Penelope K. Trickett

A prospective investigation of the impact of childhood sexual abuse on the development of sexuality.

The sexual attitudes and activities of 77 sexually abused and 89 comparison women (mean age = 20.41, SD = 3.38) were assessed 10 years after disclosure in a longitudinal, prospective study of the long-term effects of childhood sexual abuse. Abused participants were more preoccupied with sex, younger at first voluntary intercourse, more likely to have been teen mothers, and endorsed lower birth controlefficacy than comparison participants. When psychological functioning earlier in development was examined, sexual preoccupation was predicted by anxiety, sexual aversion was predicted by childhood sexual behavior problems, and sexual ambivalence (simultaneous sexual preoccupation and sexual aversion) was predicted by pathological dissociation. Findings also indicate that biological father abuse may be associated with greater sexual aversion and sexual ambivalence.

The impact of sexual abuse on female development: Lessons from a multigenerational, longitudinal research study

This is a report on the research design and findings of a 23-year longitudinal study of the impact of intrafamilial sexual abuse on female development. The conceptual framework integrated concepts of psychological adjustment with theory regarding how psychobiological factors might impact development. Participants included 6- to 16-year-old females with substantiated sexual abuse and a demographically similar comparison group. A cross-sequential design was used and six assessments have taken place, with participants at median age 11 at the first assessment and median age 25 at the sixth assessment. Mothers of participants took part in the early assessments and offspring took part at the sixth assessment. Results of many analyses, both within circumscribed developmental stages and across development, indicated that sexually abused females (on average) showed deleterious sequelae across a host of biopsychosocial domains including: earlier onsets of puberty, cognitive deficits, depression, dissociative symptoms, maladaptive sexual development, hypothalamic-pituitary-adrenal attenuation, asymmetrical stress responses, high rates of obesity, more major illnesses and healthcare utilization, dropping out of high school, persistent posttraumatic stress disorder, self-mutilation, Diagnostic and Statistical Manual of Mental Disorders diagnoses, physical and sexual revictimization, premature deliveries, teen motherhood, drug and alcohol abuse, and domestic violence. Offspring born to abused mothers were at increased risk for child maltreatment and overall maldevelopment. There was also a pattern of considerable within group variability. Based on this complex network of findings, implications for optimal treatments are elucidated. Translational aspects of extending observational research into clinical practice are discussed in terms that will likely have a sustained impact on several major public health initiatives.

Revictimization and Self-Harm in Females Who Experienced Childhood Sexual Abuse Results from a Prospective Study

Lifetime trauma histories were ascertained for females with confirmed histories of childhood sexual abuse and comparison females participating in a longitudinal, prospective study. Abused participants reported twice as many subsequent rapes or sexual assaults (p = .07), 1.6 times as many physical affronts including domestic violence (p = .01), almost four times as many incidences of self-inflicted harm (p = .002), and more than 20% more subsequent, significant lifetime traumas (p = .04) than did comparison participants. Sexual revictimization was positively correlated with posttraumatic stress disorder symptoms (PTSD), peritraumatic dissociation, and sexual preoccupation. Physical revictimization was positively correlated with PTSD symptoms, pathological dissociation, and sexually permissive attitudes. Self-harm was positively correlated with both peritraumatic and pathological dissociation. Competing theoretical explanations for revictimization and self-harm are discussed and evaluated.

Attenuation of cortisol across development for victims of sexual abuse

Inconsistencies exist in literature examining hypothalamic-pituitary-adrenal (HPA) axis activity in children and adults who have experienced childhood abuse. Hence, the extent and manner to which childhood abuse may disrupt HPA axis development is largely unknown. To address these inconsistencies, the developmental course of nonstress cortisol in a long-term longitudinal study was assessed at six time points from childhood through adolescence and into young adulthood to determine whether childhood abuse results in disrupted cortisol activity. Nonstress, morning cortisol was measured in 84 females with confirmed familial sexual abuse and 89 nonabused, comparison females. Although dynamically controlling for co-occurring depression and anxiety, hierarchical linear modeling (HLM) showed that relative to comparison females, the linear trend for abused females was significantly less steep when cortisol was examined across development from age 6 to age 30, t (1, 180) = -2.55, p < .01, indicating attenuation in cortisol activity starting in adolescence with significantly lower levels of cortisol by early adulthood, F (1, 162) = 4.78, p < .01. As a more direct test of the attenuation hypothesis, supplemental HLM analyses of data arrayed by time since the disclosure of abuse indicated that cortisol activity was initially significantly higher, t (1, 425) = 2.18, p < .05, and slopes were significantly less steep t (1, 205) = -2.66, p < .01, for abused females. These findings demonstrate how the experience of childhood abuse might disrupt the neurobiology of stress, providing some support for the attenuation hypothesis that victims of abuse may experience cortisol hyposecretion subsequent to a period of heightened secretion.

