Severe Childhood Sexual Abuse Research Articles

Experiential avoidance in participants with borderline personality disorder and other personality disorders

BackgroundThe present study has descriptive and predictive aims. The descriptive aims were to determine if participants with borderline personality disorder (BPD) reported higher levels of experiential avoidance (EA) than participants with other personality disorders (OPD) as well as determine if non-recovered participants with BPD reported higher levels of EA than participants with BPD who have recovered symptomatically and psychosocially. The predictive aim was to determine if the level of EA reported by participants with BPD was predicted by the severity of aspects of childhood or adult adversity and/or aspects of temperament.MethodsThe Overall Anxiety Severity and Impairment Scale (OASIS) was administered to 248 participants at 24-year follow-up in the McLean Study of Adult Development (MSAD). Adversity and temperament were assessed during index admission using interviews (Revised Childhood Experience Questionnaire [CEQ-R], Adult History Interview [AHI], and the NEO-FFI self-report measure).ResultsParticipants with BPD reported significantly higher levels of EA than those with OPD. Within the BPD group, non-recovered participants reported significantly higher levels of EA than recovered participants. Severity of childhood sexual abuse and lower levels of extraversion were found to be significant multivariate predictors of levels of EA in those with BPD.ConclusionsTaken together, these results suggest that EA is a serious problem for participants with BPD, particularly those who have not recovered. They also suggest that both the severity of childhood adversity and a temperament marked by lower levels of extroversion are significantly related to levels of EA reported by participants with BPD.

Sex differences in the association of childhood sexual abuse severity with premarital sex among Chinese college students in Luzhou, China

PurposeThe adverse health consequences of premarital sex and childhood sexual abuse (CSA) are both global public health problems. Based on a random sample of college students from a Chinese city, this study investigated the relationship between CSA severity and premarital sex among students, focusing on sex differences.MethodsA total of 2722 college students from 4 schools in Luzhou were recruited by multistage random sampling. Self-administered questionnaires were used to measure CSA experiences and premarital sex. Binary logistic regression analyses were conducted to analyse the relationship between CSA and premarital sex.ResultsThe prevalence of CSA was 9.39%, and that of mild, moderate and severe CSA was 4.04%, 2.90% and 2.46%, respectively. The premarital sex reporting rate was 22.42%. After adjusting for confounding variables, CSA was positively associated with premarital sex. Notably, a cumulative effect of CSA on premarital sex was observed among students. Further stratification analyses showed that males who experienced CSA had a higher premarital sex rate than females, and this sex difference was also observed among students with different CSA severities.ConclusionCSA and its severity were associated with premarital sex among college students. Furthermore, this association was stronger for males than females. Therefore, it is important to emphasize CSA prevention, especially for boys. These findings can promote understanding of the effects of CSA on premarital sex, and CSA prevention and intervention strategies should consider CSA severity and sex differences.

Expression of ANK3 moderates the association between childhood trauma and affective traits in severe mental disorders

Exposure to early life trauma increases the risk of psychopathology later in life. Here we investigated if ANK3 mRNA levels influence the relationship between childhood trauma experiences and clinical characteristics in mental disorders. A sample of 174 patients with bipolar disorder and 291 patients with schizophrenia spectrum disorder were included. Patients were diagnosed using the Structured Clinical Interview for DSM-IV, and childhood trauma was assessed using the childhood trauma questionnaire. Age at illness onset and number of psychotic and affective episodes were assessed from interview and medical records. Current depressive symptoms were measured using the calgary depression scale for schizophrenia and the inventory for depressive symptomatology. ANK3 expression was analyzed in whole blood using the Illumina HumanHT-12 v4 Expression BeadChip. Analyses were carried out with the Process adjusted for confounders. Within the total sample, patients with both high ANK3 expression and with the most severe childhood sexual abuse had more manic/hypomanic episodes and an earlier age at onset of the first episode. ANK3 mRNA levels also moderated the relationship between emotional neglect and manic/hypomanic episodes. Our results suggest that ANK3 expression levels moderate the association between specific types of childhood trauma and affective traits in mental disorders.

