Serving Substance Abuse Professionals Since 1993 Last Update: 06.03.12

C O R K   O N L I N E
powerpoint presentations
CORK database search
resource materials
clinical tools
user services
about cork

CORK Bibliography: Sexual Abuse

41 citations. January 2009 to present

Prepared: March 2012

Asgeirsdottir BB; Sigfusdottir ID; Gudjonsson GH; Sigurdsson JF. Associations between sexual abuse and family conflict/violence, self-injurious behavior, and substance use: The mediating role of depressed mood and anger. Child Abuse & Neglect 35(3): 210- 219, 2011. (56 refs.)

Objective: To examine whether depressed mood and anger mediate the effects of sexual abuse and family conflict/violence on self-injurious behavior and substance use. Methods: A cross-sectional national survey was conducted including 9,085 16-19 year old students attending all high schools in Iceland in 2004. Participants reported frequency of sexual abuse, family conflict/violence, self-injurious behavior, substance use, depressed mood, and anger. Results: Sexual abuse and family conflict/violence had direct effects on self-injurious behavior and substance use among both genders, when controlling for age, family structure, parental education, anger, and depressed mood. More importantly, the indirect effects of sexual abuse and family conflict/violence on self-injurious behavior among both males and females were twice as strong through depressed mood as through anger, while the indirect effects of sexual abuse and family conflict/violence on substance use were only significant through anger. Conclusions: These results indicate that in cases of sexual abuse and family conflict/violence, substance use is similar to externalizing behavior, where anger seems to be a key mediating variable, opposed to internalizing behavior such as self-injurious behavior, where depressed mood is a more critical mediator. Practice implications: Practical implications highlight the importance of focusing on a range of emotions, including depressed mood and anger, when working with stressed adolescents in prevention and treatment programs for self-injurious behavior and substance use.

Copyright 2011, Elsevier Science

Bal B; Mitra R; Mallick AH; Chakraborti S; Sarkar K. Nontobacco substance use, sexual abuse, HIV, and sexually transmitted infection among street children in Kolkata, India. Substance Use & Misuse 45(10): 1668-1682, 2010. (30 refs.)

A community-based cross-sectional study among 554 Kolkata city street children assessed nontobacco substance use and sexual abuses along with human immunodeficiency virus (HIV)/sexually transmitted infections (STIs) during 2007, using conventional cluster sampling technique for "hard-to-reach population" with a field-tested questionnaire and the collection of a blood sample for HIV and syphilis serology testing as a composite indicator of STIs. The reported prevalence of nontobacco substance use was 30%; 9% reported having been sexually abused. Some factors (age, lack of contact with family, orphan children, night stay at public place, etc.) were documented to be associated with substance use and sexual abuses. Seroprevalence of HIV was found to be 1% and that of STIs was 4%. This 1% HIV seroprevalence in street children is a matter of concern. Community-based intervention is necessary for them. The study's limitations are noted.

Copyright 2010, Taylor & Francis

Behnken MP; Le YCL; Temple JR; Berenson AB. Forced sexual intercourse, suicidality, and binge drinking among adolescent girls. Addictive Behaviors 35(5): 507-509, 2010. (17 refs.)

Although sexual assault victimization has been shown to predict suicidality. little is known about the mechanisms linking these two factors. Using cross-sectional data (N = 6364) from the 2007 Youth Risk Behavior Survey, binge drinking significantly mediated the relationship between forced sexual intercourse and suicide for Hispanic (n = 1915) and Caucasian (it = 2928) adolescent females. but not for African American adolescent females (n = 1521). Results suggest the need for closer monitoring of adolescent victims of sexual assault who also abuse alcohol to intervene in early suicide behaviors. Treatment and intervention programs should also be culturally sensitive to account for differences in reaction to sexual trauma among race/ethnicity. Implications for suicide prevention and alcohol intervention strategies as well as suggestions to clinical providers are discussed.

Copyright 2010, Elsevier Science

Britton PC; Wines JD; Conner KR. Non-fatal overdose in the 12 months following treatment for substance use disorders. Drug and Alcohol Dependence 107(1): 51-55, 2010. (47 refs.)

Background: Overdose (OD) is a leading cause of mortality and morbidity for individuals with substance use disorders (SUDS), and there are limited prospective data on OD during the months following treatment for SUDS. Methods: Variables associated with an OD in the 12 months after leaving an initial treatment episode were examined in an analysis of the Drug Abuse Treatment Outcomes Study (DATOS), a longitudinal naturalistic multisite study. Participants included 2966 patients with one or more SUDS. Non-fatal OD was ascertained by a positive response to "In the past 12 months, have you overdosed on drugs?" Multivariate logistic regression analyses were used to identify variables associated with OD. Results: By 12 months, 93 (3.1%) participants reported one or more ODs. Variables associated with OD were lifetime history of OD, injection drug use (IDU), male sex, greater pain, and history of sexual abuse. Conclusions: OD-risk appears to be increased by IDU, lifetime OD, sexual abuse history, and pain. The latter finding is novel for a prospective report and requires further study.

Copyright 2010, Elsevier Science

Butt S; Chou SN; Browne K. A rapid systematic review on the association between childhood physical and sexual abuse and illicit drug use among males. (review). Child Abuse Review 20(1): 6-38, 2011. (57 refs.)

This paper aims to review studies in relation to the association between childhood physical (CPA) and sexual abuse (CSA) and illicit drug use among the male clinical and general community populations using a systematic approach. Primary studies were identified using online databases which were searched comprehensively using a set of pre-determined search criteria and terms. Other sources included expert contact and the reference list of a relevant review. Associations between exposure (CPA/CSA) and outcome (illicit drug use) were considered with regards to an array of factors. A total of 5012 references were initially identified out of which 18 studies met the necessary criteria for reviewing. The review demonstrates tentative support for factors such as earlier drug initiation, intravenous drug use and greater frequency of use among some of the samples. It also demonstrates the difficulties involved in drawing conclusions due to the complex and multifaceted nature of drug use and the variability in the quality of the research available in this area. Limitations of the current review are highlighted and recommendations offered for future research with consideration given to practical implications in clinical and forensic settings.

Copyright 2011, Wiley-Blackwell

Champion JD. Context of sexual risk behaviour among abused ethnic minority adolescent women. International Nursing Review 58(1): 61-67, 2011. (37 refs.)

