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Background: PTSD symptoms are frequent in child victims of sexual abuse. Yet, authors have argued that early trauma could lead to alterations in development that go far beyond the primary symptoms of PTSD and have proposed Complex PTSD as an alternative diagnosis encompassing difficulties in affect regulation, relationships and self-concept. Objective: To delineate profiles in child victims of sexual abuse and explore whether profiles are associated with treatment response to Trauma-Focused Cognitive Behavioural Therapy. Method: Latent class analysis was used to identify symptom profiles at baseline assessment of 384 children ages 6 to 14, recruited in a Child Advocacy Centre following disclosure of sexual abuse. Dimensions of Complex PTSD diagnosis as proposed by the ICD-11 were derived from self-report questionnaires. Results: Latent class analysis identified a best fitting model of three classes: Classic PTSD regrouping 51% of children, Complex PTSD describing 23% of children, and Resilient describing 25% of children. Trauma-focused therapy was associated with a significant reduction of dissociation, internalizing, and externalizing problems for children of all three classes. Trauma-focused therapy was also linked to a significant reduction of PTSD symptoms with larger effect size (d = .90; 95%CI: 0.63–1.16) for children classified in the Complex PTSD class. Conclusion: These findings highlight the utility of a person-oriented approach to enhance our understanding of the diversity of profiles in child victims. The results offer empirical support for the ICD-11 PTSD and Complex PTSD distinction in a clinical sample of sexually abused children and the relevance of this distinction in foreseeing treatment outcomes.

Objective: The present study aimed to determine whether psychiatric comorbidity (i.e., diagnostic comorbidity in eight categories of mental and behavioral disorders) mediates the relationship between childhood sexual abuse (CSA) and diseases of the genitourinary system (International Statistical Classification of Diseases and Related Health Problems, 10th revision) among girls. Method: Using a prospective matched-cohort design, we documented diagnoses given by a physician after a medical consultation or hospitalization for diseases of the genitourinary system, for 661 sexually abused girls and 661 matched controls via administrative databases covering the period between January 1996 and March 2013. Path analyses using negative binomial regressions with CSA as independent variable, psychiatric comorbidity as mediator and genitourinary diseases diagnoses as dependent variables were performed. Results: After controlling for socioeconomic level, prior genitourinary diseases and number of years of medical data, the mediation effect for the path from CSA to genitourinary diseases through psychiatric comorbidity was significant for the urinary system (b = .125, 95% confidence interval [0.057, 0.192]) as well as for the genital system (b = .213, 95% confidence interval [0.141, 0.285]). Psychiatric comorbidity carried 62% of the sexual abuse total effect on the number of diagnoses received for genital diseases, whereas it carried 23% of the sexual abuse total effect on the number of diagnoses received for urinary diseases. Conclusions: Findings suggest that CSA may have an indirect effect on girls' diagnosed genitourinary diseases during a medical consultation or hospitalization through the increased risk for psychiatric comorbidity. Early interventions aimed at addressing psychological distress among sexually abused girls might prevent the emergence of genitourinary diseases years after the abuse. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Dating violence (DV) among youth is widespread and is now established as a significant public health problem. Yet, few studies have assessed DV experiences among youth with same-gender or multi-gender dating partners, and most failed to consider bidirectional DV. We analyzed self-reported dyadic concordance types (DCTs) among 295 youths (52% girls) who dated same-gender and multi-gender partners in the last 12 months using an adapted version of the Conflict in Adolescent Dating Relationships Inventory. Youths were classified in one of three DCTs: self-only (unidirectional perpetration of DV by the participant), partner-only (unidirectional victimization perpetrated by their partner) or both (bidirectional DV, where partners are both perpetrators and victims of DV). Overall prevalence rates of DV among sexual minority youths (SMYs) range from 11.5% for threats, to 51.2% for psychological violence, with physical and sexual violence reported by about one-fourth of participants. The both DCT was the most common pattern for psychological (59.6%) and physical (50.6%) DV across gender, while most threatening behaviors were reported as perpetrated by the partner only (47.1%). Girls were more likely to report sexual DV as partner-only perpetrated (63.6%), whereas boys reported higher rates of both (44.2%) and self-only (34.9%) perpetrated sexual violence. Because healthy intimate relationships can play a supportive and positive role in transitioning toward adulthood, it is crucial that DV prevention becomes more inclusive of sexual and gender diversity.

Attachment theory provides important insight regarding the etiology of teen dating violence perpetration (TDV-P). Attachment insecurities have been associated with TDV-P, but the mechanisms underlying this association remain unclear. Furthermore, as of now, studies have failed to explore whether the relation between attachment insecurities and TDV-P varied according to its forms (i.e., psychological, physical or sexual) or to the perpetrator’s gender. This study aimed to investigate if emotion dysregulation mediates the association between attachment insecurities and different forms of TDV-P among girls and boys. Adolescents ( Mage = 16 years; n = 3,214; 60% girls) were recruited from a one-stage stratified cluster sample of 34 high schools in Quebec, Canada. Path analyses with probit regression models were conducted separately for girls and boys. Attachment anxiety and avoidance were associated with more emotion dysregulation. Emotion dysregulation was, in turn, associated with higher probabilities of physical TDV-P in girls and psychological TDV-P in girls and boys. Surprisingly, emotion dysregulation was not associated with sexual TDV-P. Attachment anxiety remained directly related to higher probabilities of perpetrating all forms of TDV. These findings support the hypotheses set forth by attachment theory and highlight the utility of this theory to understand and potentially prevent TDV-P. Practitioners should more specifically address adolescents’ attachment anxiety, as it seems more related to TDV-P. Finally, this study underscores the necessity of considering gender and specific forms of TDV-P to understand the association between attachment insecurities, emotion dysregulation, and TDV-P.

