Rates Of Childhood Sexual Abuse Research Articles

Examining the utility of a train-the-trainer model for dissemination of sexual violence prevention in schools

Rates of childhood sexual abuse are unacceptably high, with potentially long-lasting consequences for those who have been victimized. Currently, there are a number of sexual violence prevention programs that have been developed to lower rates of victimization, increase awareness, and connect victims with resources. Within this area of research, there has been less focus on effective methods of program dissemination. For example, school-based sexual violence prevention programs have had positive outcomes; however, little is known about how these programs are disseminated. The train-the-trainer model of dissemination utilizes master trainers to equip others to implement programs, thereby allowing more adults to teach and subsequently more children to receive the program. This study used survey data from teachers and other school personnel (n = 127) to analyze the utility of a train-the-trainer model of dissemination for a sexual violence prevention program in the state of Hawai’i. Through responses of people who were trained to implement the program (59.8% of whom did implement), aspects of the training, the program itself, and factors affecting whether a person implemented the program were explored. Results suggest that time spent in training, job position, and time in that position predicted whether a person trained to implement the sexual violence prevention program followed through with teaching the program to students. Additionally, 54.7% of people who did implement the program had at least one student disclose sexual violence to them, indicating the importance of sexual violence prevention programming and dissemination of these programs.

Long-term health outcomes of childhood sexual abuse and peer sexual contact among an urban sample of behaviourally bisexual Latino men

While previous research indicates high rates of childhood sexual abuse among Latino men who have sex with men, few studies have examined the long-term health outcomes of childhood sexual abuse specifically among behaviourally bisexual Latino men. In a sample of 148 behaviourally bisexual Latino men in New York City, we examined associations between childhood sexual abuse and multiple dimensions of adult health: sexual risk behaviours; sexually transmitted infections incidence; polydrug use; depressive symptoms; and perceived stress. We compared outcomes between those with histories of childhood sexual abuse, those reporting peer sexual contact prior to age 13 and those with no sexual contact prior to age 13. Over one-fifth (22.3%) reported a history of childhood sexual abuse, which was significantly associated with engaging in receptive condomless anal intercourse (aOR = 3.59, p < .01, SE = 2.0), high perceived stress (aOR = 2.48, p < .06, SE = 1.13) and clinically significant depressive symptoms (aOR = 2.7, p < .05, SE = 1.25). Across all variables, peer sexual contact did not impact these outcomes, underscoring a key distinction between abusive and non-abusive early sexual experiences. We recommend that sexual abuse prevention policies and programmes better engage Latino youth, and that practitioners serving this population across diverse areas of practice incorporate childhood sexual abuse screening and culturally appropriate treatment and care into practice.

Reporting rates of child sexual abuse in Indigenous communities in two Australian jurisdictions

Child sexual abuse is a significant problem in many Indigenous communities; there is also evidence of chronic under-reporting of this crime. This study aimed to compare reporting rates between Indigenous and non-Indigenous cases of child sexual abuse across two Australian jurisdictions. Datasets comprising child sexual abuse reports from the Police Information Management Systems of the two jurisdictions were used to calculate reporting rates, and to compare case characteristics and case progression. Results indicated that the reporting rate for child sexual abuse of Indigenous children was between two and four times that of non-Indigenous children. In the Indigenous cases, the second jurisdiction had lower reporting rates than the first jurisdiction. Further analysis of the Indigenous cases only found that cases in the second jurisdiction were more severe, more likely to have a forensic interview, and more likely for the suspect to be charged, than in the first jurisdiction. However, there were no significant differences in conviction rates between the two jurisdictions. Differences observed in severity and case progression suggest that the lower reporting rates observed in the second jurisdiction may be due to comparatively high levels of under-reporting, rather than lower actual levels of child sexual abuse. In conclusion, reporting rates of child sexual abuse can be better understood when further information, such as case characteristics and case progression rates, is available.

Contextual, experiential, and behavioral risk factors associated with HIV status: a descriptive analysis of transgender women residing in Atlanta, Georgia.

