Nonabused Patients Research Articles

The association between abused adults and substance abuse in Taiwan, 2000–2015

ObjectiveTo investigate whether adults suffering from violence were at risk of substance abuse and provides insight into the relationship between male and female abusers and substance abuse from 2000 to 2015 in Taiwan.MethodsThis study used data on outpatient, emergency, and inpatient visits for 2 million people enrolled in universal health insurance from 2000 to 2015. ICD-9 diagnosis codes 995.8 (abused adult) and E960–E969 (homicide and injury purposely inflicted by other persons) were defined in this case study, analyzing first-time violence in adults aged 18–64 (study group). Non-abused patients (control group) were matched in a 1:4 ratio, and the paired variables were gender, age (± 1 year), pre-exposure Charlson Comorbidity Index, and year of medical treatment. SAS 9.4 and Cox regression were used for data analysis.ResultsA total of 8,726 people suffered violence (control group: 34,904 people) over 15 years. The prevalence of substance abuse among victims of violence was 78.3/104, 61.9/104, and 51.5/104 for tobacco use disorder, alcoholism, and alcohol abuse, respectively. The risk (adults, overall) of drug abuse, drug dependence, and alcoholism after exposure to violence (average 9 years) was 7.47, 7.15, and 6.86 times (p < 0.01), respectively, compared with those without violence. The risk (adults, males) of drug abuse, drug dependence, and alcohol abuse after exposure to violence (average 9 years) was 6.85, 6.27, and 6.07 times, respectively, higher than those without violence (p < 0.01). Risks of drug dependence, alcohol abuse and alcoholism (adults, females) after exposure to violence (average 9 years) were 14.92, 12.26, and 11.55 times, respectively, higher than non-abused ones (p < 0.01).ConclusionThe risks of substance abuse, after adult violence, are higher than in those who have not suffered violent injuries.

Impact of Sensitization of Family Caregivers upon Treatment Compliance among Geriatric Patients Suffering from Elder Abuse and Neglect.

Geriatric patients in various outpatient department (OPDs) have been found to agonize from elder abuse and neglect (EAN). Such suffering imposes depressive states within individuals, which in turn affects treatment compliance. The objective of this study was to evaluate the impact of sensitization (psychotherapeutic) of family caregivers (FCGs) upon two denture treatment parameters (maintenance and treatment satisfaction) among EAN patients and compare the differences in outcome with non-abused patients. A survey of completely edentulous subjects (n = 860, aged 41–80 years) provided a sampling frame of 332 EAN patients from which 150 patients (including FCGs) fulfilling the study criteria were distributed (simple random, convenient) into two groups (Group A—control, Group B—test). FCG sensitization for subjects in Group B was performed by a clinical psychologist in 2–4 short (30 min) sessions. Demographic characteristics (frequency) were measured using a self-reported questionnaire, denture maintenance was measured using a denture hygiene index (scores), and treatment satisfaction was analyzed on a 10-point visual analog scale. Relevant data were calculated for means and absolute/relative frequencies. Any difference between two groups was estimated using an unpaired t-test while the level of relationship was determined by Karl Pearson’s test at a p-value of < 0.05. The results showed highest frequency (38.6%) for neglect, with elder neglect (EN) being most common (38.14% alone and 14% in combination). EN was found more if the FCG was a son (52%), in the age group (21–30 years), and with low education and low income (75%). Patients whose FCGs were counselled (Group B) demonstrated low denture plaque scores (mean = 1.38 ± 0.618), while demonstrating comparatively higher scores in six different parameters of treatment satisfaction. Differences between the two groups for both parameters were also found to be statistically significant. Psychotherapeutic counselling in the form of FCG sensitization brings better results of denture maintenance and treatment satisfaction.

Relationships Between a History of Abuse, Changes in Body Mass Index, Physical Health, and Self-Reported Depression in Female Bariatric Surgery Patients.

