Emerging Adult LGB+ Romantic Relationships: Narratives about Met and Unmet Relationship Needs.

Although emerging adulthood is recognized as a pivotal time for relationship development, most studies concern heterosexual youth or older sexual minority partners. Using narratives from 40 college student emerging adults, we sought to understand the particularities and generalities of lesbian, gay, bisexual and other sexual minority (LGB+) relationship experiences. Positive experiences particular to being in a LGB+ relationship concerned partner support for coming and being out; support from family members for the relationship was rarely mentioned. Negative experiences were twice as likely to be mentioned as positive ones. They concerned how partners being at different levels of outness and problems with family support stressed the relationship. Generalities pertaining to positive relationship factors included meeting needs for support and using perspective taking to deal with conflict. Negative factors included unmet needs for companionship and intimacy and breakup anxiety about whether the relationship had a future. Our findings suggest the importance of developing strength-based LGB+ affirmative education for emerging adults to promote core relationship processes and strengthen skills to cope with stressors specific to sexual minority romantic partnerships.

Romantic Conflict Narratives in Emerging Adult Couples: Viewpoint and Gender Matter.

Healthy romantic relationships entail understanding the needs of the self and other when interpreting conflict events. Yet how couples make meaning around specific conflicts and their capacity to reflect on their own and their partners' unmet needs is understudied. Using narratives, we examined destructive (e.g., extreme anger and break-up anxiety) and constructive (e.g., perspective taking) interpretations of past romantic conflicts in 80 emerging adult heterosexual couples and the extent to which such interpretations varied by viewpoint and gender. Couple members were interviewed separately about two conflict episodes in which their partner did not meet their needs (victim viewpoint) and two episodes in which they did not meet their partners' needs (perpetrator viewpoint). As anticipated, destructive interpretations were more evident in the victim viewpoint and for female couple members. In contrast, within constructive interpretations, the use of insight was greater in the perpetrator than the victim viewpoint. Although perspective taking was expected to be more common in the perpetrator viewpoint and in female narratives, this was not the case, as this type of constructive interpretation was infrequent in narratives about conflict. The findings revealed aspects of meaning making that might be useful to mental health professionals concerned with building skills to improve romantic competence in emerging adult couples.

Las relaciones amorosas saludables implican comprender las necesidades del yo y del otro a la hora de interpretar situaciones de conflicto. Sin embargo, hay pocos estudios sobre la manera en la que las parejas dan sentido a conflictos específicos y su capacidad de reflexionar sobre sus propias necesidades no satisfechas y las de sus parejas. Utilizando relatos, analizamos interpretaciones destructivas (p. ej.: enfado intenso y ansiedad por una separación) y constructivas (p. ej.: adopción de un punto de vista) de conflictos amorosos del pasado en 80 parejas heterosexuales de adultos emergentes y la medida en que dichas interpretaciones variaron según el punto de vista y el género. Se entrevistó por separado a los integrantes de las parejas acerca de dos episodios de conflicto en los cuales su pareja no satisfizo sus necesidades (punto de vista de la víctima) y dos episodios en los cuales ellos no satisficieron las necesidades de sus parejas (punto de vista del perpetrador). Como se anticipó, las interpetaciones destructivas fueron más evidentes en el punto de vista de la víctima y en los integrantes femeninos de la pareja. Por el contrario, dentro de las interpretaciones constructivas, el uso de comprensión fue mayor en el punto de vista del perpetrador que en el de la víctima. Aunque se esperaba que la adopción de perspectivas fuera más común en el punto de vista del perpetrador y en los relatos femeninos, no fue así, ya que este tipo de interpretación constructiva fue infrecuente en los relatos sobre los conflictos. Los resultados revelaron aspectos de la creación de significado que podrían ser útiles para los profesionales de la salud mental interesados en el desarrollo de habilidades orientadas a mejorar la aptitud amorosa en las parejas de adultos emergentes.

Adaptation and Validation of the Shame Questionnaire Among Ugandan Youth Living with HIV.

