Executive functioning in child victims of sexual abuse: A multi-informant comparative study.

BACKGROUND: Research examining the association between child sexual abuse and executive functions is limited. Yet, exposure to traumatic situations at a young age has been associated with changes in the prefrontal cortex, which hosts executive functions (Wesarg et al., 2020). These functions are crucial for social adaptation, as they make it possible to inhibit maladaptive behavior and respond flexibly to the demands of the environment. As middle childhood is a sensitive period for the development of self-regulatory abilities, exploring executive functioning in school-age children could provide potential intervention targets (Dajani & Uddin, 2015). OBJECTIVE: Using multiple informants, this study compared executive functioning of sexually abused children to that of non-sexually victimized children and examined whether the differences were moderated by sex. METHODS: The sample consisted of 225, 6-to-12 years old children with a history of child sexual abuse (CSA) and 97 children without a history of CSA. Children completed two executive functioning tasks measuring cognitive flexibility and inhibition. Parents and teachers completed questionnaires evaluating children's executive functioning. RESULTS: In comparison to non-abused children, children with a history of CSA displayed greater executive functioning difficulties as assessed by both informant-reported questionnaires and self-completed tasks. Significant interaction effects were found, such as CSA predicting lower inhibition and executive functions at school in boys but not in girls. CONCLUSION: This study is a first step in understanding the association between CSA and executive functioning and offers a clearer picture of the differential impact of sexual trauma according to children's sex.

Exploring engagement in cervical cancer prevention services among Haitian women in Haiti and in the United States: a scoping review.

PROBLEM IDENTIFICATION: Haitian women in Haiti and in the United States experience a disproportionate burden of cervical cancer, however their uptake of cervical cancer prevention services remains concerningly low. LITERATURE SEARCH: A comprehensive search on bibliographic databases coupled with a grey literature search was conducted. A total of 401 studies were identified, with 28 studies retained after following Arksey and O'Malley's Scoping Review Guidelines. DATA EVALUATION/SYNTHESIS: Knowledge levels of HPV and cervical cancer, along with preventative measures was alarmingly low. Traditional health practices, cultural worldviews, and social networks had an influence on the uptake of cervical cancer prevention. Health systems barriers were found to be a prevalent barrier among Haitian women in the U.S. CONCLUSIONS: Future health promotion interventions developed for Haitian women must address personal, cultural, social, and structural factors with an emphasis on modifying knowledge and beliefs to improve engagement in cervical cancer prevention behaviors.

Prevalence and factors related to dating violence victimization and perpetration among a representative sample of adolescents and young adults in Haiti.

BACKGROUND: Studies examining both victimization and perpetration of dating violence among both women and men are virtually non-existent in Haiti. This study aimed to document the prevalence and factors associated with victimization and perpetration of dating violence (DV) among adolescents and young adults aged 15-24 years in Haiti. PARTICIPANTS AND SETTING: A total of 3586 participants (47.6% women; mean age = 19.37; SD = 2.71) were sampled in the 10 geographical departments according to residence areas (urban/rural), age group (15-19/20-24 years old), and gender (men/women). METHOD: Participants completed questionnaires assessing DV victimization and perpetration, witnessing interparental violence, parental violence, violence acceptance, social desirability, and self-esteem. RESULTS: Overall, 1538 participants (56% women) were in a romantic relationship in the past year. Results showed that men were more likely to experience both psychological (49.4% of women and 57% of men, X2 = 8.17, p = .004), and physical violence (11.1% of women and 18.8% of men, X2 = 8.13, p = .004). There were marginally significant differences for sexual violence between gender for adolescents aged 15 to 19 (26.5% of girls and 20.5% of boys, X2 = 3.25, p = .07), and not for young adults (21.8% of women and 24.0% of men, X2 = 0.49, p = .48). No significant difference was observed for any forms of DV perpetration. DV perpetration was positively associated with victimization (b = 0.5, p = .002), however victimization was not associated with perpetration. Results also showed different associations between violence perpetration and victimization, gender, social desirability, acceptance of violence, parental violence, and witnessing interparental violence. CONCLUSIONS: This study highlights avenues for prevention and intervention that must begin at an early age, engage teachers, train peer-educators, promote healthy, non-violent and egalitarian romantic relationships.

Diversity of adaptation profiles in youth victims of child sexual abuse.