Background: Evidence suggests that multiple influences on sexual behaviour of adolescents exist, ranging from relationships with significant others including sexual or physical abuse and childhood molestation to substances used prior to sex and environmental circumstances such as sex work. Purpose: This study aims to describe associations between childhood molestation and sexual risk behaviour. Method: African American and Mexican American adolescent women aged 14-18 years (n = 562) with sexually transmitted infection (STI) or abuse histories and enrolled in a randomized controlled trial of behavioural interventions were interviewed via self-report concerning sexual risk behaviour, abuse and childhood molestation at study entry. Results: Sexual (59%), physical (77%) and psychological (82%) abuse and childhood molestation (25%) were self-reported without differences by ethnicity. Adolescents reporting childhood molestation experienced more forms of sexual, physical and psychological abuse than others and higher incidences of STI. Fewer attended school; however, more had arrests, convictions, incarcerations and probations. Stressors including depression, running away, thoughts of death and suicide were highest for those reporting childhood molestation. Those reporting childhood molestation engaged in higher sexual risk behaviours than adolescents experiencing other forms of sexual or physical abuse (lifetime partners, bisexual relationships, anal and group sex, sex with friends with benefits, sex for money, concurrent partners, drug use including multiple substances, alcohol use and alcohol problems). These adolescents reported 'getting high' and having sex when out of control as reasons for sex with multiple partners. Conclusion: Interventions for abused adolescent women necessitate a focus on associations between childhood molestation and a multiplicity of sexual risk behaviours for prevention of abuse, substance use and sex work, STI/human immunodeficiency virus (HIV) and sequelae.

Copyright 2011, Wiley-Blackwell

Chan KL. Association between childhood sexual abuse and adult sexual victimization in a representative sample in Hong Kong Chinese. Child Abuse & Neglect 35(3): 220- 229, 2011. (61 refs.)

Objective: The current study investigated the prevalence and impact of childhood sexual abuse (CSA) on adult sexual victimization (ASV) in Hong Kong, China. This study also examines correlates of demographic characteristics, depression, suicidal ideation, and self-esteem with ASV. Methods: A total of 5,049 Chinese adult respondents were interviewed face-to-face about their experiences of CSA, childhood witness of parental violence, ASV (by non-partner), and intimate partner violence (IPV). Self-reports also measured depression, suicidal ideation, self-esteem, and demographic details. Results: Of all respondents, 0.9% reported some form of CSA, with a higher percentage being women. CSA was found to pose a significant risk for preceding year IPV (sexual) after controlling for demographic factors. Gender, age, indebtedness, alcohol and drug abuse, depression, and low self-esteem significantly increased the odds of IPV (sexual), whereas suicidal ideation and being newly arrived from China increased the risk of ASV (by non-partner). Childhood witness of parental psychological aggression and physical violence were also associated with a higher risk of IPV (sexual). Conclusions: Childhood sexual abuse may have an independent association with future sexual victimization in adulthood, but many covariates can also affect the impact of CSA and increase the risk of revictimization. Practical implications: Intervention with ASV should include an assessment of CSA history and thus a screening for multiple victimization from IPV among victims. Prevention of revictimization for IPV victims with CSA histories may focus on making social and individual changes.

Copyright 2011, Elsevier Science

Cohen LJ; Forman H; Steinfeld M; Fradkin Y; Frenda S; Galynker I. Comparison of childhood sexual histories in subjects with pedophilia or opiate addiction and healthy controls: Is childhood sexual abuse a risk factor for addictions? Journal of Psychiatric Practice 16(6): 394-404, 2010. (33 refs.)

Objective. Given the recent interest in the concept of sexual addictions, it is instructive to study subjects with pedophilia alongside chemically addicted individuals and non-addicted controls in order to help identify which factors may determine the objects of people's respective addictions, as well as any factors that may predispose people to developing an addictive disorder. Method. In this study, we considered whether childhood sexual abuse (CSA) is a specific risk factor for pedophilia as opposed to other types of addictive disorders by comparing the childhood sexual histories of 48 pedophilic sex offenders, 25 subjects with opiate addiction in remission, and 61 healthy controls. CSA was assessed with The Sexual History Questionnaire and the Child Trauma Questionnaire (CTQ). Results. Compared with both opiate addicted subjects and healthy controls, subjects with pedophilia were more likely to report experiencing adult sexual advances when they were children and a first sexual contact by age 13 with a partner at least 5 years older. Although both subjects with pedophilia and those with opiate addiction first had sex at a younger age than healthy controls, opiate addicted subjects, compared with healthy controls, reported neither increased reception of sexual advances as children nor increased rates of first sexual contact before age 13 with a partner at least 5 years older. Further, subjects with pedophilia but not those with opiate addiction scored significantly higher than healthy controls on the CTQ. Conclusion. Sexual abuse in childhood may be a specific risk factor for sexual addictions such as pedophilia but may not be a specific risk factor for chemical addictions.

Copyright 2010, Lippincott, Williams & Wilkins

Cohen LR; Tross S; Pavlicova M; Hu MC; Campbell AN; Nunes EV. Substance use, childhood sexual abuse, and sexual risk behavior among women in methadone treatment. American Journal of Drug and Alcohol Abuse 35(5): 305-310, 2009. (36 refs.)

Background: Substance use and a history of childhood sexual abuse (CSA) are risk factors for unprotected sex among women, yet questions remain as to how their combined influence may differentially affect sexual risk. Objective: The current study investigated how complex relationships among drug use and CSA may contribute to unprotected sexual occasions (USO). Methods: A Generalized Linear Mixed Model was used to examine the interaction between current cocaine/stimulants and opioid use and CSA on number of USOs in a sample of 214 sexually active women in outpatient methadone maintenance treatment. Results: For women with CSA, an increase in days of cocaine/stimulant use was associated with a significant increase in USOs. In contrast, an increase in days of opiate use was associated with a significant decrease in USOs. For the group of women who did not report CSA, there was a significant increase in USOs with increased opiate use. Conclusions: Findings: indicate that CSA is related to unprotected sexual occasions depending on drug type and severity of use. Scientific Significance: Women with CSA using cocaine are at particularly high risk for having unprotected sex and should be specifically targeted for HIV prevention interventions.

Copyright 2009, Taylor & Francis

Cutajar MC; Mullen PE; Ogloff JRP; Thomas SD; Wells DL; Spataro J. Psychopathology in a large cohort of sexually abused children followed up to 43 years. Child Abuse & Neglect 34(11): 813-822, 2010. (61 refs.)

Objective: To determine the rate and risk of clinical and personality disorders diagnosed in childhood and adulthood in those known to have been sexually abused during childhood. Methods: Forensic medical records of 2,759 sexually abused children assessed between 1964 and 1995 were linked with a public psychiatric database between 12 and 43 years later. Cases were compared to control subjects matched on gender and age groupings drawn from the general population through a random sample of the national electoral database. Results: A lifetime record of contact with public mental health services was found in 23.3% of cases compared to 7.7% of controls. The rate of contact among child sexual abuse victims was 3.65 times higher (95% Cl, 3.09-4.32, p < 0.001). It was estimated that child sexual abuse accounted for approximately 7.83% of mental health contact. Exposure to sexual abuse increased risks for the majority of outcomes including psychosis, affective, anxiety, substance abuse, and personality disorders. Rates of clinical disorders diagnosed in adulthood and childhood remained significantly higher among child sexual abuse cases. Older age at sexual abuse and those exposed to severe abuse involving penetration or multiple offenders were associated with greater risk for psychopathology. Conclusions: This study confirms that child sexual abuse is a substantial risk factor for a range of mental disorders in both childhood and adulthood. Practice implications: Those treating victims of sexual abuse must assess not only disorders commonly associated with trauma, but also low prevalence disorders such as psychosis.

