Past Intrafamilial Child Sexual Abuse. QUALITATIVE HEALTH RESEARCH 2023; 33:426-439. [PMID: 36882288 DOI: 10.1177/10497323231159802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Intrafamilial child sexual abuse (IFCSA) is a social problem with longstanding effects on victims' lives. While scholarly literature has focused on the adverse aftermath of sexual abuse, only a few studies have acknowledged older women's perspectives on their experience of IFCSA and their journey of healing and recovery. The aim of the present study was to explore how older survivors of IFCSA construct and shape their experience of healing in later life and the meaning they assign to this process. Narrative inquiry was selected to explore the narratives of 11 older women survivors of IFCSA. Participants were interviewed using a biographical narrative interviewing method. The narratives were then transcribed and analyzed using thematic, structural, and performance analyses. Four major themes emerged from the participants' narratives: Achieving closure; Spiritual framing of IFCSA as a platform for self-growth; Becoming whole in old age; and Looking to the future after IFCSA. During the aging years, IFCSA survivors may redefine their identity and their place in the world. Using life review processes, older women in this study were striving to heal and reconcile with their past.
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Affiliation(s)
| | - Hila Avieli
- Department of Criminology, Ariel University, Ariel, Israel
| | - Mili Gichaz
- Department of Gerontogy, University of Haifa, Ariel, Israel
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Roberts C, Montgomery E, Richens Y, Silverio SA. (Re)activation of survival strategies during pregnancy and childbirth following experiences of childhood sexual abuse. J Reprod Infant Psychol 2023; 41:152-164. [PMID: 34510971 DOI: 10.1080/02646838.2021.1976401] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To explore the pregnancy and childbearing experiences of women-survivors of childhood sexual abuse [CSA]. We aimed to generate a theory explaining those experiences for this population (women), this phenomenon (pregnancy and childbirth), and this context (those who have survived CSA). METHOD Participants (N=6) were recruited to semi-structured interviews about their experiences of CSA and subsequent pregnancy and childbirth. Data saturated early, and were analysed using Grounded Theory (appropriate to cross-disciplinary health research). Coding was inductive and iterative, to ensure rigour and achieve thematic saturation. RESULTS Open and focused coding led to the generation of super-categories, which in-turn were collapsed into three distinct, but related themes. These themes were: Chronicity of Childhood (Sexual) Abuse; Pregnancy and Childbirth as Paradoxically (Un)safe Experiences; Enduring Nature of Survival Strategies. The relationship between these themes was explained as the theory of: (Re)activation of Survival Strategies during Pregnancy and Childbirth following Experiences of Childhood Sexual Abuse. CONCLUSION Pregnancy and childbirth can be triggering for women-survivors of CSA. Survival strategies learnt during experiences of CSA can be (re)activated as a way of not only coping, but surviving (the sometimes unconsented) procedures, such as monitoring and physical examinations, as well as the feelings of lack of control and bodily agency.
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Affiliation(s)
- Chelsey Roberts
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - Elsa Montgomery
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Yana Richens
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK.,Maternity Services, University College London Hospitals NHS Foundation Trust, London, UK
| | - Sergio A Silverio
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK.,Department of Women & Children's Health, King's College London, London, UK
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Tsur N, Najjar AA, Katz C. "When I was a child, the doctor advised me to have sex more gently": The perceptions and experiences with the healthcare system as conveyed by adult survivors of child sexual abuse. Soc Sci Med 2023; 320:115685. [PMID: 36652755 DOI: 10.1016/j.socscimed.2023.115685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 01/15/2023]
Abstract
RATIONALE Extensive findings have illuminated the implications of child sexual abuse (CSA) for mental and physical health. Attention has been dedicated to the discrepancy between the high prevalence of CSA, and the lack of adequate CSA screening and trauma-informed care within healthcare systems. OBJECTIVE This study was designed to examine this discrepancy by providing CSA survivors' perspectives. Specifically, this study aims to uncover the perceptions and experiences of female survivors of CSA concerning their encounters with the healthcare system. METHODS Written narratives were collected from 53 female survivors of CSA as part of the Israeli Independent Public Inquiry into CSA, which were analyzed guided by an inductive thematic analysis. RESULTS This study's findings portrayed a complex scenery in which female survivors of CSA are concurrently dependent on healthcare services due to the CSA-related morbidity, yet they are hesitant and have difficulty approaching healthcare services. Additionally, the findings showed that the survivors of CSA described being perceived as mentally ill and distrustful; they also were encouraged to take excessive medication by healthcare providers, which resulted in many survivors of CSA avoiding further treatment. Furthermore, the survivors of CSA conveyed several clear messages to the healthcare system, all of which called for the urgent need to implement trauma-informed care. CONCLUSIONS These findings underline the necessity of a paradigm shift in which health and illness are viewed in light of personal, interpersonal, and social contexts. Simply put, it is time for trauma-informed care to be extensively implemented in healthcare services.
