Attachment and Breakup Distress: The Mediating Role of Coping Strategies.

Breakups are common among emerging adults and are associated with elevated depressive and anxiety symptoms, especially in the presence of attachment insecurities. Previous authors have suggested that inadequate coping strategies might explain this association, yet this has not been examined longitudinally. This study examined the mediating role of five coping strategies (self-help, approach, accommodation, avoidance, self-punishment) in the longitudinal associations between attachment insecurities (anxiety, avoidance) and depressive and anxious symptoms in 196 emerging adults experiencing a romantic breakup. Measures of pre-breakup attachment, post-breakup coping strategies (one-month post-breakup), and depressive and anxiety symptoms (one- and three-month post-breakup) were administered. Results from a longitudinal autoregressive cross-lagged model showed that pre-breakup attachment insecurities were related to higher depressive and anxiety post-breakup symptoms through higher use of self-punishment and lower use of accommodation coping strategies. Findings highlight coping strategies as potential intervention targets to promote the recovery of emerging adults experiencing breakup distress.

Correction to: Explaining the Association Between Childhood Maltreatment and Psychological Adjustment in Youth in a Romantic Relationship.

[This corrects the article DOI: 10.1007/s40653-023-00562-w.].

Correction to: Explaining the Association Between Childhood Maltreatment and Psychological Adjustment in Youth in a Romantic Relationship.

[This corrects the article DOI: 10.1007/s40653-023-00562-w.].

Childhood Sexual Abuse, Intellectual Disability, and Subsequent Physical and Mental Health Disorders: A Matched Cohort Study.

This study assesses whether children with intellectual disability (ID) are more at risk of sexual abuse and whether they have similar consultation rates for physical and mental health disorders than children without ID. The matched-cohort design study uses administrative databases of children who had a sexual abuse report corroborated by a child protection agency and a matched group from the general population. Children with ID were 3.5 times more likely to have a corroborated sexual abuse report when compared to their peers without ID and a higher post-abuse number of medical consultations for physical and mental health disorders. Children with ID are more at risk of sexual abuse and physical and mental health disorders and may also be more vulnerable to the effects of abuse.

Addressing the Complexity of Heterogeneity: Profiles of Adolescent Girls Who Have Been Sexually Abused.

Childhood sexual abuse (CSA) may have devastating effects, yet, there is considerable heterogeneity among adolescent girls who have experienced it. Addressing this heterogeneity could help to tailor practices to their particular needs. The objective was to identify profiles among adolescent girls who have been sexually abused to determine whether they exhibit distinct outcomes. Participants were drawn from a Child Protection sample of adolescent girls who have been sexually abused with contact (n = 185). Abuse and stressful events were measured using a rating scale completed by a research assistant, and a self-reported questionnaire. Coping strategies, cognitive appraisals, and psychological symptoms were measured using self-reported questionnaires. Latent class analysis was conducted using abuse and stressful events as indicators, and multinomial logistic regression analyses were used to compare classes on outcomes. Five graded classes were identified: 1) few source of stress (22%); 2) services as stressors (27%); 3) CSA as stressor (19%); 4) CSA and family as stressors (6%); and 5) multiple sources of stress (25%). These classes were associated with distinct profiles on coping strategies, cognitive appraisals, and psychological symptoms. In conclusion, we recommend that clinicians move beyond the "one size fits all" approach and tailor practices to each adolescent's needs.

Sexual Violence at University: Are Varsity Athletes More at Risk?

Some studies report that the sport context increases the risk of exposure to sexual violence for athletes. In contrast, others indicate a protective effect of sport participation against sexual violence, particularly among varsity athletes. Studies of sexual violence towards varsity athletes are limited by their failure to include control groups and various known risk factors such as age, graduate level, gender and sexual identity, disability status, international and Indigenous student status, and childhood sexual abuse. The purpose of the present study is to fill in these gaps to determine whether varsity athletes are at greater risk than non-athletes of sexual violence towards them or whether, on the contrary, involvement in a varsity sport is coherent with the Sport Protection Hypothesis. Data for this article come from the ESSIMU study (Enquête sur la Sexualité, la Sécurité et les Interactions en Milieu Universitaire), a broad survey of students, professors, and other employees at six francophone universities regarding sexual violence on university campuses. A total of 6,485 students with complete data on sexual violence, athlete status, and gender were included in the study. From this total, 267 participants identified themselves as varsity athletes. Data were analyzed using a series of logistic regressions on each form of violence using athlete status as a predictor and characteristics associated with sexual violence victimization or distinguishing between varsity athletes and non-athletes as confounding variables. When considering all confounding variables in the regression analyses on four yearly incidence rates of sexual violence, the results revealed that being a varsity athlete did not significantly increase the risk of exposure to sexual violence at university. All considered other variables were more significant predictors of the past year's risk of sexual violence victimization than athlete status was.