Copyright 2010, Elsevier Science

Dichter ME; Cerulli C; Bossarte RM. Intimate partner violence victimization among women veterans and associated heart health risks. Women's Health Issues 21(4, special issue): S190-S194, 2011. (40 refs.)

Purpose: Cardiovascular disease (CVD) is the leading cause of death for women in the United States. CVD risk factors, including depression, smoking, heavy drinking, being overweight, and physical inactivity, are associated with stress and may be linked to women's experiences of intimate partner violence (IPV) victimization. We know little about IPV and CVD risk factors among veteran women. The purpose of this study was to identify the association between lifetime IPV victimization and CVD risk factors among women, accounting for veteran status. Methods: We used data from the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System for 2006 for the eight states that included the IPV module. We explored the associations between veteran status and lifetime IPV victimization and between IPV exposure and CVD risk factors, for veteran and non-veteran women. Findings: Veteran women were more likely than non-veteran women to report lifetime IPV victimization (33.0% vs. 23.8%). IPV exposure was associated with depression, smoking, and heavy drinking. We did not find evidence for an association between IPV exposure and lack of exercise or being overweight or obese, when controlling for demographic characteristics and veteran status. Conclusion: Women veterans have particularly high rates of lifetime IPV victimization. In addition, IPV victimization is associated with an increased risk of heart health risk factors. The findings suggest that we should attend to IPV exposure among veteran women and further investigate the link between IPV and military service, and the associated health impacts.

Copyright 2011, Elsevier Science

Duncan AE; Lessov-Schlaggar CN; Nelson EC; Pergadia ML; Madden PAF; Heath AC. Body mass index and regular smoking in young adult women. Addictive Behaviors 35(11): 983-988, 2010. (56 refs.)

Little is known about the relationship between relative body weight and transition from experimentation to regular smoking in young adult women. In the current study, data from 2494 participants in wave 4 of the Missouri Adolescent Female Twin Study (aged 18-29 years) who reported ever smoking a cigarette were analyzed using logistic regression. Body mass index (BMI) at time of interview was categorized according to CDC adult guidelines, and regular smoking was defined as having ever smoked 100 or more cigarettes and having smoked at least once a week for two months in a row. Since the OR's for the overweight and obese groups did not differ significantly from one another in any model tested, these groups were combined. Forty-five percent of women who had ever smoked had become regular smokers. Testing of interactions between potential covariates and levels of the categorical BMI variable revealed a significant interaction between overweight/obesity and childhood sexual abuse (CSA; p<0.001) associated with regular smoking. Among women reporting CSA, the association between overweight/obesity and having become a regular smoker was negative (n = 374; OR = 0.48, 95% Cl: 0.28-0.81). Both underweight and overweight/obesity were positively associated with transition to regular smoking among women who did not report CSA (n = 2076; OR = 1.57,95% Cl: 1.05-2.35 and OR = 1.73, 95% Cl: 1.35-2.20, respectively). These results suggest that experiencing CSA alters the association between BMI and regular smoking in women who have experimented with cigarettes.

Copyright 2010, Elsevier Science

El-Bassel N; Gilbert L; Witte S; Wu EW; Chang MW. Intimate partner violence and HIV among drug-involved women: Contexts linking these two epidemics-challenges and implications for prevention and treatment. Substance Use & Misuse 46(2-3): 295-306, 2011. (106 refs.)

Intimate partner violence (IPV) and HIV are two serious overlapping public health epidemics that disproportionately affect drug-involved women. This article reviews research that has identified a number of contexts that may explain the links between IPV and HIV transmission risks. These contexts include sexual coercion, fear of violence, negotiation of condom use, extradyadic relationships, disclosure of sexually transmitted infections or HIV seropositivity to intimate partners, drug involvement of women and their male partners, low social status of drug-involved women, relationship dependencies, and sex ratio imbalances. The article focuses on how the bidirectional relationship between IPV and HIV risks may be mediated by a history of childhood sexual abuse and post-traumatic stress disorder. Also addressed are the challenges that substance user treatment programs face in dealing with female clients who experience IPV and the implications for HIV prevention.

Copyright 2011, Informa Healthcare

Fallot RD; McHugo GJ; Harris M; Xie HY. The trauma recovery and empowerment model: A quasi-experimental effectiveness study. Journal of Dual Diagnosis 7(1-2): 74- 89, 2011. (36 refs.)

Objective: A quasi-experimental study tested the effectiveness of the Trauma Recovery and Empowerment Model (TREM), a group intervention for women trauma survivors, in comparison to services as usual. Methods: Two hundred fifty-one women with histories of physical and/or sexual abuse and co-occurring serious mental illnesses and substance use disorders completed comprehensive study assessments at baseline and at 6 and 12 months. TREM groups were added to standard services at two community mental health agencies in Washington, DC (n = 153). Comparison group participants received usual services at two agencies in Baltimore, MD (n = 98). Results: TREM participants showed greater reductions in alcohol and drug abuse severity, anxiety symptoms, and current stressful events, and they showed greater increases in perceived personal safety. There were no group differences in change for posttraumatic stress disorder and global mental health symptoms, physical and mental health-related quality of life, and exposure to interpersonal abuse. Changes in trauma recovery skills were associated positively with gains in study outcomes for TREM group participants. Conclusions: Despite design limitations, this study provides preliminary evidence for the effectiveness of the TREM intervention for a heterogeneous population of women trauma survivors with co-occurring disorders when added to usual services.

Copyright 2011, Routledge

Fitzpatrick M; Carr A; Dooley B; Flanagan-Howard R; Flanagan E; Tierney K et al. Profiles of adult survivors of severe sexual, physical and emotional institutional abuse in Ireland. Child Abuse Review 19(6): 387-404, 2010. (49 refs.)

Adult survivors of institutional abuse were interviewed with a comprehensive assessment protocol which included the Childhood Trauma Questionnaire, the Institutional Child Abuse Processes and Coping Inventory, the Structured Clinical Interviews for Disorders of the Diagnostic and Statistical Manual of Mental Disorders IV axis I disorders and personality disorders, the Trauma Symptoms Inventory, a Life Problems Checklist, the Experiences in Close Relationships Inventory and the Kansas Marital Satisfaction Scale. Profiles were identified for subgroups that described severe sexual (N = 60), physical (N = 102), or emotional (N = 85) abuse as their worst forms of maltreatment. Survivors of severe sexual abuse had the most abnormal profile, which was characterised by higher rates of all forms of child maltreatment and higher rates of post-traumatic stress disorder, alcohol and substance abuse, antisocial personality disorder, trauma symptoms and life problems. Survivors of severe emotional abuse were better adjusted than the other two groups. The profile of survivors of severe physical abuse occupied an intermediate position between the other two groups. A thorough assessment of abuse history and current functioning should be conducted when providing services to adult survivors of institutional abuse, since this may have important implications for the intensity of services required. Survivors of severe sexual abuse may require more intensive services.

Copyright 2010, John Wiley & Sons

Friesen MD; Woodward LJ; Horwood LJ; Fergusson DM. Childhood exposure to sexual abuse and partnership outcomes at age 30. Psychological Medicine 40(4): 679-688, 2010. (39 refs.)

