Sexual Abuse Research Articles

The evolution of ACEs: From coping behaviors to epigenetics as explanatory frameworks for the biology of adverse childhood experiences

Adverse childhood experiences (ACEs) have become a topic of public and scientific attention. ACEs denote a range of negative experiences in early life, from sexual abuse to emotional neglect, that are thought to impact health over the life course. The term was coined in the CDC-Kaiser ACE Study, an epidemiological study that surveyed 17,421 adults about ACEs and correlated the responses with participants’ current health records. Shortly after the study was published in 1998, the US CDC deemed ACEs an important public health target; however, it is only recently that ACEs feature prominently in scientific and public discourses. We contend that this rise in popularity is linked to the adoption of epigenetic explanations for how ACEs affect health. Based on a literature analysis, we trace the evolution of explanatory frameworks for ACEs—from coping behaviors to allostatic load to epigenetics—and analyze how each of these explanations not only reconsiders the mechanisms by which ACEs affect health, but also who should be held responsible for addressing ACEs and how. Epigenetics provides distinctly different discursive possibilities than previous frameworks: firstly, it offers one distinct molecular mechanism for how ACEs work, lending “molecular credibility” to epidemiological findings; secondly, it raises the possibility of reversing the negative effects of ACEs on the biological level. This epigenetic articulation makes ACEs attractive for new actors in science and society. Particularly, it facilitates novel interdisciplinary collaborations and attracts actors in health advocacy who are interested in non-deterministic readings of ACEs that counteract stigma and support positive health interventions and healing.

Fluctuating emotional states before and during child sexual abuse and rape: a file review analysis of males in mandated care in The Netherlands

Purpose The purpose of this study is to examine emotional states preceding and during sexual crimes in a Dutch sample of adult male patients who were admitted to mandated clinical care. Design/methodology/approach Emotional states preceding child sexual abuse (CSA) (n = 63) and rape against adults (n = 60) were compared using the Mode Observation Scale. Findings CSA and rape were equally preceded by feelings of vulnerability, undifferentiated anger and loneliness and characterised by callous unemotionality. Emotional manipulation was more dominant in the events leading up to CSA, whereas an exaggerated sense of self-worth was more dominant in the event preceding rape. Substance-related detachment was more common preceding rape but was equally common during both types of crimes. Controlled anger was more common in rape. Practical implications CSA and rape crimes are predominantly characterised by similar emotional states of persons who were admitted to mandated clinical care. This informs the development of more effective therapeutic interventions and support services tailored to the emotional profiles of patients, potentially improving rehabilitation or treatment outcomes. Scientifically, the results of this study provide a compelling foundation for further research into the psychological mechanisms underpinning sexual violence. Originality/value While previous research has often focused on these crimes in isolation, this study bridges a critical gap by examining the emotional commonalities between them. This study challenges the conventional understanding that treats these forms of sexual violence as entirely distinct, proposing instead that they may share underlying emotional dynamics.

The impact of childhood abuse on future military sexual assault and PTSD symptomology in Australian veterans.

The trauma most commonly associated with the military is combat-related trauma. It is increasingly recognised that childhood sexual and physical abuse and military sexual assault may influence or exacerbate posttraumatic stress disorder (PTSD) when military members are exposed to combat. The study aimed to determine whether a history of childhood sexual and physical abuse would increase the likelihood of military sexual assault (MSA) and determine whether a history of sexual abuse (childhood or military) impacted the incidence and severity of post-trauma sequelae compared to veterans without this history. A retrospective correlational analysis was performed on baseline data collected from clinical case records of a cohort of 134 Australian veterans with PTSD who had attended an outpatient Military Service Trauma Recovery Day Programme between October 2020 and May 2022. Almost half (48.5%) of veterans reported a history of abuse. Prevalence rates of military sexual abuse, child sexual abuse and child physical abuse were 14.9%, 13.4% and 23.1% respectively. The relationship between those who experienced childhood abuse and those who experienced military sexual abuse was not significant. No significant differences were observed between those who experienced any sexual abuse and those who did not on intake scores of psychological symptoms. This is the first Australian study to investigate the prevalence of childhood abuse and military sexual abuse and its impact on PTSD and associated psychopathology in a sample of veterans seeking mental health treatment. No additional risks of experiencing military sexual assault were found for those who had survived childhood sexual abuse.

