Maternal and Paternal Adverse Childhood Experiences (ACEs) and Offspring Health and Wellbeing: A Scoping Review.

BACKGROUND: Adverse childhood experiences (ACEs) are common, often co-occur, and are associated with poor health outcomes across the life course. Emerging research has emphasized the lasting consequences of ACEs across generations, suggesting parental ACEs are associated with poor physical and mental health outcomes in children. However, the individual effects of fathers' ACEs and pathways of transmission remain unclear. A scoping review was conducted to summarize the current knowledgebase of the intergenerational consequences of parental ACEs on offspring health, clarify pathways of transmission, understand how ACEs are operationalized in the intergenerational literature, and identify gaps in knowledge. METHODS: Six electronic databases were searched for articles published in English from 1995 to 2022 relating to the long-term consequences of parental ACEs on offspring physical and mental health. Articles underwent title, abstract, and full-text review by two investigators. Content analysis was performed to integrate findings across the included studies. RESULTS: The search yielded 14,542 unique articles; 49 met the inclusion criteria. Thirty-six articles focused exclusively on mothers, one solely on fathers, and 12 included both mothers and fathers in their analyses. Six studies used an expanded definition of ACEs. Both direct and indirect associations between parental ACEs and poor offspring outcomes were identified, primarily through biological and psychosocial pathways. CONCLUSIONS: Findings underscore the importance and oversight of fathers and the need to solidify a unified definition and measure of ACEs. This review identified modifiable protective factors (social support, father involvement) and pathways of transmission (parental mental health, parenting); both having important implications for intervention development.

What is known on this subject? Recently, research has highlighted the intergenerational consequences of parental ACEs on offspring physical and mental health outcomes with a primary focus on mothers. Maternal exposure to ACEs is associated with poor offspring behavioral, mental and physical health, and developmental outcomes.What the study adds? This review extends prior literature by summarizing the nascent research on paternal ACEs, pathways of transmission, and suggesting the transmission of maternal ACEs to offspring outcomes is observed across a wide range of health outcomes and ACEs.

Mantram repetition and psychological distress: A systematic review and meta-analysis.

WHAT IS KNOWN ON THE SUBJECT?: Researchers have examined several interventions for psychological distress, mindfulness being a popular one. One intervention that fosters mindfulness is mantram repetition. Mantram repetition is an ancient traditional practice of repeating a sacred word/phrase at various times throughout the day and whenever needed. Psychologically, mantram repetition can mitigate immediate stressors. When used consistently, mantram repetition promotes resilience and deepens mindfulness, thereby promoting recovery from distress. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This paper examines the overall effect of mantram repetition on psychological distress symptoms (i.e., depression, anxiety and somatization). WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The portable, cost-effective, mantram repetition intervention outperformed standard therapies. In people who are prone to psychological distress, practitioners might teach this technique, encouraging them to use it initially as they go through their day and then when they are experiencing distress. Mantram repetition can quiet the mind and pairs well with breathing exercises and routine activities such as walking or exercising, or during chores, thus, integrating the mantram into daily life. ABSTRACT: INTRODUCTION: Researchers have examined several interventions for psychological distress, mindfulness being a popular one. One mindfulness intervention is mantram repetition. Mantram repetition is an ancient traditional practice of repeating a sacred word/phrase at various times throughout the day and whenever needed. AIM: To examine the evidence of the effect of mantram repetition on psychological distress (i.e., depression, anxiety and somatization). METHOD: We searched 16 databases and retrieved 12 studies testing the effects of mantram repetition; only four of these measured aspects of psychological distress with comparison groups. RESULTS: All studies showed positive effects ranging from very mild (.08) to very strong (.71). The summary effect across all studies was small (.23, p = .015). Importantly, this small effect was found when compared to treatment as usual and even psychotherapy. DISCUSSION: The portable, cost-effective, mantram repetition intervention outperformed standard therapies. IMPLICATIONS FOR PRACTICE: In patients who are prone to psychological distress, practitioners might teach this technique, encouraging them to use it initially as they go through their day and then when they are experiencing distress. Mantram repetition could be practiced with breathing exercises, when walking or exercising, or during chores, integrating the mantram into daily life.