Victims of child sexual abuse (CSA) are likely to show a wide range of adaptation difficulties. In addition, some children and their families are involved in legal proceedings following the child’s disclosure. However, little is known about the effects of legal involvement on CSA victim’s mental health and recovery. In this longitudinal study, the effects of testifying were examined in a sample of 344 children at initial assessment (67% of girls) receiving services in a Child Advocacy Centre, of which 130 children testified. The participants’ age ranged from 6 to 14 years old (M = 9.42 SD = 2.14). Children and their parents completed a series of measures to evaluate the child’s mental health (e.g. depression, anxiety, PTSD) at four points in time over a 2-year period. Multilevel analysis indicates that all the children showed significant improvement over time but the group who testified more than once shows higher levels of emotional distress 2 years after the initial assessment. This study highlights the importance of documenting the experience of CSA victims in the justice system in order to establish the adequate conditions to support child witnesses.

Le but de l’article est de presenter les resultats d’un consortium d’experts designes par le Centre d’expertise Marie-Vincent. Le mandat du consortium etait d’evaluer l’etat des connaissances sur l...

Objective Prior studies have documented the potential role of nonoffending parent support in promoting recovery of adult survivors following sexual abuse (SA). However, few studies have distinguished the maternal and paternal role and the mechanisms by which quality of the parent-child relationship might foster more positive outcomes in child victims. The purpose of this study was to examine coping strategies as mediators of the link between mother-child and father-child relationship and outcomes following child SA. Method A sample of 505 children (339 girls and 166 boys) ages 6-13 years completed measures evaluating perceived attachment security to mother and father (Kerns Security Scale; Kerns, Klepac, & Cole, 1996), as well as coping strategies related to the SA experienced (Self-Reported Coping Scale; Causey & Dubow, 1992). Outcomes evaluated were posttraumatic stress symptoms (PSS; Children's Impact of Traumatic Events Scale-II [CITES-II]; Wolfe, 2002) and self-esteem (Harter, 1985). Results Results indicated that, in girls, both attachment security to the mother and to the father are associated with lower PSS symptoms and higher self-esteem through a lesser use of avoidant coping. Avoidance coping mediated the link between attachment security to the mother and outcomes in boys. In addition, security in the relationship with the same-sex parent was associated with approach coping, which in turn was associated with both outcomes for girls and with PSS for boys. Conclusion Findings highlight the importance of involving both parents in interventions for sexually abused children as mothers and fathers appear to play different, yet complementary roles in sustaining children's recovery. (PsycINFO Database Record

In Haiti, as in several developing countries, the phenomenon of street children has become a major public health issue. These children are often victims of traumas and adverse life events. This article aimed to investigate traumas experienced by street children and their coping and resilience strategies used to deal with adversities in a logic of survival, relying on a mixed method approach. A group of 176 street children, aged 7–18 (n = 21 girls), recruited in Port-au-Prince, completed measures assessing PTSD, social support and resilience. Semi-structured interviews were conducted to document traumatic experiences, factors related to resilience and coping strategies. After performing statistical analyses to evaluate prevalence and predictors associated with PTSD, and level of social support satisfaction and resilience, qualitative analysis using a grounded theory approach was conducted. Results showed that street children experienced multiple traumas such as neglect, maltreatment, psychological, physical and sexual abuse. However, they also showed self-efficacy to face their traumatic experiences and few of them (less than 15%) obtained scores reaching clinical rates of PTSD, while a large majority presented a level of resilience between moderate to very high. A socio-ecological model of multiple traumas and a model of coping, survival and resilience strategies are conceptualized. Data provide a better understanding of the traumas experienced by street children, their coping and resilience strategies. Results underscore ways to develop practices to offer psychological support, social and vocational integration based on the real needs of these children, in a perspective of social justice.

According to the developmental psychopathology framework, adverse childhood experiences, including child sexual abuse (CSA), may alter the course of normal development in children. Attachment security has been identified as a protective factor against psychopathology and may thus play a critical role in predicting victims’ adaptation. The main objective of the present study was to investigate the mediating effect of attachment representations in the relation between CSA and behavior problems over a 1-year period. The sample consisted of 391 children (251 sexually abused) aged 3.5 to 6 years. The Attachment Story Completion Task and the Child Behavior Checklist were used. Disorganized attachment partially mediated the relation between CSA and children's internalizing and externalizing behavior problems 1 year following the initial assessment. This mediation effect was not found for ambivalent nor secure attachment dimensions. Child gender was found to moderate the association between CSA and disorganization, with larger effects of CSA among boys. These findings underscore the importance of considering attachment representations in treatment programs for preschool victims. Evidence-based practice focusing on trauma could be combined with an attachment-based intervention targeting the parent–child relationship. Moreover, interventions should be gender sensitive, as CSA appears to affect boys and girls differently.

The impact of child sexual abuse (CSA) disclosure on parents’ psychological health has been documented among samples of nonoffending parents. Much less is known about the parents’ physical health. ...

Considering the heightened risk of adults who have experienced childhood cumulative trauma (CCT) to suffer from depressive symptoms, the present study aimed to investigate mindfulness and dissociation as possible mechanisms implicated in this relationship. A total of 234 clients seeking psychotherapy for sexual and/or relational difficulties completed self-reported questionnaires as part of the evaluation phase within their treatment. The assessment tools evaluated the experience of childhood trauma, depressive symptoms, mindfulness levels, and dissociative symptoms. Results of structural equation modeling indicated that the link between CCT and depressive symptoms was fully mediated by both mindfulness and dissociation. In light of our results, it is recommended to assess systematically the presence of CCT, depressive symptoms, and dissociation in clients seeking help for sexual and/or relational issues, even though their primary motive may seem unrelated. Findings suggest that treatments focusing on fostering mindfulness might be beneficial in reducing depressive symptoms for individuals who experienced CCT.

Background Understanding factors influencing mental health of sexually abused teenagers is essential to orient treatment with this vulnerable population. The purpose of this study was to explore alexithymia as a mediator of the relationship between child sexual abuse and psychological distress using a representative sample of teenagers, while considering gender as a potential moderator. Methods Teenagers participating in the Quebec Youths’ Romantic Relationships Survey completed measures evaluating a history of child sexual abuse and alexithymia at baseline while psychological distress was evaluated 6 months later. Results A moderated mediated model revealed a partial mediation effect of alexithymia in the relationship between child sexual abuse and psychological distress. Gender acted as a moderator as the conditional indirect effects of child sexual abuse on mental health via alexithymia were stronger for boys. Conclusion Findings underscore the relevance of assessing and targeting sexually abused victims’ capacity to identify and communicate emotions to promote well-being.