THE COMORBIDITY OF DEPRESSION AND PTSD IN SEXUALLY ABUSED CHILDREN: A SYSTEMATIC REVIEW

<p><strong>Background and Purpose: </strong>In recent years, the incidence of child sexual abuse (CSA) has significantly increased, particularly among younger children. Such traumatic experiences can have profound and long-lasting effects on a child's mental health, often leading to an increased risk of developing disorders such as depression and post-traumatic stress disorder (PTSD). This study aims to investigate the comorbidity of depression and PTSD in children who have experienced sexual abuse. The primary objective is to examine whether these two disorders frequently coexist in children subjected to CSA.<strong> Method: </strong>This study follows the PRISMA 2020 guidelines and employs a systematic review methodology. No statistical analysis methods were utilized. The research sample also included adolescents, providing a broader understanding of the effects of CSA across different age groups.<strong> Results: </strong>The findings revealed a strong correlation between child sexual abuse and the comorbidity of depression and PTSD, indicating that children who have been sexually abused are at a heightened risk of developing both disorders simultaneously.<strong> Conclusion: </strong>Children who have experienced sexual abuse are highly likely to develop both depression and PTSD. However, further research is necessary to deepen our understanding of this comorbidity and to explore effective interventions.</p><p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0791/a.php" alt="Hit counter" /></p>

Prevalence of Adverse Childhood Experiences Among Adolescents.

Adverse childhood experiences (ACEs) are preventable, potentially traumatic events with lifelong negative impacts. Population-level data on ACEs among adolescents have historically relied on parent reports and excluded abuse-related ACEs. We present the self-reported prevalence of ACEs among a large population-based sample of US high school students. Using cross-sectional, state-representative data from 16 states that included core ACE questions on their 2021 Youth Risk Behavior Survey, we estimate the prevalence of 8 individual (lifetime emotional, physical, or sexual abuse, physical neglect, witnessed intimate partner violence, household substance use, household poor mental health, incarcerated parent or guardian) and cumulative ACEs (0, 1, 2-3, ≥4) among a large population-based sample of adolescents, overall and by demographic characteristics (sex, race and ethnicity, age, sexual orientation). Emotional abuse (65.8%), household poor mental health (36.1%), and physical abuse (32.5%) had the highest prevalence. ACEs were very common, with 80.5% of adolescents experiencing at least 1 ACE and 22.4% experiencing ≥4 ACEs. Experiencing ≥4 ACEs was highest among adolescents who were female (27.7%), non-Hispanic multiracial (33.7%), non-Hispanic American Indian or Alaska Native (27.1%), gay or lesbian (36.5%), bisexual (42.1%), or who described their sexual identity some other way or were not sure of their sexual identity (questioning) (36.5%). Self-reported ACE estimates among adolescents exceed previously published parent-reported estimates. ACEs are not equally distributed, with important differences in individual and cumulative ACEs by demographic characteristics. Collecting ACE data directly from adolescents at the state level provides actionable data for prevention and mitigation.

Adverse childhood experiences and dissociation among Italian public psychology service users

Different studies have provided evidence that adverse childhood experiences (ACEs) are associated with mental health problems as a function of racial and ethnic diversity. The aim of the present study was thus to study the association between ACEs and dissociation in a sample of Southern Italian public psychology service (PPS) users. A sample of 183 adults who requested psychotherapeutic treatment within an Italian PPS was recruited. ACEs were assessed via the Adverse Childhood Experiences Questionnaire (ACE-Q). Dissociative symptoms were assessed via the Dissociative Experiences Scale (DES-II) and the Somatoform Dissociation Questionnaire (SDQ-20). Dissociative syndromes were assessed via two scales of the Millon Clinical Multiaxial Inventory (MCMI-III): the Somatoform Syndrome (H) and the Post-Traumatic Stress Disorder Syndrome (R) scales. The most common types of ACEs in our sample were emotional neglect and emotional abuse. The number of ACEs showed a significant association with all the different measures of dissociation administered. Logistic regression analysis for the DES-II resulted in a solution made up of sexual abuse and parental separation or divorce. The regression analysis for the SDQ-20 resulted in a solution made up of emotional abuse, physical neglect, and parental separation or divorce. Sexual abuse positively predicted PTSD scale scores, while no solution was found for somatoform disorder. ACEs and dissociation were strongly associated in this study, but the nature of this association depended on the aspect of dissociation under investigation, particularly when we considered the distinction between dissociative symptoms versus syndromes. Cultural characteristics and clinical implications for public services are discussed.