Development, reliability, and validity of a child dissociation scale

Dissociation is a complex psychophysiological process that ranges along a continuum from minor, normal dissociation to Axis I psychopathology. High levels of dissociation are associated with increased self-destructive behaviors and other symptoms. Although several validated measures of dissociation exist for adults, no measures are available for children. The Child Dissociative Checklist (CDC) was developed to meet this need and is a reliable and valid observer report measure of dissociation in children. The CDC had a 1-year test-retest reliability coefficient of rho = .69 (N = 73, p = .0001) in a sample of normal and sexually abused girls. The CDC had high discriminant validity among four test samples including: normal control girls, sexually abused girls, boys and girls with dissociative disorder NOS and boys and girls with multiple personality disorder. The CDC is intended as a clinical screening instrument and as a research measure. The CDC is not designed to be used as a diagnostic instrument.

Violence against children in the family and the community

Dangerous Behaviour and Dangerous Contexts - a 30-Year Perspective on Research on the Developmental Effects of Child Physical Abuse The Developmental Consequences of Child Sexual Abuse Effects of Domestic Violence on Children Community Violence and Child Development - a Review of Research Individual and Family Characteristics Associated with Intrafamilial Child Physical and Sexual Abuse Violence Within the Neighbourhood and Community Societal Causes of Violence Against Children Treatment and Intervention for Child Victims of Violence Child Maltreatment - a Critical Review of Research in Treatment - Programmes for Physically Abusive Parents Toward Reducing Aggression in the Schools - Enhancing Ethnic Identity and Ethnic Understanding Neighbourhood-Based Programmes Child Abuse Prevention Programmes That Target Young Children Windows for Preventing Child and Partner Abuse - Early Childhood and Adolescence Preventing Youth Violence Through Research-Guided Intervention Prevention of Violence at the Societal Level Integrating and Advancing the Knowledge Base About Violence Against Children - Implications for Intervention and Prevention Evaluation Research on Violence Interventions - Issues and Strategies for Design Public Policy Applications of Research on Violence and Children.

Urinary Catecholamine Excretion in Sexually Abused Girls

OBJECTIVE The objective of this study was to examine urinary catecholamine excretion in a self-selected sample of sexually abused and demographically matched control girls recruited from a prospective, longitudinal study. METHOD Twenty-four--hour urinary catecholamine and metabolite concentrations of epinephrine, norepinephrine, dopamine, 3-methoxy-4-hydroxyphenylglycol, metanephrine, normetanephrine, vanillylmandelic acid, 3,4-dihydroxyphenylacetic acid, and homovanillic acid were measured in 12 sexually abused and 9 control girls, aged 8 to 15 years. Psychiatric profiles also were obtained. RESULTS The abused subjects excreted significantly greater amounts of metanephrine, vanillylmandelic acid, homovanillic acid, and total catecholamine synthesis as measured by the sum of epinephrine, norepinephrine, dopamine, and their metabolites compared to values from control subjects. When the means of all significant biochemical measures were adjusted by the covariate effect of height, only homovanillic acid and group interaction remained significant. There were positive trends toward significantly higher urinary excretion of metanephrine, vanillylmandelic acid, and total catecholamine synthesis. Sexually abused girls also had a greater incidence of suicidal ideation, suicide attempts, and dysthymia than control girls. CONCLUSIONS These findings support the idea that sexually abused girls show evidence of higher catecholamine functional activity compared with controls. The clinical significance of these findings in their similarity to the psychobiology of both post-traumatic stress disorder and major depressive disorder. Results from this pilot study may be of value in understanding the mechanisms of depressive and anxiety disorders and in the clinical treatment of maltreated children.