Attachment theory provides a relevant framework for understanding the psychosocial adjustment of victims of child sexual abuse (CSA). However, most studies have been conducted among adult populations and none have focused on the impact of both preschoolers' and mothers' experience of sexual abuse on attachment security. The aim of this study was to compare attachment representations in sexually abused (n = 258) and non-abused preschoolers (n = 133), and to explore the relation between maternal history of CSA and children's attachment representations. A story completion task assessing attachment representations was administered to children (Bretherton, Ridgeway,Cassidy, 1990). The results revealed that CSA preschoolers presented significantly higher levels of attachment disorganization compared to non-abused children, and that abused boys were at particular risk for hyperactivation and disorganization. Associations between mothers' history of CSA and children's attachment representations were non-significant. These findings support the need to consider victims' attachment representations in the implementation of efficient treatment programs. Targeting parent-child relationships in interventions could help promote attachment security in a vulnerable population of preschool victims.

Cumulative maltreatment or exposure to multiple types of child abuse or neglect increases the risk of perpetrating and sustaining intimate partner violence (IPV) in adulthood and is associated with deficits in emotion regulation, which are considered as robust determinants of psychological IPV. Yet, no research has evaluated this relationship by distinguishing the cognitive and behavioral components of emotion dysregulation. Thus, the goal of the present study was to examine the mediating role of cognitive and behavioral emotion dysregulation in the relationship uniting cumulative childhood maltreatment and psychological IPV. A total of 162 adults consulting in sexology completed self-report questionnaires assessing their experiences of cumulative trauma, emotion dysregulation, and psychological IPV. The majority (86%) of participants experienced more than one type of childhood maltreatment, whereas half of them reported having perpetrated (51%) and sustained (54%) psychological IPV. Path analyses confirmed the mediational role of emotion dysregulation in the relationship between cumulative maltreatment experiences and psychological IPV. The hypothesized model was also invariant across gender. Results highlight the necessity to assess child maltreatment and IPV experiences thoroughly in individuals consulting for sexual or relational problems.

Cette evaluation porte sur les effets d’une formation dans le domaine de la violence sexuelle, destinee au personnel en milieu scolaire et developpee par un organisme communautaire specialise dans ce domaine. Les resultats indiquent que cette formation contribue a accroitre les connaissances, les attitudes favorables exemptes de prejuges vis-a-vis la violence sexuelle et le sentiment d’autoefficacite du personnel scolaire (n = 42) a court terme et 3 mois apres la formation. De plus, les participants et participantes rapportent une frequence considerable de situations dans lesquelles ils ont transfere les apprentissages dans leurs pratiques professionnelles.

Child maltreatment has been associated with sexual risk behaviors. Previous investigators have typically studied only one form of maltreatment, preventing them from exploring interrelations between forms of maltreatment and their impact on sexual risk behaviors. Thus, this study aims to examine the unique, cumulative, and interactive effects of four maltreatment forms (sexual abuse, physical abuse, neglect, and witnessing interparental violence) on sexual risk behaviors. The sample comprised 1940 sexually active adolescents (Mage=15.6; 60.8% girls) attending Quebec (Canada) high schools. Regression results showed that all maltreatment forms were associated with having a higher number of sexual partners, casual sexual behavior, and a younger age at first consensual intercourse. Physical abuse and witnessing interparental violence were associated with inconsistent condom use, and physical abuse was associated with sexually transmitted infections. After controlling for all forms of maltreatment (unique effects), analyses showed that sexual abuse, physical abuse, neglect or witnessing interparental violence remained statistically associated depending on the sexual risk behavior. A greater number of forms of maltreatment was associated with more sexual risk behaviors (cumulative effect). When sexual abuse was not experienced, neglect was associated with a higher number of sexual partners (interactive effects). In general, associations between maltreatment and sexual risk behaviors were similar for both genders. The magnitude of the relationship between a specific form of child maltreatment and sexual risk behaviors may be inaccurately estimated when not controlling for other forms of maltreatment.

Two independent studies were conducted to validate and assess the psychometric properties of the French-Canadian version of the Child and Adolescent Mindfulness Measure among samples of French and Indigenous youth. In study 1, 589 adolescents (60% girls) aged from 15 to 18 years from two urban high schools, and, in study 2, 311 (51% girls, 43% Indigenous) adolescents aged from 14 to 19 years from two rural high schools completed the Child and Adolescent Mindfulness Measure (CAMM) and other measures to assess its construct validity. An exploratory (study 1) and a confirmatory (study 2) factor analysis validated the single-factor solution. Results also indicate that the French-Canadian version of the CAMM had no floor or ceiling effects, as well as an adequate internal consistency and 2-week and 3-month test-retest reliability. The construct validity of the scale was supported by positive correlations with measures of self-esteem, resilience, and empowerment, and by negative correlations with psychological symptoms and family violence and difficulties. Child sexual abuse was also related to lower levels of mindfulness. Overall, results suggest that the CAMM may be a useful and appropriate tool to globally assess mindfulness among youth. Data also support the cross-cultural application of this scale among Indigenous adolescents.

Dating violence (DV) is a widespread social issue that has numerous deleterious repercussions on youths’ health. Family and peer risk factors for DV have been widely studied, but with inconsistent methodologies, which complicates global comprehension of the phenomenon. Protective factors, although understudied, constitutes a promising line of research for prevention. To date, there is no comprehensive quantitative review attempting to summarize knowledge on both family and peer factors that increase or decrease the risk for adolescents and emerging adults DV victimization. The current meta-analysis draws on 87 studies with a total sample of 278,712 adolescents and young adults to examine effect sizes of the association between various family and peer correlates of DV victimization. Results suggest small, significant effect sizes for all the family (various forms of child maltreatment, parental support, and parental monitoring) and peer factors (peer victimization, sexual harassment, affiliation with deviant peers, and supportive/prosocial peers) in the prediction of DV. With few exceptions, forms of DV (psychological, physical, and sexual), gender, and age did not moderate the strength of these associations. In addition, no difference was found between the magnitude of family and peer factors’ effect sizes, suggesting that these determinants are equally important in predicting DV. The current results provide future directions for examining relations between risk and protective factors for DV and indicate that both peers and family should be part of the development of efficient prevention options.