Dissociation and multiple‐personality disorder in incarcerated women: Observations from the Washington, D.C. detention center. Jail 1987–1989

AbstractBetween 1983 and 1989, the number of women in U.S. jails more than doubled and continues to increase. Most women behind bars have been victims of violence including childhood sexual abuse. This may lead to psychiatric dissociative disorders such as Complex Post‐Traumatic Stress Disorder and Dissociative Identity Disorder (Multiple Personality Disorder.). It is difficult for clinicians to study these women. This article describes several severe dissociative disorders in the women in the Washington, D.C. Detention Center (“D.C. jail”) from September 1987 to September 1989. The author was able to live with them for more than 2 years. The author, a surgeon, kept a diary and frequently intervened in the episodes described here. Conditions in the co‐ed jail were hostile and dangerous to the women inmates. The women's observed dissociative behaviors included Dissociative Identity Disorder (“DID”), prolonged screaming, and prolonged sexual self‐abuse. Dissociative episodes could trigger ones in other women inmates or even in female jail “Officers.” The author suggests (i) that dissociation is likely to be common and severe among incarcerated women (ii) that at least one of its antecedents here is severe childhood sexual abuse and that (iii) judicial and correctional biases exacerbate these symptoms.

A Study on Factors Associated with Child Sexual Abuse and Recognizing the Severity: Special Reference to Galle District

Child Sexual Abuse has been a global epidemic with devastating consequences. One in four girls and one in six boys have been experienced some form of sexual abuse in their tender age in the world. According to Police statistics, Child Sexual Abuse (CSA) cases is growing in recent years in Sri Lanka too. Galle is among the four districts where the reported child abuse cases high and the reported CSA complaints are increasing extraordinarily. Also, there is no previous research have been done in the Southern part of the country regarding the crisis of CSA. So, main objective of this study is to determine the key risk factors that affected to a CSA in Galle Police Division, and to develop suitable regression and machine learning models to predict the severity of CSA. 225 CSA cases reported to Police Child and Women Bureau of Galle Police Division during the period 2017 – 2020 were treated for this study. Out of twenty-one risk which were found from literature and knowledge of domain experts, sixteen variables showed a significant relationship with response variable severity of CSA according to chi-square test of association. Traditional OLR model was performed to predict severity of CSA and to detect key risk factors to a CSA with two different data selection methods. Next, machine learning techniques: Decision Tree, SVM, and PNN were trained to classify severity of CSA. Random over-sampling technique was used to overcome the class imbalanced problem persists in the dataset. Finally, bagging technique was executed to conserve robustness of models and to improve performance. The OLR model classified the severity of CSA with 68.85% accuracy. Machine learning techniques, Decision Tree, SVM and PNN model classified the severity of CSA with an accuracy of 82.15%, 77.68% and 85.25% respectively. PNN model performed with higher accuracy better than other fitted models. The results obtained from this study can be used to take precautions and to arrange awareness sessions for adults to reduce CSA in Galle Police Division. Also, the study can be extended to the whole island to reduce CSA and to make it a better place for children.

Childhood Sexual Abuse: A Longitudinal Study of Disclosures and Denials.

In legal cases regarding child sexual abuse (CSA), children have various options, such as to disclose or deny maltreatment. When interviewed in adulthood, their accounts may be consistent with their childhood responses. Alternatively, denial in childhood could be followed in adulthood by disclosure ("deferred disclosure"), confirming previous suspicions. Or the adults could possibly recant. We conducted a longitudinal study of CSA disclosures and denials (N = 99; Time 1 [T1], 3- to 16-year-olds). T1 CSA disclosures and denials at a forensic unit were compared to the individuals' responses 20 years later (Time 2 [T2]. 22- to 37-years-old). We found that consistent disclosure was associated with being older at T1 and female. Deferred disclosure was significantly associated with greater T2 trauma-related symptoms. Corroboration and higher CSA severity predicted T2 recantation. Consistent denial was related to less severe CSA. Our findings add to knowledge about CSA disclosures, which affect legal pathways available to child victims.