Background. In this study, 30-year longitudinal data from the Christchurch Health and Development Study (CHDS) were used to examine the associations between childhood exposure to sexual abuse and intimate relationship outcomes at age 30. In addition, a broad range of early childhood and family confounding factors were tested, and the role of intervening factors from adolescence was explored. Method. The investigation analyzed data from a birth cohort of over 900 New Zealand adults studied to the age of 30. At ages 18 and 21 cohort members reported on any exposure to sexual abuse prior to age 16. This information, along with prospective data gathered in childhood and adolescence, was used to predict partnership outcomes at age 30. Results. After adjustment for early childhood and family factors, exposure to more severe forms of childhood sexual abuse (CSA) was associated with earlier and more frequent cohabitation, higher rates of perpetrated interpartner violence (IPV), and early parenthood, lower relationship satisfaction and investment. Several factors from adolescence partially or fully mediated these associations, notably a history of early consensual sexual intercourse, higher number of sexual partnerships, substance abuse problems, and self-esteem. After adjustment for intervening factors, exposure to CSA remained significantly associated with IPV. Conclusions. The findings support a causal chain process, whereby early childhood and family factors place some individuals at risk for CSA. The extent of CSA exposure is related to adolescent risk taking, which in turn leads to early and more frequent cohabitation, risk of IPV, and lower relationship satisfaction and investment.

Copyright 2010, Cambridge University

Hamelin C; Salomon C; Sitta R; Gueguen A; Cyr D; Lert F. Childhood sexual abuse and adult binge drinking among Kanak women in New Caledonia. Social Science & Medicine 68(7): 1247-1253, 2009

The long-term consequences of violence against women are poorly documented within the context of political domination, economic inequalities and rapid social change of indigenous communities. Using data from the first population study on violence against women and their consequences on health in New Caledonia, South Pacific, this article investigates the association between childhood sexual abuse and binge drinking among 441 adult Kanak women. Face-to-face standardised interviews were conducted in 2002-2003, among women aged 18-54 years drawn from the electoral rolls. Childhood sexual abuse before 15 years of age was reported by 11.6% of respondents. Nearly all the perpetrators (96%) were known to the victims (63% being a close relative). The rate of frequent binge drinking amongst the women within the last 12 months was 34%. After controlling for social and demographic factors, an independent association was found between childhood sexual abuse and current binge drinking. This study is the first to analyse the contribution of childhood sexual abuse to the likelihood of later heavy alcohol use in an indigenous population in the South Pacific. The findings call for improving and giving priority to care for children who are victims of violence to prevent long-term health consequences and to develop prevention programs aimed at alcohol-related behaviour in women, while taking into account simultaneous individual and collective factors.

Copyright 2009, Elsevier Science

Huang S; Trapido E; Fleming L; Arheart K; Crandall L; French M et al. The long-term effects of childhood maltreatment experiences on subsequent illicit drug use and drug-related problems in young adulthood. Addictive Behaviors 36(1-2): 95-102, 2011. (53 refs.)

Objectives: The objective of this study was to examine the associations between (a) childhood maltreatment (i e physical abuse sexual abuse and neglect) and subsequent illicit drug use and (b) childhood maltreatment and drug-related problems in young adulthood. Methods: Wave 1 and Wave 3 public-use data from the National Longitudinal: Study of Adolescent Health were used Logistic regressions controlling for adolescent drug use and other important family and peer contextual processes were estimated to determine the associations between (a) childhood maltreatment experiences and subsequent illicit drug use and (b) childhood maltreatment and drug-related problems in young adulthood. Results: Among the participants 31 9% reported some form of childhood maltreatment Childhood physical abuse was associated with a 37% (OR = 1 37 95% CI = 1 04 1 80) increase in illicit drug use during the 30 days prior to the Wave 3 survey a 48% (OR = 1 48 95% CI = 116 1 89) Increase in illicit drug use during the year prior to the Wave 3 survey and a 96% (OR = 1 96 95% CI = 1 40 2 76) increase in drug related problems in young adulthood. The latter two associations persisted even after controlling for illicit drug use in adolescence. Neglect among females was associated with a higher likelihood of past year illicit drug use in young adulthood (OR = 1 31 95% CI = 1 002 1 71) However this association was not significant once the effect of illicit drug use in adolescence was statistically controlled for. Conclusions: The present findings suggest that childhood maltreatment is related to subsequent illicit drug use and drug-related problems in young adulthood and that some of these associations differ by gender Implications for preventive intervention are discussed.

Copyright 2011, Elsevier Science

Hudson AL; Wright K; Bhattacharya D; Sinha K; Nyamathi A; Marfisee M. Correlates of adult assault among homeless women. Journal of Health Care for the Poor and Underserved 21(4): 1250-1262, 2010. (46 refs.)

The purpose of this study was to assess predictors of sexual and physical assault among homeless women. A multivariate, correlation design was utilized to identify independent correlates of adult physical and sexual assault. The sample consisted of 202 homeless women residing in shelters or living on the street in the Skid Row area of Los Angeles. Respondents reporting a history of child sexual abuse were almost four times more likely to report being sexually assaulted as adults and were almost two and one third times more likely to report being physically assaulted as adults. A range of factors increase homeless women's risk of adult physical and sexual victimization, including child sexual abuse, substance use, lifetime sex trade activity, and previous incarceration. It is important for homeless service providers to develop an individual risk profile for homeless women and to intervene in order to decrease their risk of re-victimization.

Copyright 2010, Johns Hopkins University Press

Ip EJ; Barnett MJ; Tenerowicz MJ; Perry PJ. The Anabolic 500 Survey: Characteristics of male users versus nonusers of anabolic-androgenic steroids for strength training. Pharmacotherapy 31(8): 757-766, 2011. (34 refs.)

Study Objective. To contrast the characteristics of two groups of men who participated in strength-training exercise those who reported anabolic-androgenic steroid (AAS) use versus those who reported no AAS use. Design. Analysis of data from the Anabolic 500, a cross-sectional survey. Participants. Five hundred six male self-reported AAS users (mean age 29.3 yrs) and 771 male self-reported nonusers of AAS (mean age 25.2 yrs) who completed an online survey between February 19 and June 30, 2009. Measurements and Main Results. Respondents were recruited from Internet discussion boards of 38 fitness, bodybuilding, weightlifting, and steroid Web sites. The respondents provided online informed consent and completed the Anabolic 500, a 99-item Web-based survey. Data were collected on demographics, use of AAS and other performance-enhancing agents, alcohol and illicit drug use, substance dependence disorder, other Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision diagnoses, and history of sexual and/or physical abuse. Most (70.4%) of the AAS users were recreational exercisers who reported using an average of 11.1 performance-enhancing agents in their routine. Compared with nonusers, the AAS users were more likely to meet criteria for substance dependence disorder (23.4% vs 11.2%, p<0.001), report a diagnosis of an anxiety disorder (10.1% vs 6.1%, p=0.010), use cocaine within the past 12 months (11.3% vs 4.7%, p<0.001), and report a history of sexual abuse (6.1% vs 2.7%, p=0.005). Conclusion. Most of the AAS users in this study were recreational exercisers who practiced polypharmacy. The AAS users were more likely than nonusers to meet criteria for substance dependence disorder, report a diagnosis of an anxiety disorder, report recent cocaine use, and have a history of sexual abuse. The information uncovered in this study may help clinicians and researchers develop appropriate intervention strategies for AAS abuse.

