Thirty adult women survivors of childhood sexual abuse who believed they were functioning well were selected through advertisements in local newspapers and presentations at an incest-survivor support group. Subjects were assessed by a battery of structured diagnostic interviews and standardized psychological measures, including the MMPI, the Trauma Symptom Checklist-40, and the Dissociative Experiences Scale. The results showed the existence of a subgroup of survivors of childhood sexual abuse who do not have devastating long-term psychological effects. Better adult psychological functioning was predicted by certain characteristics of the abuse, the family system, and the survivors.
"Developmental correlates of childhood maltreatment include increased aggression, emotion dysregulation, anxiety, depression, and post-traumatic stress disorder (Cicchetti & Rogosch, 2001a; Kaufman et al., 1997; Paolucci, Genuis, & Violato, 2001; Shields & Cicchetti, 1998; Shipman & Zeman, 2001; Trickett & Schellenbach, 1998). Despite this substantial research connecting childhood maltreatment to negative outcomes, not all maltreated children develop subsequent psychopathology (Binder, McNiel, & Goldstone, 1996; Kendall-Tackett, Williams, & Finkelhor, 1993). This variability in outcome represents a considerable opportunity to gain understanding of specific risk and protective factors that may shape the development of psychopathology in maltreated populations. "
[Show abstract][Hide abstract] ABSTRACT: Recent literature has emphasized the simultaneous assessment of multiple physiological stress response systems in an effort to identify biobehavioral risk factors of psychopathology in maltreated populations. The current study assessed whether an asymmetrical stress response, marked by activation in one system and a blunted response in another system, predicted higher levels of psychopathology over time.
Data were collected from an ongoing, prospective study of females with a substantiated history of childhood sexual abuse (n=52) and a non-abused comparison group (n=77). Childhood sexual abuse was determined at the initial study visit. Vagal tone and cortisol were measured 7 years later to assess physiological response to a laboratory stressor across these systems. Depressive symptoms and antisocial behaviors were assessed 6 years after the completion of the laboratory stressor.
Structural equation modeling indicated that a prior history of childhood sexual abuse predicted an asymmetrical physiological response to stress in late adolescence. In turn, this asymmetrical response predicted both higher levels of depression and antisocial behaviors in young adulthood.
Childhood sexual abuse may sensitize females to respond to moderate daily stressors in a manner that places them at higher risk for experiencing depressive symptoms and antisocial behaviors over time.
The management of mild to moderate stress in the everyday lives of maltreated females may be a particularly useful point of intervention in order to protect against later psychopathology.
"Moreover, the format and brevity of the CTQ prohibit examination of particular experiences and/or facets of abuse that may be more likely to result in experiential avoidance. That is, the extent to which childhood abuse leads to later difficulties has been found to depend upon the nature of the abuse experience, such as the context in which the abuse occurs (Binder, NcNiel, & Goldstone, 1996; Bolger & Patterson, 2001), the age at which it occurs (Bolger & Patterson, 2001; Johnson, Pike, & Chard, 2001), the relationship of the perpetrator to the survivor (Binder et al., 1996; Dubo, Zanarini, Lewis, & Williams, 1997; Tremblay , Herbert, & Piche, 1999), and characteristics of the abuse itself, including severity (Merrill et al., 2001; Rodriguez, Ryan, Rowan, Foy & 1996), force (Binder et al., 1996), duration (Binder et al., 1996; Rodriguez et al., 1996), frequency of occurrence (Jasinski et al., 2000; Kinzl, Traweger, & Biebl, 1995), and resulting injury (Johnson et al., 2001). "
[Show abstract][Hide abstract] ABSTRACT: Despite the theorized centrality of experiential avoidance in abuse-related psychopathology, empirical examinations of the relationship between childhood abuse and experiential avoidance remain limited. The present study adds to the extant literature on this relationship, providing a laboratory-based investigation of the relationships between childhood sexual, physical, and emotional abuse, experiential avoidance (indexed as unwillingness to persist on 2 psychologically distressing laboratory tasks), and self-reported emotional nonacceptance among a sample of 76 inner-city treatment-seeking substance users. As hypothesized, results provide evidence for heightened experiential avoidance and emotional nonacceptance among individuals with moderate-severe sexual, physical, and emotional abuse (compared to individuals reporting none-low abuse). However, although emotional nonacceptance was associated with increased risk for experiential avoidance, it mediated the relationship between childhood abuse and experiential avoidance only for emotional abuse. As such, results suggest that one mechanism through which emotional abuse in particular leads to experiential avoidance is emotional nonacceptance. Findings suggest the utility of interventions aimed at decreasing experiential avoidance and promoting emotional acceptance among abused individuals.
"The relationship between PTSD and threats/force by the sexual offender is well documented (Binder et al., 1996; Briggs and Joyce, 1997; Epstein et al., 1997; Lucenko et al., 2000; Lynskey and Fergusson, 1997; Pribor and Dinwiddie, 1992; Ruggiero et al., 2000; Wolfe et al., 1994). The association between PTSD and abuse-related guilt (Andrews et al., 2000; Binder et al., 1996; Wolfe et al., 1994) and the relationship of the victim to the perpetrator (Binder et al., 1996; Lynskey and Fergusson, 1997; Pribor and Dinwiddie, 1992; Wolfe et al., 1994) is unclear. Even though our study and others (Epstein et al., 1997; Pribor and Dinwiddie, 1992) found no relationship between PTSD and specific forms of abuse, previous studies have suggested that the severity of the abuse (Lynskey and Fergusson, 1997; Wolfe et al., 1994), the number of forms of abuse (Epstein et al., 1997), the duration of abuse (Wolfe et al., 1994), the frequency of abuse (Ruggiero et al., 2000) and intercourse (Briggs and Joyce, 1997) are related to PTSD. "
[Show abstract][Hide abstract] ABSTRACT: The purpose of this study is to identify predictors of resilience and adult mental disorders in women with a history of childhood sexual abuse. This cross-sectional study was conducted in a family practice center using adult female (age 18-40) patients. Outcome measures assessed the prevalence of major depressive episode, panic disorder, agoraphobia, substance abuse, posttraumatic stress disorder, borderline personality disorder, bulimia, and suicidality. Seventy-six percent of the 90 women with sufficient data met criteria for at least one adult disorder. Mental health was related to high SES, lack of family alcohol abuse, lower frequency of first perpetrator abuse, and few perpetrators. Specifics of the abuse were associated with development of borderline personality disorder, substance abuse, major depressive episode, suicidality, bulimia, agoraphobia, and panic disorder. Maternal violence against the father, substance abuse within the household of origin, and maternal care and overprotection were also important. The specifics about the abuse and the family environment during childhood are important predictors of adult psychopathology.
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