Objectives The aim of the present study was to explore sleep problems in sexually abused preschoolers over a year. Methods The sample consisted of 224 abused children and 83 nonabused children aged 3 to 6 years old at enrolment into the study (T1), and 85 abused children and 73 nonabused children at the second evaluation, approximately 1 year later (T2). Sleep problems were assessed using parental reports on the Child Behavior Checklist - Preschool Version. Results Multivariate analysis of covariance revealed that sexually abused preschoolers presented higher scores of sleep problems than nonabused children on all items related to sleep problems at T1. Results from a regression analysis revealed that sexual abuse remained associated with higher levels of sleep problems after controlling for sociodemographical variables. At T2, abused preschoolers still presented more sleep problems than nonabused children on all but one of the sleep items. Results from a repeated measure one-way analysis of covariance revealed that abused preschoolers presented higher total sleep scores at both measurement times. Time was not associated with levels of sleep problems and sleep problems did not evolve differently for abused and nonabused children. Conclusions Sexually abused preschoolers are at risk of presenting with sleep problems. These results are worrisome given the negative impacts of sleep problems on child development. Research and clinical implications are discussed.

Introduction : L’agression sexuelle durant l’enfance est associée à de nombreux problèmes de santé physique et mentale. Toutefois, au Québec, nous ne connaissons pas bien les problèmes de santé physique et mentale que présentent les enfants et les adolescents ayant vécu une agression sexuelle corroborée en comparaison de ceux de la population générale. Objectif : L’objectif de la présente étude est donc de déterminer si les jeunes agressés sexuellement consultent ou sont davantage hospitalisés pour des problèmes de santé physique et mentale que ceux de la population générale sur une période de 10 ans après un premier signalement. Méthode : Des données administratives ont servi à documenter les diagnostics médicaux de 882 jeunes (75 % filles) ayant au moins un signalement fondé d’agression sexuelle entre le 1er janvier 2001 et le 31 décembre 2010 au Centre jeunesse de Québec-Institut universitaire. Ces diagnostics sont comparés à ceux de 882 jeunes de la population générale appariés en genre et en âge au groupe de jeunes agressés sexuellement. Résultats : Les résultats indiquent que l’agression sexuelle à l’enfance entraîne un risque jusqu’à cinq fois plus élevé de consultations externes et d’hospitalisations pour des problèmes de santé mentale et physique, et ce, jusqu’à 10 ans après le signalement d’agression sexuelle., Childhood sexual abuse is associated with many physical and mental health problems. However, it is not clear how the physical and mental health problems of children and adolescents in Quebec who experienced sexual abuse compare to those of the general population. The objective of the current study is to determine if, in Quebec, sexually abused youth consult about or are hospitalized for physical and mental health problems more often than those in the general population over the 10-year period following a first report. Administrative databases were used to document the medical diagnoses of 882 children and adolescents (75 % girls) who had at least one substantiated report of sexual abuse between January 1, 2001, and December 31, 2010, at the Centre jeunesse de Québec – Institut universitaire. Their diagnoses are compared to those of 882 youth from the general population paired according to gender and age. The results reveal that childhood sexual abuse entails a five-fold increased risk of outpatient medical consultation and hospitalization, for both mental and physical health problems, up to 10 years after the substantiated report of sexual abuse., La agresión sexual durante la infancia está asociada a numerosos problemas de salud física y mental. Sin embargo, en Quebec, no conocemos bien los problemas de salud física y mental que presentan los niños y adolescentes que padecieron una agresión sexual corroborada, en comparación con aquéllos de la población general. El objetivo del presente estudio consiste pues en determinar si los jóvenes agredidos sexualmente consultan, o son hospitalizados en mayor medida, por problemas de salud física y mental que aquéllos de la población general, durante un período de 10 años después de una primera denuncia. Los datos administrativos han servido para documentar los diagnósticos médicos de 882 jóvenes (75 % de niñas) que poseen, al menos, una denuncia fundada de agresión sexual entre el 1 de enero de 2001 y el 30 de diciembre de 2010 señalada al Centre jeunesse de Québec-Institut universitaire. Dichos diagnósticos son comparados con los de 882 jóvenes de la población general, emparejados en términos de género y edad con el grupo de jóvenes agredidos sexualmente. Los resultados indican que la agresión sexual durante la infancia conlleva un riesgo de hasta cinco veces mayor de consultaciones externas y de hospitalizaciones por problemas de salud mental y física, y esto hasta 10 años después de la denuncia de agresión sexual.

Previous research has shown an association between child maltreatment (sexual abuse, physical abuse, neglect or witnessing interparental violence) and adolescent sexual risk behaviors. The mechanisms explaining this association are not well understood but attachment theory could provide further insight into them. This study examined the relationships between child maltreatment and sexual risk behaviors and investigated anxious and avoidant attachment as mediators. The sample comprised 1,900 sexually active adolescents (13 to 17 years old; 60.8% girls) attending Quebec high schools. The results of path analyses indicated that neglect was associated with a higher number of sexual partners, casual sexual behavior, and being younger at first intercourse. Anxious attachment mediated the relation between neglect and number of sexual partners, whereas avoidant attachment explained the relation between neglect and number of sexual partners, casual sexual behavior, and age at first intercourse (for boys only). Sexual abuse was directly associated with all three sexual risk behaviors. Neither anxious attachment nor avoidant attachment mediated these associations. Youth with a history of neglect and sexual abuse represent a vulnerable population that is likely to engage in sexual risk behaviors. Interventions designed to induce a positive change in attachment security may reduce sexual risk behaviors among victims of neglect.

Adolescence to young adulthood is a prolonged developmental period of growth and emergence into adult roles and independent living. A central milestone is the establishment of close relationships and sexual engagement. Adverse childhood experiences (ACEs)—in particular, the childhood maltreatment ones—are risk factors that, in the context of intimate relationships, may not function as conduits of resilience but, rather, place youth in familiar victimization contexts, as seen in sexual violence victimization and perpetration and nonoptimal sexual decision making. In particular, the sexual violence impacts need to be considered uniquely by gender, as females tend to be more common victims while male victimization may be experienced with greater violence and stigma due to prevailing masculine social norms.