Sexual and Marital Satisfaction in Older Adulthood: Effects of Childhood and Adulthood Violence Exposure.

BACKGROUND AND OBJECTIVES: Guided by the life course perspective and traumagenic dynamics theory, the current study examines (a) the long-term effects of childhood sexual abuse (CSA) and other adverse childhood experiences (ACEs) on older adults' sexual and marital outcomes, (b) the mediating role of intimate partner violence (IPV) victimization in the association between childhood adversities and sexual and marital satisfaction, and (c) whether gender moderates the mediational association. RESEARCH DESIGN AND METHODS: We examined 5,391 adults in their early 70s who participated in the 2010-2011 Wisconsin Longitudinal Study. A series of structural equation models was performed to examine the direct and indirect effect of CSA and other ACEs on sexual and marital outcomes in later life. RESULTS: CSA was directly associated with lower levels of sexual and marital satisfaction in late adulthood. Other ACEs were associated with currently not being married and greater numbers of marriages. Furthermore, other ACEs were significantly associated with low levels of marital satisfaction through IPV victimization. The moderated mediational analysis showed that the negative indirect effect of other ACEs on marital satisfaction via IPV victimization was stronger for women than men. DISCUSSION AND IMPLICATIONS: Using a population-based sample, this is one of the first studies demonstrating that distal life events such as CSA and ACEs can undermine older adults' sexual and marital health, and revictimization in adulthood may serve as a mechanism for the association. Timely intervention is needed to prevent persistent negative effects of childhood violence.

Brief Report: Child Sexual Abuse and Somatic Symptoms in Older Adulthood for Men.

Somatic symptom disorders are often misdiagnosed or minimized among men, especially in middle and older adulthood. Previous research investigating links between somatic disorders and early trauma, such as childhood sexual abuse (CSA), have mostly been based on small, non-representative, female samples using cross-sectional designs. The current study used data from the Wisconsin Longitudinal Study to assess associations between CSA and somatic symptom severity among men in middle- and late-adulthood (mid-50s to early 70s) with histories of CSA (n = 129) and a matched, non-abused comparison group (n = 2,322). Childhood (e.g., co-occurring adversities and parental education) and demographic background variables (e.g., marital status, self-rated health, and income) were controlled. Growth curve modeling was used to explore trajectories of somatic symptoms over time. Results indicated that the CSA group had higher somatic symptom severity than the non-abused group (γ01 = .10, p < .05); symptoms decreased over time for both groups with no significant differences in the rate of change. Healthcare providers should include CSA in assessments for men. Because contemporary somatic symptoms may represent unresolved early life course trauma, mental health support services should be expanded for this population. Future research should explore gender-appropriate treatment modalities for older men with histories of CSA.

Sexual abuse and mental ill health in boys and men: what we do and don't know.

The spectrum of adverse mental health trajectories caused by sexual abuse, broadly defined as exposure to rape and unwanted physical sexual contact, is well-known. Few studies have systematically appraised the epidemiology and impact of sexual abuse among boys and men. New meta-analytic insights (k = 44; n = 45 172) reported by Zarchev and colleagues challenge assumptions that men experiencing mental ill health rarely report sexual abuse exposure. Adult-onset sexual abuse rates of 1-7% are observed in the general population, but for men experiencing mental ill health, adult lifetime prevalence was 14.1% (95% CI 7.3-22.4%), with past-year exposure 5.3% (95% CI 1.6-12.8%). We note that these rates are certainly underestimates, as childhood sexual abuse exposures were excluded. Boys and men with a sexual abuse history experience substantial disclosure and treatment barriers. We draw attention to population health gains that could be achieved via implementation of gender-sensitive assessment and intervention approaches for this at-risk population.

