Social maltreatment as trauma: Posttraumatic correlates of a new measure of exposure to sexism, racism, and cisheterosexism.

OBJECTIVE: Maltreatment based on race, sex, or lesbian, gay, bisexual, transgender, queer, or other sexual and gender minorities (LGBTQ+) status is a significant life stressor, potentially independent of whether it can be categorized as a Diagnostic and Statistical Manual of Mental Disorders, fifth edition, text revision (DSM-5-TR) trauma. Yet there is a relative lack of research systematically examining these events, their intersectionality, and links to posttraumatic stress (PTS). The purpose of this study was to develop a comprehensive measure of social discrimination and maltreatment (SDM) and to examine whether these events can serve as potential traumatic stressors, above-and-beyond classic trauma exposure. METHOD: A 36-item Social Discrimination and Maltreatment Scale (SDMS), consisting of three subscales (sexism, racism, and cisheterosexism) and a total score, was developed and validated in a sample of 528 adults. RESULTS: The SDMS and its subscales were internally consistent (αs from .95 to .97) and demonstrated factorial validity in two subsamples (ns = 265 and 263). Marginalized groups each endorsed the most relevant SDMS subscale (e.g., people of color reporting more racism and women reporting more sexism). The total SDM score was associated with PTS even when controlling for general trauma exposure, and there was a linear relationship between the number of elevated SDMS subscales and PTS scores. CONCLUSIONS: Although not considered traumatic in the DSM-5-TR, exposure to sexism, racism, and cisheterosexism may be significant sources of PTS. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Child and Adolescent Exposure to Sexual Harassment: Relationship to Gender, Contact Sexual Abuse, and Adult Psychological Symptoms.

In contrast to adults, there is considerably less research on childhood or adolescent exposure to sexual harassment (CAESH), its lasting psychological correlates, and whether such experiences should be included in definitions of childhood sexual abuse. The current study examined the prevalence and symptomatic sequels of unwanted flirting, being "checked out" sexually, unwanted sexual attention, sexual comments, propositions, and related noncontact behaviors that occurred before age 18, as well as the multivariate relationship between CAESH and contact child sexual abuse (C-CSA) in a diverse online sample of 528 individuals. CAESH was very common, with over 95% of women and 64% of men reporting at least one experience of noncontact sexual harassment before age 18. When childhood sexual abuse was operationalized as the presence of either C-CSA or a total CAESH score of 18 or higher (corresponding to an average score of "3-5 times" prior to age 18), the prevalence was 67% for women and 26% for men, more than three times higher than C-CSA alone. This expanded definition was associated with significantly more anxiety, depression, and posttraumatic stress relative to C-CSA alone. These results suggest that CAESH is a significant source of symptoms in adults and support the emerging perspective that childhood sexual abuse may be best understood as including both contact and noncontact events.

Police in the rearview mirror: Social marginalization, trauma, and fear of being killed.

An online sample of 528 people was asked to respond to a hypothetical scenario: If a police car came up right behind you with its lights flashing, how much would you worry that you would be killed? Participants also reported on whether they experienced aggressive behavior by police in the past (provoked or otherwise) and, if so, completed a measure of associated posttraumatic stress. At least some fear of being killed by police (FKP) in the rearview mirror scenario was reported by the majority (56%) of Black participants, 39% of those self-describing as "other or mixed" race, and 31% of Hispanic participants, as compared to 26% of those of Asian descent and 19% of those identifying as White. When the highest level of FKP was considered, Black participants were 12 times more likely than White participants to report "extreme" fear of death at the hands of police. Lesbian, gay, bisexual, transgender, queer, and more participants were also more likely than cisgender/heterosexual respondents to report both FKP (35% vs. 20%) and "extreme" FKP (8% vs. 3%). FKP was also more prevalent among those self-reporting unprovoked police aggression in the past and those for whom police aggression had led to posttraumatic stress disorder. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Sexual assault trauma: Does prior childhood maltreatment increase the risk and exacerbate the outcome?