Copyright 2011, Pharmacotherapy Publications

Johnson SD; Cottler LB; Ben Abdallah A; O'Leary CC. History of sexual trauma and recent HIV-risk behaviors of community-recruited substance using women. AIDS and Behavior 15(1): 172-178, 2011. (36 refs.)

This study examines whether substance using women exposed to a lifetime sexual trauma (n = 457) are distinguishable from substance using women exposed to non-sexual trauma (n = 275) in terms of demographics, psychopathology and high-risk sexual behaviors. Baseline data were collected from out-of-treatment substance using women enrolled in an HIV prevention study. Logistic regression analyses revealed that when demographics, psychopathology and lifetime indicators of sexual risk were assessed simultaneously, poor health, depression, antisocial personality disorder and lifetime sex-trading were associated with sexual trauma exposure. When these significant factors were controlled, the experience of sexual trauma predicted recent (past 4 month) high risk sexual behaviors such as higher than average sexual partners. Treatment efforts with women who have experienced a sexual trauma may be enhanced by the inclusion of assessments of physical and mental health needs as well as sexual risk awareness training.

Copyright 2011, Springer

Jones DJ; Runyan DK; Lewis T; Litrownik AJ; Black MM; Wiley T et al. Trajectories of childhood sexual abuse and early adolescent HIV/AIDS risk behaviors: The role of other maltreatment, witnessed violence, and child gender. Journal of Clinical Child and Adolescent Psychology 39(5): 667-680, 2010. (74 refs.)

Childhood sexual abuse (CSA) has been associated with HIV/AIDS risk behavior; however, much of this work is retrospective and focuses on women. The current study used semi-parametric mixture modeling with youth (n=844; 48.8% boys) from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) to examine the link between trajectories of CSA (2 to 12 years old) and HIV/AIDS risk behavior at age 14 (i.e., sexual intercourse alcohol use). Trajectory analyses revealed a link between a history of CSA and the development of risky behavior. In addition, trajectories for physical and emotional abuse, but not neglect or witnessed violence, contributed to risky behavior over and above the role of CSA. Child gender did not moderate the findings. Findings highlight the signficance of CSA histories, as well as the broader context of maltreatment, for better understanding the development of risk behaviors in both girls and boys.

Copyright 2010, Taylor & Francis

Kim MM; Ford JD; Howard DL; Bradford DW. Assessing trauma, substance abuse, and mental health in a sample of homeless men. Health & Social Work 35(1): 39-48, 2010. (65 refs.)

This study examined the impact of physical and sexual trauma on a sample of 239 homeless men. Study participants completed a self-administered survey that collected data on demographics, exposure to psychological trauma, physical health and mental health problems,and substance use or misuse. Binomial logistic regression analyses were used to examine the relative significance of demographic factors and the four types of trauma exposure associated with three Outcomes: mental health, substance abuse, and physical health problems. The authors found that trauma history was significantly associated with more mental health problems but was not associated with substance abuse problems for homeless men. This study reinforces service providers' perceptions that because many homeless men experience the long-term, deleterious effects of not only current stressors, but also abuse and victimization that often begin in childhood, homeless men are a subpopulation in need of proactive prevention services that emphasize long-term continuity of care rather than sporadic crisis-based services. Study findings suggest that mentally ill, homeless men need proactive services that address the sequelae of abuse with care that is specialized and distinctly different from care for homeless adults with substance abuse or physical health care issues.

Copyright 2010, National Association of Social Workers

Klanecky AK; Salvi S; McChargue DE. Coerced childhood sexual abuse moderates the association between cigarette smoking initiation and college drug use frequency. American Journal on Addictions 18(5): 363-366, 2009. (30 refs.)

The current study examined childhood sexual abuse (CSA) as a potential moderator of the "gateway theory" association of cigarette use onset and college drug use. Covariate adjusted hierarchical regressions showed that CSA history interacted with age of first cigarette to predict total 12-month illicit drug use frequency (Delta R-2 = .048, F(10, 76) = 4.041, Mse = 8.812, p = .021). Simple effects revealed that age of first cigarette predicted drug use frequency in individuals with CSA histories (p = .045) rather than non-CSA individuals (p = .103). Exploratory analyses further revealed that the CSA moderation was carried primarily by those exposed to forced/coerced CSA events. Implications of the findings are discussed.

Copyright 2009, American Academy of Psychiatrists in Alcoholism and Addictions

Laaksonen T; Sariola H; Johansson A; Jern P; Varjonen M; von der Pahlen B et al. Changes in the prevalence of child sexual abuse, its risk factors, and their associations as a function of age cohort in a Finnish Population sample. Child Abuse & Neglect 35(7): 480-490, 2011. (55 refs.)

Objective: We examined (1) the prevalence of childhood sexual abuse (CSA) experiences as a function of cohort and gender, (2) the prevalence of factors associated with CSA as a function of cohort and whether the association of these factors with CSA remained the same irrespective of cohort, and (3) whether any cohort differences could be explainable by cohort differences in reporting bias. Method: We used the responses of 4,561 men (M=29, SD=7 years) and 8,361 female (M=29, SD=7 years) Finnish participants who responded to the Childhood Trauma Questionnaire-Short Form as well as questions regarding family structure. Results: The prevalence of CSA experiences varied between 0.7-4.6% for men and 1.8-7.5% for women depending on the item. Younger cohorts reported less CSA as well as less of the risk factors (physical neglect and abuse, emotional neglect and abuse, parental substances abuse, not growing up with both biological parents) that were positively associated with the likelihood of CSA. The effects of these risk factors did not vary as a function of the cohort. Also, the declining trend was not explainable by social desirability being higher in the younger cohorts. Conclusions: The results suggest that there is a real decline in the prevalence of CSA and it is associated with a simultaneous decline in factors associated with CSA.

Copyright 2011, Elsevier Science Ltd

Lin DH; Li XM; Fan XH; Fang XY. Child sexual abuse and its relationship with health risk behaviors among rural children and adolescents in Hunan, China. Child Abuse & Neglect 35(9): 680-687, 2011. (40 refs.)

Objective: The current study was designed to explore the prevalence of child sexual abuse (CSA) and its association with health risk behaviors (i.e., smoking, alcohol use, binge drinking, suicidal ideation, and suicide attempt) among rural children and adolescents in China. Methods: A sample of 683 rural children and adolescents (8 to 18 years of age) completed an anonymous questionnaire which assessed experiences of CSA and 5 health risk behaviors. Data on several potential confounding factors were also collected. Results: A total of 123(18%) respondents reported experiencing at least 1 kind of CSA before 16 years of age, with more boys reporting CSA than girls (21.5% vs. 14.2%). In addition, attending non-boarding schools, lower levels of self-esteem, and higher levels of perceived peer pressure for engagement in health risk behaviors were associated with higher rates of CSA. Multivariate logistic regression analyses revealed that CSA experience was significantly associated with cigarette smoking (aOR = 2.14), binge drinking (aOR = 2.68), suicidal ideation (aOR = 1.69), and suicide attempt (aOR = 2.69) after controlling for several demographic and psychological factors. Conclusion: More attention should be paid to the issues of CSA among rural children and adolescents in China. Effective CSA prevention intervention needs to address the vulnerabilities of the population, increase children's and parents' awareness of CSA and ability of self-protection.