Worldwide, it is estimated that one in five women have reported being sexually victimized before the age of 18. Girls are particularly at risk of sexual abuse at the end of adolescence and are more vulnerable to revictimization during this period. However, there is a paucity of findings related to the relational and sexual impacts of child sexual abuse among young women. The traumagenic dynamics model, proposed by Finkelhor and Browne, postulates that the consequences of sexual abuse can be analyzed in light of four distinct dynamics: traumatic sexualization, betrayal, powerlessness, and stigmatization. Among the four postulated dynamics, betrayal appears to be a key element to gain insight on the relational challenges experienced by victims, as betrayal situations can recur in romantic relationships. The present study aimed to describe, from the point of view of young women victims of child sexual abuse, the issues related to betrayals in their relational and sexual experiences. Semi-structured interviews were conducted with 19 young women aged 18 to 25 years old who had reported sexual victimization. Two main conceptual categories emerged from the narratives of the participants: (a) relational situations that echo the betrayal dynamic and (b) strategies to cope with relational situations involving betrayal: protection, reparation, and the use of both strategies, which leads to ambivalence. Findings highlight the importance of addressing the traumagenic dynamic of betrayal in interventions with sexually abuse youths, given their likelihood to experience betrayal in the context of romantic relationships and their increased risk of revictimization.

Depressive symptoms, posttraumatic stress disorder, and suicidal ideation are among the most prevalent problems associated with sexual abuse. Based on the Traumagenic dynamic of stigmatization model, the aim of this study was to investigate whether self-blame, shame, and maladaptive coping strategies predicted posttraumatic stress disorder, depressive symptoms, and suicidal ideation among sexually abused adolescent girls using a longitudinal design. A total of 100 adolescent girls completed a series of questionnaires at the initial visit at the intervention center (T1) and 6 months later (T2). Path analysis reveals shame at T1 predicted posttraumatic stress disorder symptoms at T2 whereas self-blame at T1 predicted depressive symptoms at T2. Furthermore, avoidance coping at T1 and depressive symptoms at T2 predicted suicidal ideation at T2 and accounted for 54% of the variance. These findings suggest that interventions designed for sexually abused adolescent girls should target shame, self-blame, and avoidance coping to foster recovery in this vulnerable population.

Child sexual abuse (CSA) during the preschool period can seriously undermine children's ability to develop emotional competency. Narrative tasks, such as the MacArthur Story Stem Battery (MSSB), are particularly adapted to gain a better understanding of young children's self-regulation processes. To explore the emotion regulation competencies of sexually abused preschoolers, we developed a coding grid and undertook a detailed analysis of abused and non-abused children's narratives using the MSSB. A sample of 62 sexually abused and 65 non-abused preschoolers 3½ to 6½ years old was recruited and children were presented with nine stories and an expressive vocabulary test. Analyses were performed to compare abused and non-abused children's narratives and to assess the contribution of CSA to children's narratives. CSA was associated with fewer demonstrations of empathy, help, and comfort, and less coherent and resolved stories. The narratives of CSA victims also included less emotions and emotional variations. The influence of CSA appeared the strongest in the stories involving fear. These findings suggest the presence of emotion dysregulation among sexually abused preschoolers, but also insecure attachment, and a sense of betrayal, isolation, and powerlessness.

Introduction While several studies involving adolescents have addressed issues related to romantic relationships and dating violence, there is a limited understanding of adolescent romantic relationship dynamics. Typological analyses have been useful to provide targeted interventions and to simplify our understanding of complex phenomena. Methods This study explored dynamics in adolescent romantic relationships, considering the interaction between romantic partner characteristics to identify dyadic profiles. A sample of 90 heterosexual dyads of Canadian adolescents (Mage = 18.44 years, SD = 1.47) completed a self-reported questionnaire. A hierarchical cluster analysis was conducted based on the dimensions of the Circumplex Model of Marital and Family Systems (i.e., cohesion, flexibility, and communication; Olson & Gorall, 2003). Results Analysis revealed four profiles of romantic relationship dynamics: 1) balanced dynamic (51.0% of the sample); 2) hampered dynamic (8.3%); 3) entangled dynamic (20.8%); and 4) rigid dynamic (13.5%). Taking into account the variations between and within dyads, results highlight the diversity of romantic experiences and offer a better understanding of the intricacies of different adolescent romantic relationship dynamics. Correlates indicated that the profiles can be distinguished by different personal and interpersonal characteristics. Conclusion This study emphasizes the importance of integrating a more person- and dyad-oriented framework in our understanding of adolescent romantic dynamics, since a unique approach to prevention and intervention may not address the needs of all adolescents. The results provided important insight into the identified profiles, guiding dating violence prevention efforts and programs and promoting harmonious and egalitarian romantic relationships.

Background The Canadian Hospitals Injury Reporting Prevention Program (CHIRPP) is a sentinel surveillance program that collects and analyzes data on injuries and poisonings of people presenting to emergency departments (EDs) at 11 pediatric and eight general hospitals (currently) across Canada. To date, CHIRPP is an understudied source of child maltreatment (CM) surveillance data. This study: (1) describes CM cases identified in the CHIRPP database between1997/98 to 2010/11; (2) assesses the level of CM case capture over the 14-year period and; (3) uses content analysis to identify additional information captured in text fields. Methods We reviewed cases of children under 16 whose injuries were reported as resulting from CM from 1997/98 to 2010/11. A time trend analysis of cases to assess capture was conducted and content analysis was applied to develop a codebook to assess information from text fields in CHIRPP. The frequency of types of CM and other variables identified from text fields were calculated. Finally, the frequency of types of CM were presented by age and gender. Results A total of 2200 CM cases were identified. There was a significant decrease in the capture of CM cases between 1999 and 2005. Physical abuse was the most prevalent type (57%), followed by sexual assault (31%), unspecified maltreatment (7%), injury as the result of exposure to family violence (3%) and neglect (2%). Text fields provided additional information including perpetrator characteristics, the use of drugs and/or alcohol during the injury event, information regarding the involvement of non-health care professionals, whether maltreatment occurred during a visitation period with a parent and, whether the child was removed from their home. Conclusions The findings from this initial study indicate that CHIRPP could be a complimentary source of CM data. As an injury surveillance system, physical abuse and sexual assault were better captured than other types of CM. Text field data provided unique information on a number of additional details surrounding the injury event, including risk factors.