Protective Factors against Depressive Symptoms in Female American Indian Cancer Survivors: The Role of Physical and Spiritual Well-being and Social Support.

BACKGROUND: This exploratory study examined how perceived physical well-being, spiritual well-being and social support relate to depressive symptoms among American Indian (AI) female cancer survivors. METHODS: Cross-sectional data were obtained from 73 AI female cancer survivors between 32 to 77 years of age in the Midwest of the United States. Standardized measures were used to assess for depression (Center for Epidemiologic Studies Depressive Symptoms Scale Short Form), spiritual well-being (Functional Assessment of Chronic Illness Therapy, Spiritual Well-being Scale), and social support (Medical Outcomes Study of Social Support Questionnaire). A single item measured physical well-being. After univariate and bivariate analyses, hierarchical multiple regression (HMR) was used for modeling. RESULTS: Approximately 47% of the sample scored higher than 10 on the depressive symptoms scale. HMR results indicated that perceived physical well-being, spiritual well-being, and social support were negatively associated with depressive symptoms, accounting for 47% of the variance in the final model (adjust R2 = 0.47). CONCLUSIONS: A high percentage of the sample exceeded the cut point for probable depression, highlighting the importance of addressing mental health in the aftermath of cancer treatments for AI women. Results suggest that perceived physical well-being, spiritual well-being, and social support serve as protective factors and possible levers to reduce depression in this population. Interventions designed to bolster existing social support and spirituality could improve the mental health of AI women in the aftermath of cancer treatment. Community-based, culturally appropriate health education programs should be developed to enhance AI women's physical health. 
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"The whole wall fell apart, and I felt free for the first time": Men's perceptions of helpful responses during discussion of child sexual abuse.

BACKGROUND: There is a growing awareness of the prevalence and consequences of childhood sexual abuse (CSA) for boys. Disclosure experiences often impact long-term functioning following CSA. Current understanding around disclosure has evolved from a singular act of telling to a broader, reciprocal process that can include discussion. However, there is limited empirical evidence about what constitutes a helpful response from others during the discussion of CSA for men. OBJECTIVE: This study examines the characteristics of a helpful response during the discussion of CSA among a large sample of men with histories of CSA. PARTICIPANTS AND SETTING: Participants included 487 men ranging in age from 19 to 84 years (mean = 50.1) who completed an anonymous, one-time online survey as part of a larger project on men's health and well-being. Participants were recruited through research announcements on web sites and discussion boards of national organizations that support adult survivors of CSA. METHODS: Narrative data from an open-ended prompt were analyzed using qualitative content and inductive thematic analyses over eleven months. RESULTS: The analysis yielded five superordinate themes on men's perceptions of helpful responses from others during discussions of CSA: (1) experience; (2) personal characteristics; (3) specific actions; (4) therapeutic interventions; and (5) insights. CONCLUSIONS: Clinicians and health care professionals should convey an awareness of CSA for boys, reach out to men dealing with difficulties tied to early trauma, and implement helpful response strategies in discussions of CSA. Family members, friends, and colleagues within men's social networks can also support recovery with helpful response strategies.

Childhood Adversities, Midlife Health, and Elder Abuse Victimization: A Longitudinal Analysis Based on Cumulative Disadvantage Theory.