The purpose of this study was to adapt and validate a measure of HIV-related shame, the Shame Questionnaire (SQ), among Ugandan youth living with HIV. Culturally relevant, reliable and valid measurement is critical in the accurate assessment of HIV-related shame (a painful internalized emotion encompassing feelings that the self is damaged and defective) on psychosocial functioning, as well as the determination of the efficacy of interventions among youth living with HIV in sub-Saharan Africa. We utilized qualitative (i.e., cognitive interviews; N = 31) and quantitative (i.e., classical test theory and item response theory; N = 150) methods to establish, content, criterion and construct validity of the SQ. Cognitive interviews resulted in the revision in the wording of 2 out of 8 SQ items. Participants who endorsed having shame had statistically significant higher SQ scores than participants who did not endorse having shame (p < 0.001), suggesting criterion validity. We found a statistically significant positive relationship between SQ scores and average trauma symptom scores among participants (p < 0.001), also suggesting criterion validity. Finally, we found construct validity with discrimination parameters of the graded response IRT model all in the high range with a wide range of difficulty parameters across the 8 items of the SQ. Overall our results suggest that the SQ is a contextually relevant, valid and reliable assessment tool among Ugandan youth living with HIV. Findings provide support for the utilization of qualitative and quantitative methods in the adaptation of measures for cross-cultural use in order to maintain validity and contextual relevance.

Early Stigmatization, PTSD, and Perceived Negative Reactions of Others Predict Subsequent Strategies for Processing Child Sexual Abuse.

OBJECTIVE: Trauma processing is central to healthy recovery, but few studies examine how youth process experiences of child sexual abuse (CSA). The current study builds on our prior work identifying individual differences in CSA processing strategies (i.e., Constructive, Absorbed, Avoidant) to examine whether abuse stigmatization, PTSD symptoms, and negative reactions from others experienced during the year after abuse discovery were associated with subsequent CSA processing strategies. METHOD: Participants included 160 ethnically diverse youth (8-15 years, 73% female) with confirmed cases of CSA. Predictors were measured at abuse discovery (T1) and 1 year later (T2). Individual differences in CSA processing strategies were assessed 6 years after discovery (T3) from participants' abuse narratives. RESULTS: The persistence of abuse stigmatization from T1 to T2 significantly increased the odds of using either an Avoidant or Absorbed (vs. Constructive) strategy at T3. Higher levels of PTSD symptoms at T1 as well as their persistence from T1 to T2 each significantly increased the odds of having an Absorbed versus Constructive strategy. The persistence of perceived negative reactions from others from T1 to T2 increased the odds of an Absorbed versus Avoidant strategy. Effect sizes ranged from medium to large (M d = 0.636). CONCLUSIONS: Results further validate prior work identifying distinct CSA processing strategies and suggest the persistence of abuse-specific disruptions over the year after abuse discovery may be associated with subsequent problems processing CSA experiences.

Positive and Negative Posttraumatic Change Following Childhood Sexual Abuse Are Associated With Youths' Adjustment.

Meanings made of childhood sexual abuse (CSA) experiences are important to psychosocial adjustment. The current study examined adolescents' and young adults' perceptions of posttraumatic change (PTC) in the self, relationships, sexuality, and worldviews attributed to prior CSA experiences. We sought to document the prevalence of positive and negative PTC and examine their unique and joint associations with psychosocial adjustment. Participants included 160 youth with confirmed cases of CSA (73% female; 8-14 years at abuse discovery) who were part of a longitudinal study of the long-term effects of CSA. Six years after discovery, youth were interviewed about their abuse experiences. Interviews were coded for the valence and strength of PTC. The majority of youth reported PTC, and negative changes were more frequent and stronger than positive changes. Controlling for age, gender, abuse severity, and negative PTC, positive PTC was associated with lower abuse stigmatization for all youth. Controlling for age, gender, abuse severity, and positive PTC, negative PTC was associated with greater abuse stigmatization, post-traumatic stress disorder, sexual problems, and dating aggression for all youth. Relations of positive PTC with depression and support from friends and romantic partner were moderated by negative PTC, such that positive PTC was associated with better adjustment for youth with low versus high levels of negative PTC. Results highlight the importance of both negative and positive PTC for understanding meanings made of CSA experiences and their implications for psychosocial adjustment and intervention.