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Affiliation(s)
- Noga Tsur
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel.
| | | | - Carmit Katz
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
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Daigneault I, Paquette G, De La Sablonnière-Griffin M, Dion J. Childhood Sexual Abuse, Intellectual Disability, and Subsequent Physical and Mental Health Disorders: A Matched Cohort Study. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2023; 128:134-144. [PMID: 36807477 DOI: 10.1352/1944-7558-128.2.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 06/28/2022] [Indexed: 06/18/2023]
Abstract
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.
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Affiliation(s)
- Isabelle Daigneault
- Isabelle Daigneault, Université de Montréal, Centre de recherche interdisciplinaire sur les problèmes conjugaux et l'agression sexuelle (CRIPCAS), Équipe violence sexuelle et santé (ÉVISSA), Canadian Consortium on Child and Youth Trauma
| | - Geneviève Paquette
- Geneviève Paquette, Université de Sherbrooke, Centre de recherche interdisciplinaire sur les problèmes conjugaux et l'agression sexuelle (CRIPCAS)
| | - Mireille De La Sablonnière-Griffin
- Mireille De La Sablonnière-Griffin, Institut national de la recherche scientifique (INRS), Centre de recherche interdisciplinaire sur les problèmes conjugaux et l'agression sexuelle (CRIPCAS)
| | - Jacinthe Dion
- Jacinthe Dion, Université du Québec à Chicoutimi, Centre de recherche interdisciplinaire sur les problèmes conjugaux et l'agression sexuelle (CRIPCAS), Équipe violence sexuelle et santé (ÉVISSA)
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50
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Holliday R, Nichter B, Holder N, Hill ML, Monteith LL, Norman SB, Pietrzak RH. Childhood Sexual Abuse and Military Sexual Trauma Interact to Increase Suicide Risk: Results from a Nationally Representative Veteran Sample. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:5354-5369. [PMID: 36124932 DOI: 10.1177/08862605221120909] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Childhood sexual abuse (CSA) and military sexual trauma (MST) are prevalent among veterans. Such exposures are associated with adverse mental-health sequelae, including elevated risk for suicidal thoughts and behaviors. Nonetheless, prior studies have largely focused upon discrete experiences of CSA or MST in circumscribed samples. In the current study, we analyzed data from a large, nationally representative sample of 4,069 US military veterans to examine main and interactive effects of CSA and MST in relation to suicidal thoughts and behaviors. After accounting for sociodemographics, psychiatric comorbidity, and trauma-related characteristics, we detected a significant interaction between MST and CSA as it related to report of past-year suicidal ideation, lifetime suicide attempt, and risk for future suicide attempt. These findings underscore the impact of sexual trauma throughout the lifespan, highlighting the continued importance of screening for trauma exposure and connecting veterans to appropriate, evidence-based treatment to decrease their risk for suicidal thoughts and behaviors.
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Affiliation(s)
- Ryan Holliday
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, Aurora, CO, USA
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | - Nicholas Holder
- San Francisco VA Health Care System, San Francisco, CA, USA
- University of California, San Francisco, School of Medicine, San Francisco, CA, USA
| | | | - Lindsey L Monteith
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, Aurora, CO, USA
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Sonya B Norman
- University of California San Diego, La Jolla, CA, USA
- VA San Diego Healthcare System, San Diego, CA, USA
- National Center for PTSD, Executive Division, White River Junction, VT, USA
- VA Connecticut Healthcare System, West Haven, CT, USA
| | - Robert H Pietrzak
- Yale School of Medicine, New Haven, CT, USA
- VA Connecticut Healthcare System, West Haven, CT, USA
- Yale School of Public Health, New Haven, CT, USA
- National Center for PTSD, Clinical Neurosciences Division, West Haven, CT, USA
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