OBJECTIVES: Elder abuse victimization is increasingly recognized as a pressing public health concern. However, few empirical studies have investigated whether early life course adversities and midlife sequelae heighten risks for abuse in late life. Guided by cumulative disadvantage theory, the current study examined whether compromised health in middle adulthood (physical, psychological, cognitive) mediates the association between child abuse and elder abuse. METHOD: This secondary analysis was based on data from the Wisconsin Longitudinal Study, a population-based, multi-wave dataset. We analyzed responses from 5,968 participants (mean age = 71 years; 54% female) on adapted versions of standardized measures: elder abuse victimization (outcome variable), childhood adversities (independent variable), and midlife health (physical health, depressive symptoms, cognitive functioning; mediator variables). Serial multiple mediation models were conducted, controlling for background characteristics. RESULTS: Rates for any elder abuse and child adversities were, respectively, 16.34% and 47.98%. Multivariate analyses supported the cumulative disadvantage hypothesis. Childhood adversities (0.11, p < .001) and midlife health (physical, -0.10, p < .05; depressive symptoms, 0.09, p < .001; cognitive functioning, 0.02, p < .05) had significant direct effects on elder abuse victimization. Childhood adversities also had an indirect effect on elder abuse through physical health (0.002, p < .05) and depressive symptoms (0.01, p < .001), both in serial. DISCUSSION: This innovative study advances our understanding mechanisms through which childhood trauma influences abuse in late life. Boosting health in middle adulthood could help prevent elder abuse. Other implications for clinical practice, treatment, and future research on elder abuse are discussed.

Childhood disclosure of sexual abuse and mental health outcomes in adulthood: Assessing merits of early disclosure and discussion.

BACKGROUND: Empirical research on the impact of early disclosure of child sexual abuse (CSA) on survivor health is limited and mixed. One recent study found that early disclosure may actually be detrimental for abuse cessation and adult symptomatology (Swingle et al., 2016). The current study re-examined the effects of early disclosure and related variables on long-term mental health for men with histories of CSA. OBJECTIVE: The primary aims of this study were to: a) investigate whether early disclosure and response to early disclosure were related to mental distress in adulthood, and b) examine whether having an in-depth discussion and timing of that discussion were related to mental distress in adulthood. PARTICIPANTS AND SETTING: Data were collected from a large, non-clinical sample of male survivors (N = 487), ranging in age from 19 to 84 years, through an online, anonymous survey. METHODS: Hierarchical regression analyses were conducted by entering groups of variables in four steps: control variables, CSA severity, disclosure, and discussion. RESULTS: Overall, models explained between 24-28% of the variance in mental distress. None of the CSA severity variables reached significance. Both early disclosure (ß = -0.126, p = 0.003) and response to first disclosure (ß = -0.119, p = 0.006) were significant protective factors in Model 3. In the final model, having an in-depth discussion (ß = -0.085, p = <0.036) and years until discussion (ß = 0.102, p = 0.029) were also related to mental distress. CONCLUSIONS: Results support the merits of early disclosure and discussion on long-term mental health. Implications for future research and practice are presented.

Childhood Sexual Abuse and Depression among American Indians in Adulthood.

The present study investigated distal and proximal factors associated with depression among a sample of 479 American Indian (AI) adults in the Midwest. Distal factors included histories of childhood sexual abuse (CSA) and other childhood adversities. Proximal factors included levels of health self-efficacy and treatment for alcohol problems. The study also examined the moderating effect of treatment for alcohol problems on the relationship between CSA and depression. In model 1, results indicate that CSA was positively related to depression after controlling for demographic and background variables. In model 2, childhood adversities and treatment for alcohol problems were associated with increased depression in AI adults; CSA became nonsignificant. As a protective factor, level of health self-efficacy was negatively associated with depression. In model 3, treatment for alcohol problems magnified the effect of CSA on depression. These findings suggest that early traumatic experiences may have persistent, harmful effects on depression among AIs; one mechanism exacerbating the impact of CSA on depression is treatment for alcohol problems. Targeted interventions are needed to mitigate the long-term negative health effects of childhood trauma in this population and to strengthen proximal protective factors, such as health self-efficacy.

Child Sexual Abuse and Depression in Late Life for Men: A Population-Based, Longitudinal Analysis.

