Adolescents Who Have Been Sexually Abused: Trauma Symptoms and Self-Blame while Waiting for Treatment.

OBJECTIVE: Adolescents who have been sexually abused commonly experience trauma symptoms, and many are referred for trauma-based treatment. However, they sometimes spend considerable time on waitlists before beginning treatment. This study examines the course of trauma symptoms among adolescents who have been sexually abused and are waiting for treatment, and the extent to which self-blame for the abuse predicts trauma symptoms at the beginning of treatment. METHOD: Participants were 127 adolescents (89.0% female, Mage = 13.61 years; 53.2% identified as Hispanic) at a Children's Advocacy Center in the southern United States. All had reported being sexually abused. Participants reported on their trauma symptoms and self-blame appraisals at a screening assessment (T1), and trauma symptoms were re-assessed at the beginning of treatment (T2). RESULTS: The mean level of trauma symptoms declined over time for the total sample. Regression analyses indicated that greater self-blame for the abuse at T1 was associated with higher levels of trauma symptoms at T2, even when controlling for T1 trauma symptoms and other correlates of T2 trauma symptoms. Higher levels of trauma symptoms at T1 and adolescent sex (female) were also associated with higher levels of trauma symptoms at T2. CONCLUSIONS: Findings suggest that assessing for self-blame for sexual abuse may be important in triage and treatment planning for youth with trauma symptoms after experiencing sexual abuse.

Using Virtual Reality to Create an Observational Assessment of Adolescent Resistance to Antisocial Peer Pressure.

Resistance to antisocial peer pressure consistently relates to adolescent adjustment. However, it is typically measured via a mono-method, self-report approach. The current study introduces a virtual reality (VR) protocol to create an observational measure of adolescents' responses to peer pressure to engage in antisocial activities. Data on the reliability and validity of the assessment procedure are presented. Participants (N = 264, 46% male, Mage = 18.17 years, 81% White) provided self-reports of susceptibility to antisocial peer pressure, antisocial behavior, dating violence perpetration, and depressive symptoms. Participants also engaged in 9 VR simulations, 4 of which involved antisocial peer pressure. Participant behavior in the VR simulations was coded for resistance to antisocial peer pressure. Approximately half the sample repeated the VR simulations at a 2-month follow-up. Resistance to antisocial peer pressure in 4 VR simulations evidenced item/simulation-level convergent validity with one another and discriminant validity against scores in 5 VR bystander behavior simulations. When scores from the 4 antisocial peer pressure VR simulations were summed into a total scale score, they demonstrated acceptable internal consistency, 2-month test-retest correlations, convergent validity with self-reports of susceptibility to antisocial peer pressure, and criterion validity with self-reports of antisocial behavior and dating violence perpetration. Associations with antisocial behavior and dating violence perpetration held after accounting for self-reports of susceptibility to antisocial peer pressure and participant gender. Results provide evidence that VR simulations may offer a psychometrically sound addition to self-report measures as a method for assessing responses to antisocial peer pressure.

Perceived Loss of Social Contact and Trauma Symptoms among Adolescents Who Have Experienced Sexual Abuse.

Child sexual abuse (CSA) is a robust predictor of trauma symptoms. Past research has identified many correlates of trauma symptoms following disclosure of CSA. Theory suggests that loss of social contact may be another important contributor to adolescents' trauma symptoms following CSA. A clinical sample of 166 adolescents (95% female) between 11 and 19 years (M = 13.80, SD = 1.87) reported on perceived loss of social contact, the extent to which the CSA was coercive, appraisals of self-blame for the abuse, supportiveness of a primary non-abusing caregiver, and trauma symptoms. The adolescent's relationship to the abuser, abuse severity and duration were coded from forensic interviews. Results indicated that greater perceived loss of social contact was associated with higher levels of trauma symptoms, even after controlling for other correlates of trauma symptoms and demographic variables. These findings suggest that perceived loss of social contact may be an important variable to consider in assessing and intervening with adolescents who have been sexually abused.

Children Exposed to Intimate Partner Violence: Conduct Problems, Interventions, and Partner Contact With the Child.