BACKGROUND: Some individuals who have been sexually assaulted as adolescents or adults have also been abused in childhood, although it is not clear how different forms of childhood maltreatment are related to adolescent/adult sexual assault, and how earlier abuse alters the relationship between sexual assault and current symptomatology. OBJECTIVE: We sought to determine which types of child maltreatment are associated with adolescent or adult sexual assault, whether such child maltreatment interacts with sexual assault to predict more severe symptoms, and if sexual assault has unique symptom correlates after controlling for prior child maltreatment. PARTICIPANTS AND SETTING: Participants were 398 women recruited online. RESULTS: A total of 36 % of women had experienced unwanted sexual contact at age 13 or younger (childhood sexual abuse [CSA]), 32 % had experienced unwanted sexual contact at age 14 or later (adolescent/adult sexual assault), and 24.4 % had experienced both. Of all forms of child maltreatment, only CSA was associated with sexual assault, doubling the risk relative to those without a history of CSA. CSA and sexual assault were each uniquely associated with current symptomatology, however there was no interaction between sexual assault and CSA on psychological symptoms. CONCLUSIONS: CSA is associated with a greater risk of later sexual assault, and both CSA and sexual assault have additive effects on adult symptomatology. However, prior sexual abuse does not appear to exacerbate the effects of sexual assault, and sexual assault is associated with lasting psychological sequelae even when controlling for sexual abuse.

Childhood Victimization and Physical Health in Women: The Mediating Role of Adult Attachment.

Research has shown that female survivors of childhood abuse (CA) are more likely than nonabused women to experience long-term physical health concerns. Adult attachment may influence this relationship given that attachment insecurity has been linked to poorer physical health and postulated mechanisms of action are similar. This study used structural equation modeling to investigate whether adult attachment insecurity mediates the relationship between four types of CA and self-reported physical health in 538 undergraduate women. CA prevalence rates ranged from 11.7% (sexual abuse) to 34.9% (psychological abuse). In separate structural equation models, direct pathways were significant between CA and adult attachment insecurity, CA and adult physical health, and adult attachment insecurity and adult physical health. Adult attachment insecurity was found to partially mediate health outcomes in CA survivors, S-B χ2 = 116.60 (58), p < .001; comparative fit index = .95; Tucker-Lewis index = .94; root mean square error of approximation = .05; and confidence interval = [.03, .06]. Physical health is a significant concern for survivors of CA, and these results suggest improving attachment security may represent an important avenue of intervention.

The Disorganized Response Scale: Construct validity of a potential self-report measure of disorganized attachment.

OBJECTIVE: Based on the paucity of self-report measures of disorganized attachment (DA), we developed and tested a scale examining adults' self-reported disorganized verbalizations, cognitions, and behaviors when discussing their childhoods. METHOD: The Disorganized Response Scale (DRS) was created and administered to 640 university students, and its associations with variables known to covary with DA, such as childhood maltreatment, insecure attachment, and psychological symptoms, were examined. RESULTS: Factor analysis of DRS items revealed a single 15-item dimension that reflected participants' self-reported disorganized responses when discussing their childhoods. Structural equation modeling indicated a good fit to a model in which fearful caretaking and childhood abuse and neglect were associated with the DRS. In turn, the DRS, along with anxious and avoidant attachment, was independently related to symptoms and partially mediated the relationship between child maltreatment and symptomatology. Hierarchical multiple regression indicated that the DRS accounted for significant additional variance in posttraumatic stress, externalization, somatization, and, especially, dissociation, even after demographics and both anxious and avoidant attachment were taken into account. CONCLUSIONS: Analyses support the construct validity of the DRS as a measure of disorganized attachment-related responses in adults. Further research is indicated to replicate these findings and to evaluate their convergence with interview measures of DA. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Childhood maltreatment, attachment, and borderline personality-related symptoms: Gender-specific structural equation models.