Experiencing sexual violence is an important risk factor for trauma symptoms, and these symptoms significantly impair psychosocial functioning. Sexual and gender minority university students are more likely than their heterosexual and cisgender peers to experience sexual violence (e.g., sexual harassment, unwanted sexual contact, or sexual coercion) while attending university, but research on the consequences of these experiences is needed to inform service provision to these vulnerable populations. Using a large-scale study of university-based sexual violence in Quebec, the current study examined how gender and sexual minority status were associated with the severity of trauma symptoms among students who experienced sexual violence ( N = 1,196). Findings indicated that compared with their cisgender peers, gender minority students experienced significantly higher levels of trauma symptoms as a result of sexual violence, controlling for the severity of sexual violence behaviors experienced and other variables. Among cisgender women, but not cisgender men, sexual minority identity was also associated with higher levels of trauma symptoms, controlling for severity of sexual violence behaviors experienced and other variables. Furthermore, gender of perpetrator and amount of sexual violence moderated the associations between sexual identity and trauma symptoms among cisgender women. These findings not only suggest that gender minority and some sexual minority university students are more likely to experience sexual violence, but that they are also more likely to experience negative psychological sequelae as a consequence of these experiences. Ultimately, these findings may suggest the need for services that are more supportive of the specific needs of gender and sexual minority students with regard to sexual violence.

BACKGROUND: Child sexual abuse (CSA) is associated with high rates of psychological problems such as anxiety (Yansen et al, 2011). Yet, studies consistently highlight the diversity of outcomes of children confronted with CSA underscoring the need to identify factors influencing outcomes. One of the crucial intervening variables is related to coping strategies, with studies finding that relying on avoidant coping is associated with increased anxiety symptoms and a low self-esteem (Gauthier-Duchesne et al, 2017). In addition, some authors have proposed that parent-child attachment could act as a mediator in the relationship between CSA and internalized behavior problems in sexually abused preschoolers (Charest et al. 2018) OBJECTIVES: The present study aimed to explore the contribution of attachment security to the mother, self-esteem and coping strategies to the prediction of anxiety symptoms in children victims of CSA. DESIGN/METHODS: Children were recruited in five different settings offering services following disclosure of CSA. Anxiety symptoms were evaluated with the Revised Children’s Manifest Anxiety Scale (Reynolds & Bert, 2008), attachment security with the Kerns Security Scale (Kerns et al, 1996), self-esteem with the Self-Perception Profile for Children (Harter, 1985), and the coping strategies with the Self-Report Coping Style (Causey & Dubow, 1992). Hierarchical regression were used to test the contribution of coping strategies, attachment, and self-esteem in the prediction of anxiety symptoms. Age and gender were entered first and security attachment to the mother, self-esteem and coping strategies as a second step of the regression analysis. RESULTS: The sample consisted of 755 children victims of CSA (528 girls, 227 boys) aged 6 to 12 years old. 72.3% of cases involved intra-familial abuse. 59.9% of children described very severe abuse (penetration or attempted penetration) and 34.4% reported chronic abuse. Hierarchical regression showed that high attachment security to the mother (ß = -.102, p

OBJECTIVE: To explore the mechanisms through which early puberty is associated with psychological distress in women aged 18–25. This cross-sectional study aims to investigate whether body-related concerns and social interactions moderate or mediate this association. METHODS: Participants were compared on measures evaluating psychological distress, body image dysphoria, bulimic symptomatology and negative intimacy with best friend according to three pubertal timing groups: (1) “very early” puberty (menarche at 9 years old or less), (2) “early” puberty (menarche at 10 years old), and (3) “on-time” puberty (menarche between 11 and 13 years old). Forward stepwise multiple regressions and multiple mediation analysis were successively performed to see whether body-related concerns and peer interactions mediate or moderate the relationship between premature puberty and psychological distress. RESULTS: Controlling for age and ethnicity, results indicated (1) that women who began puberty “very early” had significantly higher levels of psychological distress than their “on-time” counterparts; (2) the association found between very early puberty and psychological distress was mediated by body image dysphoria and negative intimacy with best friend and was moderated by bulimic symptomatology. No mediational effect was found in women whose puberty was “early”. CONCLUSION: These findings highlight the importance of using more than one group of early pubertal timing and the role of body and intimacy concerns in the explanation of psychological distress in women. Intervention strategies addressing the increased risk of psychological distress in women who begin puberty very early should target their body image and ability to form intimate friendships.

Casual sexual relationships and experiences (CSREs) are still considered to be detrimental to the psychological well-being of youth even though findings remain inconclusive. Most studies have focused on emerging adulthood. Using a prospective design based on a representative sample of high school students in the province of Québec, we measured sexually active adolescents’ (N = 2,304) psychological well-being six months after engaging in these relationships while controlling for prior well-being. We analyzed two forms of CSREs, friends with benefits (FWB) and one-night stand (ONS) relationships, as well as levels of sexual intimacy. The results show that CSREs had a small impact (small effect sizes) on subsequent psychological well-being, especially among girls; FWB relationships involving penetrative contact increased girls’ psychological distress and both their alcohol and drug consumption. ONSs including sexual touching increased girls’ psychological distress and their drug use. None of the CSREs influenced boys’ psychological well-being. The findings underscored the importance of using caution when arguing that CSREs are detrimental or harmless to the psychological well-being of adolescents. The results also highlight the importance of taking into account gender and forms of CSREs in prevention and health interventions.

Child sexual abuse (CSA) is associated with a host of deleterious impacts, yet little is known about the short-term correlates in children. This study aimed to investigate the association between dissociation and sleep problems in a sample of preschool-age sexual abuse victims while controlling for potentially confounding variables, including gender, age, polytrauma, CSA characteristics, and parental distress.The sample consisted of 179 children (ages 3-6 years) and their non-offending parents. Parents completed questionnaires assessing their child's dissociative symptoms and sleep problems as well as their own level of psychological distress.Regression analyses revealed that sleep problems were significantly associated with dissociative symptoms over and above all other control variables (children's gender and age, polytrauma, and parental distress). A longer duration of sexual abuse also predicted greater dissociative symptoms in preschool children.Findings highlight the association between sleep problems and dissociation in preschool-age victims of CSA. Further research is needed to understand their impact on children's development to design appropriate treatment and prevention initiatives aimed at fostering resilience in young vulnerable children.