This study assessed the prevalence of self-reported HIV infection among a community sample of transgender women and identified associated contextual, experiential, and behavioral factors. Ninety-two transgender women completed a self-administered interview. Recruitment occurred through an LGBT service organization, a transgender support group, transgender advocates, and informal communications. Eighty-two percent were African American/Black. Of 83 who knew their status, 60% reported being HIV infected. High rates of childhood sexual abuse (52%), rape (53%), intimate partner violence (56%), and incarceration (57%) were reported. Many did not have health insurance (53%), were not employed full-time nor in school (63%) and had been recently homeless (49%). HIV-infected transgender women as compared to HIV-uninfected transgender women were more likely to be African American/Black ( P = 0.04), and older than 34 years ( P = 0.01), unemployed/not in school ( P < 0.001). HIV-infected transgender women also experienced less trans-related discrimination ( P = 0.03), perceived less negative psychosocial impact due to trans status ( P = 0.04) and had greater happiness with their physical appearance ( P = 0.01). HIV-infected transgender women may experience relatively less trans-related stress compared to their HIV-uninfected counterparts. High rates of HIV, trauma, and social marginalization raise concerns for this population and warrant the development of structural and policy-informed interventions.

Evaluating the association between childhood sexual abuse and attempted suicide across the lifespan: Findings from a nationwide study of women in jail.

Previous studies have found childhood sexual abuse to predict suicidal behavior in adulthood. Women in jail suffer disproportionately high rates of childhood sexual abuse and attempted suicide relative to women in the general population. Thus, better understanding the association between childhood sexual abuse and attempted suicide among women in jail may inform prevention, assessment, and treatment initiatives for this at-risk population. This study examined the association between childhood sexual abuse and the onset of attempted suicide across the life span in a nationwide sample of women in jail. Participants included a randomly selected subsample of women (N = 115), drawn from a larger probability sample (N = 491), who completed Life History Calendars, which were coded for the presence/absence of attempted suicide and childhood sexual abuse across life history stages. Survival analysis and Cox regression indicated that women with histories of childhood sexual abuse perpetrated by an adult or a peer were significantly more likely to have attempted suicide across the life span, including increased risk for the onset of attempted suicide in adulthood. This study demonstrates the salience of childhood sexual abuse as a predictor of suicidal behavior among women in jail, and extends previous research by demonstrating the temporal sequence of childhood sexual abuse relative to attempted suicide across the life span. Given these findings, researchers, clinicians, and policymakers should consider further the influence of childhood sexual abuse with regard to the high rates of attempted and completed suicide among women in jail. (PsycINFO Database Record

Cumulative trauma and current posttraumatic stress disorder status in general population and inmate samples.

This research was undertaken to examine the role between cumulative exposure to different types of traumatic events and posttraumatic stress disorder (PTSD) status in general population and prison samples. Two archival datasets were examined: the standardization sample for the Detailed Assessment of Posttraumatic States (DAPS; Briere, 2001), and data from a study on trauma and posttraumatic sequelae among inmates and others. PTSD was found in 4% of the general population sample and 48% of the prison sample. Trauma exposure was very common among prisoners, including a 70% rate of childhood sexual abuse for women and a 50% rate for men. Lifetime number of different types of trauma was associated with PTSD in both the general population and prison samples, even when controlling for the effects of sexual trauma. Cumulative interpersonal trauma predicted PTSD, whereas cumulative noninterpersonal trauma did not. In the general population sample, participants who had only 1 type of trauma exposure had a 0% likelihood of current PTSD, whereas those with 6 or more other trauma types had a 12% likelihood. In the prison sample, those with only 1 type of trauma exposure had a 17% percent likelihood of current PTSD, whereas those exposed to 6 or more other trauma types had a 64% chance of PTSD. Cumulative trauma predicts current PTSD in both general population and prison samples, even after controlling for sexual trauma. PTSD appears to develop generally as a function of exposure to multiple types of interpersonal trauma, as opposed to a single traumatic event. (PsycINFO Database Record

Childhood sexual abuse and two stages of cigarette smoking in African-American and European-American young women

