Presence Of Sexual Abuse Research Articles

Effects of Therapy at a Community Based Trauma Therapy Service Treating Child Abuse and Neglect: A Pre-Post Study Using Administrative Data

This repeated-measures study examined the effects of a hybrid of Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) with other therapeutic approaches at a community-based clinic in Perth Western Australia among a sample of children and young people overwhelmingly experiencing multiple forms of maltreatment and with complex family situations (i.e., family and domestic violence, parental mental health, parental substance abuse). Drawing on 1713 individual client records from between 2017 and 2020, the researchers identified 113 children and young people with viable pre-post treatment assessments including 78 on the TSCC, 36 on the TSCYC, and 12 on the CBCL. Significant improvements on most clinical scales were identified on the TSCC and TSCYC. Sub-analysis of the TSCC results found no differences across gender, age, care status, therapy funding source, and the presence of sexual abuse in the rate of improvement on trauma symptoms. Overall, the study highlights that integrating different therapy approaches for populations with multiple and complex trauma symptoms accessing community-based services can be useful for supporting the delivery of TF-CBT for difficult to treat populations.

Social-Cultural Factors Associated with Common Mental Health Disorders among Pregnant and Parenting Teenagers: A Case Study of Korogocho Slums, Nairobi County, Kenya

Background: Teenage pregnancy is a significant problem in Kenya, with over 18% of teenagers aged 15-19 being pregnant or already mothers, with rates even higher in low-income areas such as slums. Existing research has shown that teenage pregnancy increases the risk of mental health disorders, and maternal complications during childbirth, and postpartum. Objective: The study aimed to determine the social-cultural factors associated with common mental health disorders among pregnant and parenting teenagers. Method: An analytical cross-sectional research design was applied. A stratified random sampling technique was utilized to recruit 153 study participants, where Cochran formula for smaller populations was applied to determine sample size. Both qualitative and quantitative techniques of data collection were applied. The chi-square test for independence was employed to determine the degree of association between the dependent and independent variables. Statistical significance was set at p=≤0.05. Results: The prevalence of common mental health disorders in this study was 55%. When the bivariate analysis was done, the following social-cultural factors were found to be significantly associated with common mental health disorders. Absence of social support (X2=2.983, df=3, P<0.005), intimate partner violence (X2= 25.970; df=1, P-value=< 0.000). Presence of physical violence (Physical abuse before pregnancy(X2=19.006, df=2,p<0.001*), Physical abuse during pregnancy(X2=21.169, df=2, <0.001*), Physical abuse after delivery(X2=26.173, df=2, <0.001*),) and presence of sexual violence(Sexual abuse before pregnancy(X2=13.896, df=2, <0.001*), Sexual abuse during pregnancy(X2=5.208, df=2, 0.035*) and Sexual abuse after pregnancy(X2=8.405, df=2, 0.003*). Conclusion: The prevalence of common mental health disorders in this study was high. The following social-cultural factors were found to be significantly associated with common mental health disorders, absence of social support, presence of physical violence, presence of sexual abuse, and the presence of intimate partner violence. There is a need to develop psychosocial and legal support programs targeting pregnant and parenting teenagers to prevent them from common mental health disorders. Furthermore, the community including parents, teachers, and policymakers should support adolescents during their growth and development stages and protect them against teenage pregnancies which will ultimately lead to a healthier population.

Psychiatric Outcomes of Childhood Maltreatment: A Retrospective Chart Review from a Children's Psychiatric Inpatient Program.