Dissociative experiences of adolescents with borderline personality disorder: description and prediction

AimsThe first purpose of this study was to assess the severity of dissociative experiences reported by adolescent inpatients with borderline personality disorder (BPD). The second purpose was to compare the severity of their dissociative symptoms to those reported by a sample of adult inpatients with BPD. The third purpose of this study was to assess a range of clinically meaningful predictors of the severity of dissociation in adolescents and adults with BPD.MethodsThe Dissociative Experiences Scale (DES) was administered to a total of 89 hospitalized girls and boys aged 13–17 with BPD and 290 adult inpatients with BPD. Predictors of the severity of dissociation in adolescents and adults with BPD were assessed using the Revised Childhood Experiences Questionnaire (a semi-structured interview), the NEO, and the SCID I.ResultsBorderline adolescents and adults had non-significant differences on their overall DES scores and subscale scores. They also had a non-significant distribution of low, moderate, and high scores. In terms of multivariate predictors, neither temperament nor childhood adversity was a significant predictor of the severity of dissociative symptoms in adolescents. However, co-occurring eating disorders were found in multivariate analyses to be the only bivariate predictor to significantly predict this outcome. In adults with BPD, however, both the severity of childhood sexual abuse and co-occurring PTSD were significantly related to the severity of dissociative symptoms in multivariate analyses.ConclusionsTaken together, the results of this study suggest that the severity of dissociation is not significantly different in adolescents and adults with BPD. However, the etiological factors differ substantially.

Associations Between Latent Classes of Trauma Exposure and Minority Stressors and Substance Use Among Cisgender Sexual Minority Women.

Psychosocial stressors (e.g., minority stressors, trauma exposure) profoundly impact sexual minority women's (SMW's) risk of alcohol and other drug (AOD) use. However, research has not examined whether there are distinct typologies (i.e., patterns) of psychosocial stressors and whether these vary based on sociodemographic characteristics or are differentially associated with AOD outcomes (e.g., alcohol dependence) among SMW. This study aimed to identify latent classes of SMW reporting distinct typologies of psychosocial stressors and examine predictors and outcomes of latent classes of psychosocial stressors among SMW. Participants included a community sample of 602 SMW (Mage = 39.9, SD = 14.0; 74.0% lesbian; 37.4% White, 36.6% Black, 22.3% Latinx; 26.6% annual income ≤$14,999). Latent class analysis was used to identify typologies of psychosocial stressors. Regression analyses were employed to examine sociodemographic predictors and AOD outcomes of class membership. Three classes of psychosocial stressors emerged. Participants in Class 1 were likely to report relatively low adversity. SMW in Class 2, who reported childhood physical abuse (CPA), severe childhood sexual abuse, and adult physical assault, were vulnerable to discrimination and stigma consciousness. A distinct subgroup of SMW (Class 3) was at heightened risk of CPA, adult sexual assault (ASA), and stigma consciousness. Older SMW, Black SMW, and SMW with lower social support were more likely to be in classes characterized by higher adversity. Older SMW were at disproportionate risk of CPA and ASA. Different combinations of psychosocial stressors were uniquely associated with AOD outcomes. Findings underscore the importance of considering within-group heterogeneity in SMW's differential risk of psychosocial stressors and AOD outcomes. Routine screening of psychosocial stressors across several dimensions, brief interventions targeting AOD outcomes, and policies mitigating structural drivers of SMW's increased risk of trauma and minority stressors may be especially important for older SMW, Black SMW, and SMW who lack social support.