Background/Objectives: A history of physical and sexual abuse has been implicated in weight gain. Although bariatric surgery is effective for weight loss in severely obese individuals, we investigated whether bariatric surgery patients who self-report a history of physical and/or sexual abuse have differential outcomes regarding weight loss, body mass index (BMI), quality of life (SF-36), and depressive symptoms (Center for Epidemiologic Studies Depression [CESD]) compared with nonabused patients. Materials and Methods: Standardized assessments at baseline and follow-up visits were performed on 103 obese (BMI >35) female bariatric surgery patients (mean age: 44.11 years, standard deviation: 11.67 years). Results: In total 49.5% of participants reported abuse. Abused group had significantly higher BMI (p < 0.01) and depression scores (p < 0.01). After surgery, the BMI between the two groups was no longer significantly different, although the abused group remained significantly more depressed. Mixed models showed that abuse was associated with CESD scores (p < 0.01) and SF-36 mental composite scores (p = 0.03) after adjusting for smoking history. Conclusion: Bariatric surgery leads to a better weight loss in abused patients. Abuse history might be an additional factor for clinicians to consider when advising bariatric surgery, as our study suggests that women with history of abuse may have a higher weight loss benefit but less mental health improvement from the intervention.

Spine Injuries in Child Abuse.

Although rare, spinal injuries associated with abuse can have potentially devastating implications in the pediatric population. We analyzed the association of pediatric spine injury in abused children and determined the anatomic level of the spine affected, while also focusing on patient demographics, length of stay, and total hospital charges compared with spine patients without a diagnosis of abuse. A retrospective review of the Kids' Inpatient Database was conducted from 2000 to 2012 to identify pediatric patients (below 18 y) who sustained vertebral column fractures or spinal cord injuries. Patients with a documented diagnosis of abuse were identified using ICD-9-CM diagnosis codes. Our statistical models consisted of multivariate linear regressions that were adjusted for age, race, and sex. There were 22,192 pediatric patients with a diagnosis of spinal cord or vertebral column injury during the study period, 116 (0.5%) of whom also had a documented diagnosis of abuse. The most common type of abuse was physical (75.9%). Compared with nonabused patients, abused patients were more likely to be below 2 years of age (OR=133.4; 95% CI, 89.5-198.8), female (OR=1.67; 95% CI, 1.16-2.41), and nonwhite (black: OR=3.86; 95% CI, 2.31-6.45; Hispanic: OR=2.86; 95% CI, 1.68-4.86; other: OR=2.33; 95% CI, 1.11-4.86). Abused patients also presented with an increased risk of thoracic (OR=2.57; 95% CI, 1.67-3.97) and lumbar (OR=1.67; 95% CI, 1.03-2.72) vertebral column fractures and had a multivariate-adjusted mean length of stay that was 62.2% longer (P<0.001) and mean total charges that were 52.9% higher (P<0.001) compared with nonabused patients. Furthermore, 19.7% of all pediatric spine patients under 2 years of age admitted during the study period belonged to the abused cohort. Spine injuries are rare but can be found in the pediatric population. With an additional documented diagnosis of abuse, these injuries affect younger patients in the thoracolumbar region of the spine, and lead to longer lengths of stay and higher hospital costs when compared with nonabused patients. Because of these findings, physicians should maintain a higher level of suspicion of abuse in patients with spine injuries, especially patients under 2 years of age. Level III evidence-a case-control study.

The Impact of Adverse Life Events on Clinical Features and Interaction with Gene Variants in Mood Disorder Patients

Background: Adverse life events are precipitating and maintenance factors for mood and anxiety disorders. However, the impact of such events on clinical features and treatment response is still unclear. Sampling and Methods: The aim of this study was to investigate whether specific adverse events (early parental loss and physical abuse) influence clinical features in a sample of 1,336 mood disorder patients, and whether genetic parameters interact with adverse events to influence treatment outcomes in a subsample of 252 subjects. Participants were collected in the context of a European multicenter study and treated with antidepressants at adequate doses for at least 4 weeks. We focused on two genes (BDNF and CREB1) due to prior evidence of association with treatment outcomes in the same sample. Results: Patients with a history of physical abuse had higher suicidal risk (including history of attempts), comorbid panic disorder, posttraumatic stress disorder and alcohol dependence compared to non-abused patients. Experience of early parental loss was a less detrimental type of life stressor. Treatment response was not affected by adverse events. No gene-environment interaction was found with genetic variations, using a corrected significance level. Conclusions: A limitation of the present study is that the subsample is too small for detecting gene-environment interactions. The clinical message of our findings is that mood disorder patients with a history of physical abuse showed a worse clinical profile, characterized by higher comorbid Axis I psychopathology and increased suicidal behavior.

