Executive functioning in child victims of sexual abuse: A multi-informant comparative study.

BACKGROUND: Research examining the association between child sexual abuse and executive functions is limited. Yet, exposure to traumatic situations at a young age has been associated with changes in the prefrontal cortex, which hosts executive functions (Wesarg et al., 2020). These functions are crucial for social adaptation, as they make it possible to inhibit maladaptive behavior and respond flexibly to the demands of the environment. As middle childhood is a sensitive period for the development of self-regulatory abilities, exploring executive functioning in school-age children could provide potential intervention targets (Dajani & Uddin, 2015). OBJECTIVE: Using multiple informants, this study compared executive functioning of sexually abused children to that of non-sexually victimized children and examined whether the differences were moderated by sex. METHODS: The sample consisted of 225, 6-to-12 years old children with a history of child sexual abuse (CSA) and 97 children without a history of CSA. Children completed two executive functioning tasks measuring cognitive flexibility and inhibition. Parents and teachers completed questionnaires evaluating children's executive functioning. RESULTS: In comparison to non-abused children, children with a history of CSA displayed greater executive functioning difficulties as assessed by both informant-reported questionnaires and self-completed tasks. Significant interaction effects were found, such as CSA predicting lower inhibition and executive functions at school in boys but not in girls. CONCLUSION: This study is a first step in understanding the association between CSA and executive functioning and offers a clearer picture of the differential impact of sexual trauma according to children's sex.

The investigation of sleep patterns in relation to interpersonal violence victimization and mental health in adolescent girls.

Empirical studies reveal that interpersonal violence victimization is a highly prevalent phenomena in youth and is associated with a host of difficulties, including mental, physical, and behavioral issues. Sleep, a developmentally fundamental process, is implicated in these unfavorable effects. Despite this, little is known about the interplay between interpersonal violence victimization, sleep, and mental health in adolescent girls, who are at greater risk of victimization, sleep problems, and mental health difficulties than boys. OBJECTIVE: The aim of the current study was to identify distinct patterns of sleep problems to understand how they are associated with interpersonal violence victimization and key mental health outcomes, namely dissociation and emotional dysregulation. METHOD: Latent class analyses were conducted on a sample of 706 adolescent girls aged 14-18 (88% of Canadian descent), who completed an online survey. RESULTS: Three classes of sleep were identified: poor-, moderate-, and high-quality sleep. Controlling for posttraumatic stress disorder, classes were found to differ regarding childhood sexual abuse, community violence, and emotional abuse. In addition, exposure to community violence was associated with dissociation only among girls in the poor-quality sleep class, indicating a moderation effect of sleep. CONCLUSION: The findings of this study, while awaiting replication with a more diverse sample, highlight the continued need to understand the interplay between interpersonal violence and sleep quality, which can help to inform trauma-focused clinical interventions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Investigating the role of alexithymia in the association between cumulative childhood maltreatment and teen dating violence victimization.

BACKGROUND: Childhood maltreatment is increasingly recognized as an important risk factor for teen dating violence (TDV) victimization. However, far too little research has studied the mechanisms that could explain this higher risk of revictimization. The present study investigated the role of alexithymia in the association between cumulative childhood maltreatment, TDV victimization occurrence and chronicity, and TDV-related post-traumatic stress disorder (PTSD) symptoms. METHODS: A total of 2780 adolescents, aged 13 to 19, completed measures of childhood maltreatment and alexithymia at Time 1 and TDV victimization and TDV-related PTSD symptoms at Time 2 (6 months later). Two mediational models were tested to examine the role of alexithymia as a risk factor for revictimization. One model assessed TDV occurrence as an outcome, while the other explored TDV chronicity and TDV-related PTSD symptoms as outcomes. RESULTS: Findings suggest that cumulative childhood maltreatment is associated with an increased probability of TDV occurrence through alexithymia. Cumulative childhood maltreatment and alexithymia are also associated with TDV chronicity and TDV-related PTSD symptoms. Notably, cumulative childhood maltreatment is associated with higher levels of alexithymia among adolescent victims of TDV, which, in turn, predicts higher TDV chronicity and TDV-related PTSD symptoms. LIMITATIONS: This study relied on abbreviated measures and did not include all forms of child maltreatment (e.g., emotional and physical neglect). CONCLUSIONS: Promoting emotional awareness and identification among youth victims of child maltreatment could reduce the risk of TDV occurrence, TDV chronicity, and TDV-related PTSD symptoms.

Alexithymia as a mediator of the associations between child maltreatment and internalizing and externalizing behaviors in adolescence.