ObjectiveThe aim of the current study was to determine whether the higher rates of childhood sexual abuse (CSA) but lower rates of cigarette smoking in African-American vs. European-American women can be explained in part by a lower magnitude of association between CSA and smoking in African-American women. MethodsData were drawn from a same-sex female twin study of substance use (n=3521; 14.3% African-American). Cox proportional hazards regression analyses using CSA to predict smoking initiation and progression to regular smoking were conducted separately by race/ethnicity. Co-twin status on the smoking outcome was used to adjust for familial influences on smoking (which may overlap with family-level influences on CSA exposure). ResultsAfter adjusting for co-twin status, CSA was associated with smoking initiation in European Americans (hazard ratio (HR)=1.43, 95% confidence intervals (CI): 1.26–1.62) and with smoking initiation ≤16 in African Americans (HR=1.70, CI: 1.26–2.29). CSA was associated with regular smoking onset ≤15 in European Americans (HR=1.63, CI: 1.21–2.18), with no change in HR after adjusting for co-twin status. In the African-American subsample, the HR for CSA was reduced to non-significance after adjusting for co-twin status (from HR=3.30, CI: 1.23–8.89 to HR=1.16, CI: 0.71–1.92 for regular smoking ≤15). ConclusionsCSA is associated with moderate elevation in risk for initiating smoking among African-American and European-American women. By contrast, CSA is associated with elevated risk for (adolescent onset) regular smoking only in European-American women. Furthermore, there is significant overlap between risk conferred by CSA and familial influences on regular smoking in African-American but not European-American women.

Childhood sexual abuse in adult patients with borderline personality disorder.

Background:Researchers have found elevated rates of childhood sexual abuse (CSA) in borderline personality disorder (BPD) patients. They have also implicated the role of CSA later in BPD. However, there has been a scarcity of studies regarding this in Indian population.Objectives:To profile the occurrence of CSA and its parameters in BPD patients and to document symptomatology of BPD associated with CSA.Materials and Methods:Thirty-six consecutive patients with BPD were administered with a two-staged semi-structured interview by different interviewers with the first stage for collecting sociodemographic details and confirming BPD diagnosis and the second stage for collecting information about CSA.Results:Of 36 BPD patients, 16 (44.44%) reported a history of definite CSA. The majority of CSA associated with BPD were having characteristics of onset at 7–12 years, <10 occasions of abuse, perpetrator being a close relative or a close acquaintance and genital type of CSA. Identity disturbances (P = 0.0354), recurrent suicidal/self-harm behavior (P = 0.0177), and stress-related paranoid/dissociative symptoms (P = 0.0177) were significantly associated with the presence of CSA while unstable interpersonal relationships (P = 0.001) were significantly associated with the absence of CSA.Conclusion:Significant proportion of BPD patients reported CSA. The specific symptom profile of BPD patients can be used to predict the presence of CSA in these patients, which has a direct implication in the treatment of these patients.

Complexity of Childhood Sexual Abuse: Predictors of Current Post-Traumatic Stress Disorder, Mood Disorders, Substance Use, and Sexual Risk Behavior Among Adult Men Who Have Sex with Men

Men who have sex with men (MSM) are the group most at risk for HIV and represent the majority of new infections in the United States. Rates of childhood sexual abuse (CSA) among MSM have been estimated as high as 46%. CSA is associated with increased risk of HIV and greater likelihood of HIV sexual risk behavior. The purpose of this study was to identify the relationships between CSA complexity indicators and mental health, substance use, sexually transmitted infections, and HIV sexual risk among MSM. MSM with CSA histories (n=162) who were screened for an HIV prevention efficacy trial completed comprehensive psychosocial assessments. Five indicators of complex CSA experiences were created: CSA by family member, CSA with penetration, CSA with physical injury, CSA with intense fear, and first CSA in adolescence. Adjusted regression models were used to identify relationships between CSA complexity and outcomes. Participants reporting CSA by family member were at 2.6 odds of current alcohol use disorder (OR 2.64: CI 1.24-5.63), two times higher odds of substance use disorder (OR 2.1: CI 1.02-2.36), and 2.7 times higher odds of reporting an STI in the past year (OR 2.7: CI 1.04-7.1). CSA with penetration was associated with increased likelihood of current PTSD (OR 3.17: CI 1.56-6.43), recent HIV sexual risk behavior (OR 2.7: CI 1.16-6.36), and a greater number of casual sexual partners (p=0.02). Both CSA with Physical Injury (OR 4.05: CI 1.9-8.7) and CSA with Intense Fear (OR 5.16: CI 2.5-10.7) were related to increased odds for current PTSD. First CSA in adolescence was related to increased odds of major depressive disorder. These findings suggest that CSA, with one or more complexities, creates patterns of vulnerabilities for MSM, including post-traumatic stress disorder, substance use, and sexual risk taking, and suggests the need for detailed assessment of CSA and the development of integrated HIV prevention programs that address mental health and substance use comorbidities.