Copyright 2011, Elsevier Science

Lown EA; Nayak MB; Korcha RA; Greenfield TK. Child physical and sexual abuse: a comprehensive look at alcohol consumption patterns, consequences, and dependence from the National Alcohol Survey. Alcoholism: Clinical and Experimental Research 35(2): 317-325, 2011. (65 refs.)

Background: Previous research has documented a relationship between child sexual abuse and alcohol dependence. This paper extends that work by providing a comprehensive description of past year and lifetime alcohol consumption patterns, consequences, and dependence among women reporting either physical and sexual abuse in a national sample. Methods: This study used survey data from 3,680 women who participated in the 2005 U.S. National Alcohol Survey. Information on physical and sexual child abuse and its characteristics were assessed in relation to 8 past year and lifetime alcohol consumption measures. Results: Child physical or sexual abuse was significantly associated with past year and lifetime alcohol consumption measures. In multivariate analyses, controlling for age, marital status, employment status, education, ethnicity, and parental alcoholism or problem drinking, women reporting child sexual abuse vs. no abuse were more likely to report past year heavy episodic drinking (ORadj = 1.7; 95% CI 1.0 to 2.9), alcohol dependence (ORadj = 7.2; 95% CI 3.2 to 16.5), and alcohol consequences (ORadj = 3.6; 95% CI 1.8 to 7.3). Sexual abuse (vs. no abuse) was associated with a greater number of past year drinks (124 vs. 74 drinks, respectively, p = 0.002). Sexual child abuse was also associated with lifetime alcohol-related consequences (ORadj = 3.5; 95% CI 2.6 to 4.8) and dependence (ORadj = 3.7; 95% CI 2.6 to 5.3). Physical child abuse was associated with 4 of 8 alcohol measures in multivariate models. Both physical and sexual child abuse were associated with getting into fights, health, legal, work, and family alcohol-related consequences. Alcohol-related consequences and dependence were more common for women reporting sexual abuse compared to physical abuse, 2 or more physical abuse perpetrators, nonparental and nonfamily physical abuse perpetrators, and women reporting injury related to the abuse. Conclusion: Both child physical and sexual abuse were associated with many alcohol outcomes in adult women, even when controlling for parental alcohol problems. The study results point to the need to screen for and treat underlying issues related to child abuse, particularly in an alcohol treatment setting.

Copyright 2011, Wiley-Blackwell

Makin-Byrd K; Cronkite RC; Timko C. The influence of abuse victimization on attendance and involvement in mutual-help groups among dually diagnosed male veterans. Journal of Substance Abuse Treatment 41(1): 78-87, 2011. (34 refs.)

Although abuse victimization and dual diagnosis are associated with poor functioning across numerous domains, their impact on attendance and involvement in mutual-help groups (MHGs) is not well understood. This study. examined the impact of physical or sexual abuse victimization on MUG attendance and involvement and the influence of abuse on the association between MHG involvement and outcomes of abstinence and psychiatric health. Participants were 217 dually diagnosed men assessed at intake into mental health treatment and 6 months later. Compared with nonabused patients, sexually abused patients exhibited more substance use, psychiatric, and social problems at baseline and attended and were involved with MHGs more than nonabused patients at follow-up. Moreover, MHG involvement was most predictive of abstinence for sexually abused patients, as compared with nonabused and physically abused patients. Although dually diagnosed patients with abuse histories demonstrate more severe initial problems, they are likely to utilize MHGs, which may benefit efforts to achieve abstinence.

Copyright 2011, Elsevier Science

Meade CS; Drabkin AS; Hansen NB; Wilson PA; Kochman A; Sikkema KJ. Reductions in alcohol and cocaine use following a group coping intervention for HIV-positive adults with childhood sexual abuse histories. Addiction 105(11): 1942-1951, 2010. (71 refs.)

Aims: Few interventions exist to reduce alcohol and non-injection drug use among people living with HIV/AIDS. This study tested the effects of a coping group intervention for HIV-positive adults with childhood sexual abuse histories on alcohol, cocaine and marijuana use. Design: Participants were assigned randomly to the experimental coping group or a time-matched comparison support group. Both interventions were delivered in a group format over 15 weekly 90-minute sessions. Setting and Participants A diverse sample of 247 HIV-positive men and women with childhood sexual abuse were recruited from AIDS service organizations and community health centers in New York City. Measurements Substance use was assessed pre- and post-intervention and every 4 months during a 12-month follow-up period. Using an intent-to-treat analysis, longitudinal changes in substance use by condition were assessed using generalized estimating equations. Findings: At baseline, 42% of participants drank alcohol, 26% used cocaine and 26% used marijuana. Relative to participants in the support group, those in the coping group had greater reductions in quantity of alcohol use (Wald chi(2)((4)) = 10.77, P = 0.029) and any cocaine use (Wald chi(2)((4)) = 9.81, P = 0.044) overtime. Conclusions: Many HIV patients, particularly those with childhood sexual abuse histories, continue to abuse substances. This group intervention that addressed coping with HIV and sexual trauma was effective in reducing alcohol and cocaine use, with effects sustained at 12-month follow-up. Integrating mental health treatment into HIV prevention may improve outcomes.

Copyright 2010, Society for the Study of Addiction to Alcohol and Other Drugs

Oviedo-Joekes E; Marchand K; Guh D; Marsh DC; Brissette S; Krausz M et al. History of reported sexual or physical abuse among long-term heroin users and their response to substitution treatment. Addictive Behaviors 36(1-2): 55-60, 2011. (50 refs.)

Opioid dependent individuals with a history of abuse have exhibited worse mental and physical health compared to those without such a history, however the evidence regarding the influence of abuse histories on addiction treatment outcomes are conflicting. In the present study we identified history of physical or sexual abuse at treatment initiation in relation to drug use and health among long term opioid dependent individuals and we determined the relationship of abuse histories with treatment outcomes following substitution treatment. We analyzed data from a randomized controlled trial that compared the effectiveness of opioid agonists in the treatment of chronic opioid dependence. The North American Opiate Medication Initiative (NAOMI) was conducted in Vancouver and Montreal (Canada) and provided oral methadone injectable diacetylmorphine or injectable hydromorphone the last two on a double blind basis over 12 months. A total of 112 (44.6%) participants reported a history of physical or sexual abuse at baseline. Participants with an abuse history reported a significantly higher number of chronic medical problems, suicide attempts, and previous drug treatments, and had poorer psychiatric family and social relations, and quality of life status, compared to those without abuse histories. No differences in current and past substance use were found between those with and without abuse histories. Following 12 months of treatment the participants with abuse histories improved to a similar degree as those without a history of abuse in all of the European Addiction Severity Index sub scales, with the exception of medical status. The findings suggest that individuals with abuse histories were able to achieve similar outcomes as those without abuse histories following treatment, despite having poorer scores in physical and mental health, social status, and quality of life at treatment initiation. These findings suggest that the substitution treatments as provided in this study can benefit the most vulnerable and access needs to be expanded to reach this population

Copyright 2011, Elsevier Science

Peltan JR; Cellucci T. Childhood sexual abuse and substance abuse treatment utilization among substance-dependent incarcerated women. Journal of Substance Abuse Treatment 41(3): 215-224, 2011. (52 refs.)