The goal of the current study was to explore the rates of medical consultation and hospitalizations of sexually abused boys. Specifically, to examine if sexually abused boys had higher rates of medical consultations and hospitalizations for physical and mental health problems than boys from the general population. Administrative databases were used to compare medical diagnoses of 222 boys with a substantiated sexual abuse report with those of 222 matched-controls. Results revealed that sexually abused boys were up to five times more likely than those from the general population to consult a physician for mental health problems. With regards to physical health problems, sexually abused boys were as likely as those from the general population to consult a physician, but up to 10 times more likely to be hospitalized.

Childhood sexual abuse or assault (CSA) is a non-specific risk factor for psychopathology such as post-traumatic stress disorder or depression. However, the impact of CSA greatly varies among individuals. Mediating mechanisms and moderating factors have been proposed to explain how the effects of CSA translate into varied symptoms. Mindfulness is one of the potential variables linked to the diversity of outcomes of CSA. As mindfulness-based interventions are increasingly being used among adolescents and those sexually abused or assaulted in childhood, it is essential to know more about the mechanisms by which it influences post-traumatic symptoms in these populations. This study’s aim is to assess whether mindfulness mediates and moderates the relationship between self-reported exposure to CSA and post-traumatic symptoms in adolescence. A sample of 246 adolescents (48 % female) reported their exposure to CSA and completed the Child Acceptance and Mindfulness Measure and the Trauma Symptoms Checklist for Children. The relation between CSA, mindfulness and post-traumatic symptoms was investigated using mediation and moderation regression models from the Process script. Results reveal that mindfulness acted as a mediator of post-traumatic symptoms, as CSA was associated with lower levels of mindfulness, which in turn were associated with more post-traumatic symptoms. On the other hand, mindfulness only acted as a moderator of CSA for anger and anxiety but not in the expected direction. Further investigation is needed to shed light on the moderator role of mindfulness in sexually abused youth.

BACKGROUND: Child sexual abuse is associated with adverse outcomes, including heightened vulnerability that may translate into risk of revictimization. The aims of the study were: (1) to explore the direct and indirect links between child sexual abuse and cyberbullying, bullying, and mental health problems and (2) to study maternal support as a potential protective factor. METHODS: Teenagers involved in the two first waves of the Quebec Youths' Romantic Relationships Survey (N = 8,194 and 6,780 at Wave I and II, respectively) completed measures assessing child sexual abuse and maternal support at Wave I. Cyberbullying, bullying, and mental health problems (self-esteem, psychological distress, and suicidal ideations) were evaluated 6 months later. RESULTS: Rates of cyberbullying in the past 6 months were twice as high in sexually abused teens compared to nonvictims both for girls (33.47 vs. 17.75%) and boys (29.62 vs. 13.29%). A moderated mediated model revealed a partial mediation effect of cyberbullying and bullying in the link between child sexual abuse and mental health. Maternal support acted as a protective factor as the conditional indirect effects of child sexual abuse on mental health via cyberbullying and bullying were reduced in cases of high maternal support. CONCLUSIONS: Results have significant relevance for prevention and intervention in highlighting the heightened vulnerability of victims of child sexual abuse to experience both bullying and cyberbullying. Maternal support may buffer the risk of developing mental health distress, suggesting that intervention programs for victimized youth may profit by fostering parent involvement.© 2016 Wiley Periodicals, Inc. Language: en

Sexually abused children present a host of psychological difficulties, including dissociation and post-traumatic stress (PTSD) symptoms. Negative repercussions associated with sexual abuse may interfere with children's ability to interact competently with their peers, and might put them at risk for peer victimization. The aims of the study were 1) to describe peer victimization experiences of sexually abused children using a multi-informant approach (self, parents, teachers), and 2) to examine if peer victimization experiences are associated with clinical levels of PTSD and dissociation after controlling for relevant variables.Participants were 158 children (104 girls and 54 boys; Mean age=9.10) and their non-offending parents consulting after the disclosure of sexual abuse. Children, parents, and teachers completed a measure assessing peer victimization (Self-Report Victimization Scale). Measures of trauma-related symptoms (PTSD and dissociation) were used as outcome variables.More than half (60%) of sexually abused children reported being picked on, 51% reported sustaining verbal victimization and a third (35%) physical victimization by peers in the school context. Inter-informant agreement was higher between parents and teachers than between self-reports and adults' reports. Peer victimization experiences increased the odds by up to three-fold for clinical levels of dissociation and PTSD symptoms.Our findings are based on cross-sectional data, and therefore, causal relationships cannot be inferred. No control group was included in the study.Results have significant relevance for prevention and intervention. Clinicians should include assessment of peer victimization experiences when evaluating sexually abused school-aged children. Prevention initiatives in terms of peer victimization could indirectly prevent worsening of symptoms in abused children.

Child sexual abuse (CSA) is associated with emotion regulation deficits in childhood. Parents play a crucial role in the development of emotion regulation in their children, especially at younger ages. Close to 50% of mothers of sexually abused children report having been sexually victimized themselves as children. They are consequently at risk of experiencing significant distress following the disclosure of sexual abuse of their child. Parents' distress could interfere with their ability to provide support and to foster development of emotion regulation in their children. The aim of the present study was to explore the relationship of parental factors (history of sexual victimization in childhood and the current level of distress) to sexually abused preschoolers' emotion regulation competencies. Emotion regulation was assessed in 153 preschoolers by their parents with the Emotion Regulation Checklist; 75 of these children were abused (14 boys); 78 were not abused (21 boys) and were part of a comparison group. Parents reported their level of distress using the Psychiatric Symptom Index. Results indicated that parental factors contributed to some dimensions of preschoolers' emotion regulation (namely displays of underregulation of emotion) above and beyond children's victimization status and gender (Cohen's ƒ(2) = .15). Identifying parental distress and history of sexual victimization as positively associated with emotional dysregulation in preschool children victims of CSA has important research and clinical implications.