Childhood maltreatment is linked to deleterious outcomes, whereby post-traumaticstressdisorder (PTSD) has been identified as one of the most debilitating. This retrospective chart review examined whether self-reported affective measures (anxiety, depression, trauma), type of maltreatment (sexual, physical, emotional/verbal abuses), and demographics predicted a diagnosis of anxiety or PTSD among 169 children in a psychiatric inpatient hospital. Secondly, this study identified significant predictors of a PTSD diagnosis. Results indicated self-reported anxiety predicted a diagnosis of PTSD, while self-reported depression predicted PTSD only in maltreated children. Self-reported trauma predicted an anxiety diagnosis. PTSD risk variables including duration of stay, sex, self-reported anxiety, presence of sexual abuse, and presence of emotional/verbal abuse, showed sound sensitivity/specificity as predictors of risk for a PTSD diagnosis in an inpatient setting. Clinical implications are discussed.

The impact of sexual abuse on psychopathology of patients with psychogenic nonepileptic seizures.

In the present study, we evaluated if the presence of sexual abuse in the clinical history of patients with psychogenic non-epileptic seizures (PNES) is associated with a different psychopathological profile. In a consecutive population of 63 PNES patients, we compared two demographically and clinically matched groups of patients with (no. 15) and without (no. 48) a history of sexual abuse using a comprehensive psychopathological assessment (Beck Depression Inventory, Hamilton Anxiety Rating Scale, Dissociative Experience Scale, Somatoform Dissociation Questionnaire, and Toronto Alexithymia Scale). We found that the group of patients reporting sexual abuse is characterized by higher scores on Dissociative Experience Scale (p = 0.003) and Beck Depression Inventory (p = 0.001) with respect to the other group. No significant statistical differences in Hamilton Anxiety Rating Scale (p = 0.103), Toronto Alexithymia Scale (p = 0.137), and Somatoform Dissociation Questionnaire (p = 0.486) were captured. Moreover, we found that the negative effect on dissociate symptoms was also hampered by the increasing of seizure frequency. This study reinforces the importance of traumatic screening in the clinical spectrum of PNES in order to implement and improve specific therapeutic strategies.

The association between childhood trauma and facial emotion recognition in patients with stable schizophrenia

IntroductionThe impairment of facial emotion recognition (FER) among patients with schizophrenia (SCZ) is a significant feature of the illness. Childhood trauma (CT) is reported with a high prevalence in SCZ and is considered one of its risk factors.ObjectivesTo investigate the relationship between FER and CT in SCZ.MethodsFifty-eight outpatients with stable SCZ completed the Childhood Trauma Questionnaire retrospectively assessing five types of childhood trauma (emotional, physical and sexual abuse, and emotional and physical neglect). They also completed a newly developed and validated FER task constructed from photographs of the face of a famous Tunisian actress and evaluating the ability to correctly identify Ekman's six basic facial emotions (happiness, sadness, anger, disgust, fear and surprise).ResultsPatients with higher scores of CT performed significantly worse in FER task. Our results suggest that the presence of sexual abuse is specifically correlated to a poor identification of anger (P = 0.02) and disgust (P = 0.03) while the presence of emotional abuse and physical neglect are correlated to a poor identification of happiness and sadness.ConclusionsCT may represent one of the causes of the FER deficits in schizophrenia. Further studies are necessary to confirm the link between specific kinds of childhood trauma and deficits in the recognition of discrete emotions.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Effects of Abuse Within Violence Exposed Youth: Desensitization or Masked Effects?

The current study examined the differences in presentation of psychopathology following varying types of maltreatment, including the witnessing of intimate partner violence. Families recruited from a community mental health center specializing in child trauma were asked to complete questionnaires related to multiple realms of psychosocial functioning. Results indicated that the presence of sexual abuse significantly impacted the development of depressive and anxiety symptoms in children; however, this was not observed following other types of trauma. Analyses also revealed significant mediative relationships with respect to family variables. Although findings supported the original hypothesis, it was proposed that, rather than desensitization, these children might be may be explained by cognitive dissonance. More research needs to examine these findings.