Children's contact with their mother's violent partner is a potentially important variable for understanding conduct problems among children exposed to intimate partner violence (IPV). Within the context of a treatment study evaluating a parenting intervention (Project Support) for families exiting a domestic violence shelter, this study tested four hypotheses regarding children's postshelter contact with their mother's violent partner: (1) participation in Project Support decreases the frequency of children's contact with their mother's violent partner; (2) postshelter contact is positively associated with children's conduct problems and is associated more strongly for girls than boys; (3) frequency of contact mediates Project Support's effects on children's conduct problems; and (4) frequency of contact is positively associated with IPV and partner-child aggression, and these latter associations help explain effects of contact on children's conduct problems. Participants were 66 women (26 White) with a child (32 girls) between 4 and 9 years. Families were assessed every 4 months for 20 months after departure from a domestic violence shelter. Project Support reduced the extent of partner-child contact. In addition, within-subject changes in contact over time were associated with girls', but not boys', conduct problems, and it partially mediated effects of Project Support on girls' conduct problems. Higher average levels of contact over time were also positively associated with further incidents of IPV and partner-child aggression, and partner-child aggression helped explain effects of contact on children's conduct problems. Children's postshelter contact with the mother's violent partner relates positively to several negative family outcomes.

A High School-Based Evaluation of TakeCARE, a Video Bystander Program to Prevent Adolescent Relationship Violence.

Although bystander programs to prevent relationship and sexual violence have been evaluated with college students, few evaluations have been conducted with high school students. This study evaluated the effectiveness of TakeCARE, a brief video bystander program designed to promote helpful bystander behavior in situations involving relationship violence among high school students. Students (N = 1295; 52.5% female; 72.3% Hispanic) reported their bystander behavior at a baseline assessment. Classrooms (N = 66) were randomized to view TakeCARE or to a control condition, and high school counselors administered the video in the classrooms assigned to view TakeCARE. Students again reported their bystander behavior at a follow-up assessment approximately 3 months afterward. Results indicate that students who viewed TakeCARE reported more helpful bystander behavior at the follow-up assessment than students in the control condition. Results of exploratory analyses of the likelihood of encountering and intervening upon specific situations calling for bystander behavior are also reported. TakeCARE is efficacious when implemented in an urban high school by high school counselors.

Interpersonal Violence, Racial Discrimination, and Mental Health Symptoms Among Adolescents of Color in the Juvenile-Justice System.

The current study examined how interpersonal racial discrimination experiences operate together with other forms of interpersonal violence to contribute to mental health symptoms among justice-involved adolescents of color. Participants were 118 justice-involved adolescents of color aged 14 to 17 (M = 15.77, SD = 1.08; 52.5% male; 77.1% Black/African American) and their mothers. At baseline, adolescents reported on experiences of interpersonal racial discrimination, harsh parenting, teen dating violence, and exposure to interparental physical intimate partner violence. At baseline and the 3-month follow-up assessment, adolescents reported on trauma symptoms, and adolescents and their mothers reported on the adolescents' externalizing and internalizing symptoms. Multivariate multilevel modeling results indicated that interpersonal racial discrimination experiences contributed additively to adolescent mental health symptoms at both the baseline and 3-month follow-up assessments, after accounting for exposure to other forms of interpersonal violence. The current findings highlight the importance of considering adolescents' experiences of interpersonal racial discrimination, together with other forms of interpersonal violence, in work focused on understanding the mental health symptoms of justice-involved adolescents of color.

Associations of caregiver-adolescent conflict and caregiver emotional support with adolescent trauma symptoms and adjustment after sexual abuse.