The influence of childhood abuse and adult attachment style on clinical relationships in breast cancer care

Objective In a previous report, breast cancer patients reporting a history of childhood abuse were less likely to feel fully supported in their relationships with clinical staff than were patients who did not report an abuse history. Our aims were to replicate this effect, to test whether surgeons’ difficulties in these relationships mediated the relationship of abuse to patients feeling less supported, and to test whether patients’ attachment style mediates the influence of abuse on patients’ or surgeons’ experience of the relationship. Method Women with primary breast cancer ( N = 100) completed self-report questionnaires around the time of surgery to assess: emotional distress; adult attachment (models of self and other); sexual, physical and emotional abuse before age 16; and childhood parental care. After consultation three weeks post-operatively patients and surgeons completed self-report questionnaires to measure, respectively, patients’ perceptions of support from the surgeon, and surgeons’ perceptions of difficulty in their relationship with the patient. Results Patients recalling abuse were more than seven times more likely to feel incompletely supported by the surgeon than those not recalling abuse, after controlling for emotional distress. Surgeons reported greater difficulty in relationships with patients recalling abuse than with non-abused patients. Attachment (poor model of self) mediated the relationship of abuse with patient perceptions of incomplete support, but not the relationship with surgeon ratings of difficulty. Conclusion The damaging effects of childhood abuse on adult relationships extend to relationships with surgeons in cancer care. While effects of abuse on attachment can explain the damage that patients experience, mediators of the difficulty that surgeons experience need further research.

The influence of abuse victimization on attendance and involvement in mutual-help groups among dually diagnosed male veterans

Although abuse victimization and dual diagnosis are associated with poor functioning across numerous domains, their impact on attendance and involvement in mutual-help groups (MHGs) is not well understood. This study examined the impact of physical or sexual abuse victimization on MHG attendance and involvement and the influence of abuse on the association between MHG involvement and outcomes of abstinence and psychiatric health. Participants were 217 dually diagnosed men assessed at intake into mental health treatment and 6 months later. Compared with nonabused patients, sexually abused patients exhibited more substance use, psychiatric, and social problems at baseline and attended and were involved with MHGs more than nonabused patients at follow-up. Moreover, MHG involvement was most predictive of abstinence for sexually abused patients, as compared with nonabused and physically abused patients. Although dually diagnosed patients with abuse histories demonstrate more severe initial problems, they are likely to utilize MHGs, which may benefit efforts to achieve abstinence.

Aftermath of sexual abuse history on adult patients suffering from chronic functional pain syndromes: An fMRI pilot study

ObjectiveThis preliminary study investigates the neural substrates of empathy-induced pain in multisomatoform pain patients “with vs. without” a history of sexual abuse during childhood. MethodsUsing functional magnetic resonance imaging (fMRI) and behavioral measurements, we compared eight abused with eight nonabused patients using an established empathy-for-pain paradigm. ResultsHigher activations in left lateral and medial superior frontal gyrus as well as a nonsignificant activation of the right supplementary motor area in abused patients were detected. The nonabused participants showed higher activation of left hippocampus. There was no significant difference in subjective pain ratings between the groups. ConclusionAlthough the number of participants still needs to be increased, our main findings mirror the clinical impression and support the notion of perturbed neuroprocessing of grievous stimuli in chronic pain patients with a history of sexual abuse.

Suicide Risk and Personality Traits in Physically and/or Sexually Abused Acute Psychiatric Inpatients: A Preliminary Study

The aim of the present study was to analyze hopelessness and the affective temperament profile and MMPI characteristics among suicidal and nonsuicidal psychiatric inpatients with or without childhood physical and sexual abuse. The participants were 62 acute psychiatric inpatients (14 men, 48 women) admitted to the Sant'Andrea Hospital's psychiatric ward in Rome. Participants were administered the Italian versions of the Childhood Trauma Questionnaire, the Mini-International Neuropsychiatric Interview (MINI), the Italian Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Autoquestionnaire version (TEMPS-A-Rome), the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), and the Beck Hopelessness Scale. The suicide risk was evaluated by 6 items of the MMPI-2 assessing suicidal intent. Patients with physical/sexual abuse reported high Hopelessness and differed from nonabused patients on several temperamental and personality traits. Patients who reported bruises or marks caused by physical abuse by family members were 9 times more likely to be at higher risk for suicide; those who reported having been punished with a belt or other hard objects were 20 times more likely to be at higher risk for suicide, and those who reported having been insulted by family members were 6 times more likely to be at higher risk for suicide than patients who denied such abuse experiences. Results suggest that clinicians who identify suicide attempts and suicidal tendencies among patients should routinely be assessed for sexual or physical abuse.