The Associations between Self-Silencing and Delinquency in Adolescent Who Experienced Child Sexual Abuse

ABSTRACT A large body of research reveals that child sexual abuse is an adverse experience associated with many negative socioemotional and behavioral consequences during adolescence. Notably, adolescent victims of child sexual abuse are more likely to engage in delinquent behavior, which has importance for their adaptation later in life. While research on the psychological antecedents of delinquent behavior has independently considered each core feature of silencing the self (i.e., low assertiveness and self-expression, conflict avoidance, presenting a non-authentic self, anger, and hostility), it has failed to jointly consider these as potential predictors of delinquent behaviors in adolescent victims of child sexual abuse. The purpose of this study was to examine the associations between the two dimensions of self-silencing (i.e., divided self and silencing the self) and delinquency in adolescent victims of child sexual abuse. A sample of 110 adolescents seeking services following child sexual abuse completed self-reported questionnaires, and case files were analyzed to gather information regarding child sexual abuse severity. Hierarchical regression analyses revealed that, after controlling for the effect of age, gender, parental monitoring, and child sexual abuse severity, self-silencing was positively associated with delinquent behaviors, affiliation with delinquent peers, as well as alcohol and drug use. Divided self contributed to the prediction of aggressive behaviors. Implementing interventions aimed at increasing adolescents’ assertiveness, conflict management skills, and emotion regulation and promoting congruence between their behaviors and authentic selves may lower their involvement in delinquency.

Childhood sexual abuse and pervasive problems across multiple life domains: Findings from a five-decade study.

The aim of this study was to use longitudinal population-based data to examine the associations between childhood sexual abuse (CSA) and risk for adverse outcomes in multiple life domains across adulthood. In 937 individuals followed from birth to age 45y, we assessed associations between CSA (retrospectively reported at age 26y) and the experience of 22 adverse outcomes in seven domains (physical, mental, sexual, interpersonal, economic, antisocial, multi-domain) from young adulthood to midlife (26 to 45y). Analyses controlled for sex, socioeconomic status, prospectively reported child harm and household dysfunction adverse childhood experiences, and adult sexual assault, and considered different definitions of CSA. After adjusting for confounders, CSA survivors were more likely than their peers to experience internalizing, externalizing, and thought disorders, suicide attempts, health risk behaviors, systemic inflammation, poor oral health, sexually transmitted diseases, high-conflict relationships, benefit use, financial difficulties, antisocial behavior, and cumulative problems across multiple domains in adulthood. In sum, CSA was associated with multiple persistent problems across adulthood, even after adjusting for confounding life stressors, and the risk for particular problems incremented with CSA severity. The higher risk for most specific problems was small to moderate, but the cumulative long-term effects across multiple domains reflect considerable individual and societal burden.

The Effects of Severe Childhood Physical and Sexual Abuse on Adult Socioeconomic Prosperity.

Our study utilizes Adverse Childhood Experience (ACE) scores to estimate the relationship between forced sexual intercourse and physical abuse on socioeconomic outcomes in adulthood. ACEs have been shown to have long-term negative impacts on health, mental health, and cognition. We expand upon the literature that analyzes the effects of ACEs on human capital investment and adult socioeconomic outcomes by focusing on the ACE scores pertaining to repeated physical and forced sexual abuse in childhood. Specifically, we estimate probit models using data from the Behavioral Risk Factor Surveillance System to measure the marginal effects of childhood sexual abuse (CSA) and physical abuse on the probability of high school completion, unemployment, and the likelihood of living in poverty in adulthood. We find adults who suffered physical abuse in childhood are more likely to live in poverty. Adult survivors of CSA are less likely to finish high school and more likely to live in poverty. The likelihood of high school noncompletion increases when the individual suffered both forms of abuse. We also find that only those who suffered both forms of abuse in childhood had a greater likelihood of being unemployed and high school noncompletion. We find the negative socioeconomic impact in adulthood is larger for women than for men, implying gender heterogeneity in outcomes of CSA and physical abuse. Researchers should control for the correlation between sexual abuse and physical abuse in childhood, particularly in women, when estimating their effects on socioeconomic outcomes.