OBJECTIVES: Survivors of early interpersonal trauma may experience relational problems, anger, impulsive and self-destructive behaviors, identity disturbance, and other difficulties that are associated with borderline personality disorder. Insecure attachment also has been documented in survivors and may be related to borderline personality-related symptoms (BPRS). The goal of the current study was to examine an integrative model of maternal and paternal childhood maltreatment and insecure attachment as they predict BPRS. METHOD: The sample was composed of 954 participants who completed self-report measures of parental maltreatment during childhood, attachment security, and trauma-related symptoms. RESULTS: Structural equation modeling suggested differential impacts of maternal and paternal maltreatment on male and female participants. Both maternal and paternal maltreatment were directly associated with BPRS in women, whereas in men, only paternal maltreatment was directly related to BPRS. In women, paternal maltreatment was indirectly associated with BPRS through attachment anxiety but not through attachment avoidance. In men, maternal maltreatment was indirectly associated with BPRS through attachment anxiety but not through attachment avoidance. CONCLUSION: These findings have implications for the understanding of gender-specific etiologies of borderline personality symptoms and underscore attachment security as an important intervention target. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Intimate Partner Violence in Male Survivors of Child Maltreatment: A Meta-Analysis.

Intimate partner violence (IPV) is a major public health concern. Yet, despite an increasingly extensive literature on interpersonal violence, research on male victims of IPV remains sparse and the associations between different forms of child maltreatment (CM) and IPV victimization and perpetration in men remains unclear. The present meta-analysis evaluated five different forms of CM (sexual, physical, and psychological abuses, neglect, and witnessing IPV) as they predicted sexual, psychological, and physical IPV perpetration and victimization in men. Overall, most available studies examined men as perpetrators of IPV, whereas studies of victimization in men were relatively scarce. Results reveal an overall significant association ( r = .19) between CM and IPV. The magnitude of this effect did not vary as a function of type (perpetration vs. victimization) or form (sexual, psychological, or physical) of IPV. Although all forms of CM were related to IPV, with effect sizes ranging from .05 (neglect and IPV victimization) to .26 (psychological abuse and IPV victimization), these associations varied in magnitude according to the type of CM. Findings suggest the importance of expanding research on CM and IPV to include a range of different kinds of abuse and neglect and to raise concerns about the experience of men as both victims and perpetrators of IPV.

Disengaged parenting: Structural equation modeling with child abuse, insecure attachment, and adult symptomatology.

Based on attachment theory, we hypothesized that self-reported childhood experiences of disengaged parenting (DP) would predict adults' psychological symptoms even more than, on average, childhood sexual, physical, or psychological abuse. In a large (N=640) university sample, bootstrapped multiple regression analyses indicated that although various forms of child maltreatment were correlated with symptomatology at the univariate level, DP was the primary multivariate predictor. Structural equation modeling indicated significant direct paths from (a) DP to both nonsexual child maltreatment and sexual abuse, (b) DP and nonsexual child maltreatment to insecure attachment, and (c) sexual abuse and insecure attachment to symptomatology. There were significant indirect effects of DP on psychological symptoms through sexual and nonsexual abuse, as well as through attachment. These results suggest that although child abuse has direct and indirect impacts on psychological symptoms, exposure to DP may be especially detrimental, both by increasing the risk of child abuse and by virtue of its impacts on attachment insecurity. They also support the potential use of attachment-oriented intervention in the treatment of adults maltreated as children.

Adult Sexual Outcomes of Child Sexual Abuse Vary According to Relationship Status.

This study tested a moderation model in which the association between child sexual abuse severity and negative sexual outcomes (i.e., sexual avoidance and compulsivity) differed as a function of relationships status (i.e., single, cohabiting, and married individuals). A sample of 1,033 adults completed self-report questionnaires online, and 21.5% reported childhood sexual abuse. Path analyses indicated that child sexual abuse severity was associated with higher sexual compulsivity in single individuals, both higher sexual avoidance and compulsivity in cohabiting individuals, and higher sexual avoidance in married individuals. The moderation model was invariant across men and women. These results suggest that the time course of negative sexual outcomes associated with child sexual abuse may follow distinct patterns of expression according to relationship status.