Serum concentrations of brain-derived neurotrophic factor and mental disorders in imprisoned women.

Mental disorders and early trauma are highly prevalent in female inmates. Brain-derived neurotrophic factor (BDNF) plays an important role in learning, memory processes, and mood regulation. The aim of this study was to evaluate the relationship between serum BDNF levels and mental disorders among imprisoned women as compared with age- and education-matched controls. A consecutively recruited sample of 18 female prisoners with mental disorders was assessed for sociodemographic, criminal, and clinical variables using standardized instruments, the Mini International Neuropsychiatric Interview Plus (MINI Plus), and serum BDNF levels. High rates of childhood sexual abuse and posttraumatic stress disorder (PTSD) were found in the group of forensic patients. Serum BDNF levels in the forensic group did not differ from those of healthy controls, and were significantly higher when compared with those of women with mental disorders hospitalized in a general hospital. Elevated serum BDNF levels were found in imprisoned women. The results of this study may suggest neurobiological mechanisms similar to those seen in previous clinical and preclinical studies showing the involvement of BDNF in the pathophysiology of PTSD.

Prevalence and Nature of Child Sexual Abuse in the Netherlands: Ethnic Differences?

In most epidemiological prevalence studies of child sexual abuse, the role of ethnicity remains unclear. This study examined the prevalence and nature of child sexual abuse in four non-Western ethnic minority groups and compared them with a native Dutch group. A sample of 3,426 young adults (aged 18–25) completed a structured, online survey on experiences of child sexual abuse. A total of 42.9% (n = 1,469) participants reported at least one form of child sexual abuse victimization before the age of 18. Surinamese and Turkish respondents’ prevalence rates did not differ from the native Dutch youth. However, the Dutch Antillean respondents reported significantly higher rates of child sexual abuse on specific forms of abuse, whereas the Moroccan respondents reported lower rates compared with their native Dutch peers. With this study, we have more insight into the differences—however small they may be—between ethnic groups and native Dutch youth regarding child sexual abuse.

Child Maltreatment in the World: A Review Article

Child abuse is a recognized public health and social problem in the worldwide. According to the World Health Organization (WHO), child abuse includes all forms of physical and/or emotional ill-treatment, sexual abuse, neglect and negligent treatment and exploitation. Child maltreatment is a global problem with serious life-long consequences. In spite of recent national surveys in several low- and middle-income countries, data from many countries are still lacking. Estimates of child maltreatment indicate that nearly a quarter of adults (22.6%) worldwide suffered physical abuse as a child, 36.3% experienced emotional abuse and 16.3% experienced physical neglect, with no significant differences between boys and girls. However, the lifetime prevalence rate of childhood sexual abuse indicates more marked differences by sex – 18% for girls and 7.6% for boys. The lifelong consequences of child maltreatment include impaired physical and mental healthe, poorer school performance, and job and relationship difficulties. Ultimately, child maltreatment can contribute to slowing a country's economic and social development. We conclude that child maltreatment is a widespread, global phenomenon affecting the lives of millions of children all over the world, which is in sharp contrast with the United Nation's Convention on the Rights of the Child.