BACKGROUND: Emotional support from a caregiver is believed to be important for reducing the likelihood of adolescent trauma symptoms and adjustment problems after sexual abuse. Conflict with a caregiver, another relational dynamic, is very common during adolescence, but little is known about how it might operate in tandem with emotional support to influence adolescent trauma symptoms and adjustment after sexual abuse. OBJECTIVE: To better understand how caregiver emotional support and caregiver-adolescent conflict jointly contribute to adolescent trauma symptoms and adjustment after sexual abuse. PARTICIPANTS AND SETTING: Participants were 477 adolescents (Mage = 13.59, SD = 1.77) and a non-offending caregiver presenting at a children's advocacy center. METHODS: Adolescents completed measures of caregiver-adolescent conflict, caregiver emotional support, and their own trauma symptoms and adjustment. Caregivers completed a measure of adolescent adjustment. RESULTS: Caregiver-adolescent conflict and caregiver emotional support each correlated in the expected direction with adolescent trauma symptoms and adjustment (conflict correlations ranged from 0.27 to 0.38, all p values ≤.001; support correlations ranged from -0.15 to -0.21, all p values ≤.01). Regression analyses, which simultaneously considered conflict and support, indicated that conflict related to adolescent trauma symptoms and each of the measures of adolescent adjustment, whereas caregiver emotional support contributed to caregiver reports of adolescent adjustment. Caregiver-adolescent conflict did not moderate any of the relations between caregiver emotional support and adolescent trauma symptoms or adjustment. CONCLUSIONS: In the aftermath of sexual abuse, caregiver-adolescent conflict contributes to adolescent trauma symptoms and adjustment.

Quantifying College Students' Bystander Behavior to Prevent Sexual Assault and Intimate Partner Violence: Can We Make Improvements?

Sexual assault and intimate partner violence (IPV) are prevalent on college campuses, and bystander intervention programs are often employed as a method for preventing such violence. Unfortunately, there are concerns about current strategies for the measurement and quantification of bystander behavior. Accounting for the opportunity to engage in bystander behavior is theorized to be important, but it remains unclear if doing so improves the validity of the measurement of bystander behavior. The current study compares four methods of quantifying bystander behavior when information about the opportunity to help is also available. First-year undergraduate students (n = 714) from three universities participated. Participants completed the risky situations subscale of the Bystander Behavior Scale, using a modified response scale to measure both bystander behavior and opportunity for such behavior. Measures of criterion variables theorized to be linked with bystander behavior (efficacy to intervene, responsibility to intervene, and moral courage) were also completed. Four types of bystander behavior scores were calculated: breadth, missed opportunity, offset, and likelihood. Likelihood scores, which reflect the likelihood of engaging in bystander behavior when presented with the opportunity to help, correlated more strongly with the criterion variables than other scores. Likelihood scores demonstrated added value in quantifying bystander behavior over other scoring methods. Findings from the current study add to the knowledge of how best to measure and quantify bystander behavior. Such knowledge has significant implications for research on correlates of bystander behavior and evaluations of bystander intervention programs for sexual assault and IPV prevention.

Effect of azithromycin on small bowel motility in patients with gastrointestinal dysmotility.

OBJECTIVE: To investigate the effect of azithromycin (AZI) on small bowel activity in patients with gastrointestinal dysmotility (GID). MATERIAL AND METHODS: Manometric data on a consecutive series of 21 patients was reviewed. Only those patients with gastroparesis and small bowel dysmotility as defined by antroduodenal manometric criteria were included. Pressure profiles were recorded in three stages: baseline period, fed state and postprandial after administration of erythromycin (ERY) and AZI. The measured parameters included the number and characteristics of activity fronts and migrating motor complexes (MMCs) including duration, amplitude and frequency of contractions. The data were analyzed using repeated measures analysis of variance for comparison of each medication. RESULTS: AZI induced more MMCs in the duodenum with origin of activity fronts in the antrum than did ERY (18 patients with AZI, 10 patients with ERY). No significant difference between AZI and ERY was seen with respect to the amplitude of MMCs or number of cycles per minute. The average duration of activity fronts was longer with AZI compared with ERY (AZI mean 18.5 min, ERY mean 9.7 min, p < 0.02). CONCLUSIONS: AZI induces activity fronts in the antrum followed by duodenal contractions more frequently than ERY in patients with GID. AZI potentially promises to be a prokinetic for treatment of small bowel dysmotility.

Physical and psychological intimate partner violence: Relations with child threat appraisals and internalizing and externalizing symptoms.