Variables psicosociales y riesgo de violencia grave en parejas con abuso de sustancias tóxicas y maltrato previo [Psychosocial variables and risk of severe violence in couples with substance abuse and previous maltreatment

The aim of this ex post facto study was to investigate what variables are related to severe intimate partner violence (IPV), in a sample of 90 couples attending a community treatment program for drug abusers. Multiple variables were analyzed: Sociodemographic characteristics, couple’s relationship, maltreatment circumstances, some characteristics of aggressors and victims, as well as sexual, physical or psychological abuses and type of substance abuse. Results showed high scores in the severe IPV risk prediction scale. The victims were classified as high-risk (26%), moderate-risk (59%) and low-risk (15%), depending on the cutoff scores in the revised scale. The variables more related to risk severe violence of IPV were: Couples in which both use drugs or both heavy drinking of alcohol, heroin abuse by the perpetrator, presence of sexual abuse, lack of social and family support and less economic autonomy from the victims, and others characteristics of the aggressor (ie., harassment behaviors, violates a restraining order) and maltreatment circumstances. The variables identified could be useful in predicting the risk of lethal or severe violence in relationships where one or both members have problems with drugs.

Co-morbid depression and sexual abuse during childhood as confounding factors in the analysis of glucocorticoid-receptor supersensitivity in patients with posttraumatic stress disorder

INTRODUCTION Evidence shows that posttraumatic stress disorder (PTSD) patients have low basal cortisol levels and glucocorticoid-receptor (GR) supersensitivity following a pharmacological challenge. These findings, however, are controversial, partially due to the presence of confounding factors, such as co-morbidity with major depressive disorder (MDD) and childhood trauma. In the present study, salivary cortisol levels of victims of violence with and without PTSD were assessed following a prednisolone suppression test (PST), controlling for the presence of MDD and sexual abuse during childhood. METHOD The sample was nested in an epidemiological study performed in Sao Paulo City. The subjects with a diagnosis of PTSD (PTSD+) and a matched control group (PTSD-) were submitted to SCID-I; after which Early Trauma Inventory (ETI), Clinician-Administered PTSD Scale (CAPS), Beck Depression (BDI) and Anxiety Inventory (BAI) and the Peritraumatic Dissociative Experiences Questionnaire (PDEQ) were used. Saliva samples were collected before and after 1,5 mg of prednisolone, administered at 10 PM. Discussion These results confirm previous findings that PTSD patients have lower cortisol levels by showing a blunted response to exogenous GC), which is likely due to increased GR responsiveness. Separating the patients with PTSD alone from those with co-morbid MDD showed that hypocortisolism is specific to PTSD, and the presence of MDD counterbalances PTSD-related dysfunction to “normalize” the curve of patients with both diagnoses. The presence of sexual abuse during childhood correlated negatively with lower the salivary cortisol concentrations. Early sexual abuse, but not other types of trauma such as general, physical, and psychological traumas, was correlated with cortisol dysfunction. The presence of sexual abuse during childhood is a potent risk factor for developing an Axis I diagnosis during adulthood [1]. Some authors find a correlation between early abuse and lower cortisol concentrations after a psychosocial stressor test and pharmacological challenge, an effect that is independent of the presence of an Axis I diagnostics [2-3]. The question raised here is whether the presence of severe sexual abuse during childhood and HPA axis response to stress is an endophenotype. Another aspect to consider is whether subjects with a particular type of HPA axis response are at a greater risk for PTSD development after a severe adulthood stressor. PTSD related to increased GR supersensitivity should be investigated further. Research also should address whether the presence of different endophenotypes depends on the timing of the trauma (considering epigenetic phenomenon). Interestingly, we did not find differences between controls and PTSD patients. Despite the fact that 40% of our sample had PTSD+MDD, the presence of PTSD symptoms had a predominant effect on HPA axis by lowering cortisol concentrations, as demonstrated by our comparison of PTSD+ (either with or without MDD) with controls.

