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"Child Abuse - psychology"
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Understanding child neglect : biopsychosocial perspectives
\"This concise book reviews the various types of neglect in childhood, providing an operational definition that incorporates existing viewpoints. It describes risk factors for neglect to increase awareness for improved identification, prevention, and treatment of this pervasive problem. This is particularly important as neglect is a growing worldwide issue which receives less attention than more florid forms of abuse. The book aims to facilitate conceptualization and treatment of adult clients who have suffered neglect as well as treatment plans for at risk home environments.\"--Publisher's website.
Book
Cognitive Behavioral Therapy for Trauma and Self-Care (CBT-TSC) in Men Who have Sex with Men with a History of Childhood Sexual Abuse: A Randomized Controlled Trial
To address childhood sexual abuse (CSA) related distress and HIV risk in men who have sex with men (MSM) using cognitive-behavioral therapy for trauma and self-care (CBT-TSC), which is a novel intervention integrating HIV risk reduction with modified cognitive and behavioral therapy strategies for post-traumatic stress. We compared CBT-TSC to HIV voluntary counseling and testing (VCT)-only in an initial 2-arm RCT in 43 HIV-negative MSM at with a history of CSA and HIV risk. Serodiscordant condomless anal/vaginal sex (CAS; CAS with HIV-postive or HIV unknown status partners) and posttraumatic stress disorder (PTSD) symptoms (Davidson Trauma Scale: total score and avoidance, intrusions, hyperarousal subscales) were outcomes immediately post-treatment, and at 6- and 9-month follow-up. At post-treatment, CBT-TSC had decreased odds (approximately 60%) of any CAS and greater reductions in CAS compared to VCT-only. Additionally, the CBT-TSC condition experienced greater reductions in total PTSD and avoidance symptoms. At the follow-up visits, CBT-TSC condition had significant reductions in the odds of any CAS and reductions in CAS. However, for PTSD symptoms, only the avoidance subscale remained significantly different compared to VCT-only. CBT-TSC is a potentially efficacious approach to address HIV risk in MSM with a CSA history, with replication and extension in a larger trial needed. This proof-of-concept trial is the first to integrate the treatment of a commonly occurring mental-health syndemic problem in MSM with a health psychology approach to self-care in MSM.Trial Registration Clinicaltrials.gov NCT01266122
Journal Article
Fighting back : what an Olympic champion's story can teach us about recognizing and preventing child sexual abuse-- and helping kids recover
\"More than 75% of sexually victimized children know and trust their abuser--and two-time Olympic gold medalist Kayla Harrison was once among them. Kayla, now an impassioned advocate for children and teens, was abused by her judo coach from ages 12 to 16. Combining Kayla's powerful story with science-based information from two renowned therapists, this unique book provides critical guidance for parents and professionals. Learn how to spot the signs that a child or teen is being groomed, why kids stay silent about their trauma, how they struggle with self-blame and the brutal betrayal of a trusted authority figure, what steps caregivers should take when abuse is discovered, and exactly what kind of help victims need to recover. Kayla Harrison is a true fighter--share her inspiring journey.
\"-- Provided by publisher.
\"-- Provided by publisher.
Book
Phase-based treatment versus immediate trauma-focused treatment in patients with childhood trauma-related posttraumatic stress disorder: study protocol for a randomized controlled trial
Background
The treatment of posttraumatic stress disorder (PTSD) related to a history of sexual and/or physical abuse in childhood is the subject of international debate, with some favouring a phase-based approach as their preferred treatment, while others argue for immediate trauma-focused treatment. A history of (chronic) traumatisation during childhood has been linked to the development of distinct symptoms that are often labelled as symptoms of complex PTSD. Many therapists associate the presence of symptoms of complex PTSD with a less favourable treatment prognosis. The purpose of this study is to determine whether a phase-based approach is more effective than stand-alone trauma-focused therapy in individuals with PTSD and possible symptoms of complex PTSD resulting from a history of repeated sexual and/or physical abuse in childhood. An additional aim is to investigate moderators, predictors of treatment (non) response and drop-out.
Method
The sample consists of patients between 18 and 65 years old with a diagnosis of PTSD who report a history of repeated sexual and/or physical abuse in childhood (
N
= 122). Patients will be blindly allocated to either 16 sessions of eye movement desensitization and reprocessing (EMDR) therapy preceded by a stabilization phase (eight sessions of Skills Training in Affect and Interpersonal Regulation (STAIR)) or only 16 sessions of EMDR therapy. Assessments are carried out pre-treatment, after every eighth session, post-treatment, and at 3 and 6 months follow up. The main parameter will be the severity of PTSD symptoms (PTSD Symptoms Scale-Self Report). Secondary outcome variables are the presence of a PTSD diagnosis (Clinician-Administered PTSD Scale for DSM-5), severity of complex PTSD symptoms (Structured Interview for Disorders of Extreme Stress-Revised and symptoms-specific questionnaires), changes in symptoms of general psychopathology (Brief Symptom Inventory), and quality of life (Euroqol-5D). Health care consumption and productivity loss in patients will also be indexed.
Discussion
The study results may help to inform the ongoing debate about whether a phase-based approach has added value over immediate trauma-focused therapy in patients suffering from PTSD due to childhood abuse. Furthermore, the results will contribute to knowledge about the safety, efficacy, and cost-effectiveness of treatments in this target group.