Prevalence of Sexual Abuse Among Children with Conduct Disorder: A Systematic Review

Many clinicians and researchers have speculated that child sexual abuse and conduct disorder co-occur frequently, yet no systematic reviews of literature have specifically addressed both these conditions. To estimate the prevalence of sexual abuse among children with conduct disorder, the pertinent literature was systematically reviewed. Ten databases were searched, supplemented with hand search of reference lists from retrieved papers. Blind assessments of study eligibility and quality were conducted by two independent researchers. Disagreements were resolved by consensus. Twenty-three studies meeting minimum quality criteria that were enough to insure objectivity and not to invalidate results and including 7,256 participants with either conduct disorder or child sexual abuse were examined. The prevalence of child sexual abuse among participants with conduct disorder was 27 %; however, such figure might be underestimated due to selection, sampling, and recall biases; poor assessment methods; and narrow definitions of abuse in included studies. Participants with conduct disorder, compared with healthy individuals, reported higher rates of child sexual abuse. However, compared with other psychiatric populations, they reported similar or lower rates. There was also some evidence suggesting that children with conduct disorder might be more likely to report child physical abuse. Female participants with conduct disorder, compared with males, were significantly more likely to report child sexual abuse. Youths with conduct disorder are at risk of being (or having been) sexually abused, although such risk seems to be neither more specific to nor stronger for these individuals, compared with people with other psychiatric disorders.

Child sexual abuse and health outcomes in the Chinese context

Reported rates of child sexual abuse in China fall at the lower end of the range found in Western studies. However, most of the studies were conducted in only one city or province and thus their results may not be generalisable. Acknowledging the infeasibility of recruiting a truly representative sample, we conducted a survey during 2009–10 using a probability sampling procedure to obtain a large and diverse sample of school-aged adolescents from six regions in China. About one in every 13 children had had experience of sexual abuse. Routine screening in medical and social settings is urged. Efforts should be made to ensure wide awareness of this issue.

Coming of age on the streets: Survival sex among homeless young women in Hollywood

This study examined childhood physical or sexual abuse, involvement in dependency or delinquency systems, psychiatric hospitalization, and suicide as possible risk factors for survival sex among homeless young women. Homeless young women were found to have similarly high rates of childhood sexual abuse, dependency and delinquency systems involvement, and psychiatric hospitalization. Homeless young women involved in survival sex disclosed higher rates of attempted suicide and reported marginally higher rates of childhood physical abuse. Analysis of qualitative data showed that those engaged in survival sex were motivated primarily by desperation to meet basic needs including a place to stay, food and money, and one third mentioned that peers commonly were influential in decisions to engage in survival sex. Others were influenced by coercion (10%) or pursuit of drugs (10%). Young women engaged in survival sex generally experienced regret and shame about their experience.

Capsule Commentary on Walsh et al. Sexual Violence and Mental Health Symptoms Among National Guard and Reserve Soldiers

Walsh et al.1 explored the relationship between sexual violence, PTSD, and depression among National Guard and Reserve soldiers, finding 27–37 % of women and 4 % of men reported experiencing sexual violence at some point in their lives. Rates of sexual violence during the most recent deployment ranged from 0–2.6 %. Moreover, soldiers who had ever experienced sexual trauma had 3.5-fold higher odds of suffering from PTSD; nearly half of PTSD cases could be attributed to life-time sexual violence. The rate of deployment-related sexual trauma in this population-based cohort is lower than that reported in VA samples. A major strength of this study is its large randomized sample that is not drawn from the VA or a treatment-seeking population. That lifetime rates of sexual violence are elevated among female soldiers, and that these experiences increase vulnerability to mental health problems, are important findings both for epidemiological purposes and to enhance treatment efforts. The assessment of sexual violence was done within the context of screening for 21 different traumatic events, and subjects were asked if they have ever “been raped” or “experienced another kind of sexual assault or unwanted sexual contact as a result of force, threat of harm, or manipulation.” As the authors note, this use of single questions may underestimate the prevalence of sexual assault. Further, it would be helpful in future studies to differentiate between childhood sexual abuse and such assault in adulthood. The CDC’s Adverse Childhood Events studies have documented a high prevalence of childhood sexual abuse (17.2 % for women and 6.7 % for men).2 Other research has documented similar or higher rates of childhood sexual abuse, and studies have reported increased risk for individuals with this history for a range of psychiatric and other life difficulties.3,4 Future research would benefit from exploring both the timing and context of sexual violence among soldiers, trying to differentiate the contribution of childhood experiences versus sexual trauma that occurred in adulthood but prior to military service. Walsh and colleagues urge clinicians to assess lifetime sexual violence both in treatment-seeking clients and in all soldiers. While this assessment is likely routine in most psychiatric treatment settings, this research highlights the importance of assessing this domain regularly in primary care settings and in research. Enhancing our ability to conceptualize the many factors that contribute to human suffering is important to improving our assessment and intervention approaches.