COMT but not serotonin‐related genes modulates the influence of childhood abuse on anger traits

Anger-related traits are regulated by genes as well as early environmental factors. Both childhood maltreatment and genes underlie vulnerability to suicidal behaviors, possibly by affecting the constitution of intermediate phenotypes such as anger traits. The aim of this study was to test the interaction between nine candidate genes and childhood maltreatment in modulating anger-related traits in 875 adult suicide attempters. The State-Trait Anger Expression Inventory and the Childhood Trauma Questionnaire were used to examine anger traits and traumatic childhood experiences, respectively. The functional polymorphism of the catecholamine-O-methyl-transferase (COMT) gene Val158Met significantly modulated the association between sexual abuse and anger-trait level (P = 0.001). In the presence of sexual abuse, individuals carrying the Val high-activity allele displayed greater disposition toward anger than individuals homozygous for the Met allele (P = 0.0003). Notably, none of the serotonin-related genes influenced the effect of childhood abuse on anger traits. The results of the present study suggest that anger-trait level is influenced by the interaction between childhood abuse and functional polymorphism in the COMT gene. This study was carried out in a population with a high frequency of childhood abuse and a high disposition toward anger, and replication in healthy subjects is needed.

Sexual Abuse and Violence Among Adolescent Girls in Botswana: A Mental Health Perspective

The presence of sexual abuse among societies in Botswana is a phenomenon whose occurrence is usually denied albeit the police report on it and legal frameworks have been established to combat it. Several factors influence the concealment of sexual abuse among adolescent girls, which includes cultural factors and social status of the perpetrators. This paper espouses the concept of sexual abuse among adolescent girls, the existence of the problem, its magnitude, the factors that increase vulnerability to violence and abuse, and how these factors intersect with HIV and AIDS. Two case studies using a discovery method were used to explore the phenomenon under the study. The findings of the study indicated that sexual abuse and violence have profound mental health consequences including guilt, anxiety, depression and anger. Future research is suggested to explore this problem on a wider scale and develop interventions that can assist victims and perpetrators to cope with the situation.

Sexual Abuse and Eating Disorders in a Community Sample of Mexican American Women

The purpose of this study was to examine the association between sexual abuse and eating disorders in a voluntary community sample of Mexican American women. Eighty eating disorder cases were compared to 110 healthy controls on presence of sexual abuse and on characteristics of the abuse. The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision) and the Eating Disorder Examination were used to determine diagnoses and psychiatric comorbidity. Results indicated that compared to controls, cases were more likely to report sexual abuse and had experienced more instances and longer duration of abuse. For the majority of cases, sexual abuse occurred before onset of eating disorder symptoms. There was no relationship between sexual abuse and type of eating disorder or psychiatric comorbidity. Sexual abuse seems to be a risk factor for disordered eating in Mexican Americans. Prolonged abuse and revictimization may increase this risk.

The impact of physical and sexual abuse on body image in eating disorders

Objective The role of childhood sexual abuse as a risk factor for the development of eating disorders has gained considerable attention in the literature in the last few years, especially its role in bulimia nervosa. Although physical abuse was also frequently explored in the history of patients with eating disorders, its role was unclear in the aetiopathogenesis of these disorders. The goal of our study was to test the hypothesis, based on our clinical experience, that physical abuse is more frequent in eating disorders than thought previously and that the patient's distortion in body image is more severe in these cases. Method A standardized interview method was used to elicit details of physical and sexual abuse in a group of 63 patients with eating disorders. The frequency of laxative use and the severity of body image distortion was also examined with the Body Attitude Test. These clinical data were analysed on the whole sample and also on the subgroups of eating disorders. Results We found significantly more severe body image distortions in those patients who had been physically abused (p < 0.05) and there were significantly more severe body image distortions in those patients who had a history of laxative abuse (p < 0.001). Sexual abuse occured in 29%, physical abuse in 57% and laxative abuse in 46% within the whole sample of examined eating disorder patients. Physical abuse and laxative abuse were the most frequent in the binge eating/purging type of anorexia nervosa (92% and 69%). Also, these patients had the worse rates on sexual abuse and body image distortion items. According to our results, the presence of sexual abuse was not associated with more severe body image distortion in eating disorder patients. Conclusions Childhood physical abuse seems to be a more important factor in the development of body image distortion than had been thought before; its importance in this aspect may be greater than sexual abuse. Physical abuse, laxative abuse and the binge–purge subtype in anorexia nervosa are a considerable risk factor for the severity of the distortion in body image and their presence makes the prognosis of the eating disorder worse. Further studies of the nature of these relationships are warranted. Copyright © 2005 John Wiley & Sons, Ltd and Eating Disorders Association.