Gay Abuse Screening Protocol (GASP):Screening for Abuse in Gay Male Relationships

ABSTRACT Thirty-two male patients in gay relationships and eight family physicians were recruited from a family practice in order to determine comfort with an eight-question Gay Abuse Screening Protocol (GASP). The GASP was administered during a typical clinical encounter. After the encounter, physicians and patients each completed a 5-point Likert Scale questionnaire to assess their comfort levels with each of the 8 GASP questions (Likert Scale: 1 = not at all comfortable to 5 = very comfortable). The mean comfort score was high (Likert >4) for both patients (4.16 ± 0.18) and physicians (4.71 ± 0.18). However, mean comfort scores were significantly lower for abused patients (3.26 ± 0.75) than nonabused patients (4.57 ± 0.26). Patients were comfortable (Likert >3) with 76.2% of GASP items while physicians were comfortable with all GASP items.

Falling Forever: The Price of Chronic Shock

Manifestations of chronic shock and annihilation anxiety—including autistic defenses, chaotic relationships, disorganized attachment, split–off affective states, and vulnerability to disintegration—exist side by side with apparent ego strength and high functioning, even in nonabused patients. Chronic shock stemming from uncontained distress and failed dependency during childhood can persist throughout the lifespan, creating ripples of dysfunction that mask as character distortion and contribute to therapeutic impasse. Patients rely on omnipotent defenses to provide a sense of “having skin” in the face of the fear of breakdown, striving to avoid vulnerability, and trying to insulate themselves from shock experience. Although the relinquishment of autistic defenses and subsequent integration of disowned affect states are overwhelming and painful, patients can emerge from this process with significant shifts in intrapsychic, interpersonal, and existential/spiritual functioning. Clinical material from one psychodynamic psychotherapy group tracks the group process and growth trajectories of seven group members struggling with chronic shock. The ability to recognize subtle dissociative states is a valuable tool in the repertoire of the group psychotherapist.

Childhood sexual abuse in relation to neurobiological challenge tests in patients with borderline personality disorder and normal controls

This study examined whether abnormal responses to neurobiological challenge tests in borderline personality disorder (BPD) are related to a history of childhood sexual abuse (CSA). We compared patients meeting BPD criteria ( n = 24), with and without histories of CSA, with normal controls ( n = 12) on the results of challenges with meta-chlorphenylpiperazine (m-CPP), pyridostigmine and clonidine. No differences were found between abused and non-abused patients with BPD. These results do not support the hypothesis that CSA is directly related to neurobiological abnormalities in BPD.

Sexual and physical abuse among Korean female inpatients with schizophrenia

The study reports the prevalence and correlates of sexual and physical abuse in a sample of 100 female inpatients with schizophrenia in South Korea. Clinical assessment interviews consisted of the Positive and Negative Syndrome Scale, the Scale for the Assessment of Positive Symptoms, an interview assessing history of sexual and repeated physical abuse, and demographic and psychosocial factors. Lifetime prevalence of severe sexual or physical abuse was 52%. Compared with nonabused patients (n = 48), the abused patients (n = 52) showed more nonpsychotic symptoms (i.e., anxiety, depression) and higher levels of distress, but no difference in psychotic symptoms. This study failed to note significant differences in positive symptoms addressed in previous Western studies.

Prior History of Physical and Sexual Abuse Among the Psychiatric Inpatient Population: A Comparison of Males and Females

Despite increasing attention given to the high prevalence and effects of abuse in the severely mentally ill, few studies have looked at its effects among males. While both male and female psychiatric patients report greater abuse history than the general population, studies have focused on females alone. The current study compared the effects of abuse history between 271 severely mentally ill males (n = 160) and females (n = 111). The mean age of participants was 33.7 years (SD = 9.73), and included 129 Caucasians, 120 African Americans, 15 Hispanic-Americans, and 7 "Other" (i.e., Asian and native American descent). Primary Axis I diagnoses included Bipolar disorder (23.2%) major depressive disorder (27.7%) schizophrenic disorder (26.6%), substance-related disorders (10.3%), and miscellaneous disorders (12.1%). Each patient completed a comprehensive assessment, including clinician ratings, self-report measures, clinical and structured interviews. Comparisons between genders revealed that females were more likely to report both physical and sexual abuse, and males were more likely to report no history of abuse. In addition, Caucasians were more likely to report abuse than were African Americans, and voluntary patients were more likely to endorse abuse history than those admitted involuntarily. Few gender differences were found in psychological symptoms among males and females. Satisfaction with the home environment was significantly lower for abused than nonabused females. This was not true for males. However, abused psychiatric patients were perceived by the physicians, nurses, and themselves as having greater emotional disturbance than were nonabused patients, regardless of gender. Clinical implications are discussed.