OBJECTIVE: Child sexual abuse (CSA) is associated with long-term negative consequences in adolescents, but some survivors display resilience. The purpose of this study was to delineate profiles of adaptation in adolescent victims of CSA and to examine their associations with individual and environmental-systemic protective factors. METHOD: As part of a population-based survey, 8,230 high school students were questioned about CSA and completed measures assessing a host of protective factors and indicators of positive adaptation across 5 domains: self-perception, academic success, mental health, health risk behaviors and romantic relationships. RESULTS: Using a latent class analysis, a best fitting model of 4 classes was identified. This model included a reference group of nonsexually abused teenagers and 3 classes characterizing survivors of CSA: Resilient profile (33% of youth), Externalized profile (34% of youth) and Internalized profile (33% of youth). Sexually abused youth assigned to the Resilient profile were similar to nonsexually abused youth in terms of self-esteem, academic performance, absence of clinical levels of psychological distress and dating violence. Despite experiencing CSA of comparable severity, youth in the Resilient profile reported more optimism and were less likely to rely on avoidant or emotional strategies to cope with difficulties and more likely to report high maternal and paternal support. CONCLUSIONS: Findings highlight the utility of a person-oriented approach to enhance our understanding of the diversity of adaptation profiles in youth victims of CSA. Results also underscore the importance of tailoring intervention efforts to efficiently tackle the diverse needs of teen victims of CSA. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Transmission of parental childhood trauma to child behavior problems: Parental Hostile/Helpless state of mind as a moderator.

BACKGROUND: Little attention has been given to intergenerational transmission of risk, mainly whether caregivers' history of childhood maltreatment is linked to behavioral symptoms in their children and which protective/risk factors are involved in this transmission process. OBJECTIVE: This study examined if parental Hostile/Helpless (H/H) state of mind with respect to attachment moderated the association between parental childhood trauma and behavior problems in maltreated children. PARTICIPANTS AND SETTING: The sample included 61 parents and their children victims or at very high risk of maltreatment, aged between 1 and 6 years old. METHOD: Parents retrospectively reported their childhood trauma and completed a measure of their children's behavior problems. Independent observers assessed H/H attachment representations. RESULTS: Among parents with H/H states of mind, more severe traumatic childhood experiences were associated with more externalizing and internalizing behavior problems in their children. Among non-H/H parents, associations between parental childhood trauma and child behavior problems were not significant. CONCLUSIONS: In the context of trauma, this study suggests that the absence of a H/H state of mind in parents (i.e., the presence of an organized attachment state of mind) is a protective factor for child adjustment. H/H mental representations of self and attachment experiences as targets of intervention for parents with histories of maltreatment may help reduce the transmission of risk in maltreating families.

A latent class analysis of parent-child discrepancies in reports of peer victimization: Associations to child sexual abuse status and psychological adjustment.

Researchers face an important challenge when assessing peer victimization in children, since self-reports are often discrepant with parent-reports. A latent class analysis identified patterns of response to items assessing peer victimization, which were either divergent or convergent between the parent and the child. Classes were then compared on the child sexual abuse status and on various behavioral and social outcomes. Participants were 720 school-aged child victims of sexual abuse and a comparison group of 173 nonvictims and their caregivers. We identified two discordant subgroups (self-identified and parent-identified) and two concordant groups (nonvictims and concordant victims of peer victimization). Compared to children of the comparison group, sexually abused children were five times more likely to be identified as targets of peer victimization solely by their parent than the contrary. Sexually abused children with concordant reports of peer victimization showed the poorest adjustment on all studied outcomes assessed 6 months later. Children who discounted experiencing peer victimization while their parent reported it were also at risk of maladjustment. Results underscore the importance of supplementing self-reports with other available sources of information, especially in young and vulnerable populations who may be inclined to discount their victimization experiences.

Psychometric Properties of the Dominic Interactive in a Sample of French Canadian Sexually Abused Children.