Trial registration
Nederlands Trialregister,
NTR5991
. Registered on 23 august 2016.
http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5991
Journal Article
Mental imagery in adolescent PTSD patients after child abuse: a comparison with matched healthy controls
Background
Intrusive mental imagery (MI) plays a crucial role in the maintenance of posttraumatic stress disorder (PTSD) in adults. Evidence on the characteristics of MI in adolescents suffering from PTSD is sparse. The aim of this study was to thoroughly assess MI in an adolescent sample suffering from PTSD after the experience of childhood sexual abuse and/or childhood physical abuse (CA).
Methods
Thirty-two adolescents with a primary diagnosis of PTSD after CA and 32 adolescents without any mental disorder and without a history of CA, matched for age and gender, completed questionnaires assessing the characteristics of negative and positive MI, as well as images of injury and death that lead to positive emotions (ID-images).
Results
The PTSD group reported significantly more frequent, more vivid, more distressing and more strongly autobiographically linked negative MI compared to the control group. Although positive MI was highly present in both groups (PTSD: 65.6%; controls: 71.9%), no significant differences emerged between the two groups regarding the distinct characteristics of positive MI. The frequency of the ID-images did not significantly differ between the two groups (PTSD: 21.9%; controls: 9.4%), although the ID-images were more vivid in the PTSD group.
Discussion
Negative MI appears to be crucial in adolescent PTSD, whilst positive MI are unexpectedly common in both the PTSD and the control group. The role of positive MI as well as that of ID-images remain unclear. Specific interventions for changing negative MI that are tailored to the developmental challenges in adolescents with PTSD should be developed.
Trial registration
Some of the PTSD patients in this study were also part of a randomized controlled trial on Developmentally adapted Cognitive Processing Therapy (D-CPT). This trial was registered at the German Clinical Trial Registry (GCTR),
DRKS00004787
, 18 March 2013.
Journal Article
Sexual and physical abuse in childhood is associated with depression and anxiety over the life course: systematic review and meta-analysis
Objectives
To determine whether depression and anxiety in adulthood are associated with abuse exposure in childhood.
Methods
A search of PUBMED, EMBASE and PSYCHINFO databases (2002–2012) was supplemented by hand searches of bibliographies of articles and reviews. We included studies contrasting abuse exposure vs. no-abuse exposure before age 16 years to depression and anxiety after age 16 years. Data on sample and exposure and outcome instruments, covariates and odds ratios (ORs) with the respective 95 % confidence intervals (CI) were extracted. Combined ORs and 95 % CI were calculated using random effects models. Heterogeneity was quantified using the
I
2
test.
Results
Inclusion criteria were met by 19 studies with 115,579 study participants, for assessing depression (
n
= 14) and anxiety (
n
= 13). The combined ORs for depression were 2.04 (95 % CI: 1.65–2.53) for sexual abuse and 1.49 (95 % CI: 1.29–1.72) for physical abuse. The combined ORs for anxiety were 2.52 (95 % CI: 2.12–2.98) for sexual abuse and 1.70 (95 % CI: 1.33–2.18) for physical abuse.
Conclusions
High levels of depression, anxiety and distress are reported in adults exposed to childhood sexual and physical abuse. These findings require increased awareness for the potential needs of adults exposed to child abuse and public health interventions to prevent child abuse.
Journal Article
Not that bad : dispatches from rape culture
\"In this ... anthology, ... Roxane Gay collects original and previously published pieces that address what it means to live in a world where women have to measure the harassment, violence, and aggression they face, and where they are 'routinely second-guessed, blown off, discredited, denigrated, besmirched, belittled, patronized, mocked, shamed, gaslit, insulted, bullied' for speaking out\"-- Provided by publisher.
Book
Reported Physical and Sexual Abuse in Childhood and Adult HIV Risk Behaviour in Three African Countries: Findings from Project Accept (HPTN-043)
Childhood sexual and physical abuse have been linked to adolescent and adult risky sexual behaviors, including early sexual debut, an increased number of sexual partners, unprotected sex, alcohol and drug use during sex and sexual violence. This paper explores these relationships among both men and women who report histories of childhood abuse from representative samples of communities in three countries in southern and eastern Africa (South Africa, Zimbabwe and Tanzania). Data were collected as part of a 3-year randomized community trial to rapidly increase knowledge of HIV status and to promote community responses through mobilisation, mobile testing, provision of same-day HIV test results and post-test support for HIV. The results indicate that reported childhood sexual and physical abuse is high in all three settings, also among men, and shows strong relationships with a range of sexual risk behaviors, including age at first sex (OR −0.6 (CI: −0.9, −0.4,
p
< 0.003)—among men, OR −0.7 (CI: −0.9, −0.5,
p
< 0.001)—among women), alcohol (OR 1.43 (CI: 1.22, 1.68,
p
< 0.001)—men, OR 1.83 (CI: 1.50, 2.24,
p
< 0.001)—women) and drug use (OR 1.65 (CI: 1.38, 1.97,
p
< 0.001)—men, OR 3.14 (CI: 1.95, 5.05,
p
< 0.001)—women) and two forms of partner violence—recent forced sex (OR 2.22 (CI: 1.66, 2.95,
p
< 0.001)—men, OR 2.76 (CI: 2.09, 3.64,
p
< 0.001)—women) and ever being hurt by a partner (OR 3.88 (CI: 2.84, 5.29,
p
< 0.001)—men, OR 3.06 (CI: 2.48, 3.76,
p
< 0.001)—women). Individuals abused in childhood comprise between 6 and 29 % of young adult men and women living in these African settings and constitute a population at high risk of HIV infection.
Journal Article