Sexual Violence at University: Are Indigenous Students More at Risk?

University-based sexual violence prevalence is worryingly high and leads to many serious consequences for health and academic achievement. Although previous work has documented greater risk for sexual violence among Indigenous Peoples, little is known about university-based sexual violence experienced by Indigenous students. Using a large-scale study of university-based sexual violence in Canada, the current study aims to (1) examine the risk of sexual violence against Indigenous students compared to non-Indigenous students, and (2) to document sexual violence experiences of Indigenous students. Undergraduate students from six universities (N = 5,627) completed online questionnaires regarding their experience and consequences of university-based sexual violence (e.g., forms of sexual violence experiences, gender, and status of the perpetrator, context of the violence, PTSD, disclosure). Findings indicated that compared with their non-Indigenous peers, Indigenous students experienced significantly higher levels of sexual harassment. However, no difference was found for unwanted sexual behaviors, nor for sexual violence contexts. Among Indigenous students, those having experienced sexual violence after age 18 (outside university) were more likely to report university-based sexual violence. Overall, findings highlight that Indigenous students, as well as non-Indigenous students, experience university-based sexual violence. Given their history, Indigenous students may have different needs, so sustainable policies that foster cultural safety on all campuses are clearly needed.

Child Sexual Abuse and Age at Onset of Psychotic Disorders: A Matched-cohort Study: L'âge d'apparition des troubles psychotiques chez les victimes d'agression sexuelle à l'enfance: Une étude prospective de cohortes appariées.

OBJECTIVE: Victims of child sexual abuse (CSA) present with a higher risk of psychotic disorders. However, the developmental course of psychosis following CSA, such as the age at onset, remains unknown. This study aimed to determine whether the age at onset of psychotic disorders was influenced by sexual abuse, sex, and confounding factors (substance misuse, intellectual disability, and socioeconomic status). METHOD: A prospective matched-cohort design was used, with administrative databases from a child protection agency (CPA) and a public health system. Children who received a substantiated report of CSA at the CPA and whose health data could be retrieved were selected (n = 882) and matched with children from the general population using their date of birth, sex, and geographical area. Survival analysis was performed to estimate the association between sexual abuse, sex, and confounding factors and the age at onset of psychotic disorders. RESULTS: Sexual abuse and substance misuse are significantly associated with the age at onset of psychotic disorders. In the sexually abused group, only substance misuse is associated with the age at onset of psychotic disorders, but this was not significant for the general population. CONCLUSIONS: These findings highlight the importance of prevention of psychotic disorders among sexually abused youth, especially those with a substance misuse diagnosis.

Childhood sexual abuse, girls' genitourinary diseases, and psychiatric comorbidity: A matched-cohort study.

Objective: The present study aimed to determine whether psychiatric comorbidity (i.e., diagnostic comorbidity in eight categories of mental and behavioral disorders) mediates the relationship between childhood sexual abuse (CSA) and diseases of the genitourinary system (International Statistical Classification of Diseases and Related Health Problems, 10th revision) among girls. Method: Using a prospective matched-cohort design, we documented diagnoses given by a physician after a medical consultation or hospitalization for diseases of the genitourinary system, for 661 sexually abused girls and 661 matched controls via administrative databases covering the period between January 1996 and March 2013. Path analyses using negative binomial regressions with CSA as independent variable, psychiatric comorbidity as mediator and genitourinary diseases diagnoses as dependent variables were performed. Results: After controlling for socioeconomic level, prior genitourinary diseases and number of years of medical data, the mediation effect for the path from CSA to genitourinary diseases through psychiatric comorbidity was significant for the urinary system (b = .125, 95% confidence interval [0.057, 0.192]) as well as for the genital system (b = .213, 95% confidence interval [0.141, 0.285]). Psychiatric comorbidity carried 62% of the sexual abuse total effect on the number of diagnoses received for genital diseases, whereas it carried 23% of the sexual abuse total effect on the number of diagnoses received for urinary diseases. Conclusions: Findings suggest that CSA may have an indirect effect on girls' diagnosed genitourinary diseases during a medical consultation or hospitalization through the increased risk for psychiatric comorbidity. Early interventions aimed at addressing psychological distress among sexually abused girls might prevent the emergence of genitourinary diseases years after the abuse. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Trauma Symptoms Resulting From Sexual Violence Among Undergraduate Students: Differences Across Gender and Sexual Minority Status.