OBJECTIVE: Research investigating long-term effects of childhood sexual abuse (CSA) on mental health for men is vastly underdeveloped. This study strengthened the knowledge base by examining: (a) long-term trajectories of depressive symptoms for men with and without a history of CSA, and (b) moderating effects of social support over time. METHOD: We analyzed multiple waves of data from the Wisconsin Longitudinal Study. The sample (N = 2,451) consisted of men with histories of CSA and a stratified, randomly sampled comparison group. Growth curve modeling was employed for analyses. RESULTS: After controlling for demographic, parental, and health factors, men with CSA histories had greater depressive symptoms than those with no history of CSA. For both groups, depressive symptoms decreased over time; slope patterns did not differ. We found a significant moderating effect of social support on the relationship between CSA and depressive symptoms. DISCUSSION: This innovative, population-based, longitudinal study demonstrated that CSA can undermine mental health for men across the life span and into old age. Social support appears to mitigate these deleterious effects. In early, middle, and late adulthood, practitioners should assess for CSA and strengthen support resources for male survivors.

Re-experiencing Violence Across the Life Course: Histories of Childhood Maltreatment and Elder Abuse Victimization.

OBJECTIVES: This study primarily examines the associations between histories of childhood maltreatment (i.e., neglect, emotional, physical, and sexual abuse) and elder abuse victimization and explores whether gender moderates the associations. METHODS: We conducted a secondary data analysis of 5,968 older adults (mean age = 71 years) based on data from the Wisconsin Longitudinal Study (2010-2011). Using retrospective self-reports of childhood and current (past 12 months) victimization experiences, logistic regression analyses were conducted to estimate the effects of early-life adversities on the likelihood of elder abuse victimization. RESULTS: Results indicate that childhood emotional abuse and childhood sexual abuse (CSA) were associated with greater risk of being abused as older adults, after controlling for childhood and adult background factors. We also found that the effect of CSA on elder abuse victimization was weaker for women than men. DISCUSSION: Findings suggest that the phenomenon of revictimization may occur not only in early and middle adulthood, but also in late life. To advance our understanding of victimization across the life course, future research on root causes of elder abuse should include histories of child abuse.

"I Will Never Know the Person Who I Could Have Become": Perceived Changes in Self-Identity Among Adult Survivors of Clergy-Perpetrated Sexual Abuse.

Clergy-perpetrated sexual abuse (CPSA) during childhood represents a tragic betrayal of trust that inflicts damage on the survivor, the family, and the parish community. Survivors often report CPSA has a disturbing impact on their self-identity. Despite intense media coverage of clergy abuse globally in the Catholic Church (and other faith communities) over several decades, relatively few empirical studies have been conducted with survivors. Beyond clinical observations and advocacy group reports, very little is known about survivors' perceptions of how the abuse impacted their long-term self-identity. Using data collected during the 2010 Health and Well-Being Survey, this qualitative analysis represents one of the first large-scale studies with a non-clinical sample of adult male survivors of CPSA from childhood (N = 205). The negative effects of the sexual abuse on participants were expressed across six domains of self-identity: (a) total self, (b) psychological self, (c) relational self, (d) gendered self, (e) aspirational self, and (f) spiritual self. These findings highlight the range and depth of self-suffering inflicted by this pernicious form of sexual violence. The findings are useful for developing clinical services for survivors, shaping public and institutional policies to address clergy-perpetrated sexual abuse, and guiding future research with this population.

Externalizing behaviors among adopted children: A longitudinal comparison of preadoptive childhood sexual abuse and other forms of maltreatment.