Incarcerated women have high rates of substance abuse problems and trauma. A variety of variables may influence whether these women seek help or are referred for substance abuse problems. This study reports an exploratory project on service utilization among incarcerated substance-dependent women (N = 40) in southeastern Idaho. Using self-report and interview tools, most participants reported some substance abuse treatment history, although extent and types of treatment varied. Most of the women also reported some type of childhood abuse. Age, income, and consequences of alcohol and other drug use related positively to substance abuse treatment. However, severity of childhood sexual abuse and current trauma symptoms were negatively correlated with substance abuse treatment episodes. These women may use substances to cope with childhood trauma or may not perceive the substance abuse system as responsive to their co-occurring trauma symptoms.

Copyright 2011, Elsevier Science

Petry NM; Ford JD; Barry D. Contingency management is especially efficacious in engendering long durations of abstinence in patients with sexual abuse histories. Psychology of Addictive Behaviors 25(2): 293-300, 2011. (55 refs.)

Exposure to sexual victimization is prevalent among persons with substance use disorders (SUDs). Contingency management (CM) treatments utilize concrete and relatively immediate positive reinforcers to retain patients in treatment and reduce substance use, and CM may have particular benefits for patients with histories of sexual victimization. Using data from three randomized trials of CM (N = 393), this study evaluated main and interactive effects of sexual abuse history and treatment condition (standard care versus CM) with respect to during treatment outcomes (retention, proportion of negative urine samples submitted, and longest duration of abstinence) and abstinence at a nine-month follow-up. Compared to patients without sexual abuse histories (N = 316), those with sexual abuse histories (N = 77) submitted a significantly higher proportion of negative samples in treatment. In CM, but not in standard care, patients with sexual abuse histories achieved significantly longer durations of abstinence during treatment than those without sexual abuse histories. Although sexual abuse history was not associated with abstinence at nine-month follow-up evaluations, longest duration of abstinence during treatment was significantly associated with this long-term outcome. Results suggest that SUD patients with sexual abuse histories may accrue particular benefits during CM treatment that are associated with long-term abstinence.

Copyright 2011, American Psychological Association

Robboy J; Anderson KG. Intergenerational child abuse and coping. Journal of Interpersonal Violence 26(17): 3526-3541, 2011. (53 refs.)

Many studies have investigated the consequences of child sexual abuse (CSA) but few have examined the intergenerational effects of poly-victimization and maladaptive coping. The purpose of this investigation was to examine patterns of maltreatment and maladaptive coping among second-generation CSA survivors. It is hypothesized that: (a) maternal CSA history would be associated with a higher incidence of poly-victimization and maladaptive coping and (b) experiencing more forms of abuse would mediate the relation between maternal CSA history and maladaptive coping behaviors. The method used was a chart review of 139 sexually abused females aged 12 to 17, examining maternal abuse history, maladaptive coping behaviors, and child maltreatment. The results showed that poly-victimization differed as a function of maternal CSA history but maladaptive coping did not. Experiencing more types of abuse was associated with both self-injurious behaviors and substance use. In conclusion, results support the hypothesis that second generation CSA survivors are more likely to experience poly-victimization. Future research should address how intergenerational patterns of abuse might affect presenting symptomatology and treatment outcome.

Copyright 2011, Sage Publications

Sansone RA; Whitecar P; Wiederman MW. The prevalence of childhood trauma among those seeking buprenorphine treatment. Journal of Addictive Diseases 28(1): 64-67, 2009. (12 refs.)

In this study, the authors examined the prevalence of five types of childhood trauma among a sample of adult patients who were addicted to opioids and seeking treatment with buprenorphine. Using a survey methodology, the authors examined a consecutive sample of 113 participants and found that 20.4% reported having experienced sexual abuse, 39.8% reported having experienced physical abuse, 60.2% reported having experienced emotional abuse, 23.0% reported having experienced physical neglect, and 65.5% reported having witnessed violence. Only 19.5% of the sample denied having experienced any of the five forms of childhood trauma. Most respondents (60.2%) reported having experienced one, two, or three different forms of childhood trauma. A minority reported having experienced four (13.3%) or all five (7.1%) forms of childhood trauma. These data indicate that among individuals with opioid dependence who are seeking treatment with buprenorphine, the prevalence rates of various types of childhood trauma are quite high.

Copyright 2009, Haworth Press

Schafer I; Verthein U; Oechsler H; Deneke C; Riedel-Heller S; Martens M. What are the needs of alcohol dependent patients with a history of sexual violence? A case-register study in a metropolitan region. Drug and Alcohol Dependence 105(1/2): 118-125, 2009. (50 refs.)

Background: Sexual violence has become increasingly apparent as a factor determining more complex treatment needs in patients with substance abuse. However, empirical evidence on specific patterns of differences between patients with and without a history of sexual violence is scarce. Methods: Our sample consisted of alcohol dependent outpatients treated during a two-year period in a German metropolitan region. The analysis was based on a local case register and included all patients for whom information on lifetime sexual violence was available (N=1981; 33.4% female). In a case-control design, patients with a history of sexual violence were compared to patients without such experiences regarding a wide range of clinical and social factors indicative of potential needs. Results: More than 35% of the female patients and 6% of the male patients reported a history of sexual violence. Victims differed from non-victims across a variety of domains, including psychiatric symptoms and suicide attempts, legal problems, financial and family problems, previous use of services, and need for additional services during the current treatment. Patient gender emerged as a significant moderator of several of these associations. Conclusions: The findings indicate that an effort needs to be made to link addiction treatment, other parts of the health care system, and further institutions, such as family services and parts of the legal system, so that the complex needs of this vulnerable population can be met in an adequate way.

Copyright 2009, Elsevier Science

Shin SH; Hong HG; Hazen AL. Childhood sexual abuse and adolescent substance use: A latent class analysis. Drug and Alcohol Dependence 109(1-3): 226-235, 2010. (117 refs.)