Experiencing sexual violence is an important risk factor for trauma symptoms, and these symptoms significantly impair psychosocial functioning. Sexual and gender minority university students are more likely than their heterosexual and cisgender peers to experience sexual violence (e.g., sexual harassment, unwanted sexual contact, or sexual coercion) while attending university, but research on the consequences of these experiences is needed to inform service provision to these vulnerable populations. Using a large-scale study of university-based sexual violence in Quebec, the current study examined how gender and sexual minority status were associated with the severity of trauma symptoms among students who experienced sexual violence (N = 1,196). Findings indicated that compared with their cisgender peers, gender minority students experienced significantly higher levels of trauma symptoms as a result of sexual violence, controlling for the severity of sexual violence behaviors experienced and other variables. Among cisgender women, but not cisgender men, sexual minority identity was also associated with higher levels of trauma symptoms, controlling for severity of sexual violence behaviors experienced and other variables. Furthermore, gender of perpetrator and amount of sexual violence moderated the associations between sexual identity and trauma symptoms among cisgender women. These findings not only suggest that gender minority and some sexual minority university students are more likely to experience sexual violence, but that they are also more likely to experience negative psychological sequelae as a consequence of these experiences. Ultimately, these findings may suggest the need for services that are more supportive of the specific needs of gender and sexual minority students with regard to sexual violence.

Mental health disorders as cooccuring and predictive factors of psychotic disorders in sexually abused children.

BACKGROUND: Little is known about the factors associated with psychosis in sexually abused children. Many factors have been associated with both sexual abuse and psychosis, and some mental health disorders have been identified as implied in the relationship between childhood trauma and psychosis. OBJECTIVES: This study aims to identify factors cooccurring with psychotic disorders in sexually abused youth and to determine which predict the development of psychosis in this population. PARTICIPANTS AND SETTING: Children with a corroborated report of sexual abuse (n = 882) at a Child Protection Agency (CPA) between 2000 and 2010 and whose health data could be retrieved from public health databases were selected for this study. METHODS: A prospective matched-cohort design was used, with administrative databases from a CPA and a public health system. Logistic regressions were performed to determine which mental health diagnoses were associated with, and which predicted, psychotic disorders. RESULTS: Logistic regressions revealed that personality disorders were significantly associated with psychotic disorders whereas substance misuse disorders and intellectual disability significantly predicted psychotic disorders. CONCLUSIONS: Psychotic disorders and personality disorders appear concomitantly in sexually abused youth. Having received a substance misuse disorder diagnosis increases the risk of developing a psychotic disorder in sexually abused youth. Health professionals should be aware of those risk factors to help reduce the severity of youth sexual abuse consequences and, ultimately, prevent psychosis.

Relationship between Child Sexual Abuse, Psychiatric Disorders and Infectious Diseases: A Matched-Cohort Study.

Child sexual abuse (CSA) has been strongly associated with a range of psychological and physical problems in childhood and adulthood, such as anxiety, post-traumatic stress disorder (PTSD), and infectious diseases. Despite the strength of these associations, no studies to date have investigated psychobiological processes that might underlie the relationship between CSA and physical health problems occurring during childhood, such as infectious diseases. The goal of the current study is to evaluate PTSD as a potential mediator between CSA and the occurrence of infectious diseases among children and adolescents. Furthermore, we postulate that PTSD plays a specific role as an indicator of chronic stress during childhood, in comparison to other mental disorders, such as anxious and non-anxious disorders (e.g., depression). Via a prospective matched-cohort design, administrative data were used to document PTSD, anxious and non-anxious disorders, and infectious diseases. The sample size was 882 persons with a substantiated report of sexual abuse and 882 matched controls. Negative binomial regressions revealed that CSA is associated with a greater number of anxious diseases diagnoses that, in turn, predict more infectious diseases diagnoses. These findings highlight the importance of preventing and intervening among sexually abused youth with anxious disorder symptoms to limit negative outcomes on physical health.