Lifetime physical and sexual abuse in chronic pain patients: psychosocial correlates and treatment outcomes

Purpose : This study describes a subgroup of diagnostically heterogeneous chronic pain patients, with a lifetime history of physical and/or sexual abuse, who underwent a pain management programme. A battery of psychosocial and pain measures were assessed, as well as 1-year post-treatment socio economic outcomes. Method : The prevalence of a history of abuse was assessed via a semi-structured interview of 162 consecutive patients (112 females and 50 males) presenting for 4-8 weeks of treatment in an interdisciplinary, outpatient rehabilitation programme. Treatment outcome data were gathered immediately, 6 months and 1 year following discharge. The chronic pain patients with a history of abuse were compared to those without a history of abuse on several pre-treatment psychosocial variables--pain severity, psychological distress, DSM-IV Axis I comorbidity and health care utilization. Patient groups were matched on age, race, primary pain diagnosis, time in pain prior to treatment and gender. Results : Results indicated that 61% of patients had a history of lifetime physical and/or sexual abuse. Rates of sexual, and combined sexual and physical, abuse across the lifespan were higher for women than for men. Abused patients had a greater number of psychiatric diagnoses than nonabused patients. Abused patients also reported greater affective distress, less perceived life control, and a greater number of ER visits in the 6 months prior to treatment than their nonabused counterparts. A model consisting of gender (female), a higher number of psychiatric diagnoses, and higher affective distress was found to be a sensitive and relatively accurate predictor of abuse history. Finally, analyses indicated that, despite having greater psychosocial risk factors during the pre-treatment period, chronic pain patients with a history of abuse benefited from treatment and maintained treatment gains to a degree similar to nonabused chronic pain patients. Conclusions : Chronic patients with an abuse history can successfully complete a rehabilitation programme if the programme is designed to treat their psychosocial distress. Moreover, this also carries over to treatment outcome. A history of abuse does not have to negatively impact long-term treatment outcomes in this population of chronic pain patients.

Type and Severity of Abuse as Predictors of Psychiatric Symptoms in Adolescence

There has been little previous research about histories of child maltreatment and psychological symptoms in adolescent psychiatric patients. This study investigated whether type and characteristics of child physical and/or sexual abuse predicted individual differences in symptoms. Participants were 187 patients in day or residential treatment facilities. Abuse was assessed using structured interviews with the adolescent, the therapist, and the caseworker. Participants completed a standardized, self-report measure of internalizing and externalizing symptoms. Adolescents with histories of dual abuse (i.e., sexual and physical abuse) had elevated depression and anxiety compared with nonabused patients. Histories of any type of abuse were associated with elevated posttraumatic symptoms. Among physically abused patients, severity and duration of abuse predicted individual differences in depression and anxiety, whereas severity and concomitant sexual abuse predicted elevated posttraumatic symptoms. Among sexually abused patients, the characteristics of sexual abuse did not predict individual differences in symptoms. Thus, child abuse, particularly dual abuse and severe physical abuse, predicted elevated internalizing symptoms, even in comparison with other adolescent psychiatric patients. The need for replication is discussed.

Media Impact on Biased Perceptual Processing of Threat-Relevant Imagery Among Patients Who Recovered Memory of Childhood Sexual Abuse Prior to the Onset of Treatment

ABSTRACT Several recent studies have indicated that patients who report a history of sexual abuse, on the basis of recovered or delayed recall of memory, process Rorschach stimuli in ways that substantially deviate from non-abused patients. They exhibited sensitivity to threat-relevant imagery that was highly similar to the biased perceptual processing found among patients with continuously held memories of sexual abuse. In the present study, perceptual processing of threat-relevant imagery was examined as an artifact of media exposure in 40 patients who recovered memories of childhood sexual abuse as adults and in 40 patients who were not sexually abused. The two patient samples were divided into high and low media groups on the basis of a composite measure of media exposure. The results indicated that information gained from media exposure was unrelated to patients' responses to Rorschach stimuli. Recovered memory patients produced threat-relevant imagery that is reminiscent of trauma irrespective of the level of media exposure; non-abused patients did not. That this imagery remained essentially unnoticed by even the most active consumers of the sexual abuse media among non-abused patients suggests that the popular media does not play a contagious role in the perceptual processing of threat-relevant imagery.