Prevalence and social determinants of anxiety and depression among adults in Ghana systematic review

Abstract Background Anxiety and depression are major public health concerns, yet their prevalence and social determinants contributing to mental health disparities remain underexplored. This review, to our knowledge, is the first of its kind, aiming to examine the prevalence of anxiety and depression symptoms and disorders among adults in Ghana, along with social determinants associated with their occurrence. Methods A search of nine electronic databases and seven grey literature sources was conducted up to September 25, 2023. Two reviewers independently screened and appraised the studies. Forty-six studies were included. Prevalence estimates were pooled using a random-effects model. Subgroup analysis and meta-regression explored potential moderators. A narrative synthesis explored social determinants associated with anxiety and depression. Results Preliminary results showed a high prevalence of anxiety (43.7%, 95% CI: 35.6-54.4%) and depression (37.8%, 95% CI; 32.5% to 46%), with regional variations. There were significant differences in the prevalence of anxiety and depression across chronic physical conditions and method of condition assessment. Meta-regression showed significant association between average age and anxiety prevalence. Social determinants associated with anxiety included being female, non-Christian, low income, self-employed, limited social support, and basic education, while that for depression included being young (< 25yr), low income, government employed, childhood physical and sexual abuse, gender-based violence and urban residence. Protective factors for both were male gender, strong social support and higher education. Conclusions Preliminary results indicate a high prevalence of anxiety and depression linked to social determinants. While methodological limitations exist (eg, study heterogeneity), findings highlight a need for evidence-based interventions targeting social determinants to reduce the burden of anxiety and depression among adults in Ghana. Key messages • Our review suggests addressing the social determinants of mental health, aligned with sustainable developmental goals, may reduce the burden of anxiety and depression. • While Ghana is working towards improving mental health via its revised 12year Mental Health Policy launched in 2021, this review can facilitate planning and resource allocation for mental healthcare.

Equipping prospective teachers for culturally and religiously sensitive sexuality education: curriculum reviews at Islamic universities in Indonesia

ABSTRACT Sexuality education is essential for equipping children to prevent sexual abuse and fostering understanding of their bodies, relationships, and boundaries. Early childhood education programs in Indonesia were recommended to integrate sexuality education courses tailored to child development and sensitive to religious and cultural contexts. This research employed qualitative methods to investigate the integration of sexuality education courses at eight Islamic universities in Indonesia. Data were collected through interviews with eight course instructors and documentation of their Semester Learning Plans, using content and thematic analysis. Findings revealed that while two universities offered dedicated sexuality education courses, six integrated them into child development and parenting psychology courses. Dedicated sexuality education courses had more comprehensive learning objectives compared to integrated approaches. Teaching methods predominantly included lectures, paper presentations, with some incorporating field studies and project-based learning. Challenges included credit allocation impacting study durations, which hindered the integration of specialized courses like sexuality education. Enhancing pedagogy and ensuring effective delivery of sexuality education were identified as crucial tasks requiring the refinement of curricula in early childhood education. This approach would enable prospective educators to impart knowledge sensitively, taking into account children’s developmental stages and cultural-religious norms.