Child maltreatment is known to be an etiological factor for developing alexithymia which refers to the difficulty to identify and express feelings. Yet, scarce data is available regarding the vulnerability in child victims of sexual abuse to develop alexithymia. The current study aimed to compare level of alexithymia among a sample of school-aged victims of child sexual abuse (CSA) and a comparison group of non-victimized children. Results also investigated the mediational role of alexithymia in the association between CSA and both internalized and externalized behavior problems. The sample involved 429 sexually abused and 98 non-abused children aged 6 to 12 years old and their parents. The Children's Alexithymia Measure (Way et al., 2010) and the Child Behavior Checklist (Achenbach and Rescorla, 2001) were completed by parents. Clinicians filled out an adapted version of the History of Victimization Form to assess CSA characteristics (Hebert and Cyr, 2010). Analyses revealed that victims of CSA presented significantly higher levels of alexithymia compared to their non-abused counterparts. Results also highlighted the role of alexithymia mediating the association between CSA and both internalized and externalized behavior problems. Focussing on alexithymia is a promising avenue to sustain resilience and prevent further difficulties in sexually abused children.

Background Despite burgeoning interest in the phenomenon of intergenerational continuity, literature concerning risk and protective factors in the context of child sexual abuse (CSA) is still underdeveloped. Objective Since the identification of such risk and protective factors is essential in order to break these negative cycles, the present study aimed to identify specific multilevel factors associated with the continuity of CSA in a large sample of mother–child dyads using secondary analysis of data. Participants and setting Mother-child dyads (n = 1,250) were divided into four groups: 1) CSA Both (mother and child are victims); 2) CSA Mother (only mothers are victims); 3) CSA Neither (mother and child are not victims); and 4) CSA Child (only children are victims). Methods Mothers completed a series of self-report measures assessing maternal characteristics (e.g., history of intimate partner victimization, psychological functioning), parenting and familial characteristics (e.g., cohesion, conflicts, empowerment), and demographic variables (e.g., early maternity, income, education). Results The four groups were compared using analyses of variance and chi-square analyses. Overall, mothers in the CSA Both group showed an increased number of risk factors compared to the mothers in the other three groups; however, mothers in the CSA Child group also presented with high levels of risk factors. Conclusions Findings suggest that practitioners should be attentive to the needs of the mothers of young CSA victims they are serving, since mothers involved in the cycle of intergenerational continuity appear to be particularly vulnerable and distressed.

Child sexual abuse (CSA) can severely affect the mental health of children and their parents. While correlates of recovery have been documented in children, factors exacerbating parents’ adaptation to their child’s unveiling of CSA deserves further attention. Parents’ history of abuse has been inconsistently identified as a predictor of their distress in reaction to their child’s abuse disclosure. This study proposes a mediation model that explores various processes underlying mother’s psychological distress (posttraumatic stress disorder [PTSD], dissociation, and their comorbidity) following their children’s unveiling of CSA. It investigates the influence of mother’s own CSA, as well as of her exposure to additional forms of past and current victimization, on her reaction to the child’s CSA disclosure, while considering coping mechanisms as mediators (avoidance, problem solving, search for social support, and feeling of guilt). Data were collected through self-report measures completed by 298 mothers of children who had recently disclosed CSA. Path analyses revealed that mother’s exposure to interparental violence as a child acted as a primary predictor of dissociation and of its comorbidity with PTSD, while a history of CSA was directly and exclusively linked to dissociation. Being exposed to recent partner violence was indirectly related to trauma symptoms, with coping mechanisms acting as mediators. This study outlines the relationship between mother’s psychological distress and her cumulative, past, and current exposure to various forms of victimization. Exposure to interparental violence as a child represents a particularly important factor for identifying mothers most in need of support, as it is a significant predictor of dissociation and of its comorbidity with PTSD.

The purpose of this study was to identify patterns of teen dating victimization among boys and girls and examine their association with family and peer contextual risk factors and injuries and mental health indicators. As part of the population-based Youths’ Romantic Relationships Project , 8 230 high school students were questioned about their victimization experiences. Latent class analysis was used to identify classes for both girls and boys. Latent class analysis identified a best fitting model of three classes for girls: Low victimization (61% of girls), Sexual and psychological violence (27%) and Multiple victimization (12%). Similarly for boys, three classes were identified including a Low victimization (84% of boys), a Multiple victimization (9%) and an Unwanted sexual contacts and psychological violence (7%). Associations between class membership and family and peer contextual risk factors and mental health indicators revealed more distinctive features among classes for girls than for boys. Confirming our hypothesis, both genders in the Multiple violence class reported experiencing the most injuries (e.g., bruise or cut, pain the next day or need of a medical appointment). A history of childhood interpersonal traumas was significantly related to classes of dating victimization, suggesting that different forms of child abuse (neglect, exposure to interparental violence, physical or sexual abuse) are associated with a heightened risk of revictimization in the context of their first romantic relationships. Our findings suggest that child sexual abuse may act as a specific vulnerability factor for more pervasive forms of TDV for girls. The findings highlight the utility of a person-oriented approach to enhance our understanding of the diversity of victimization experiences in the context of teen romantic relationships. Results also underscore the importance of tailoring prevention efforts to efficiently tackle teen dating violence and the relevance of trauma-informed practices.

The objective this study was to investigate the relative contributions of gender, common mental health symptoms, and experiences of interpersonal violence to the presence of sleep disturbances in Youth in Care under Child Welfare Society admitted to residential facilities.A sample of 315 teenagers (14-18 years old) completed a self-reported questionnaire upon admission, followed by a medical consultation with a nurse and a physician. Information regarding experiences of interpersonal violence, mental health symptoms, and sleep disturbances was collected using a standardized questionnaire.Anxiety, ADHD symptoms, and sexual abuse were associated with sleep disturbances, F(10, 264) = 5.95, p 0.001. Results from hierarchical regression analyses revealed that experiences of interpersonal violence, more specifically sexual abuse, were associated with sleep disturbances over and beyond gender and the presence of mental health symptoms.These results highlight practical implications for health professionals in terms of assessment and intervention for vulnerable youth exposed to interpersonal violence. Implications for research and practice are discussed.