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Frequent attenders in primary care (FAs) consume a disproportionate amount of healthcare resources and often have depression, anxiety, chronic health issues, and interpersonal problems. Despite extensive medical care, they remain dissatisfied with the care and report no improvement in quality of life. To pilot a Telephone-based Interpersonal Counseling intervention for Frequent Attenders (TIPC-FA) and assess its feasibility and efficacy in reducing symptoms and healthcare utilization. Top 10% of primary care visitors were randomly assigned to TIPC-FA, Telephone Supportive Contact (Support), or Treatment as Usual (TAU). TIPC-FA and Support groups received six telephone sessions over twelve weeks, while the TAU group was interviewed twice. Multilevel regression tested for changes over time, considering patient and counselor variance. TIPC-FA and Support groups demonstrated reduced depressive symptoms, and the TIPC-FA group showed decreased somatization and anxiety. The TIPC-FA group demonstrated a trend towards less healthcare utilization than the TAU group. This pilot study suggests that IPC via telephone outreach is a feasible approach to treating FAs, achieving a reduction in symptoms not seen in other groups. Promising reduction in healthcare utilization in the TIPC-FA group warrants further exploration in larger-scale trials. [ABSTRACT FROM AUTHOR]

In the present study we sought to shed light on the experience of adults who were sexually abused by females. Narratives in the current study were chosen from a large set of narratives (n = 505) that were submitted to the Israeli Independent Public Inquiry on CSA. Twenty-eight (n = 28) narratives of adults who experienced CSA committed by females were included in the study and analyzed using inductive thematic analysis. Two main themes were identified: (1) adults who as children experienced CSA committed by females, and (2) personal, interpersonal, and social constructions of the abuse. Most of the narratives included intrafamilial abuse, with half of the participants reporting that their mother was the one who committed the CSA, which often occurred during daily routine activities, with the main abuse scene being the shower/bathroom. Participants described various abuse experiences including the experience of powerlessness, "standing together," and captivity. Finally, participants discussed how social constructions of gender impacted how they understood and experienced the abuse. Child sexual abuse committed by females was described by the participants as having serious consequences for their lives. Participants shared how perceived gender roles and social scripts have an important role in casting doubt on the existence and reliability of CSA experiences committed by females. Findings from the current study help to identify key characteristics of sexual abuse that was conducted by females, and suggests social mechanisms that may help explain why perpetration by females is understood and treated differently than perpetration by males. [ABSTRACT FROM AUTHOR]

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Background The current study is based on the established association between child sexual abuse (CSA) and self-compassion, and CSA and sexual functioning, with an overall goal to better understand how self-compassion explains the association between CSA and sexual functioning. Aim The current study examined the role of self-compassion as a potential mediator, and relationship satisfaction as a potential moderator, in the association between CSA and sexual functioning among a nonclinical sample of men and women. Methods Participants completed an online survey assessing CSA, self-compassion, sexual functioning, and relationship satisfaction. The sample consisted of 914 individuals, of whom 582 reported currently being in a romantic relationship and were included in the current analysis. The majority of the sample was female (n = 534, 91.8%), with a mean age of 31.85 years (SD, 9.76). Outcomes Self-compassion mediated the link between CSA and sexual dysfunction, and relationship satisfaction moderated this same link. Results Results indicate that self-compassion mediated the association between CSA and sexual functioning. In addition, there was a significant 2-way interaction between CSA and intimate relationship satisfaction predicting sexual functioning. Specifically, CSA was negatively associated with sexual functioning only when there were low levels of relationship satisfaction, whereas in the presence of average and high intimate relationship satisfaction, the association between CSA and sexual functioning was nonsignificant. Clinical Implications Findings from the current study suggest that clinicians working with CSA survivors should take into account survivors' self-compassion and relational functioning when engaging in therapeutic work around their sexual dysfunction. Strengths and Limitations The study included a nonclinical sample of individuals and used self-report measures, which are highly subjective and increase the possibility of social desirability biases. Additional research should be conducted among clinical samples and among couples to explore this model from a dyadic perspective. Conclusion Our results highlight the importance of self-compassion and relationship satisfaction when considering sexual dysfunction following CSA. [ABSTRACT FROM AUTHOR]