Potential pathways from stigmatization and externalizing behavior to anger and dating aggression in sexually abused youth.

Although experiencing childhood sexual abuse (CSA) puts youth at risk for involvement in relationship violence, research is limited on the potential pathways from CSA to subsequent dating aggression. The current study examined prospective pathways from externalizing behavior problems and stigmatization (abuse-specific shame and self-blame attributions) to anger and dating aggression. One hundred sixty youth (73% female, 69% ethnic/racial minorities) with confirmed CSA histories were interviewed at the time of abuse discovery (T1, when they were 8-15 years of age), and again 1 and 6 years later (T2 and T3). Externalizing behavior and abuse-specific stigmatization were assessed at T1 and T2. Anger and dating aggression were assessed at T3. The structural equation model findings supported the proposed relations from stigmatization following the abuse to subsequent dating aggression through anger. Only externalizing behavior at T1 was related to later dating aggression, and externalizing was not related to subsequent anger. This longitudinal research suggests that clinical interventions for victims of CSA be sensitive to the different pathways by which youth come to experience destructive conflict behavior in their romantic relationships.

Making meaning of traumatic events: youths' strategies for processing childhood sexual abuse are associated with psychosocial adjustment.

The need to make meaning of childhood sexual abuse (CSA) is common and often persists long after the abuse ends. Although believed to be essential for healthy recovery, there is a paucity of research on how youth process their CSA experiences. The current study identified individual differences in the ways youth process their CSA and examined associations with psychosocial adjustment. A sample of 108 youth with confirmed abuse histories enrolled in the study within 8 weeks of abuse discovery, when they were between 8 and 15 years old. Six years later, they participated in interviews about their CSA experiences, reactions, and perceived effects. Using a coding system developed for this study, youths' CSA narratives were reliably classified with one of three processing strategies: Constructive (13.9%), Absorbed (50%), or Avoidant (36.1%). Absorbed youth reported the highest levels of psychopathological symptoms, sexual problems, and abuse-specific stigmatization, whereas Constructive youth tended to report the fewest problems. Avoidant youth showed significantly more problems than Constructive youth in some but not all areas. Interventions that build healthy processing skills may promote positive recovery by providing tools for constructing adaptive meanings of the abuse, both in its immediate aftermath and over time.

Abuse-specific self-schemas and self-functioning: a prospective study of sexually abused youth.

Potential pathways from childhood sexual abuse (CSA) to negative self-schemas to subsequent dissociative symptoms and low global self-esteem were examined in a prospective longitudinal study of 160 ethnically diverse youth with confirmed CSA histories. Participants were interviewed at the time of abuse discovery, when they were 8 to 15 years of age, and again 1 and 6 years later. Abuse-specific indicators of stigmatization, in particular the combination of shame and self-blame more than general self-blame attributions for everyday events, explained which youth with CSA histories experienced more dissociative symptoms and clinically significant levels of dissociation. Abuse-specific stigmatization was found to operate as a prospective mechanism for subsequent dissociative symptoms but not self-esteem.

Childhood sexual abuse, stigmatization, internalizing symptoms, and the development of sexual difficulties and dating aggression.

Potential pathways from childhood sexual abuse (CSA) to subsequent romantic intimacy problems were examined in a prospective longitudinal study of 160 ethnically diverse youth with confirmed CSA histories. Participants were interviewed at the time of abuse discovery, when they were 8-15 years of age, and again 1-6 years later. Stigmatization (abuse-specific shame and self-blame) and internalizing symptoms (posttraumatic stress and depressive symptoms), more than abuse severity, explained which youth with CSA histories experienced more sexual difficulties and dating aggression. Stigmatization was found to operate as a predictive mechanism for subsequent sexual difficulties. Internalizing symptoms were not predictive of romantic intimacy problems, although they did show correlational relations with sexual difficulties and dating aggression. Early interventions such as trauma-focused cognitive-behavioral therapy that target stigmatization may be important for preventing the development of sexual difficulties in CSA youth.