Patterns of disclosure and perceived societal responses after child sexual abuse

BackgroundDisclosure of child sexual abuse (CSA) is key for abused children to access help and to protect them and other children. ObjectiveThe aim of this study was to investigate patterns of disclosure of child sexual abuse and how children perceived responses from people they disclosed to. Participants and settingData were collected online in classrooms and during home studies in a national probability-based sample of 3282 third-year students in Swedish high schools in 2020–2021 (the age of the students varied between 16 and 23 years (M = 18,2)). MethodsResults are presented with frequencies (n) and percentages (%). Pearson's chi-squared test was used for comparisons between groups. ResultsFirst, a substantial share of abused girls and most abused boys had not yet told anyone about the abuse, leaving them unable to access protection or rehabilitation. Second, participants who had disclosed sexual abuse had most often turned to a peer, more rarely to an adult, and seldom to a professional or volunteer. Third, although the societal responses that the participants perceived were mixed, more severe abuse was associated with more negative societal responses. Fourth, most participants stated that they did not need any professional support. Fifth, among the minority who had sought help, half were satisfied and a third dissatisfied. ConclusionsResults showed that most children with experience of CSA did not have access to the protection, support, and rehabilitation that they have a right to. Preventive measures need to target children and young people, while societal responses after CSA, especially severe CSA, need to be improved.

SOCIAL MANAGEMENT MODEL OF HOLISTIC GOVERNANCE FRAMEWORK FOR PREVENTION OF CHILD SEXUAL ABUSE

In a country like India, which has a child population exceeding 472 million Office of the Registrar General and Census Commissioner (2011), Child safety is given paramount importance. According to research done by the "MWCD," 53.2 percent of children examined were victims of Child Sexual Abuse (CSA), with 20.9 percent being violently assaulted Kacker et al. (2007). “The "Protection of Children from Sexual Offenses Act" (POCSO) went into force on November 14, 2012”. It conferred protective rights to the victims of CSA cases. The rationale behind the formulation of the Statute was to obliterate CSA, and also to create awareness about the severity of CSA. It is imperative to note here that POCSO works only as a legislative deterrence and deterrence alone cannot annihilate the problem. This paper suggests a Social Management Model of Holistic Governance Framework effectively done by reviewing sixteen different prevention strategies associated with the development of the child community as a constructive solution at large.

Childhood sexual abuse and food addiction severity in a clinical sample of individuals with overweight or obesity.

A higher risk of food addiction (FA) in individuals reporting childhood sexual abuse (CSA) has been well demonstrated with community samples, but studies including clinical samples failed to replicate this relation. This study examined, among individuals presenting eating and weight disorders, the risk of FA for those reporting CSA while considering the severity of CSA and other types of traumas. Participants (N = 187) completed a DSM-5 diagnosis assessment and questionnaires on LimeSurvey evaluating FA, interpersonal traumas, depressive level, body esteem, dieting/weight preoccupations, and body mass index (BMI). Logistic regressions were used to calculate the odds ratio (OR) of FA using interpersonal traumas as risk factors, and t tests were used to compare individuals with FA and CSA and those with FA without CSA. Of all interpersonal traumas, CSA was associated with the highest risk of FA, with ORs of 1.73 (p = 0.094) and 2.07 (p = 0.034). The relationship with the abuser, the type of sexual abuse and the number of abuses were significant or marginally significant risk factors, with ORs ranging from 1.26 to 1.50. Finally, no significant difference was found between FA with CSA and FA without CSA. Using a clinical sample, this study showed a higher risk of FA in individuals reporting CSA and provided evidence that the relationship with the abuser, the type of sexual abuse, and the number of abuses are relevant factors. Additionally, in individuals with FA, the presence or absence of CSA did not influence depressive level, body esteem, dieting/weight preoccupations, or BMI. Level V, cross-sectional, descriptive study.

Mindful Awareness Promotes Resilience: Buffered Links Among Childhood Sexual Abuse Severity, Goal-Directed Emotion Dysregulation, and Psychopathology.