This study examined whether interparental physical and psychological intimate partner violence (IPV) have additive effects on child threat appraisals and internalizing and externalizing symptoms, and whether relations between psychological IPV and child difficulties differ when physical IPV has occurred, as compared to when it has not occurred. Participants were 531 children (51% male) aged 7-10 years and their mothers. Children reported on IPV, and on their threat appraisals; children and mothers both reported on child internalizing and externalizing symptoms. Families participated in three assessments spaced 6 months apart. Results indicated that physical and psychological IPV had additive effects on child threat appraisals and child reports of disruptive behavior problems, but not on other measures of child internalizing or externalizing symptoms. Results of moderator analyses indicated that relations between psychological IPV and mothers' reports of child internalizing symptoms, and between psychological IPV and child reports of disruptive behavior problems were stronger when physical IPV had occurred. Notably, psychological IPV was also associated with child threat appraisals, anxiety symptoms, and disruptive behavior problems even in the absence of physical IPV. The findings suggest that in child and family research and service settings, when aspects of the interparental relationship are relevant, the risks posed by psychological IPV should be considered. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Self-Blame in Adolescents Who Have Been Sexually Abused: Factor Structure and Differential Correlates of Abuse-Specific and Global Measures.

Self-blame appraisals are frequently studied among adolescents following sexual abuse. However, the conceptualization and operationalization of self-blame varies across studies, with some examining self-blame specific to the abuse and others examining global self-blame. The present study examined the factor structure and theorized correlates of measures of self-blame appraisals among a sample of adolescents who had been sexually abused (N = 493, 91% female). Results of confirmatory factor analyses indicated that a two-factor model, in which abuse-specific and global self-blame appraisals load onto separate factors, produced a superior model fit compared with a single-factor model, though the two factors were highly correlated. Abuse-specific and global self-blame appraisals are differentially associated with theorized correlates, such as experiencing coercion during the abuse. Taken together, the findings suggest that adolescents' abuse-specific and global self-blame appraisals following sexual abuse are measuring distinct constructs.

Non-supportive responses to adolescents who have experienced sexual abuse: Relations with self-blame and trauma symptoms.

BACKGROUND: Youth who have experienced sexual abuse sometimes also experience non-supportive responses, such as accusations of lying, from people in their family and social environment. Little is known about how such responses from different sources (caregivers, friends, other adults) correlate with one another and operate together in the prediction of youth problematic thinking, such as self-blame, and trauma symptoms. OBJECTIVE: To better understand how non-supportive responses from different sources relate to one another and contribute to youth problems following sexual abuse. PARTICIPANTS AND SETTING: Participants were 475 youths (Mage = 13.57, SD = 1.77) brought to a children's advocacy center in the southern United States. METHODS: Participants completed measures of non-supportive responses from caregivers, friends, and other adults. They also completed measures of abuse-specific self-blame and trauma symptoms. RESULTS: Non-supportive responses from caregivers, friends, and other adults correlated with each other and with abuse-specific self-blame and trauma symptoms (correlations ranged from 0.12 to 0.18; all p values <.001). Results of regression analyses indicated that only non-supportive responses from caregivers contributed independently to abuse-specific self-blame, whereas non-supportive responses from caregivers and friends contributed to trauma symptoms. CONCLUSIONS: In the aftermath of sexual abuse, non-supportive responses from caregivers and friends relate to youth trauma symptoms. Assessing non-supportive responses broadly across the social network can be useful in understanding youth adjustment following sexual abuse.

Prevalence of Sexual Victimization Among Female and Male College Students: A Methodological Note With Data.

This study provides insight on how sample recruitment methods may affect reported rates of sexual victimization on college campuses. The study compares sexual victimization rates among students who complete surveys after initial requests with those who complete them only after multiple reminders. Using probability sampling methods, undergraduate students from 12 universities were invited to complete a survey on campus violence; initial invitations were followed with up to five reminders. Women (n = 1,008) and men (n = 344) who completed surveys were categorized as early, middle, or late responders based on the number of reminders required to convert them from non-responders to responders. About 24.2% of women and 15.6% of men reported sexual victimization in the previous two months. In initial analyses, female early and late responders did not differ on sexual victimization, but males did. Male late responders reported higher rates of sexual victimization than early responders. In sensitivity analyses that re-defined early and late responders, women who were early responders reported more sexual victimization than women who were late responders, while men who were early responders reported less sexual victimization than men who were late responders. These findings suggest that researchers may underestimate sexual victimization rates for male college students unless multiple attempts are made to solicit their participation. Researchers are encouraged to utilize multiple reminders to increase research participation.

