Adolescent Physical Abuse Research Articles

Overcoming Adversity in Adolescence: Narratives of Resilience

Our overarching goal is to understand the unfolding of resilient development. Our person-based approach is based on a follow-back design, enabling us to examine previously recorded adolescent clinical and adult attachment interviews of now-competent young adults who experienced significant adversity during their adolescent years. In their adolescent years, these young adults encountered three serious misfortunes. Between 13 and 16 years old (middle adolescence) they were sent to live in a psychiatric hospital, from 2 to 12 months. Their physical home ties with their parents and community friends were abruptly severed, as they lived full-time in High Valley Hospital. In addition, experiencing a serious psychiatric disorder leading to hospitalization, regardless of how time limited, can markedly change the experience of self, often leading to lowered self-regard and lowered personal competence. The label of psychiatric patient is made even more indelible by living in a psychiatric hospital. Their third serious misfortune was trauma. Many of the young adults previously reported serious child and adolescent physical abuse at the hands of immediate family members or other close relatives. Using a profile definition (ego development levels, attachment coherence, close relationships, and social competence), we identified nine young adults who were now functioning in the upper 50th percentile of all former patients and same age high school nonpatient adolescents. After being identified, our intensive study of the narratives embedded in earlier interviews revealed key themes for these resilient young adults—including agency, reflectiveness, relationship recruiting—differentiating them from contrasting young adults, who were also former patients. We illustrate these differences through narratives of two resilient young adults.

RELATIONSHIP OF ADOLESCENT PHYSICAL AND SEXUAL ABUSE TO PERIMENSTRUAL SYMPTOMS (PMS) IN ADULTHOOD

Research is lacking regarding adolescent physical and sexual abuse and permenstrual symptoms (PMS). This study examined the relationship between adolescent physical and sexual abuse and PMS in adult women. Secondary data analysis of a longitudinal study of a community sample of 568 women (35% underrepresented ethnicities), using the database “Nursing Assessment of PMS: Neurometric Indices,” was performed. History of both adolescent physical abuse and sexual abuse was significantly associated with PMS in adulthood. Women with a history of adolescent physical and sexual abuse had significantly more severe PMS patterns with more dysphoria than women without abuse.

The Relationship Between Adolescent Physical Abuse and Criminal Offending: Support for an Enduring and Generalized Cycle of Violence

Prospective investigations have demonstrated support for the cycle of violence theory. However, few studies have examined whether or not abuse occurring during adolescence increases the prevalence and frequency of criminal involvement, or explored the long-term consequences of such victimization. In addition, there has been little investigation of whether or not the effects of abuse vary depending on characteristics of the victim, such as sex, race/ethnicity, age, family structure or income. Using data from the National Youth Survey, this study demonstrates that adolescent physical abuse has immediate and enduring effects on the prevalence and frequency of a variety of self-reported offenses, including violent and non-violent crimes, drug use and intimate partner violence. Furthermore, the study reveals that while victimization increases the prevalence of offending for victims of varying backgrounds, the frequency of offending is moderated by family income, area of residence, and family structure. Implications for prevention are discussed.

Neural mechanisms of childhood-onset bipolar illness.

Substantial evidence exists for a cohort effect (earlier onset and increased prevalence) for both unipolar and bipolar affective disorder in every generation born since World War II. This effect could be related to inherited mechanisms (e.g., bi-Hneal pedigrees or genetic anticipation) or to environmental/experiential effects on gene expression (e.g., stressor effects on the induction of transcription and growth factors, enzymes, hormones and their receptors, and signal transduction molecules) as documented in preclinical models of neonatal maternal separation. This laboratory evidence is summarized and new clinical data on the impact of severe stressors on the unfolding course of bipolar illness are noted. The reported occurrence of childhood or adolescent physical or sexual abuse, compared to those who report their absence, is associated with: earlier bipolar illness onset; faster cycling (including ultradian) patterns; increased Axis I and II comorbidities; and increased time ill in a prospective year of follow-up. Selectively, physical abuse was associated with a reported pattern of increasingly severe mania and sexual abuse with increased numbers of serious suicide attempts. In a retrospective survey of parents of children with an approximate average age of 13 who were diagnosed with bipolar illness (compared to those with other diagnoses and those with no diagnosis), a cluster of symptoms related to irritability and dyscontrol differentiated the bipolar children earliest. These symptoms included: temper tantrums, irritability, inattention, hyperactivity, impulsivity, poor frustration tolerance, and increased aggression. Given the growing evidence that episodes of affective dysfunction can not only convey morbidity and mortality, but may also sensitize to further recurrence and thus change the course of illness, opportunities abound for early recognition and intervention in childhood onset bipolar illness. Such a successful endeavor would both allow a more normal psychobiological development and allow the possibility of preventing the unfolding of more full-blown bipolar illness altogether.