Child maltreatment is a global concern that profoundly affects individuals throughout their lives. This study investigated the relationships between various forms of child maltreatment and behavior problems involving internalization and externalization during adolescence. Data obtained from a diverse sample of 1802 Canadians aged 14-18 years was used to examine the mediating role of alexithymia-a difficulty in recognizing and expressing emotions-in these associations. Results indicated that adolescents who experienced sexual abuse, emotional abuse, and exposure to intimate partner violence (IPV) in their childhood exhibited higher levels of alexithymia, which was correlated with elevated levels of both internalizing and externalizing problems. Physical abuse and parental neglect were only associated with externalizing problems. Gender differences also emerged, with gender-diverse adolescents reporting a higher prevalence of maltreatment, alexithymia, and behavior problems compared with their peers. However, alexithymia's mediating role was consistent across genders. Overall, this study highlights the intricate relationships between child maltreatment, alexithymia, and adolescent behavior problems. The findings of this study how different forms of child maltreatment significantly shape behavioral outcomes and indicate the importance of interventions in enhancing emotional awareness and expression in adolescents with a childhood history of maltreatment.

A latent class analysis of adolescent dating violence: Associations with daily conflict management.

BACKGROUND: Adolescent dating violence (ADV) is a major public health concern experienced by more than half of adolescents. Previous studies have found considerable diversity in patterns of ADV and suggest that its various forms often occur concurrently and reciprocally within adolescent dating relationships. While multiple robust distal correlates of ADV have already been established, research on situational factors, such as conflict-related variables, is still sparse. OBJECTIVE: This study aimed to identify patterns of ADV based on the co-occurrence of different types of ADV victimization and perpetration. Multiple correlates of these ADV patterns were examined, including daily conflict-related factors (e.g., occurrence, resolution). METHODS: A sample of 216 adolescents (M = 17.03 years; SD = 1.49) who were currently involved in a dating relationship completed a baseline assessment followed by 14 consecutive daily diaries. RESULTS: Latent class analysis revealed five classes, including Low violence (21.8 %), Emotional violence (50.9 %), Emotional and sexual violence (13 %), Psychological violence and control (7.9 %), and Multiple violence (6.5 %). Demographic, relationship, distal, and daily conflict-related indicators differentiated the classes. Findings indicated that youth in the Psychological violence and control and Multiple violence classes were involved in longer-lasting relationships and displayed higher externalized problems and emotion dysregulation, more frequent experiences of childhood traumas, and, notably, more difficulties in managing daily conflicts. CONCLUSION: Adolescence is a crucial time to reduce the onset, persistence, and adverse consequences of ADV. By identifying situational conflict-related factors associated with ADV victimization and perpetration, this study can inform important prevention efforts.

Implementing a sexual violence prevention program in two Canadian Indigenous communities: Challenges and lessons learned.

BACKGROUND: The prevalence of child sexual violence remains overwhelming, particularly among Indigenous populations, despite increased awareness. Therefore, implementing efficient initiatives is crucial in preventing and reducing sexual violence rates among these groups. OBJECTIVE: This study aimed to examine the processes involved in the implementation of a sexual violence prevention program in two Indigenous communities in Canada and assess application of culturally safe practices. METHOD: Eight Indigenous and non-Indigenous project managers underwent semi-structured interviews before the program's implementation; five of them also participated in the follow-up interviews. Moreover, thirteen Indigenous service providers from the two communities answered open-ended questions when the included training ended. RESULTS: Thematic analysis revealed the importance of following an ongoing process (not only before implementing a program) to assess the needs of community members and involving them in decision-making. Administrative injunctions were also identified as a significant challenge during implementation. Results showed that participants reported the taboo of sexual violence as a challenge but that constant discussions about the prevention of sexual violence helped defuse the discomfort and foster trust between Indigenous and non-Indigenous professionals. Finally, participants provided recommendations to improve research and intervention practices. CONCLUSIONS: Several takeaways were discussed to improve research practices with, by, and for Indigenous peoples, such as using collaborative communication, developing common understanding relative to work agendas, and increasing cultural competencies to build trust within the partnership.

A Dyadic Analysis of Sexual Assertiveness and Sexual Outcomes in Adolescent Romantic Relationships.