Harassment of interns, medical interns and residents: consequences and complaints

Abstract Introduction Workplace harassment manifests in various forms for healthcare students, potentially leading to modifications in their lives and academic activities. Objectives To describe the type of harassment experienced by interns, medical interns, and residents, and its consequences. Methods A cross-sectional and prospective study was conducted, including medical interns, social service interns, and residents from Veracruz who reported experiencing harassment in their assigned areas during their last academic year. Direct and virtual invitations were sent through various electronic means. Results 58 students were included, with 39 (67.2%) being women. 50% reported experiencing psychological abuse, and 65.5% reported experiencing sexual harassment. The most severe sexual harassment incidents included sexual assault with physical force (1.7%) and three instances of non-consensual sexual relations (5.2%), while the most common were sexual jokes/comments (72.4%). Following harassment experiences, 25% of participants reported feeling anxious, 22% stressed, and 17% angry. Students who perceived psychological abuse reported anger (69%), stress (58.6%), and anxiety (58.6%) as the most frequent consequences, while those reporting sexual abuse indicated anger (73.7%), shame (68.4%), and anxiety as primary consequences. The most frequently identified harassers were attending physicians (56.9%), senior students (34.5%), and non-medical personnel (34.5%). Students filed complaints with hospital authorities (6.9%), university authorities (6.9%), and external agencies (5.2%). The individual who experienced sexual assault with physical force did not file any complaint, while only one person reported non-consensual sexual relations to hospital authorities. Conclusions It is crucial to establish safe spaces for students within the hospital environment to promote their overall well-being and academic success, as well as to encourage a culture of reporting. Key messages • Highlighting the need for intervention within the work teams where our students are placed, promoting a violence-free environment. • Annexing a therapist as part of the work team could favor the well-being of students, since mental health is one of the main points affected within a violent environment.

Listening in Stereo and Communicating in Semaphore: Child Sexual Abuse Survivor-Led Strategies for Culture Change in the Catholic Church

This expository piece, focusing on a grassroots movement called LOUDfence to address child sexual abuse in religious settings, explores the ways in which the symbolic activity of tying ribbons to church fences offers an active and adaptable listening strategy for giving visibility and voice to survivors and survivor-allies. Working through signs, symbols, embodied actions, and ecclesial metaphors, it offers a methodology and mode for creative, trauma-informed, and lay-led cultural change in Catholic and Anglican church contexts.

Clinical and Sociodemographic Characteristics that May Affect Delays in Child Sexual Abuse Disclosures: Ten Years in Practice

Clinical and Sociodemographic Characteristics that May Affect Delays in Child Sexual Abuse Disclosures: Ten Years in Practice

Domestic Violence in India- Issues and Challenges

Domestic violence is violence or abusive behaviour which is used by one partner to control another partner in any relationship. Domestic violence can be physical, sexual, emotional, and psychological or any pattern. For example, it may take the form of sexual assault psychological abuse or verbal abuse to anyone. It affects people of all socioeconomic backgrounds and education levels. Domestic violence not only affects those who are abused, but also affects family members, friends, co-workers, other witnesses, and the community at large. According to the National Family Health Survey (NFHS), 2019-2021, 29.3% of married Indian women between the ages of 18 and 49 have experienced domestic or sexual violence in India. That is only the number of cases reported by women, there are frequently many more that never make it to the police. According to NFHS data, 87% of married women are victims of marital violence. The National Commission for Women said in 2020-21, it received 26,513 complaints from women, an increase of 25.09%, compared with the 20,309 complaints registered in 2019-20. The Indian legal system has formed Section 498A of the Indian Penal Code according to the Criminal Law (Second Amendment) Act, 1983 (46 of 1983), especially for dealing with domestic violence. 498A IPC states that “Husband or relative of husband of a woman subjecting her to cruelty. —Whoever, being the husband or the relative of the husband of a woman, subjects such woman to cruelty shall be punished with imprisonment for a term which may extend to three years and shall also be liable to a fine. Sec 498A IPC is cognizable, non-compoundable and non-bail able. Even though the law provides for the security of women, there is a big loophole; a lack of awareness among the victims, most of whom do not know that they have the option to approach the law. In this paper, the researchers have tried to explore the issue and challenges for stopping domestic violence in India.