Sexual-related post-traumatic stress symptoms (sexual-related PTSS) refers to the traumatic reactions that are replicated during sexual activity among survivors of child sexual abuse (CSA). However, the construct of sexual-related PTSS have been adapted from clinical work with survivors, and research with limited examination of the scales themselves. Given this gap, the current study offers the development of a new measure (PT-SEX) that examines sexual-related PTSS. The study was conducted online, among two convenience samples of women survivors of CSA (study 1 included 451 women and study 2 included 330 women). Six reliable PT-SEX factors emerged from Study 1: Dissociation during sex, intrusiveness during sex, shame and guilt in regard to sexual aspects, pleasing the other during sex, interpersonal distress, and hypervigilance during sex. Study 2 revealed survivors of CSA had significantly higher sexual-related PTSS levels as compared to participants without such a history. Also, post-traumatic stress disorder and sexual-related PTSS made unique and unshared contributions to the observed data, including sexual self-esteem, sexual motives, relationship satisfaction, compulsive sexual behavior, and mental health. CSA significantly moderated the associations between sexual-related PTSS and sexual self-esteem, sexual motivations of self-affirmation and coping, and depression and anxiety. Findings from the current study show that over time, the trauma of CSA seems to be implicated in survivors' sexual experience. As sexual difficulties are accompanied by sexual-related PTSS, these symptoms are unlikely to resolve by trauma-focused therapy and must be actively targeted in therapy. [ABSTRACT FROM AUTHOR]

Background: Despite a robust consensus regarding the potentially negative implications of childhood sexual abuse (CSA), research investigating risk and protective factors—particularly among well-functioning young adults—is scant. Dissociation is one of the major maladaptive outcomes of CSA. Nevertheless, CSA explains only about 10% of the variance of dissociation. Possibly, this modest effect size is due to protective factors moderating the relation between CSA and dissociative symptoms. One such factor may be the extent to which one has succeeded in developing a clear and coherent sense of who they are. Objective: We aimed to explore whether self-concept clarity (SCC) moderates the relationship between CSA and dissociation (Model 1), and an alternative hypothesis, whereby CSA may moderate the relationship between SCC and dissociation (Model 2). Participants and Setting: This was tested among 65 well-functioning young women drawn from an earlier study that intentionally oversampled CSA survivors. Methods: We included data from survivors of CSA by a known perpetrator (n = 35) and women with no sexual trauma (n = 30). Results: Findings were consistent with both Model 1 and Model 2, but only when depersonalization-derealization, namely detachment, was considered. Simple effects analyses revealed that CSA was related to depersonalization-derealization only under low SCC levels (Model 1), and SCC was negatively related to depersonalization-derealization only in the CSA group (Model 2). Conclusions: Findings suggest that SCC is a protective factor, buffering the association between CSA and detachment (depersonalization-derealization) symptoms. Clinical implications are discussed. [ABSTRACT FROM AUTHOR]

Childhood maltreatment (CM) has been associated with psychological symptoms (i.e., psychopathology) among clinical and nonclinical samples. The mechanisms underlying this link have been understudied, especially among well-functioning adults. Arguably, exposure to CM may be translated into negative and critical self-appraisals and self-blame, reflected in high self-criticism. CM may also result in difficulty in extending kindness towards oneself, that is, low self-compassion. These characteristics are linked with elevated psychopathology. Nevertheless, no study has yet tested the extent to which self-criticism and self-compassion may serve as independent mechanisms linking CM and psychopathology and whether in this context self-compassion buffers the link between self-criticism and psychopathology. Here, we tested an integrative model in which the relation between CM and psychopathology was mediated by self-compassion and self-criticism, and the path between self-criticism and psychopathology was moderated by self-compassion. A convenience sample of 914 individuals completed online self-report questionnaires. Results indicated that CM was related to psychopathology through the mediation of self-compassion and self-criticism, with a significant interaction between self-criticism and self-compassion. Showing a moderated-mediational effect, the link between self-criticism and psychopathology was weaker under high than under low levels of self-compassion. Our findings highlight the importance of self-compassion, a robust resilience factor related to reduced psychopathology and moderating the link between self-criticism, a potent transdiagnostic risk factor, and psychopathology in the context of CM. These results thus provide empirical evidence for the relevance of compassion and mindfulness in counseling settings, particularly with CM survivors, who are at greater risk for psychopathology. [ABSTRACT FROM AUTHOR]

Objective: This research explores the implications of father absence due to divorce on young adults' well‐being and romantic relationships. Background: Studies have demonstrated the negative implications of father absence, a common consequence of divorce, on children's development. However, previous research has not systematically compared complete versus partial father absence. Method: Young adults who, as children, experienced complete (n = 38) or partial (n = 41) father absence were compared with 40 participants in a father‐presence control group. Results: Compared with those in the control group, young adults in the partial father‐absence group reported higher psychopathology and maternal overprotection, and lower maternal care, romantic intimacy, commitment, and passion. Under elevated maternal care, the partial‐absence group reported lower dyadic adjustment and consolidated sense of identity. Participants in the complete‐absence group reported higher self‐criticism and maternal overprotection and lower maternal care than controls. Conclusion: Partial father absence might have particularly pernicious consequences for young adults' well‐being. Implications: Clinical and public policy implications are discussed. [ABSTRACT FROM AUTHOR]