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

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

An examination of bias in volunteer subject selection: findings from an in-depth child abuse study.

Remarkably few reported studies tested the assumption that a research sample can be constructed which is representative of the population of interest. In order to investigate potential volunteer bias in abuse research, we utilized a database assembled for an NIMH funded study investigating the relationship among adolescent physical abuse, suicidal behavior, and psychopathology. Extensive information was available concerning the nonparticipant pool from which this sample was assembled, allowing for a comprehensive assessment of possible sample bias. The volunteer sample of 99 abused families who agreed to participate in our study was compared on a large number of variables with a random sample of 99 abused families who declined to participate. Comparisons of the two groups did not support the hypothesis that the non-participating families represented a more dysfunctional population. The two groups were far more similar to, than disparate from, each other.

Family violence

Domestic and intimate partner abuse, child and adolescent physical and sexual abuse, and elder abuse constitute family violence. Such violence is responsible for a significant proportion of intentional injury and, accordingly, is a major public health problem. This chapter provides information on aspects of each type of family violence.

Adolescent Physical Abuse and Suicide Attempts

The rate of suicide attempts and the exposure to risk factors for suicide in an unselected sample of confirmed cases of physically abused adolescents recruited directly from the New York State Central Register for Nassau and Suffolk Counties was compared with those of a community sample of nonabused adolescents. Semistructured and structured diagnostic interviews were used in the assessment of psychopathology of adolescents and their parents The proportion of adolescents attempting suicide did not differ for the two groups. However, the abused adolescents showed significantly greater exposure to risk factors for adolescent suicide, including family disintegration, and diagnoses of depression, disruptive behavior disorders, and substance abuse and dependence. Comparisons of the 8 physically abused adolescents who attempted suicide with the 91 who did not attempt suicide showed that the following factors were associated with significantly greater risk for suicide attempts: adolescents' perceptions of their families as lacking cohesiveness and maternal support, higher adolescent "hostility" ideation scores, adolescent diagnoses of disruptive disorders and conduct disorders, adolescent substance abuse/dependence, and exposure to a suicide attempt by a family member or a friend. A transactional model of abuse, family and personal stressors, and the development of adolescent vulnerability leading to psychopathology is offered to explain the results.

Multiple substance use among adolescent physical and sexual abuse victims

Objective: This study was conducted to examine the relationship between substance use patterns among adolescents and their histories of physical and/or sexual abuse. Method: The Minnesota Student Survey was administered in 1995 to 122,824 public school students in Grades 6, 9, and 12. Substance user groups were created based on frequency of use and the number of substances used. Use of individual substances, use of multiple substances, age of first use, and reasons for use were examined with respect to histories of physical and/or sexual abuse. Results: Physical and sexual abuse were associated with an increased likelihood of the use of alcohol, marijuana, and almost all other drugs for both males and females in the three grades surveyed. Use of multiple substances was highly elevated among victims of abuse, with the highest rates seen among students who reported both physical and sexual abuse. Abuse victims also reported initiating substance use earlier than their nonabused peers and gave more reasons for using, including use to cope with painful emotions and to escape from problems. Conclusion: Because of their increased vulnerability, young victims of physical and sexual abuse need improved prevention, early intervention, and treatment services related to substance use.