Party frequency, party-safety strategies, and sexual victimization among first-year female college students.

Objective: This study examined whether the use of party-safety strategies weakens the association between frequency of party attendance and sexual victimization among first-year female college students. Participants: First-year female college students (n = 450) from three universities in the United States participated in this study. Methods: Participants completed questionnaires on frequency of party attendance, use of party-safety strategies, and sexual victimization. Results: Frequency of party attendance was positively associated with sexual victimization. This association was moderated by use of party-safety strategies: frequency of party attendance was unrelated to sexual victimization when students reported greater use of party-safety strategies. However, frequency of party attendance was positively related to sexual victimization when students reported lower use of party-safety strategies. Conclusions: Teaching and reinforcing party-safety strategies may be helpful additions to efforts to prevent sexual victimization on college campuses.

Intimate Partner Violence, Police Involvement, and Women's Trauma Symptoms.

This study examined whether police involvement in intimate partner violence (IPV) incidents is associated with women's trauma symptoms. Participants were 95 women recruited from domestic violence shelters. Women reported on their trauma symptoms, the frequency of IPV victimization, the use of a weapon during IPV, and police involvement over the year following shelter departure. Police involvement in IPV was associated with higher levels of reexperiencing trauma symptoms 1 year after shelter departure, even after controlling for baseline trauma symptoms, the frequency of IPV, and the use of a weapon during IPV. Women's race and ethnicity did not moderate the results. These findings suggest police involvement in IPV incidents may be associated with higher levels of trauma symptoms experienced by women. Further investigation into law enforcement practices and policies to help reduce women's distress is needed.

Families seeking services for sexual abuse: Intimate partner violence, mothers' psychological distress, and mother-adolescent conflict.

Child sexual abuse (CSA) and intimate partner violence (IPV) are both global problems with negative health implications. This study examines whether mothers' lifetime experiences of IPV relate to their own psychological distress and to mother-adolescent conflict in families in which an adolescent has disclosed sexual abuse. The recency of IPV was examined as a potential moderator of these relations. Participants were 356 adolescents and their nonoffending mothers. Families were seeking services from a children's advocacy center in the southern United States. Mothers reported their IPV victimization (both lifetime and past month) and symptoms of psychological distress; mothers and adolescents both reported on mother-adolescent conflict. In bivariate analyses, mothers' lifetime experiences of IPV were positively related to mothers' psychological distress, and to mother and adolescent reports of mother-adolescent conflict. These same relations emerged in regression analyses that controlled for characteristics of the sexual abuse (time between the disclosure of CSA and the assessment, severity, relationship to the alleged perpetrator, duration), and adolescent age and sex. Recency of IPV did not moderate these relations. In exploratory analyses, mothers' lifetime experiences of IPV were more strongly associated with mother-son conflict than with mother-daughter conflict. In addition, mothers' psychological distress partially mediated the relation between their lifetime experiences of IPV and their reports of mother-adolescent conflict. The findings point to the potential utility of conducting IPV screenings with caregivers in families seeking services for an adolescent after a sexual abuse disclosure. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Comparison of the effect of azithromycin versus erythromycin on antroduodenal pressure profiles of patients with chronic functional gastrointestinal pain and gastroparesis.