There are few computerized questionnaires assessing mental health in children. Although the psychometric properties of the Dominic Interactive have been verified for clinical and nonclinical populations, no study has specifically targeted sexually abused children. This study aimed to explore the reliability and validity of the Dominic Interactive with a sample of sexually abused children. The sample consisted of 687 children aged from 6 to 11 recruited in specialized intervention centers in Quebec. We conducted confirmatory factor analysis to assess the factorial structure of the questionnaire and assessed the internal consistency of the subscales with Cronbach alphas and McDonalds omegas. Subscales of the Dominic Interactive showed good fit with the factorial structure and met the prescribed criteria, except for Specific Phobias and Separation Anxiety subscales that showed high interitem correlations. After accounting for intercorrelation errors, all model fit indices showed good adjustment to the factorial structure and met the fit indices criteria. The different subscales of the DI were found to be significantly correlated (r ranging from .13 to .30) with their equivalent parent-reported assessments. The results extend previous findings and suggest that the Dominic Interactive is a valid tool to quickly diagnose various behavioural problems in sexually abused children.

Latent class analysis of post-traumatic stress symptoms and complex PTSD in child victims of sexual abuse and their response to Trauma-Focused Cognitive Behavioural Therapy.

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.

Antecedentes: Los síntomas de TEPT son frecuentes en niños víctimas de abuso sexual. Sin embargo, los autores han argumentado que el trauma temprano podría llevar a alteraciones en el desarrollo que van más allá de los síntomas primarios de TEPT y han propuesto el TEPT Complejo como una alternativa diagnóstica que abarca las dificultades en la regulación de los afectos, las relaciones interpersonales y el autoconcepto.Objetivo: Delinear perfiles en niños víctimas de abuso sexual y explorar si los perfiles están asociados con respuesta al tratamiento de Terapia Cognitivo Conductual Centrada en el Trauma.Método: Se utilizó análisis de clase latente para identificar perfiles de síntomas en la evaluación inicial de 384 niños, edades entre 6 a 14 años, reclutados en el Centro de Defensa Infantil luego de la revelación del abuso sexual. Las dimensiones diagnósticas de TEPT Complejo según lo propuesto por la CIE-11 se derivaron de cuestionarios de auto-reporte.Resultados: El análisis de clase latente identificó el mejor modelo de tres clases: TEPT Clásico reagrupó al 51% de los niños, TEPT Complejo describió al 23% de los niños, y Resiliente describió al 25% de los niños. La terapia centrada en el trauma se asoció con una reducción significativa de disociación, y problemas internalizantes y externalizantes de los niños de las tres clases. La terapia centrada en el trauma también se vinculó con una reducción significativa de síntomas de TEPT con un mayor tamaño de efecto (d=.90; 95% IC: 0.63-.1.16) para los niños clasificados en el grupo de TEPT Complejo.Conclusiones: Los hallazgos resaltan la utilidad de un enfoque orientado a la persona para mejorar nuestra comprensión de la diversidad de perfiles en niños víctimas. Los resultados ofrecen apoyo empírico para la distinción en la CIE-11 de TEPT y TEPT Complejo en una muestra clínica de niños abusados sexualmente y la relevancia de esta distinción para prever los resultados del tratamiento.

Child Sexual Abuse among a Representative Sample of Quebec High School Students: Prevalence and Association with Mental Health Problems and Health-Risk Behaviors.

OBJECTIVE: The objective of this study was to estimate the prevalence of child sexual abuse in a representative sample of Quebec high school youths and document its associations with mental health problems and health-risk behaviors. METHOD: Data were drawn from the Quebec Youths' Romantic Relationships Survey, which involved a one-stage stratified cluster sampling of 34 Quebec high schools from Grades 10 to 12. A total of 8,194 youths (mean age = 15.35) were recruited. The survey assessed child sexual abuse, mental health problems (psychological distress, post-traumatic stress symptoms, suicidality), health services utilization, and health-risk behaviors (alcohol, drug, and cannabis use). Gender-stratified multivariate analyses were used to assess associations between child sexual abuse and mental health problems and health-risk behaviors while controlling for confounding demographic variables and other forms of child maltreatment experienced in childhood. RESULTS: A total of 14.9% of girls and 3.9% of boys reported having experienced child sexual abuse. Child sexual abuse was independently associated with an increased risk of psychological distress, greater health services utilization, and increased health-risk behaviors, after controlling for other forms of childhood maltreatment experienced. CONCLUSIONS: Child sexual abuse is prevalent among youths in Quebec and is associated with an increased risk of a host of negative consequences. Continued efforts in the development of early detection strategies as well as prevention and intervention programs are warranted.

Multiple traumas and resilience among street children in Haiti: Psychopathology of survival.

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.