Sexual anxiety and eroticism predict the development of sexual problems in youth with a history of sexual abuse.

Youth with confirmed histories of sexual abuse (N = 118) were followed longitudinally to examine associations between their initial sexual reactions to abuse and subsequent sexual functioning. Participants were interviewed at abuse discovery (ages 8 through 15) and again 1 and 6 years later. Eroticism and sexual anxiety emerged as distinct indices of abuse-specific sexual reactions and predicted subsequent sexual functioning. Eroticism was associated with indicators of heightened sexuality, including more sexual risk behavior and views of sexual intimacy focused on partners' needs. Sexual anxiety was associated with indicators of diminished sexuality, including few sexual partners and avoidant views of sexual intimacy. Age at abuse discovery moderated some associations, suggesting that the timing of abuse-specific reactions affects trajectories of sexual development. Findings point to the need for a developmental approach to understanding how abuse-specific sexual reactions disrupt sexual development and the need for early interventions promoting healthy sexual development.

Childhood sexual abuse and abuse-specific attributions of blame over 6 years following discovery.

OBJECTIVE: The purpose of this study was to examine patterns of change in attributions for childhood sexual abuse (CSA) over a 6-year period and whether such patterns were related to abuse severity, age, gender, and subsequent symptoms of depression and PTSD. METHODOLOGY: One-hundred and sixty children, 8-15 years old, were interviewed within 8 weeks of the time the CSA was reported to child protective services (i.e., the time of abuse discovery). Follow-up interviews were conducted 1-year later on 147, and 6 years later on 121 of the original participants. Abuse-specific attributions were obtained using two methods. Participants first responded to an open-ended interview question about why they believed the CSA had happened to them and then completed a rating scale about the extent to which possible attributions for the CSA applied to them (e.g., "Because I was not smart enough"). RESULTS: Over time, perpetrator-blame attributions were consistently more common than self-blame attributions for CSA (using both interview and rating measures). Youth were more likely to report self-blame attributions on the rating measure than the open-ended interview question. The interview method indicated that youth often felt confused about why the abuse happened up to a year following discovery but this response diminished by the third assessment. On average, ratings of perpetrator-blame attribution remained high over time (p<.05), whereas ratings of self-blame decreased (p<.01). Penetration was related to more self-blame (p<.05) and less perpetrator-blame (p<.05), and the use of force was related to more perpetrator-blame. The initial level of self-blame attribution ratings predicted subsequent symptoms of depression (p<.05) and intrusive experiences (p<.05) after controlling for age at abuse discovery, gender, and self-blame attributions for common events. Perpetrator-blame attributions were not related to symptoms. CONCLUSIONS: The findings of this study suggest that assessing responses to open-ended interview questions about the perceived reasons for the abuse and ratings of attributions are important for understanding how youth make sense of their abuse. Abuse-specific self-blame attributions at abuse discovery have a persistent effect on internalizing symptoms and should be assessed and the target of treatment as soon as possible after CSA has been reported to the authorities.

Potential pathways from stigmatization and internalizing symptoms to delinquency in sexually abused youth.

Although childhood sexual abuse (CSA) has been linked to risk for delinquency, research is limited on the potential pathways from CSA to subsequent delinquent outcomes. A total of 160 youth with confirmed CSA histories were interviewed at the time of abuse discovery, when they were 8 to 15 years of age, and again 1 and 6 years later. The findings supported the proposed relations from stigmatization following the abuse (abuse-specific shame and self-blame attributions) and internalizing symptoms to subsequent delinquency through anger and affiliation with deviant peers. This longitudinal research suggests that clinical interventions for victims of CSA must be sensitive to these affective and cognitive processes and how they affect delinquent activity.

The persistence of shame following sexual abuse: a longitudinal look at risk and recovery.

This study investigated persistence in abuse-related shame during a 6-year period. One-hundred-eighteen sexually abused youth were interviewed at the time of discovery, and again both 1 and 6 years later. Individuals high in shame 1 year following discovery were especially at risk for persistently high levels of shame 6 years later. Youth with high shame for the abuse at 1 and 6 years were the most likely to report clinically significant levels of intrusive recollections at 6 years. Persistent shame may explain failure to process the abuse and the maintenance of posttraumatic stress disorder symptoms. The findings from this longitudinal study suggest that shame as a consequence of childhood sexual abuse should be a focus of treatment.