Dissociation in Temporal Lobe Epilepsy and Pseudo-Epileptic Seizure Patients

Patients with epileptic seizures (ES) and especially those with temporal lobe epilepsy (TLE) share many symptoms with patients with pseudo-epileptic seizures (PES), and the differentiation between them is often difficult There is growing evidence that a subgroup of PES patients suffer from a dissociative disorder. It is recognized that dissociative symptoms pertain to both psychological and somatoform components of experience. Questionnaires assessing dissociation might provide positive criteria for the diagnosis of PES. In this study, the Dissociation Questionnaire (DIS-Q) and the Somatoform Dissociation Questionnaire (SDQ-20) were administered to patients with ES (TLE, non-TLE) and PES. To control for the influence of general psychoneurotic complaints, the SCL-90 was administered. Apart from this, answers on a trauma questionnaire were related to the diagnosis. Results showed that PES patients scored significantly higher on the SDQ-20, also after correction with the SCL-90, and no difference was found on the DIS-Q. Also, PES patients significantly more often reported sexual traumatic experiences. A logistic regression revealed that results on the SDQ-20 have no independent value in addition to the contribution of gender, age, age at seizure onset, and the presence of sexual abuse in the prediction of the diagnosis. In conclusion, somatoform and not psychological dissociative symptoms are characteristic for PES patients in comparison to ES patients. Other measures are needed within the framework of the differential diagnosis between PES and ES.

Dyads and triads of abuse, bereavement and separation: a survey in children attending a child and family centre

AbstractObjectives: To determine the frequency with which abuse, parental separation and bereavement occur on their own or together in children attending child psychiatry services and to assess the relationship between these traumas and attendance and outcome.Method: A review of all case notes over a 12 month period (n = 435) was conducted and a proforma completed. Information was gathered on clinical presentation, rate of attendance, the presence of sexual abuse, non-sexual abuse including bullying, bereavement and parental separation and a measurement of outcome by subjective assessment was made.Results: Fifty-nine per cent of the children had experienced at least one of the specified traumas; 13% had experienced two and 2.5% had experienced three. The children who had been abused or bereaved were more likely to require fairly long-term work; those who were adjusting to parental separation required less intervention over time. The children who had been sexually abused had, relatively, the poorest outcome in contrast to those adjusting to bereavement where 87% were considered to have made significant improvement.Conclusions: Bereavement, abuse and parental separation are common in children referred to the child psychiatric services and these children often require long-term intervention. Increased resources will be required in order to continue to provide adequate intervention and treatment for these children.

Cross-Generation Sexual Abuse Within the Extended Family

There are many signs indicating the presence of sexual abuse within a family. Yet, many factors stand in the way of the diagnosis and the prevention of that abuse. Among these factors are: parents’ psychological health, their sexual education, patriarchal authority, and authority of adults over children. Through the following example, namely Salam’s case (a victim of sexual abuse that started when she was three years old and lasted until 14 years of age), we would like to highlight the family’s role in the perpetuation of sexual abuse. In addition, we want to stress the extent to which sexual abuse affects the psychological health of the victim, as well as the necessity of a systematic therapeutic plan which includes individual, family and group therapeutic interventions to secure the rehabilitation of the victim and his/her family, ensures this phenomenon would not recur in the family and would not be transferred to the next generation.