Trauma and Cultural Safety: Providing Quality Care to HIV-Infected Women of Aboriginal Descent

In Canada, the Aboriginal community is most at risk for HIV infection. Aboriginal peoples have disproportionately high rates of violence, drug use, and challenging socioeconomic circumstances. All of this is related to a history of colonization that has left Aboriginal people vulnerable to HIV infection through unsafe sex, needle sharing, and lack of access to health promotion and education. Aboriginal women are at particular risk for HIV infection. They experience a disproportionate degree of trauma, which is associated with colonization, high rates of childhood sexual abuse, and illicit drug use. A history of trauma impacts on access to health care, uptake of antiretroviral therapy, and mortality and morbidity in people with HIV. We describe the case of a 52-year-old, HIV-infected Aboriginal woman. We review the current evidence related to her case, including colonization, intersectionality, post-traumatic stress disorder, depression, revictimization, and substance use.

Explaining lower rates of sexual abuse in China

Accumulating research suggests that rates of child sexual abuse are comparatively low in China. This commentary is an effort to evaluate whether it reflects a true lower prevalence or alternatively the effect of inhibited disclosure by victims. We conclude that while some estimates have almost certainly been affected by inhibited disclosure, the overall magnitude of the contrast between Chinese and international rates, particularly for girls, and its consistency with other indicators do suggest a true lower prevalence, although the evidence is equivocal. We discuss some factors that could account for such lower rates including Confucian family values, definitions of masculinity and a collectivist culture that may be protective.

An examination of a gender-specific and trauma-informed training curriculum: Implications for providers.

Residential group care facilities are experiencing an increase in the number of adolescent females in these facilities who have high rates of childhood sexual abuse. The mental health needs of this population are often unrecognized and not treated, which often results in re-victimization. Residential care agencies are actively seeking competent direct care staff members to work with females who have been sexually traumatized. However, gender-specific and trauma-informed training curricula for direct care staff members have lacked clarity and effective implementation. The purpose of this study was to evaluate a gender-specific and trauma-informed training curriculum for residential staff. It was hypothesized that participant knowledge score would be different after the training curricula in the treatment group; the pre knowledge score in the control group would remain the same after the treatment group; mean post knowledge would be different between the treatment group and control group; that there would be a significant difference of the post Survey of Knowledge scores between the treatment and control group; and that participant satisfaction score would be different after the training curricula in the treatment group. The participant scores showed some improvement prior to the training curriculum and there was a significant difference between the pre and post knowledge scores for the control group. While results showed that there was no significant difference between the scores of knowledge and retention between the treatment and control group, implications for counselors and recommendations for future studies were provided.

Pornography Actresses: An Assessment of the Damaged Goods Hypothesis

The damaged goods hypothesis posits that female performers in the adult entertainment industry have higher rates of childhood sexual abuse (CSA), psychological problems, and drug use compared to the typical woman. The present study compared the self-reports of 177 porn actresses to a sample of women matched on age, ethnicity, and marital status. Comparisons were conducted on sexual behaviors and attitudes, self-esteem, quality of life, and drug use. Porn actresses were more likely to identify as bisexual, first had sex at an earlier age, had more sexual partners, were more concerned about contracting a sexually transmitted disease (STD), and enjoyed sex more than the matched sample, although there were no differences in incidence of CSA. In terms of psychological characteristics, porn actresses had higher levels of self-esteem, positive feelings, social support, sexual satisfaction, and spirituality compared to the matched group. Last, female performers were more likely to have ever used 10 different types of drugs compared to the comparison group. A discriminant function analysis was able to correctly classify 83% of the participants concerning whether they were a porn actress or member of the matched sample. These findings did not provide support for the damaged goods hypothesis.