Association between child sexual abuse and infectious disease diagnoses.

BACKGROUND: Though many studies have linked child sexual abuse (CSA) to psychological health problems, little is known regarding the relationship between CSA and children and adolescents' physical health. OBJECTIVE: The objective of this study was to assess the relationship between CSA and infectious disease diagnoses. PARTICIPANTS: Of the 955 eligible children and adolescents who had a substantiated report of sexual abuse between 2001 and 2010, medical data was retrieved for 882 individuals, who formed the sexually abused group. These 882 participants were matched to 882 participants on age, gender, and administrative healthcare region to form the general population group. SETTING AND METHODS: This matched-cohort study, conducted in a large Canadian city, compared the number of infectious disease diagnoses between the date of the substantiated sexual abuse report and August 1, 2013, between the two groups. RESULTS: Results indicate that sexually abused participants had 1.27 times more (95% CI - 1.13 to 1.42) infectious diseases diagnoses than those from the general population. They received 1.83 times more genitourinary infection diagnoses (95% CI - 1.43 to 2.33), 1.31 times more diagnoses for other types of infections (95% CI - 1.11 to 1.55) and 1.21 times more respiratory and ear infection diagnoses (95% CI - 1.05 to 1.40). There was no statistically significant difference regarding skin infection diagnoses. These results indicate an association between CSA and more frequent infectious diseases diagnoses.

A Matched Cohort Study of the Association Between Childhood Sexual Abuse and Teenage Pregnancy.

PURPOSE: This matched cohort study aims to determine whether teenagers with a history of childhood sexual abuse (CSA) are at greater risk of consulting for a pregnancy and related complications than teenagers from the general population. It also aims to compare provoked abortion, live births, and fetal losses of participants who were sexually abused in childhood and those of the general population. METHODS: A total of 661 girls (aged 13-18 years) with a corroborated by Child Protection Services CSA report between 2001 and 2010 were matched to 661 girls from the general population upon age, biological sex, urban Child Protection Services area, and public drug insurance admissibility at reporting date. Pregnancy consultations and complications during pregnancy and delivery were documented using diagnoses from public health insurance administrative databases from January 1996 to March 2013. Socioeconomic status was controlled. RESULTS: Results indicate that compared with participants from the general population, those with a history of CSA were 4.6 times more likely to consult for at least one pregnancy, 5.3 times more likely to consult for at least one complication during pregnancy or delivery, and on average 5.2 and 3.3 times more likely to consult for at least one live birth and provoked abortion, respectively. There were too few observations to compare fetal losses between groups. CONCLUSIONS: Medical interventions for teenage pregnancies and related complications should take into consideration a possible history of CSA to reinforce gynecological follow-up and treatment for girls who were sexually abused and to prevent unfavorable outcomes.

Acceptance and Commitment Therapy for Psychosis and Trauma: Investigating Links between Trauma Severity, Attachment and Outcome.

BACKGROUND: Although Acceptance and Commitment Therapy (ACT) may be effective for individuals with psychosis and a history of childhood trauma, little is known about predictors of treatment response among such patients. AIMS: The current study examined: (1) whether severity of trauma predicted treatment response, and (2) profiles of patients with regard to their responses to treatment. METHOD: Fifty participants with psychosis and childhood trauma history were recruited and randomized to take part in either eight sessions of group-based ACT, or to be on a waiting list for the ACT group (i.e. treatment as usual group). The entire sample was used for the first part of the analyses (aim 1), whereas subsequent subsample analyses used only the treatment group (n = 30 for aim 2). RESULTS: It was found that trauma severity did not moderate the effectiveness of ACT on symptom severity, participants' ability to regulate their emotional reactions, or treatment compliance with regard to help-seeking. In addition, among those receiving ACT, the results revealed three distinct and clinically relevant change profiles. Avoidant attachment style and number of sessions attended were predictive of belonging to the different clusters or profiles. Patients in the profile representing the least amount of clinical change attended an average of two sessions less than those in the other change profiles. CONCLUSION: ACT offered in a group format appears to be a promising treatment for those with psychosis and history of trauma regardless of trauma severity. Given the brevity of the intervention, patients should be encouraged to attend each session to obtain maximum benefit.