Surviving Roots of Trauma: Prevalence of Silent Signs of Sex Abuse in Patients Who Recover Memories of Childhood Sex Abuse as Adults

Recent research suggests that victimization imagery is chronically accessible in sex-abused populations, which is helpful in distinguishing them from nonabused populations. Eight categories of victimization imagery were selectively activated by Rorschach stimuli. These 8 sex-abuse signs were replicated in a new sample of 36 patients with continuous memory of sex abuse. Classification accuracy was 83%. By contrast, these signs were present in only 4% (5 of 115) of the protocols of nonabused patients. Taken together, the 2 studies confirm reasonably high sensitivity of the 8 signs for sex-abused populations and high specificity for nonabused populations. The 8 signs were also differentially salient for patients who recovered memory of childhood sexual trauma as adults. The Rorschach protocols of 59 of 114 patients with delayed recall of sexual abuse possessed signs of sex abuse. There was no linkage between therapy and recovered-memory cases with and without sex-abuse signs. Emergence of trauma memories was not uniquely traceable to treatment. Memories arose outside of the context of therapy in over 56% of the cases. Implications for the false-memory debate are discussed.

Sexual and physical abuse during early childhood or adolescence and later drug addiction

Sexual or physical abuse of children are discussed as possible causes or risk-factors for psychiatric disorders like posttraumatic stress disorder, alcohol and drug addiction. The aim of this study was to identify possible differences between sexually or physically abused and non-abused patients with polytoxic drug abuse. 100 patients with polytoxic drug abuse were interviewed during their therapy about a history of sexual abuse prior to the age of sixteen. Using different questionnaires we tried to find possible differences between drug users being sexually abused or not and risk factors for later drug addiction. 70% of the female and 56% of the male drug users had been sexually abused as children, 40% of the male and 50% of the female participants had a history of severe sexual abuse with sexual intercourse. In over 50% friends or relatives were the perpetrators committed the crime, in no case the parents had. More than 40% showed also a history of physical abuse. Significantly more drug users than alcohol abusers had a sexual trauma. Especially severe sexual abuse was associated with abuse of hard illegal drugs. Furthermore, we could find significantly more symptoms such as autoaggressive and suicidal behaviour, social isolation, reduced emotional binding to others, tendency to be persistently victimized, prostitution and violence against others in the group of sexually abused. Many of these symptoms are not only characteristic of addiction, but can be found also in other psychiatric diseases such as borderline and eating disorder. In conclusion, we could not find a significant correlation between sexual abuse and later drug addiction. 80% of the drug users themselves did not relate the fact of being sexually abused as child to later drug abuse. However, there seems to be a positive correlation between sexual abuse and a more severe addiction to illegal drugs as well as higher rates of symptoms with a negative course of the disease. For this group of patients with an unfavourable prognosis special therapeutic concepts are needed.

Texture response patterns associated with sexual trauma of childhood and adult onset: developmental and recovered memory implications

Objective: Reduce texture sensitivity on the Rorschach is proposed as a sequela of early sexual abuse that is unlikely to be contaminated by situational variables. If this conceptualization has merit, texture attributes offer a roadmap for studying vying claims in the recovered memory debate. To explore this possibility, we examined the extent to which intense preoccupation with sexual trauma of childhood and of adult onset was related to reduced texture productivity. Method: Texture productivity was measured in 4 groups comprised of 108 patients using the Rorschach. Twenty-seven patients with recovered memory were compared with 27 patients with continuous memory of childhood sexual trauma, 27 post trauma stress patients with sexual trauma of adult onset, and 27 non-abused patients. Results: The study replicated previous findings of reduced texture productivity among patients who always remembered sexual trauma of childhood-onset. The same texture deficiency pattern was observed among patients who recovered memory of childhood sexual abuse. This pattern was not observed in Post Traumatic Stress Disorder (PTSD) patients intensely preoccupied with sexual trauma of adult onset despite the fact that they mimicked the recovered memory group in respect to enduring preoccupation with distressing thoughts of sexual abuse. Conclusion: The findings indicate that intrusive memories of sexual trauma do not shape patients’ response to textural cues on the Rorschach. Variations in texture productivity are primarily moderated by age of trauma onset. Dismissal of claims of recovered memories on the basis of intense sexual preoccupation is not warranted.