Previous research has established that child sexual abuse (CSA) and other forms of child maltreatment can have lasting and profound implications for survivors in terms of externalizing symptomatology. Few studies, however, have examined long-term consequences of CSA and maltreatment among adopted children. Guided by a polyvictimization framework, the present study investigated: (a) rates of co-occurrence of pre-adoptive CSA and maltreatment among adopted children, and (b) the relative impact of pre-adoptive CSA and maltreatment on externalizing behaviors at 14 years post-adoption. Analyses were based on four waves of data from the California Long-Range Adoption Study (CLAS) (n = 522); outcomes were measured using an adapted version of the Behavioral Problems Index (BPI). The diverse sample (36% non-White) was evenly divided by gender (50% female/male) and included a large number of children adopted from foster care (42.1%). Results indicated that 24.3% (n = 127) of children experienced at least one form of maltreatment; of those children, nearly half (46.5%; n = 59) experienced multiple abuse types (e.g., neglect, sexual, physical). Among cases of CSA (7.7%; n = 40), the vast majority (92.5%; n = 37) occurred with other forms of maltreatment. Hierarchical linear mixed models indicated that pre-adoptive CSA was associated with nearly a full unit increase in BPI scores (.92; p<.01). Neglect was associated with nearly a half unit increase in BPI (.48; p<.05). Gender was also significant; girls had lower BPI scores than boys (-0.57; p< .001). Implications for future research and practice are discussed.

A History of Childhood Maltreatment and Intimate Partner Violence Victimization Among Native American Adults.

This study examined the association between childhood maltreatment and intimate partner violence (IPV) victimization among Native American adults. Based on Riggs's theoretical model of the long-term effects of childhood abuse, we also examined the mediating roles of insecure attachment patterns and depressive symptoms. The current study was a secondary data analysis using the 2013 General Well-Being Among Native Americans dataset ( N = 479). Structural equation modeling was used to examine the hypothesized relationships among key constructs. Consistent with existing literature of revictimization, our findings showed that the experience of childhood maltreatment was positively associated with IPV victimization. Mediation analyses indicated that depression was a significant mediator in the association between childhood maltreatment and IPV victimization. In addition, all the paths linking childhood maltreatment, fearful attachment, depressive symptoms, and IPV victimization were statistically significant, although the overall mediation effect was not significant. The results of this study suggest that Riggs's model can serve as a useful theoretical framework for understanding the long-term effects of childhood maltreatment among Native American adults. Practitioners in the area of IPV should include maltreatment history and current attachment patterns in client assessments, which could help address conflict and violence within intimate relationships.

The Kessler psychological distress scale: translation and validation of an Arabic version.

BACKGROUND: The Kessler Psychological Distress Scale has been widely used in assessing psychological distress among general and clinical populations from different cultural backgrounds. To our knowledge, however, researchers have not yet validated any translated versions in Arabic. The purpose of this study was to test the reliability and validity of Arabic translations of the ten item (K10) and six item (K6) versions among public sector employees in the Occupied Palestinian Territories. METHODS: As part of a larger research project on life satisfaction, researchers collected data from 234 Palestinian social workers in June and July of 2016. The survey included several mental health measures, including the K10, which were translated from English to Arabic by an experienced language expert. In the current study, we tested reliability by measuring internal consistency using Cronbach's alpha coefficient. Next, we assessed factor structure using variance-covariance matrix with maximum likelihood estimation. Confirmatory factor analysis was performed to examine three competing models: unidimensional K10 model, unidimensional K6 model and two-factor K6 model. Fit indices and parameter estimates were reported. Last, convergent validity was examined by assessing correlations with Generalized Anxiety Disorder (GAD-7) and Somatic Symptoms Scale (SSS-8). RESULTS: The mean scores for the K6 and K10 were, respectively, 12.87 (SD = 4.02) and 21.8 (SD = 6.7), indicative of mild to moderate levels of distress. Scale reliability analysis showed satisfactory results on both K6 and K10 versions (Cronbach's α = .81 (K6) and .88 (K10)). Among three competing models, the two-factor K6 scale demonstrated the best model fit with high factorial correlations (r = .60, p < .001). Moreover, the K6 has high convergent validity with GAD-7 (r = .66, p < .001) and SSS-8 (r = .61, p < .001). CONCLUSION: Results indicated that the translated version of the two-factor K6 scale is a valid and reliable measurement of psychological distress. Our findings suggest that practitioners and researchers can use this instrument in screening and assessing psychological symptoms with Arabic-speaking populations.