How could you help me? Children's voices on violence in child welfare files: A thematic analysis

BackgroundA significant number of children experience violence, frequently from parents or other caregivers. Yet, many of these children lack access to community support, largely due to the challenges they face in disclosing abuse. Even when children do disclose abuse, it does not necessarily lead to their receiving the help needed. Recognizing children as epistemic subjects is essential both for ensuring their access to adequate support and for advancing knowledge about child abuse. ObjectiveThis study aimed to explore children's voices on violence in child welfare files to enhance our understanding of their experiences of violence. Participants and settingThe sample consisted of 120 children who provided abuse information in Swedish child welfare investigations into physical and sexual abuse. MethodData were collected from child welfare files and analyzed qualitatively using thematic analysis. ResultsSix themes were identified—acts of violence, emotions, context, disclosure, agency, and abuse dynamics—all of which informed the overarching theme: Children's voices highlight violence as a specific problem characterized by power and control dynamics that significantly impact their lives. ConclusionsThe collective findings indicate that mechanisms of violence extend beyond physical acts, emphasizing the need for Child Welfare Services (CWS) to recognize child abuse as a distinct issue characterized by dynamics of power and control. These dynamics significantly affect children's health and their capacity to assert their own interests. Failure to address these aspects risks underestimating the severity of the violence and impeding the provision of adequate support.

“One can’t Occur without the Other”: How Men Describe the Connection Between Healing from Childhood Sexual Abuse and Addiction Recovery

ABSTRACT The role that healing from childhood sexual abuse (CSA) plays in the context of substance use disorder (SUD) recovery is not well understood, particularly in male survivors. Building on interviews with 25 men and using grounded theory, this qualitative study explored the connection between healing from CSA and SUD recovery among male survivors. The findings reveal a cyclical nature in the connection between healing from CSA and addiction recovery, where sobriety enables healing and healing from CSA enables long-term recovery. This study highlights the importance of acknowledging and addressing sexual trauma in the treatment of SUD, particularly in male survivors.

Association of Childhood Abuse with Incident Inflammatory Bowel Disease.

A link between inflammatory bowel disease (IBD), stressful life events and psychological factors has previously been reported. Our objective was to examine the relationship between childhood emotional, physical, and sexual abuse and risk of IBD using a large cohort of female health professionals. We included participants in the Nurses' Health Study II who completed the Physical and Emotional Abuse Subscale of the Childhood Trauma Questionnaire and the Sexual Maltreatment Scale of the Parent-Child Conflict Tactics Scale in 2001. Diagnosis of IBD was determined by self-report and confirmed independently by two physicians through review of medical records. We used Cox proportional hazard modeling to estimate the risk of Crohn's disease (CD) and ulcerative colitis (UC) while adjusting for covariates. Among 68,167 women followed from 1989 until 2017, there were 146 incident cases of CD and 215 incident cases of UC. Compared to women with no history of abuse, the adjusted hazard ratios of CD were 1.16 (95% CI 0.67 - 2.02) for mild, 1.58 (95% CI 0.92 - 2.69) for moderate, and 1.95 (95% CI 1.22 - 3.10) for severe abuse (Ptrend = 0.002). We did not observe an association between childhood abuse and risk of UC. Women who reported early life severe abuse had an increased risk of CD. These data add to the growing body of evidence on the critical role of early life stressors in development of CD.

Exploring factors associated with domestic violence among pregnant women in Pakistan and its implications for maternal and perinatal health