BACKGROUND: Current pharmacologic treatments for gastroparesis have been disappointing due to the limited options available. Erythromycin ethylsuccinate is a potent prokinetic agent that stimulates gastric emptying. Recently, erythromycin has been linked to the occurrences of sudden cardiac death due to QT prolongation. Azithromycin is similar to erythromycin in structure but does not have significant drug-drug interactions as seen with erythromycin. PURPOSE: This study aims to determine whether azithromycin stimulates antral activity in patients with chronic gastrointestinal pain and refractory gastroparesis. METHODS: Small bowel manometric data on 30 patients undergoing clinical evaluation for chronic digestive problems or documented refractory gastroparesis were reviewed. Antral activity was measured after infusion of erythromycin 250 mg intravenous and azithromycin (500 or 250 mg intravenous) given at different intervals during the small bowel manometry. The parameters measured included the total duration of effect, mean amplitude of antral contractions, duration of the highest antral contraction phase, number of cycles per minute, and the motility index. RESULTS: Comparison of erythromycin and azithromycin at similar doses showed a similar positive effect on antral activity. However, comparison of erythromycin and azithromycin at the higher dose of 500 mg showed that the mean amplitude, duration of antral activity, and motility index were significantly increased with azithromycin (P < 0.05). CONCLUSIONS: Azithromycin stimulates antral activity similar to erythromycin and moreover has a longer duration of effect. However, unlike erythromycin, azithromycin does not have significant drug-drug interactions and maybe a potential new medication for the treatment of gastroparesis and gastrointestinal dysmotility.

From doubt to trust: Swedish mothers' and counsellors' experience testing a parenting programme for mothers exposed to intimate partner violence whose children have developed behavioural problems.

Many countries seek evidence-based interventions for children who have been exposed to domestic violence, and they frequently turn to interventions developed in the US and disseminated to Europe as a solution. Societal and cultural differences may, however, pose barriers to successful implementation. Project Support (PS), piloted in this study through social services agencies in Sweden, has shown positive effects in the US for families with children who have been exposed to intimate partner violence (IPV). The aim of this study was to investigate counselors' and caregivers' experiences when giving/receiving PS in Sweden.The study was based on interviews conducted with 11 mothers and 13 counselors with experience in the programme. A thematic analysis showed three themes (Initial doubts, Confidence from positive change, and Flexibility- challenge for the organization) and the study adds information about obstacles for implementation of PS in Sweden. Cultural and organizational differences between Sweden and the US in practice and child-rearing attitudes are highlighted, as well as the importance of making adjustments while maintaining treatment fidelity, and promoting the dissemination of the approach.

Measuring Teen Dating Violence Perpetration: A Comparison of Cumulative and Single Assessment Procedures.

Objective: There are concerns about the measurement of teen dating violence (TDV) perpetration. The current study compares data on TDV perpetration derived from a cumulative assessment procedure and a single assessment procedure. The prevalence and frequency of TDV perpetration are examined, as well as their associations with hypothesized precursors of TDV. Method: A sample of court-referred adolescents (n = 147, Mage = 15.85) completed a baseline assessment that included measures of three hypothesized precursors to TDV: externalizing problems, exposure to community violence, and attitudes about dating violence. For the cumulative assessment procedure, adolescents then completed up to 6 phone interviews on their TDV perpetration (physical, sexual, and emotional), once every 2 weeks over the course of a 3-month period. Data from these interviews were aggregated to form a cumulative measure of TDV perpetration over the 3 months. For the single assessment procedure, adolescents completed an identical interview on their TDV perpetration in a lab assessment 3 months after baseline, but were asked about perpetration over the entire 3 months. Results: Results of within-subjects comparisons indicated that, compared to the single assessment procedure, the cumulative assessment procedure yielded higher prevalence and greater frequency of physical, sexual, and emotional TDV. Across analytic methods, all types of TDV perpetration were more strongly related to externalizing problems, and sexual TDV perpetration was more strongly related to exposure to community violence, when measured cumulatively. Conclusions: Cumulative assessment procedures might provide a more sensitive and valid measurement of TDV perpetration than single assessment procedures.

Police Involvement in Intimate Partner Violence and Children's Anxiety Symptoms.

This study examined whether police involvement in intimate partner violence (IPV) is associated with children's anxiety symptoms and threat appraisals. Participants were 117 mothers and their children (7-10 years) recruited from domestic violence shelters and followed for 6 months. Mothers reported on IPV and police involvement in the past 6 months; children reported their own anxiety symptoms and threat appraisals. Police involvement in IPV incidents at Time 1 was positively related to children's anxiety symptoms at both the Time 1 and Time 2 assessments, even after controlling for the severity of the IPV. Police involvement was not associated with children's threat appraisals. Police involvement in IPV may inadvertently contribute to an increase in children's anxiety symptoms. Efforts to mitigate adverse outcomes should be investigated.