Obesity Risk for Female Victims of Childhood Sexual Abuse: A Prospective Study

OBJECTIVE. Efforts are under way to articulate environmental, psychosocial, and biological conditions that may predispose the development and maintenance of obesity. There is increasing evidence that adverse childhood experiences such as childhood abuse may be implicated in the development of obesity. Given the dearth of prospective evidence for this link, the objective of this study was to track body mass across development (from childhood, through adolescence, and into young adulthood [ie, ages 6–27]) in a prospective, longitudinal study of abused and nonabused female subjects. METHODS. Height and weight were obtained for 84 female subjects with substantiated childhood sexual abuse and 89 demographically similar comparison female subjects at 6 points during development. Obesity status was examined at various stages during development, and body-mass growth trajectories were contrasted across the 2 groups. It was hypothesized that, in comparison with their nonabused peers, abused female subjects would be more likely to (1) manifest obesity by early adulthood and (2) manifest high-risk growth trajectories throughout development. RESULTS. Obesity rates were not different across groups in childhood or adolescence. By young adulthood (ages 20–27), abused female subjects were significantly more likely to be obese (42.25%) than were comparison female subjects (28.40%). Hierarchical linear modeling growth-trajectory analyses indicated that abused female subjects, on average, acquired body mass at a significantly steeper rate from childhood through young adulthood than did comparison female subjects after controlling for minority status and parity. CONCLUSIONS. Psychosocial difficulties (eg, depression) and psychobiological conditions (eg, hypothalamic-pituitary-adrenal axis dysregulation) that have been shown to be related to both childhood abuse and obesity may help to explain these results. The identification of high-risk growth trajectories may improve health outcomes for victims. Systematic study of the mechanistic pathways and mediating processes that would help to explain the connection between childhood sexual abuse and later obesity is encouraged.

Salivary Alpha Amylase-Cortisol Asymmetry in Maltreated Youth

BACKGROUND Maltreatment represents a major stressor in the lives of many youth. Given the known effects of stress exposure on subsequent functioning of biological stress response systems, researchers have been interested in the effects of maltreatment on the functioning of these systems. Experimental studies reveal that previous exposure to stress affects the symmetry between components of the physiological stress response to subsequent stress. The present study examined asymmetry between salivary alpha amylase (sAA), a sympathetic indicator, and cortisol reactivity to a social stressor among maltreated and comparison youth age 9 to 14 years. Consistent with earlier studies suggesting that stress leads to asymmetry between hypothalamic-pituitary-adrenal axis and sympathetic nervous system activity, we expected that maltreated youth would exhibit greater sAA-cortisol asymmetry than would comparison youth. METHODS Forty-seven maltreated and 37 comparison youth visited the laboratory and engaged in a social stress protocol. We collected 2 saliva samples before the stressor and 4 after, at 0 min post-stress and every 10 min for 30 min. RESULTS Maltreatment status moderated the relation between sAA and cortisol activity in response to the stressor. Comparison youth showed significant links between the sAA and cortisol responses; maltreated youth had no significant associations between responses in the two biomarkers. CONCLUSION The data were consistent with sAA-cortisol asymmetry among maltreated youth. Further research should seek to replicate this finding and investigate its implication for developmental trajectories.

Impact of Child Sexual Abuse on Females: Toward a Developmental, Psychobiological Integration

In the last decade, it has become clear that the sexual abuse of children is much more prevalent than previously realized and that such abuse has extensive mental health sequelae. Females are reported victims of sexual abuse much more often than males. The peak age of onset of sexual abuse for females is prepubertal—7 or 8 years of age—and the average duration fends to be about 2 years. The basic theme of this article is that there may be directly traceable mechanistic relationships between the impact of sexual abuse on specific psychological and biological developmental processes for females and some of the adult outcomes of that abuse. Specifically, it is proposed that, to understand the long-term impact of sexual abuse, it is necessary to investigate how it may interfere with both the psychological and the biological processes of pubertal development.