Clinical Characteristics of Women With a History of Childhood Abuse

To determine the prevalence of childhood physical or sexual abuse in women seen in primary care practices; to identify physical and psychologic problems associated with that abuse; and to compare the effects of childhood physical vs sexual abuse and childhood vs adult abuse. Cross-sectional, self-administered, anonymous survey. Four community-based, primary care internal medicine practices. A total of 1931 women of varied age and marital, educational, and economic status examined from February through July 1993. Prevalence of physical and sexual abuse, physical symptoms, psychological symptoms (Symptom Checklist-22), alcohol abuse (CAGE questions), and street drug use. Of the 1931 respondents, 424 (22.0%) reported childhood or adolescent physical or sexual abuse. Compared with women who reported never having experienced abuse (n=1257), women who reported abuse as children but not adults (n=204) had more physical symptoms (mean+/-SE, 6.2+/-0.2 vs 4.0+/-0.9; P<.001) and had higher scores for depression, anxiety, somatization, and interpersonal sensitivity (low self-esteem) (P<.001); were more likely to be abusing drugs (prevalence ratio [PR], 4.7; 95% confidence interval [CI], 2.9-7.6) or to have a history of alcohol abuse (PR, 2.2; 95% CI, 1.5-3.2); were more likely to have attempted suicide (PR, 3.7; 95% CI, 2.6-5.1); and were more likely to have had a psychiatric admission (PR, 3.2; 95% CI, 2.2-4.7). Women abused only as children did not differ from women who reported current, but not childhood, abuse in number of physical symptoms, emotional distress, substance abuse, or suicide attempts. Patients who reported both childhood and adult abuse had higher levels of psychological problems and physical symptoms than those who reported childhood or adult abuse alone. Childhood physical or sexual abuse is associated with adult health problems including physical symptoms, psychological problems, and substance abuse; for many variables, this association is as strong as for patients experiencing current abuse.

The long-term sequelae of child and adolescent abuse: A longitudinal community study

The purpose of the present study was to examine the relationship between childhood and adolescent physical and sexual abuse before the age of 18 and psychosocial functioning in mid-adolescence (age 15) and early adulthood (age 21) in a representative community sample of young adults. Subjects were 375 participants in an ongoing 17-year longitudinal study. At age 21, nearly 11% reported physical or sexual abuse before age 18. Psychiatric disorders based on DSM-III-R criteria were assessed utilizing the NIMH Diagnostic Interview Schedule, Revised Version (DIS-III-R). Approximately 80% of the abused young adults met DSM-III-R criteria for at least one psychiatric disorder at age 21. Compared to their nonabused counterparts, abused subjects demonstrated significant impairments in functioning both at ages 15 and at 21, including more depressive symptomatology, anxiety, psychiatric disorders, emotional-behavioral problems, suicidal ideation, and suicide attempts. While abused individuals were functioning significantly more poorly overall at ages 15 and 21 than their nonabused peers, gender differences and distinct patterns of impaired functioning emerged. These deficits underscore the need for early intervention and prevention strategies to forestall or minimize the serious consequences of child abuse.

Adolescent Physical Abuse

Research indicates that adolescent physical abuse represents an increasing proportion of child abuse. Adolescent abuse differs from the abuse of prepubertal children in its association with higher socioeconomic status, less severe injury, and family dynamics. This article presents a summary of the research on the prevalence, demographics, associated mental health problems, and treatment strategies for abused adolescents.

The ecology of adolescent maltreatment: A multilevel examination of adolescent physical abuse, sexual abuse, and neglect.

This study examined the individual characteristics, family relations, and stress/social support of 50 maltreated adolescents and their mothers. Dyads were divided into 4 demographically similar groups: neglect, physical abuse, sexual abuse, and nonmaltreatment control. Results show that adolescent neglect was primarily associated with extrafamilial difficulties and social isolation. Adolescent physical abuse was linked more with rigidity in family relations, poorer maternal understanding of child developmental skills, and adolescent externalizing behaviors. In contrast, adolescent sexual abuse was related to maternal emotional problems and adolescent internalizing behaviors. In general, each group of maltreated adolescents experienced lower levels of family cohesion, more attention problems, and more daily stress than did their nonmaltreated counterparts. Findings are consistent with an ecological model of adolescent maltreatment.

The ecology of adolescent maltreatment: A multilevel examination of adolescent physical abuse, sexual abuse, and neglect.

The ecology of adolescent maltreatment: A multilevel examination of adolescent physical abuse, sexual abuse, and neglect.

Patterns of reported child abuse and neglect

Confirmed reports of abuse and neglect logged in a large state registry file from 1977 to 1984 are analyzed. Boys tend to sustain more frequent and more serious injuries. Victims of male perpetrators tend to sustain more serious injuries. A modest same-sex perpetrator/victim pattern is revealed for physical abuse; males are more likely to physically abuse boys while females are more likely to physically abuse girls. Among younger victims (aged 12 and younger) boys outnumber girls in all reporting categories except sexual abuse. Among adolescent victims, female victims greatly outnumber male victims in all reporting categories. Similarities between adolescent physical abuse and spouse abuse are noted; males are are the predominant perpetrators and females the predominant victims. As expected, victim age emerged as a strong predictor of severity of physical abuse injury. Several other factors including social isolation, mental health problems, lower income, and unemployment of the father are identified as modest predictors of severity.