Children who have exposure to child sexual abuse (CSA) are at particular risk for developing substance abuse in adolescence, but the extent to which CSA may shape patterns of adolescent substance use remains uncertain. The aim of this paper is to characterize the variations in patterns of adolescent substance use and to examine the association between CSA and qualitatively distinct patterns of adolescent substance use. Latent class analyses identified homogenous groups of adolescents with similar patterns of substance use using a sample of 1019 adolescents (mean age: 15.9 years; range: 13-18) who were selected from five publicly funded service systems. Different patterns of latent class structures were identified in boys and girls (a 4-class solution for girls and a 3-class solution for boys). CSA was associated with an increased risk of being a heavy polysubstance user in girls, even after adjustment of age, race/ethnicity, parental substance use, sibling use, peer use, psychopathology and other forms of childhood maltreatment including physical abuse and neglect. Findings indicate that female victims of CSA who are involved with public service systems are at high risk for developing multiple-substance use in adolescence.

Copyright 2010, Elsevier Science

Testa M; Hoffman JH; Livingston JA. Alcohol and sexual risk behaviors as mediators of the sexual victimization-revictimization relationship. Journal of Consulting and Clinical Psychology 78(2): 249-259, 2010. (65 refs.)

Objective: Women who experience sexual victimization, whether in childhood, adolescence, or adulthood, are at elevated risk of sexual revictimization. The mechanism responsible for this robust association is unclear, however. The present study proposed and tested a prospective, mediated model that posited that the association between adolescent and college victimization is mediated via 2 types of risk exposure in the first semester of college: alcohol-related and sexual risk behaviors. Method: Female adolescents (N = 469) were recruited from the community at the time of high school graduation. They completed baseline assessments as well as follow-ups at the end of the first and second semesters of college. Results: Consistent with hypotheses, adolescent sexual victimization was associated indirectly, via high school risk behaviors, with increased first-semester college risk behaviors (i.e., sexual partners, hookups, heavy episodic drinking, and heavy drinking contexts), which were, in turn, strongly predictive of sexual victimization experiences in the first year of college. College risk behaviors partially mediated the significant association between adolescent and first-year college victimization; however, even women without prior victimization faced elevated risk of college victimization with higher levels of college risk behaviors. Conclusions: Women who have experienced adolescent sexual victimization engage in higher levels of risk taking in college, thereby increasing vulnerability to college victimization. Intervention to reduce these primarily alcohol-related risk-taking behaviors may reduce vulnerability to college sexual victimization.

Copyright 2010, American Psychological Association

Thompson RG; Hasin DS. Cigarette, marijuana, and alcohol use and prior drug treatment among newly homeless young adults in New York City: Relationship to a history of foster care. Drug and Alcohol Dependence 117(1): 66-69, 2011. (39 refs.)

Background: This study examined whether a history of foster care was associated with the risk for substance use among newly homeless young adults, controlling for demographics and other risk factors. Methods: Multiple logistic regression analyses, adjusted for controls, among consecutive admissions of 424 newly homeless young adults (18-21 years), determined the association between foster care and substance use. Results: A history of foster care was reported by 35% of the sample. Alcohol, marijuana, and cigarettes were the most frequently used substances. After adjusting for demographics, childhood emotional, physical, and sexual abuse, prior arrest, unemployment, lack of high school diploma, and family drug use, homeless young adults with histories of foster care were: three times as likely to smoke cigarettes (AOR=3.09); more than three times as likely to use marijuana (AOR=3.30); and almost nine times as likely to have been in drug treatment (AOR=8.81) than those without such histories. Conclusions: It is important to screen homeless young adults who exited foster care for substance use, particularly cigarettes and marijuana. Risk reduction interventions should be targeted and tailored to their substance prevention needs.

Copyright 2011, Elsevier Science

Trickett PK; Noll JG; Putnam FW. The impact of sexual abuse on female development: Lessons from a multigenerational, longitudinal research study. Development and Psychopathology 23(2): 453- 476, 2011. (112 refs.)

This is a report on the research design and findings of a 23-year longitudinal study of the impact of intrafamilial sexual abuse on female development. The conceptual framework integrated concepts of psychological adjustment with theory regarding how psychobiological factors might impact development. Participants included 6- to 16-year-old females with substantiated sexual abuse and a demographically similar comparison group. A cross-sequential design was used and six assessments have taken place, with participants at median age 11 at the first assessment and median age 25 at the sixth assessment. Mothers of participants took part in the early assessments and offspring took part at the sixth assessment. Results of many analyses, both within circumscribed developmental stages and across development, indicated that sexually abused females (on average) showed deleterious sequelae across a host of biopsychosocial domains including: earlier onsets of puberty, cognitive deficits, depression, dissociative symptoms, maladaptive sexual development, hypothalamic-pituitary-adrenal attenuation, asymmetrical stress responses, high rates of obesity, more major illnesses and healthcare utilization, dropping out of high school, persistent posttraumatic stress disorder, self-mutilation, Diagnostic and Statistical Manual of Mental Disorders diagnoses, physical and sexual revictimization, premature deliveries, teen motherhood, drug and alcohol abuse, and domestic violence. Offspring born to abused mothers were at increased risk for child maltreatment and overall maldevelopment. There was also a pattern of considerable within group variability. Based on this complex network of findings, implications for optimal treatments are elucidated. Translational aspects of extending observational research into clinical practice are discussed in terms that will likely have a sustained impact on several major public health initiatives.

Copyright 2011, Cambridge University Press

Ulibarri MD; Strathdee SA; Ulloa EC; Lozada R; Fraga MA; Magis-Rodriguez C et al. Injection drug use as a mediator between client-perpetrated abuse and HIV status among female sex workers in two Mexico-US border cities. AIDS and Behavior 15(1): 179-185, 2011. (42 refs.)

We examined relationships between client-perpetrated emotional, physical, and sexual abuse, injection drug use, and HIV-serostatus among 924 female sex workers (FSWs) in Tijuana and Ciudad Juarez, two large Mexico-US border cities. We hypothesized that FSWs' injection drug use would mediate the relationship between client-perpetrated abuse and HIV-seropositivity. The prevalence of client-perpetrated emotional, physical, and sexual abuse in the past 6 months was 26, 18, and 10% respectively; prevalence of current injection drug use and HIV was 12 and 6%, respectively. Logistic regression analyses revealed that client-perpetrated sexual abuse was significantly associated with HIV-seropositivity and injection drug use, and that injection drug use was positively associated with HIV-seropositivity. Injection drug use partially mediated the relationship between client-perpetrated sexual abuse and HIV-seropositivity. Results suggest the need to address client-perpetrated violence and injection drug use when assessing HIV risk among FSWs.

Copyright 2011, Springer

Wilson DR. Health consequences of childhood sexual abuse. Perspectives in Psychiatric Care 46(1): 56-64, 2010. (54 refs.)

PURPOSE: This article provides a summary for advocacy, court testimony, assessment, treatment, prevention, and further research studies in the field of childhood sexual abuse. FINDINGS: A literature review identifies the psychiatric, social, and disease disorders to which this population is predisposed. Adult survivors experience more depression, obesity, autoimmune disorders (irritable bowel syndrome, asthma, fibromyalgia), eating disorders, and addictions. PRACTICE IMPLICATIONS: A holistic perspective allows understanding of health consequences for survivors. A model through which to consider these phenomena is presented. CONCLUSIONS: The long-term consequences of childhood sexual abuse must be assessed and addressed by healthcare professionals.

Copyright 2010, Wiley-Blackwell Publishing