Identity and relatedness as mediators between child emotional abuse and adult couple adjustment in women.

The empirical literature indicates that childhood emotional abuse (CEA) produces long lasting impairments in interpersonal relatedness and identity, often referred to as self-capacities. CEA has also been shown to negatively impact couple functioning. This study examined the role of identity and interpersonal conflicts in mediating the relationship between CEA and women's report of couple adjustment among 184 French Canadian women from the general population. Path analysis revealed that CEA was related to poorer couple adjustment through its impact on dysfunctional self-capacities and the experience of greater conflicts in relationships. Findings highlight the importance of assessing CEA to better explain couple adjustment in women with relationship difficulties and provide potential intervention targets based on the self-capacities framework.

Dissociation in individuals denying trauma exposure: findings from two samples.

A number of studies suggest that dissociation is reliably related to trauma exposure, and that inadequate regulation of posttraumatic distress may be a significant factor. We examined whether affect dysregulation predicts dissociation in those denying any lifetime exposure to trauma. These relationships were evaluated in a general population sample and a second sample of nontraumatized university students. In the first study, multivariate analyses indicated that, along with gender, affect dysregulation was a relatively strong predictor, accounting for 27% of the variance in dissociation. In the replication study, dissociation was associated with affect dysregulation, but not gender. Affect dysregulation seems to predict dissociative symptomatology in nontraumatized individuals. It is hypothesized that emotional distress, whether from trauma or other etiologies, motivates dissociation to the extent that it challenges the individual's compromised capacity for affect regulation. Treatment implications may include the potential helpfulness of interventions that increase emotion regulation skills.

Avoidant and compulsive sexual behaviors in male and female survivors of childhood sexual abuse.

The main objectives of this study were to test a theory-based mediation model in which the relation between childhood sexual abuse (CSA) and dyadic adjustment is mediated through adult sexual avoidance and sexual compulsivity and to examine the gender-invariance of this model. A sample of 686 adults currently involved in a close relationship completed online self-report computerized questionnaires. Prevalence of CSA was 20% in women and 19% in men. In line with our hypotheses, path analyses and structural equation analyses showed that, for both women and men, CSA was associated with more sexual avoidance and sexual compulsivity, which, in turn, predicted lower couple adjustment. Overall, these findings suggest that both avoidant and compulsive sexuality are relevant intervention targets with couples in which one or both partners are CSA survivors.

Physical and psychological maltreatment in childhood and later health problems in women: an exploratory investigation of the roles of perceived stress and coping strategies.

OBJECTIVE: This retrospective, cross-sectional study investigated the association between childhood physical and psychological maltreatment and self-reported physical health concerns in adult women. The mediating roles of perceived stress and coping strategies were examined. METHODS: Participants were 235 women (aged 18-59 years) recruited from the community. Semi-structured interviews and questionnaires were used to assess self-reported childhood maltreatment and current perceived stress, coping strategies, and health status. Data were analyzed using structural equation modeling. RESULTS: After controlling for a history of child sexual abuse and relevant demographic variables, child physical and psychological maltreatment were significantly associated with greater physical health concerns. Support was found for models in which perceived stress and emotion-focused coping partially mediate the relation between maltreatment and health problems; problem-focused and avoidance coping did not operate as mediators. Multi-mediation model testing indicated that emotion-focused coping and perceived stress together better explain the relationship between child maltreatment and physical health than either variable alone. CONCLUSION: Findings suggest that child maltreatment is an important risk factor for adverse health outcomes in later life and that current stress and coping strategies may influence this relationship. Implications for the physical health of maltreatment survivors are discussed. PRACTICE IMPLICATIONS: The management of perceived stress and the use of adaptive emotion-focused coping responses in the everyday lives of maltreated women may be particularly useful points of intervention in order to mitigate physical health concerns in adulthood.