Emotional support and adjustment over a year's time following sexual abuse discovery.

OBJECTIVE: This study investigated age and gender differences in perceived emotional support in children and adolescents who experienced sexual abuse from the time of discovery to 1 year later. Also examined were the relations among sources of support and adjustment and whether support explained resilience, defined as better adjustment over a year's time. METHOD: One hundred and forty-seven sexually abused youth were interviewed at the time of discovery (T1) and 1 year later (T2). Information gathered included severity of the sexual abuse, satisfaction with support from caregivers, same-sex and other-sex friends, feelings of shame about the abuse, and attributional style. Youth adjustment was measured using reports from the youth themselves, caregivers, and teachers. RESULTS: Children reported the most satisfaction with support from caregivers followed by friends whereas adolescents reported similar levels of support from friends and caregivers. Satisfaction with support was differentially related to adjustment. Youth who reported more satisfaction with caregiver support at T1, reported less depression, better self-esteem but more sexual anxiety 1 year later. More satisfaction with support from friends predicted lower self-esteem but less sexual anxiety. More satisfaction with initial caregiver support at T1 predicted better parent- and teacher-rated adjustment 1 year later, after controlling for initial adjustment. CONCLUSIONS: In general, initial caregiver emotional support at the time of abuse discovery predicted resilience in child and adolescent victims of sexual abuse. Findings suggested that treatment should include a focus on helping caregivers provide appropriate emotional support.

Trying to understand why horrible things happen: attribution, shame, and symptom development following sexual abuse.

This study concerns the nature of specific attributions for sexual abuse and their relation to psychological distress over time. Participants (80 children and 57 adolescents) were seen within 8 weeks of discovery of the abuse and 1 year later They described why they believed the abuse happened, rated the extent to which internal and external attributions for the abuse event applied to them, and completed measures of general attribution styleforeveryday events, shame for the abuse, and symptoms of depression, PTSD, and self-esteem. Parents and teachers rated behavior problems. Abuse-specific internal attributions were consistently related to higher levels of psychopathology and were particularly importantforpredicting PTSD symptoms and parent and teacher reports of internalizing behavior problems, even after controlling for age, gender, abuse events, and general attributional style. Shame also was an important predictor of symptom level and mediated the relation between abuse-specific internal attributions and PTSD symptoms.

"Explaining why": a closer look at attributions in child abuse victims.

In summary, the empirical and conceptual articles in this special issue examine victims' attributions from multiple perspectives, including abuse-specific, abuse-related, and general attributions as well as attributions made by children and adults abused as children. The commentaries examine attributions in relation to treatment and in the context of a model of child abuse sequelae. Together, these articles examine some of the clinical/therapeutic, measurement, and scientific implications of this emerging topical area (e.g., what types of attributions merit evaluation and with what types of methods, how and when do we best modify maladaptive attributions, what assessment and treatment studies are needed to examine the role of attributions). We hope these articles will stimulate colleagues working with all forms maltreatment who are interested in research and treatment pertaining to attribution styles in childhood victims. Despite the complexities involved, the rewards for understanding which children are most at risk and for designing more effective treatments are many.

Adjustment following sexual abuse discovery: the role of shame and attributional style.

This study examined adjustment following sexual abuse as a function of shame and attributional style. One hundred forty-seven participants (83 children and 64 adolescents) were seen at the time of abuse discovery and again 1 year later. Once adjustment at abuse discovery was accounted for, shame and attribution style explained additional variation in subsequent adjustment, whereas abuse severity did not. A pessimistic attribution style at abuse discovery moderated the relation between severity of abuse and subsequent depressive symptoms and self-esteem. The relations between abuse severity and these outcomes were significant only at high levels of pessimistic attribution style. Of note, patterns of change in shame and attribution predicted which children remained at risk or improved in adjustment. In addition, age and gender differences were found in adjustment over time.