ABSTRACT Domestic violence during pregnancy is a critical health issue due to its significant implications for both maternal and fetal well-being. Women in South Asian countries are particularly at a higher risk of experiencing domestic violence. The objective of this study was to identify factors associated with domestic violence among pregnant women attending tertiary care antenatal services in Pakistan. The secondary aim was to evaluate the impact of domestic violence on maternal and perinatal outcomes. The study participants were 681 pregnant women registered for antenatal care and delivery at a tertiary care hospital in Islamabad, Pakistan. Data were collected through in-person surveys and medical chart reviews. Associations between domestic violence and study variables were examined by logistic regression analysis. Among the study participants, 31.4%experienced some form of domestic violence during pregnancy, with psychological abuse (16.4%) being the most prevalent followed by sexual abuse (9.5%) and physical violence (1.8%). Women whose husbands were unemployed were three times more likely to experience domestic violence (aOR; 3.3, 95%CI: 1.6, 7.0). Similarly, husband’s substance abuse was significantly associated with domestic violence during pregnancy (aOR: 120.8, 95%CI: 57.9, 252.2). Domestic violence was a significant predictor of adverse maternal outcomes, including anemia, preterm labor, and recurrent abdominal pain. Similarly, domestic violence was a significant predictor of NICU admission (aOR: 20.6, 95%CI: 12.6, 33.8) and low birthweight (aOR: 24.4, 95%CI: 10.2, 58.4). The study findings emphasize the urgent need for comprehensive interventions targeting domestic violence among women and preventing its cascading effects on pregnancies.

Are emotions and psychophysiological states experienced when observing a child sexual abuse interview associated with confirmation bias in subsequent question formulation?

Are emotions and psychophysiological states experienced when observing a child sexual abuse interview associated with confirmation bias in subsequent question formulation?

Patterns of Adolescent Peer Affiliation among Youth At-Risk of Maltreatment

This study examined patterns of peer affiliations and their associations with child maltreatment, substance use, and future expectations. This study focused on 844 adolescents from the Longitudinal Studies of Child Abuse and Neglect. We identified four distinct peer-affiliation patterns: (1) no affiliation with peers who engage in either prosocial or deviant behaviors; (2) affiliation with peers using substances; (3) affiliation with peers who engage in severe deviant behaviors; and (4) affiliation with peers who engage in prosocial behaviors. Youth with sexual abuse experiences were more likely to be affiliated with peers who engage in severe deviant or prosocial behaviors. We also found different substance use and future expectations depending on peer affiliations. This study highlights the importance of examining both prosocial and deviant peer affiliations.

Multiple dimensions of immorality

ABSTRACT We conducted a four-part study to map out the conceptual space of a diverse set of immoral items, including those that are extreme and/or intergroup (e.g. child sex abuse, genocide, slavery), with the goal of identifying attributes spontaneously used in moral judgment. In Part 1, we identified 56 immoral items. In Part 2, participants completed a similarity-based card sort task of the 56 immoral items. Multidimensional scaling (MDS) indicated that three-dimensional space was needed to capture the perceived differences among the items. In Part 3, regression analysis indicated that perceived similarity among the immoral items related to their commonness, objectivity, forgivability, and legality. In Part 4, regression analysis indicated that the configuration of immoral items corresponded to the amount of anger and disgust the items elicited and items’ perceived harmfulness. We attempt to synthesize these results and answer questions about the roles of anger, disgust, and harm in moral judgment.

Association between Sexual Abuse Experience and Salivary Stress Biomarkers among Transgender and Gender Non-Conforming Individuals in Chennai – A Cross-Sectional Study

Introduction: Gender-nonconforming people undergo unimaginable sexual and physical abuse. This leads to stress and other stress-related disorders which can be easily determined by salivary stress biomarkers. Early life stress has an association with the immune system linked with stress. Transgenders and gender nonconforming people are prone to sexual abuse in early life more compared to normal people. This study aims to know about the association between sexual and physical abuse experience and salivary stress biomarkers in Transgender and gender-nonconforming individuals. Materials and Methods: This study was a cross-sectional epidemiological study. A snowball sampling design was adopted. The study was conducted in various places in Thozhi Shelter for Transgenders, Chetpet, Chennai among Gender non-conforming individuals and Transgenders. This study was conducted in April 2022. MDA and IL-6 levels were determined from their saliva using the passive drool method. Result: Interleukin L 6 and MDA levels were significantly higher in the GNC Group than in the control group. 63.64% of Transgender and gender non-conforming individuals experienced sexual abuse whereas 73% of them have experienced physical abuse in their lifetime. Conclusion: Transgender and gender non-conforming individuals who experienced physical/sexual abuse have increased IL 6 levels and decreased MDA levels in saliva when compared to the non-transgender individuals.