Posttraumatic stress symptoms as a mediator between sexual assault and adverse health outcomes in undergraduate women.

This study investigated the links between sexual assault experiences, posttraumatic stress symptoms, and adverse physical health outcomes among undergraduate women. Existing research has demonstrated that posttraumatic stress disorder mediates the relationship between trauma exposure and physical health in general, but this has yet to be tested for sexual assault specifically. Using structural equation modeling, support was found for a model in which posttraumatic stress symptom severity partially mediates the association between sexual assault severity and self-reported health outcomes. An alternative model using depression symptoms did not meet the criteria for mediation. Implications for the physical health of sexual assault survivors are discussed.

Sexual revictimization: the role of sexual self-esteem and dysfunctional sexual behaviors.

Disproportionately high rates of sexual revictimization have been noted among former victims of child sexual abuse (CSA), yet researchers have yet to determine the source of this apparent vulnerability to reexperience sexual violence. This study explores this issue by examining sexual self-esteem, sexual concerns, and sexual behaviors among 402 university women. Compared to women without a history of CSA (n = 348), women with a history of CSA (n = 54) had lower sexual self-esteem, poorer sexual adjustment, and were 2 times more likely to have experienced sexual assault since the age of 14 years. Structural equation modeling indicated that the relationship between child abuse (i.e., CSA and child psychological maltreatment) and sexual revictimization was partially mediated by sexual self-esteem, sexual concerns, and high-risk sexual behaviors. This study emphasizes the need for further research on child maltreatment, revictimization, and women's sexual adjustment.

Is dissociation a multidimensional construct? Data from the Multiscale Dissociation Inventory.

The dimensionality of dissociation was examined in a combined sample of 1,326 general population, clinical, and university participants who completed the Multiscale Dissociation Inventory (MDI). Principal components analysis identified five moderately intercorrelated factors (mean r = .39): Disengagement, Identity Dissociation, Emotional Constriction, Memory Disturbance, and Depersonalization/Derealization. Differential relationships were found between individual MDI factors and demographics, trauma history, clinical status, posttraumatic stress, and scores on other dissociation measures. Surprisingly, after controlling for sex and age, trauma exposure accounted for only 3 to 7% of the variance in MDI factors. The notion of dissociation as a general trait was not supported. Instead, dissociation may represent a variety of phenomenologically distinct and only moderately related symptom clusters whose ultimate commonality is more theoretical than empirical.

The Inventory of Altered Self-Capacities (IASC): a standardized measure of identity, affect regulation, and relationship disturbance.

This article describes the Inventory of Altered Self-Capacities (IASC), a 63-item standardized measure of disturbed functioning in relation to self and others. The seven scales of the IASC are Interpersonal Conflicts, Idealization-Disillusionment, Abandonment Concerns, Identity Impairment, Susceptibility to Influence, Affect Dysregulation, and Tension Reduction Activities. The psychometric properties of the IASC were examined in general population, clinical, and university samples. The IASC was found to have internal consistency/reliability and validity in all three samples. Generally as predicted, IASC scales were associated with existing measures tapping borderline and antisocial personality features, depression, suicidality, substance abuse, somatization, and dysfunctional sexual behavior

Health concerns of university women with a history of child physical and sexual maltreatment.

Three health symptom checklists were used to measure physical health concerns among university women in relation to prior child physical maltreatment (CPM) (20%, n = 153) and child sexual abuse (CSA) (19%, n = 143). A history of CPM was related to all three general areas of health concerns as well as to many of the specific subscales comprising the measures (e.g., muscular-skeletal symptoms and gynerological problems), whereas an interaction between CSA and CPM was linked to greater premenstrual distress subscale scores (particularly emotional and behavioral symptoms). Overall, although CSA was not related to health symptoms, within the CSA subgroup, greater duration and severity of CSA was predictive of higher premenstrual distress even after controlling for CPM. This study emphasizes the need for greater awareness of the physical health-related correlates of both physical and sexual maltreatment in childhood and their associated implications for women's health care needs.