"A Very Steep Climb": Therapists' Perspectives on Barriers to Disclosure of Child Sexual Abuse Experiences for Men.

Recent studies indicate that men experience unique barriers to disclosure of child sexual abuse. Blind spots held by mental health providers and social service agencies may inadvertently help produce and sustain these barriers. However, therapists who specialize in treating this population may also hold important insights into the barriers clients face. Because delayed and nondisclosure of child sexual abuse have been associated with negative mental health outcomes for adult survivors, understanding these barriers is critical to improve clinical practice and facilitate help-seeking. Using conventional content analysis, this study examined the perceptions of nine therapists who specialize in the treatment of men who were sexually abused in childhood, many of whom are considered pioneers in the field. Analyses identified nine types of barriers, which were organized into three categories: intrapersonal experience (difficult feelings, lack of language, and self-engagement), social milieu (internalized social stigma, negative responses, social loss or judgment, and masculine identity dissonance), and health care environment (structural barriers, relational challenges with therapists, and unhelpful therapeutic strategies). Implications for future research, clinical training, and clinical practice are discussed.

The Effect of Child Sexual Abuse on Men: Toward a Male Sensitive Measure.

Child sexual abuse (CSA) is a trauma that affects males in substantial numbers, sometimes in ways that are gender-specific (e.g., compromised masculine identity, confusion regarding sexuality). Much of the identification of the male-specific outcomes has been derived from practitioner experience and small qualitative studies. The current study explores gender-specific outcomes and describes the development of a scale to measure the effects of CSA on men. First, qualitative interviews with 20 men who were sexually abused in childhood were thematically analyzed. The emergent themes of sexuality, self-concept, psychological and emotional well-being, and social functioning were used to construct a 30-item instrument which was later completed by 147 men with histories of CSA. The dimensionality of the 30 items was then assessed for suitability as scales using confirmatory factor analysis (CFA). The final instrument, the Male Sexual Abuse Effects Scale (MSAES), combines three subscales: Negative Identity, Guilt and Self-Blame, and Psychological and Emotional Well-Being. Items concerning masculine identity were shown to be valid in the scale. MSAES scores were compared with the General Health Questionnaire-28 (GHQ-28) and found to be significantly correlated. GHQ-28 clinical thresholds were applied to differentiate clinical from nonclinical cases; an independent-samples t test showed that the clinical cases from the GHQ-28 had high scores on the MSAES. The new scale has the potential to help clinicians and researchers identify men who have been severely affected by CSA and who should be of clinical concern.

Mental health indicators fifty years later: A population-based study of men with histories of child sexual abuse.

Childhood sexual abuse (CSA) is a widely acknowledged trauma that affects a substantial number of boys/men and has the potential to undermine mental health across the lifespan. Despite the topic's importance, few studies have examined the long-term effects of CSA on mental health in middle and late life for men. Most empirical studies on the effects of CSA have been conducted with women, non-probability samples, and samples of young or emerging adults with inadequate control variables. Based on complex trauma theory, the current study investigated: a) the effect of CSA on mental health outcomes (depressive symptoms, somatic symptom severity, hostility) in late life for men, and b) the moderating effects of childhood adversities and masculine norms in the relationship between CSA and the three mental health outcomes. Using a population-based sample from the 2004-2005 Wisconsin Longitudinal Study, multivariate analyses found that CSA was positively related to both depressive and somatic symptoms and increased the likelihood of hostility for men who reported a history of CSA. Both childhood adversities and masculine norms were positively related to the three outcomes for the entire sample. Among CSA survivors, childhood adversities exerted a moderating effect in terms of depressive symptoms. Mental health practitioners should include CSA and childhood adversities in assessment and treatment with men. To more fully understand the effects of CSA, future studies are needed that use longitudinal designs, compare male and female survivors, and examine protective mechanisms such as social support.