Teaching staff have been especially vulnerable to experiencing psychopathology and compassion fatigue during COVID-19, given the significant demands they have experienced. Yet, research on risk and resilience factors is scant. We assessed the psychological status of Israeli teaching staff during COVID-19, focusing on psychopathology (depression, anxiety, somatization), compassion fatigue (burnout, secondary traumatic stress), and compassion satisfaction. We also examined the role of transdiagnostic risk and resilience factors-mentalizing, self-compassion, self-criticism, social support, and specialized trauma training-in predicting psychological status and mitigating the link between COVID-19-related distress and psychological status. An online questionnaire was completed by 350 teaching staff. Analyses included outlining the distributions of psychological status outcomes and running a series of moderation models using hierarchical robust regression. While 48% of the participants exhibited moderated-to-high levels of anxiety and 28.27% had no somatization, only 13% exhibited moderate-to-severe levels of depression; 60% had moderate levels of burnout, 48% had moderate levels of secondary traumatic stress, and 52% had low levels of compassion satisfaction. COVID-19-related distress, self-criticism, prementalizing modes, low socioeconomic status, and being in an intimate relationship emerged as key risk factors positively associated with psychological status, while self-compassion, general mentalizing, interest and curiosity about mental states, and social support were negatively linked with these outcomes. Teacher's mentalizing about students' mental states and social support moderated the link between COVID-19-related distress and psychological status. The findings highlight the importance of risk and resilience factors for assessing and preventing teaching staff's psychopathology and compassion fatigue during COVID-19. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Background: Ample studies have focused on the negative consequences of COVID-19 on mental well-being, but fewer have explored the specific role of childhood abuse and neglect in the context of risk and resilience during this unprecedented crisis., Objective: We aimed to identify distinct profiles of individuals based on their experiences of childhood abuse and neglect, coping strategies, and psycho-social transdiagnostic risk and protective factors, using a person-centered approach., Participants and Setting: A convenience sample of 914 Israelis completed self-report questionnaires during the second wave of COVID-19., Methods: Latent Profile Analysis was employed based on levels of childhood abuse and neglect, coping strategies, and established factors underpinning risk and resilience in mental health: dissociation, self-criticism, self-efficacy, self-compassion, attachment insecurity, psychological resilience, mentalizing, distress disclosure, psychopathology, and relationship satisfaction. Profiles were compared in COVID-19-related distress and well-being using ANOVAs., Results: A four-profile solution was found to be optimal for describing individuals with different profiles of risk and resilience: "risk" (5.1 %)-individuals with meaningfully high levels of childhood abuse and neglect and dissociation; "vulnerable" (14.2 %)-individuals high in risk factors and low in protective factors; "moderately resilient" (47.6 %)-those with moderate levels of protective and risk factors; "highly resilient" (33.1 %)-individuals high in protective factors and low in risk factors; groups differed in mental well-being and COVID-19-related distress., Conclusions: Results highlight the importance of childhood abuse and neglect in differentiating between the two distinct profiles of at-risk individuals. Implications for risk assessment and treatment in the context of potential traumatic stress are discussed., Competing Interests: Declaration of competing interest The authors have no conflict of interest to disclose., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Childhood sexual abuse (CSA) is a significant risk factor with consistently demonstrated negative implications for satisfaction with adult romantic relationships. Yet, research on risk and protective factors in this context is scarce, particularly among well-functioning adults., Objective: Addressing this gap, the present study focused on the potential mediating and moderating roles of mentalizing or reflective functioning, i.e., the capacity to understand oneself and others in terms of intentional mental states. We investigated whether impairments in mentalizing underlie the association between CSA and relationship satisfaction and whether robust mentalizing can buffer the CSA-relationship satisfaction link., Method: A sample of 667 individuals engaged in a meaningful romantic relationship was drawn from a larger sample obtained in an online convenience survey. A mediation and moderation model was examined using PROCESS., Results: The results confirmed our integrative model-the association between CSA and satisfaction with romantic relationships was mediated by impairments in mentalizing (uncertainty about mental states) and was simultaneously moderated by robust mentalizing (certainty about mental states). These effects were shown even when controlling for age, gender, education, and psychopathological symptoms., Conclusions: These findings highlight the importance of mentalizing, a key transdiagnostic factor. Reduced mentalizing is a risk factor for harmful impact of CSA on romantic relationships, while greater mentalizing abilities can be a significant resilience factor protecting CSA survivors. This study supports the potential contribution of mentalization-based interventions with survivors of CSA at risk for dissatisfaction with romantic relationships. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Background: Childhood maltreatment (CM) is a significant risk factor for intimate relationship and marital quality. However, there has been limited research exploring the underlying mechanisms of this link, with most studies focusing on individuals, while not considering the dyadic context and reciprocal influences within intimate relationships. Intimate relationships entail mutual processes, where each partner's abusive experiences can affect the partner's marital quality. In this study, we aimed to examine whether self-compassion is an underlying factor in the dyadic associations between CM and one's own and one's partner's marital quality., Method: A convenience sample of 115 heterosexual couples completed self-report questionnaires., Results: Utilizing an actor-partner interdependence model, we found partial support for our hypotheses, indicating that each partner's CM was indirectly associated with their own marital quality through their self-compassion. However, CM did not significantly impact their partner's marital quality through self-compassion., Conclusions: These findings contribute to the existing evidence supporting the mediating role of self-compassion as a transdiagnostic protective factor associated with increased marital quality for individuals with a history of CM. Nevertheless, the results suggest that this mediating effect may be specific to one's own marital quality and may not extend to the partner's marital quality. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