Childhood sexual abuse is linked to long-term consequences, including depression and anxiety in adulthood. Although considerable progress has been made to understand mechanisms that may account for this relation, such as emotion dysregulation, less attention has been given to protective factors that may mitigate it. One such protective factor might be mindful awareness. Those who act with awareness in daily living tend to engage in healthy emotion regulation skills when faced with stressors and experience less depression and anxiety. In the current study, we aimed to replicate the positive associations among childhood sexual abuse severity, emotion dysregulation, and psychopathology across time, and also identify a personal strength-in this case, mindful awareness-that might mitigate these effects. Participants were 491 women recruited from the community who completed self-report assessments at three time points over a 32-month period. A series of moderated mediation models revealed childhood sexual abuse severity predicted later reports of depression and anxiety symptoms through greater emotion dysregulation in the form of difficulties engaging in goal-directed behaviors. As expected, mindful awareness weakened the relation between goal-directed emotion dysregulation and symptoms of depression and anxiety, such that greater levels of mindful awareness fully buffered these effects. Through a better understanding of natural resiliency processes among survivors, we can ultimately encourage continued examination of what might be effective additions to existing treatments for the mental health consequences of trauma and adversity.

Investigating the associations between childhood trauma and cardiovascular health in midlife.

Growing evidence suggests that childhood trauma is associated with poorer cardiovascular health in adulthood, but few studies have examined potential mediators of these associations. We examined the links between different forms of childhood trauma (i.e., abuse, neglect, cumulative trauma) and cardiovascular health and explored potential mediators. Cross-sectional data from 1,251 participants in the National Survey of Midlife Development in the United States' II Biomarker Project were analyzed. Path analyses were conducted to examine the associations between childhood trauma and cardiovascular health (i.e., American Heart Association's Life's Simple 7 [LS7] score). Depressive symptoms and sleep quality were explored as potential mediators, and exploratory analyses examined whether these associations were moderated by sex. Women reported more severe childhood emotional and sexual abuse and emotional neglect, p<.001 to p=.018, and higher LS7 scores, p=.027, than men. Path analyses demonstrated the total effects of increasing severity of all forms of childhood trauma with LS7 scores were significant, and cumulative childhood trauma was inversely associated with LS7 score Bs=-0.306- -0.076, p<.001-p=.048. The range of total effects of different forms of childhood trauma on LS7 scores mediated by depressive symptoms and sleep quality was 26.8%-57.5%. Sex moderated the associations between all forms of childhood trauma and cardiovascular health. Longitudinal studies are needed that examine mediators of the associations between childhood trauma and cardiovascular health. Findings suggest sex-specific, trauma-informed approaches for cardiovascular disease prevention in adults exposed to childhood trauma may be needed.

Personalization of Treatment for Patients with Childhood-Abuse-Related Posttraumatic Stress Disorder.

Background: Differences in effectiveness among treatments for posttraumatic stress disorder (PTSD) are typically small. Given the variation between patients in treatment response, personalization offers a new way to improve treatment outcomes. The aim of this study was to identify predictors of psychotherapy outcome in PTSD and to combine these into a personalized advantage index (PAI). Methods: We used data from a recent randomized controlled trial comparing prolonged exposure (PE; n = 48), intensified PE (iPE; n = 51), and skills training (STAIR), followed by PE (n = 50) in 149 patients with childhood-abuse-related PTSD (CA-PTSD). Outcome measures were clinician-assessed and self-reported PTSD symptoms. Predictors were identified in the exposure therapies (PE and iPE) and STAIR+PE separately using random forests and subsequent bootstrap procedures. Next, these predictors were used to calculate PAI and to retrospectively determine optimal and suboptimal treatment in a leave-one-out cross-validation approach. Results: More depressive symptoms, less social support, more axis-1 diagnoses, and higher severity of childhood sexual abuse were predictors of worse treatment outcomes in PE and iPE. More emotion regulation difficulties, lower general health status, and higher baseline PTSD symptoms were predictors of worse treatment outcomes in STAIR+PE. Randomization to optimal treatment based on these predictors resulted in more improvement than suboptimal treatment in clinician assessed (Cohens’ d = 0.55) and self-reported PTSD symptoms (Cohens’ d = 0.47). Conclusion: Personalization based on PAI is a promising tool to improve therapy outcomes in patients with CA-PTSD. Further studies are needed to replicate findings in prospective studies.