Psychotic disorders in sexually abused youth: A prospective matched-cohort study.

Child sexual abuse has been identified as a potential risk factor for developing a psychotic disorder. However, little is known about the prevalence of psychotic disorders in youth who were sexually abused during adolescence and young adulthood. Gender differences also remain unclear. This study used administrative databases from a Child Protection Agency and a public health care system. It aimed to investigate the prevalence of psychotic disorders in sexually abused youth between the first substantiated report of sexual abuse and the beginning of adulthood. A second objective was to assess gender differences. Administrative health data for 882 sexually abused youth were compared with 882 matched controls from the general population over a 13-year period using conditional generalized linear mixed models. Stratified analyses by gender (group comparison) and group (gender comparison) were also performed. Sexually abused youth were 10 times more at risk of receiving a diagnosis of psychotic disorder than youth from the general population. There was no gender difference in the prevalence of psychotic disorders among sexually abused youth. These results highlight the importance of targeted prevention of psychotic disorders among sexually abused youth. Future studies should investigate risk factors and developmental trajectories of psychotic disorders in this population.

Sexual Violence on Campus: Differences Across Gender and Sexual Minority Status.

PURPOSE: Sexual violence is a pervasive problem on university campuses. Although previous work has documented greater vulnerability for sexual violence among sexual and gender minority students, little is known about contextual variation in vulnerability to this kind of violence. The goals of the current study were (1) to identify vulnerability among sexual and gender minority students with regard to sexual violence, and (2) to explore if the context of this violence differs across sexual and gender minority status. METHODS: Undergraduate students (ages 18-24) from six francophone universities in Quebec, Canada (N = 4,264) completed online questionnaires regarding their experience of sexual violence, as well as the context of these acts (e.g., the gender of the perpetrator, the status of the perpetrator, and the location of the violence). They also provided information regarding their sexual and gender minority status. Binary logistic regressions were conducted to assess for variation in experiencing sexual violence across sexual and gender minority status. RESULTS: Transgender/nonbinary students generally reported higher levels of sexual violence than their cisgender peers, while variation occurred with regard to vulnerability across sexual identity subgroups. Few differences in context were observed across sexual minority identity. Transgender/nonbinary students were significantly more likely to report sexual violence in athletic contexts and during volunteering activities compared to their cisgender peers. CONCLUSIONS: Findings highlight the higher levels of vulnerability for sexual violence among gender minority and some sexual minority university students. They also point to the contexts in which such violence occurs, suggesting specific strategies for prevention.

Genitourinary Health of Sexually Abused Girls and Boys: A Matched-Cohort Study.

OBJECTIVE: To compare genitourinary health problems of children and adolescents with a substantiated report of sexual abuse with those of the general pediatric population. STUDY DESIGN: Via a prospective matched-cohort design, administrative databases between January 1996 and March 2013 were used to document genitourinary problems of 882 sexually abused children and those of 882 matched controls. Generalized linear mixed models determined the association between a substantiated sexual abuse and diagnoses for sexually transmitted infections and urinary and genital health problems. RESULTS: Adjusted results revealed that up to 12 years after a sexual abuse was substantiated, abused girls had, respectively, 2.1 and 1.4 times more diagnoses for urinary and genital health problems compared with girls from the general population, whereas no difference was found for sexually transmitted infections. Sexually abused boys had an equivalent number of diagnoses as those from the general population for all 3 outcomes. Depending on the genitourinary health problem, abused girls and those from the general population had between 2.5 and 11 times more diagnoses than abused boys or those from the general population. CONCLUSIONS: This study showed that substantiated childhood sexual abuse is associated with more urinary and genital health problems among girls but not boys. Early prevention and intervention efforts may mitigate the problems such that they do not persist or worsen over time and into adulthood.