In the present study we sought to shed light on the experience of adults who were sexually abused by females. Narratives in the current study were chosen from a large set of narratives ( n = 505) that were submitted to the Israeli Independent Public Inquiry on CSA. Twenty-eight ( n = 28) narratives of adults who experienced CSA committed by females were included in the study and analyzed using inductive thematic analysis. Two main themes were identified: (1) adults who as children experienced CSA committed by females, and (2) personal, interpersonal, and social constructions of the abuse. Most of the narratives included intrafamilial abuse, with half of the participants reporting that their mother was the one who committed the CSA, which often occurred during daily routine activities, with the main abuse scene being the shower/bathroom. Participants described various abuse experiences including the experience of powerlessness, "standing together," and captivity. Finally, participants discussed how social constructions of gender impacted how they understood and experienced the abuse. Child sexual abuse committed by females was described by the participants as having serious consequences for their lives. Participants shared how perceived gender roles and social scripts have an important role in casting doubt on the existence and reliability of CSA experiences committed by females. Findings from the current study help to identify key characteristics of sexual abuse that was conducted by females, and suggests social mechanisms that may help explain why perpetration by females is understood and treated differently than perpetration by males., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Studies have consistently demonstrated the negative impact of childhood sexual abuse (CSA) on intimate relationships. The majority of studies have focused on revictimization in at-risk or clinical samples, with very few addressing the impact of CSA on otherwise well-functioning adults and even fewer investigating the psychological mechanisms involved. To fill this gap, this study focuses on the effect of CSA on "normative" (nonviolent) romantic relationships in otherwise well-functioning young women, and the mediating role of personality dimension self-criticism and attachment in this regard. Specifically, we investigate whether self-criticism and attachment avoidance mediate the relationship between CSA and romantic relationship satisfaction, while also examining the potential reciprocal associations between these variables., Method: The hypothesized mediation model was examined in a 2-wave, 6-month, cross-lagged longitudinal design, using structural equation modeling. Participants were 59 well-functioning (psychologically, socially, occupationally) young women drawn from an earlier study that purposefully oversampled for CSA survivors. For the purpose of the current study, data from women who had been either sexually abused by a familiar perpetrator (n = 30) or had no history of sexual trauma (n = 29) were included., Results: Consistent with expectations, self-criticism mediated the association between CSA and romantic relationship satisfaction over time. In addition, a scarring effect of romantic relationship satisfaction on attachment avoidance was demonstrated., Conclusion: Findings suggest that CSA may lead to elevated levels of self-criticism, which in turn may be linked with reduced satisfaction in romantic relationships, setting in motion a vicious cycle involving relationship satisfaction and attachment avoidance. (PsycINFO Database Record, ((c) 2018 APA, all rights reserved).)

Objective: Despite growing recognition of the importance of childhood emotional maltreatment (CEM) on the development of psychopathology, very few studies have addressed its impact on adult romantic relationship functioning, particularly among otherwise relatively well-functioning individuals. In an attempt to further elucidate the mechanism underlying the negative impact of CEM on romantic relationships, we tested an integrative mediational model linking CEM to romantic relationships through the impact of CEM on the development of self-criticism and adult attachment. Recent work in this context suggests that while self-criticism concerns broad cognitive-affective schemas related to achievement and failure, attachment avoidance assesses the expression of these broad schemas in close relationships (Luyten & Blatt, 2011; Sibley & Overall, 2008, 2010)., Method: This hypothesized mediational model was examined in a sample of young adult undergraduates (N = 99, 85 female), using structural equation modeling., Results: The mediational model was in large part supported. Attachment avoidance, but not attachment anxiety, fully accounted for the mediating role of self-criticism in the relationship between CEM and romantic relationship satisfaction, even when controlling for the potential role of concurrent levels of posttraumatic stress disorder severity., Conclusions: Understanding the long-term psychological dynamics related to CEM and identifying mediating vulnerability factors-self-criticism and attachment avoidance-might have implications for both the assessment and treatment of individuals with a history of CEM, particularly as effective interventions to address self-criticism and attachment issues are available. (PsycINFO Database Record, ((c) 2016 APA, all rights reserved).)