Patient crying during psychotherapy intake sessions: Relationship to patient characteristics and early treatment process.

The aim of the present study is to further the understanding of who cries at the beginning of psychotherapy and patients' experience of crying in that process. Intake sessions for 53 patients beginning psychotherapy at a university-based clinic were coded for discrete crying segments. Data about patient characteristics were also collected at intake. Results indicate that crying during intake sessions was related to lower global functioning and higher severity of childhood sexual abuse. Furthermore, patients who cried at intake were over four times more likely to also cry at feedback, and those who cried at feedback were almost 12 times more likely to have cried at intake. Finally, crying in the intake session did not appear to be related to patient- or therapist-rated working alliance. Overall, the present study provides valuable information about characteristics of patients who cry at the outset of the therapy process and patients' experience of crying over time in therapy. Findings suggest the need for further research on patient characteristics and aspects of the therapy process that may predict patient crying over the course of treatment, as well as how these early crying experiences may be related to eventual patient outcomes.

Symptom patterns of sexually abused teenage girls seeking services.

Child sexual abuse (CSA) is associated with a host of negative repercussions. Yet, scholarly reports highlight the diversity of symptom presentation in survivors of CSA. Relying on the complex posttraumatic stress disorder (C-PTSD) framework, this study aimed to identify symptom profiles in teenage girls seeking services following disclosure of CSA. Participants included 207 teenage girls aged 12-18. They completed questionnaires on PTSD symptoms (i.e., reexperiencing, avoidance, and hyperarousal) and domains of impairments of the C-PTSD (i.e., interpersonal difficulties, biology, affect and behavioral regulation, dissociation, cognition, and self-concept). A latent profile analysis identified three profiles: PTSD, Complex PTSD, and Resilient. Results support the validity of the C-PTSD model with a subgroup reporting classic PTSD symptoms as well as alterations in several domains of functioning. Our second aim was to explore potential correlates of the resulting symptom profiles. Both personal and family factors were found to distinguish profiles, with teens in the Resilient group reporting fewer associations with delinquent peers, less use of avoidance coping strategies, and more maternal support than the two other profiles. Furthermore, CSA severity did not differ between the Complex PTSD and the Resilient profiles. The current findings argue in favor of a more individualized approach to treatment taking into consideration differences in presentation of symptoms among profile teenage survivors of CSA. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Age of Occurrence and Severity of Childhood Sexual Abuse: Impacts on Health Outcomes in Men Who Have Sex with Men and Transgender Women

ABSTRACT Childhood sexual abuse (CSA) is associated with a wide range of health outcomes and is more prevalent among men who have sex with men (MSM) compared to men who have sex with women exclusively and among transgender women (TW) compared to cisgender peers; however, there is a lack of consensus regarding an explanatory theoretical model. This analysis examined these models across health outcomes using baseline data from a longitudinal study of MSM and TW in Chicago (n = 1,035) collected from 2015 to 2019. Severity of CSA was measured for two age ranges (prior to 13 and 13–17). Logistic regression and negative binomial regressions were estimated. Teenage experiences of CSA were associated with alcohol problems, cannabis problems, suicide ideation/attempt, depression, condomless anal sex partners, rectal STI, and HIV. Pre-teenage CSA was associated with alcohol use and depressive symptoms. Significant interactions across age of experience of CSA were found for alcohol problems, cannabis problems, and condomless anal sex partners. Consistent with previous literature, this analysis found CSA to be a significant influence on various health outcomes. No single explanatory framework emerged; however, adolescent exposures may be more closely linked to health outcomes and risk behaviors than pre-teenage or cumulative exposures.