The revictimization of child sexual abuse survivors: an examination of the adjustment of college women with child sexual abuse, adult sexual assault, and adult physical abuse

Child sexual abuse (CSA) is associated with greater vulnerability to victimization in adulthood. Such experiences may have a cumulative effect. This study compared the adjustment of 633 women experiencing revictimization, multiple adult victimizations, single adult victimization, CSA only, or no victimization. Somatization, depression, anxiety, interpersonal sensitivity, hostility, and post-traumatic stress disorder (PTSD) symptomatology were examined. Results support the cumulative effect of trauma but do not indicate differential effects for child to adult revictimization. Women with revictimization and multiple adult assaults reported more difficulties compared to women with only one form of adult abuse or no victimization. Women with CSA only reported similar symptoms as revictimized women and women with multiple adult assaults reported higher levels of distress than nonabused women and appeared somewhat more likely to experience anxiety and PTSD-related symptoms as compared to women with only adult abuse. Women with adult assault only and no abuse reported similar levels of distress.     

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.     

From the newborn infant to the child, to the adult: historia magistra vitae

The hypothesis of the prenatal programming of adult diseases took on increasing interest from the moment that, in the 60s, an epidemiological association was proposed between low birth weight and cardiovascular diseases. In the last 20 years it has been demonstrated that individuals with low weight, low stature and thinness at birth have a higher risk of developing cardiovascular diseases and type 2 diabetes. Animal and clinical studies are casting light on the biological mechanisms underlying the association between modified development in the uterus and diseases, and on how growth in adolescence and in adult life can modulate this initial proneness to disease. One of the mechanisms that has aroused most interest among researchers is the reduced number of nephrons, associated with low birth weight, which predisposes to glomerulosclerosis and increased systemic arterial pressure in adult life. A correlation has also been found between low weight at birth and peripheral resistance to insulin. Nevertheless, it is thought that modified prenatal development is only a predisposing factor, open to profound influences in the course of postnatal development. It has in fact been demonstrated that accelerated development in the period of infancy and adolescence can extend the initial condition of neonatal suffering. Indirectly these studies renew and at the same time extend the concept of prevention, a priority aim of the physician of the third millennium.     

Physical abuse: the profile of aggressor and child victim

OBJECTIVE: To establish the profile of children who suffer abuse and of abuse perpetrators. METHODS: 225 cases of confirmed child-abuse in Curitiba, state of Paraná, were studied in 1998 based on information collected using a protocol. RESULTS: The following patterns were observed: 56% of the children were in school age; 59.6% were the first child of the couple; 84.4% were natural offspring; and 71.1% of the children had a satisfactory school record. Multiple injuries (38.2%) were found on the victim? bodies, mostly bruises (37.8%). The main aggressor was the mother (42.2%); 25.8% of them said that the reason for the violence was disciplining the child; 72% of the mothers denied the use of alcohol. CONCLUSION: Our results reveal that the children who are most affected by physical abuse are the first-borns of married couples, with age between 5 and 11 years; their schooling level is compatible with their age. Most violent acts are performed by the mother, who hits the child leaving bruises on several parts of the victimacute;s body, with the objective of educating, or setting limits to the child.     

An ecological approach to understanding sexual revictimization: linking personal, interpersonal, and sociocultural factors and processes

This article applies an ecological model to the problem of sexual revictimization to advance the understanding of how personal, interpersonal, and sociocultural factors contribute to child sexual abuse victims' increased risk of being sexually victimized later in life. This ecological model explores how sexual revictimization is multiply determined by factors related to the victim's personal history (e.g., traumatic sexualization), the relationship in which revictimization occurs (e.g., decreased ability to resist unwanted sexual advances), the community (e.g., lack of family support), and the larger culture (e.g., blaming the victim attitudes). This article represents a step toward integrating findings on sexual revictimization and providing directions for future empirical work.     

Adult sexual revictimization among black women sexually abused in childhood: a prospective examination of serious consequences of abuse

This study is a prospective investigation of adult sexual revictimization among 113 Black women with documented histories of childhood sexual abuse. The purpose was to obtain information on the frequency of sexual abuse in both childhood and adulthood and to determine which characteristics of the child sexual abuse were predictive of revictimization. Thirty percent of the participants were revictimized and physical force predicted subsequent victimization. This study also investigated possible sexual behavioral correlates of revictimization. Revictimized women reported more involvement in prostitution and partner violence. Finally, the present study considered the reproductive and sexual health correlates of revictimization. When compared to women abused in childhood only, revictimized women experienced more problems conceiving, repeated vaginal infections, sexually transmitted diseases, and painful intercourse. Suggestions for intervention are discussed.     

Disclosure, reactions, and social support: findings from a sample of adult victims of child sexual abuse

Information about abuse characteristics, disclosure, and current social support was collected through semistructured interviews and questionnaires from 122 adult women reporting exposure to child sexual abuse by someone close. Women who used an active disclosure strategy in childhood reported more physical and violent abuse. Moreover, women who reported more severe abuse had more often received negative reactions from the social network. Furthermore, a relation was found between current social support and positive-but not negative-reactions.     

From child health surveillance to child health promotion, and onwards: a tale of babies and bathwater

Child health surveillance (CHS) has evolved greatly over the past 30 years from a proactive screening process by health professionals to a more passive approach of child health promotion (CHP), which places the main responsibility for detection of developmental problems on carers. The impetus for this change came from the Hall Report (1989), which reported a lack of evidence for CHS. Although research on developmental screening is sparse, some data show that use of structured methods for identifying deviations from normal increases the pick-up rate of abnormalities, compared with informal or parent-initiated methods. The majority of countries recommend a universal 'CHS' type of programme, in contrast to the UK and some other European countries. Alternatives to universal CHS include 'targeting' which, however, has been criticised for including too many 'normal' children and missing those who are most in need. CHS and CHP are basically primary care activities but require essential support from secondary paediatric services. There are concerns about the competence and numbers of general practitioners and health visitors who deliver child healthcare. Both these professional groups are under great pressure because of continuing reorganisations of the National Health Service in the UK. Politically driven agendae complicate the fundamental aim of enhancing child health at the primary level and it is vital to keep the focus on providing high-quality services to the most needy children. CHS has evolved beyond CHP to a Healthy Child Programme (HCP). Hopefully this is not an 'emperor's new clothes' situation and will improve outcomes. A major problem is the 'inverse care law', and reliance on carers runs the risk of excluding those children who need most input. Inequality is currently a headline problem and the change from CHS to HCP may not have helped. More research is urgently needed to resolve uncertainty about the application of these fundamental procedures for secondary preventive of childhood disability.     

Prevention of child sexual abuse: evaluation of a community media campaign

Given that mass media techniques have been an effective tool within the public health field for affecting behavioral change, these strategies may prove successful for the primary prevention of child sexual abuse (CSA). This study was an independent evaluation of a CSA media campaign. Two hundred parents were recruited from eight sites across the United States. Results indicated that the combined mass media campaign affected knowledge about CSA at the time of intervention compared to no intervention. No significant differences were found in regards to CSA attitudes. A significant positive impact on primary prevention response behaviors assessed using hypothetical vignettes was found; however, no significant findings were noted for several other behavioral responses. Knowledge and behavioral gains were not maintained at the one-month follow-up. Small sample size at follow-up may have affected findings. Results of this study imply that media campaigns alone may not significantly affect primary prevention of CSA.