Amid adolescence, youth are developing the relational skills necessary to form and maintain positive intimate relationships. Sexual assertiveness is a key skill that could be related to couples' sexual outcomes (i.e. sexual satisfaction, sexual concerns, and sexual function). However, dyadic studies are lacking, and associations between sexual assertiveness and adolescents' sexual health and well-being remain underexplored. This cross-sectional dyadic study examined associations between dimensions of sexual assertiveness and sexual outcomes in adolescent romantic relationships. The Actor-Partner Interdependence Model guided analyses of self-reported questionnaires from 110 romantic dyads (aged 14-19 years; M = 16.51). Participants' gender was considered in the models, and gender differences emerged in the associations between study variables. Path analyses revealed that sexual needs and desires communication, refusal of unwanted sex, sexual intimacy initiation, and comfort talking about sex have significant actor and partner effects on adolescents' sexual outcomes in mixed-gender dyads. These findings suggest that authentically expressing one's own sexual needs, desires, and limits in adolescence may influence not only one's own sexual satisfaction, sexual concerns, and sexual function, but also their partner's. The aforementioned dimensions of sexual assertiveness could be important targets for research-based interventions to promote sexual health and well-being in adolescent romantic relationships.

"I Just Want to Feel Good Without Making You Feel Bad": Sexual Assertiveness Negotiation in Adolescent Romantic Relationships.

Sexual assertiveness is often conceptualized as an individual's ability to express one's own sexual needs, desires, and limits. Given that sexual assertiveness is embedded in interactions and can affect not only both partners' sexual well-being but also relationship satisfaction, dyadic approaches are needed to investigate sexual assertiveness negotiation within adolescent romantic relationships. This qualitative study aimed to document adolescents' ability to negotiate their sexual needs, desires, and limits with their partners during interactions where they discussed their sexual concerns. A directed content analysis, based on the life positions of the transactional analysis theory, was conducted on the interactions of 40 adolescent romantic dyads aged 14-19 years (M = 16.65; SD = 1.49). The results revealed four categories of strategies: (1) mutual assertiveness: negotiation of one's own sexual needs, desires, and limits with those of the partner; (2) singular passiveness: repression of one's own sexual needs, desires, and limits to privilege those of the partner; (3) singular aggressiveness: prioritization of one's own sexual needs, desires, and limits over those of the partner; and (4) mutual lack of negotiation skills: neglecting both partners' sexual needs, desires, and limits. Among other things, adolescents' ability to be sexually assertive was hindered by anticipations, including assumptions leading to disregarding one's own sexual needs, desires, and limits or fearing to ignore the partner's. To promote mutually rewarding sexual activities and prevent sexual violence, sexual education initiatives should support adolescents' ability to assertively negotiate their sexuality with their partner and avoid passiveness, aggressiveness, and lack of negotiation.

Do You See What I See? Emotion Recognition Competencies in Sexually Abused School-Aged Children and Non-Abused Children.

Child sexual abuse (CSA) is a worldwide phenomenon that has been linked to deleterious consequences. Adverse life events, such as sexual abuse, can compromise the development of emotional competencies, an important dimension of children's psychosocial development. This study aimed at evaluating emotion recognition competencies in sexually abused and non-abused children. The sample consisted of 97 sexually abused children (65 girls) and 78 non-abused children (56 girls) aged between 6 and 12 years. They were recruited in specialized intervention centers and elementary schools from the Montreal area. Recognition of joy, anger, fear, sadness, and neutral expressions was assessed using the Developmental Emotional Faces Stimulus Set (DEFSS; Meuwissen et al., 2017). Results of an ANCOVA revealed that the total scores of emotion recognition were significantly lower for victims of SA (M = 18.12, SE = 0.33) relative to non-abused children (M = 19.36, SE = 0.37), F(1,170) = 5.70, p < .05. Analyses performed on specific expressions yielded lower scores for the recognition of anger, F(1, 170) = 6.12, p = .014, partial η2 = .03, and joy, F(1, 170) = 8.04, p =.005, partial η2 = .04. Our findings highlight the importance of assessing emotion recognition competencies to improve intervention programs provided to sexually abused children and prevent the development of severe psychosocial problems.

The association between child sexual abuse and self-reported sleep in adolescent girls.

STUDY OBJECTIVES: Child sexual abuse is associated with negative consequences on both physical and mental health. It has been found to influence child and adolescent sleep, which is an important developmental factor, which also influences mental and physical health. However, the literature examining this topic is plagued by methodological limitations, such as small sample sizes and unvalidated measures. METHODS: Using the Pittsburgh Sleep Quality Index (PSQI), the present study examined 7 self-reported sleep dimensions, including sleep latency, efficiency, duration, disturbances, subjective sleep quality, daytime dysfunction, and use of sleep medication, in a sample of 707 adolescent girls aged 14-18 years old. RESULTS: Statistical analyses revealed that child sexual abuse had a significant moderate association with the total PSQI score. Sexually abused adolescent girls, compared with their nonabused counterparts, reported more sleep difficulties. Significant differences also emerged on all sleep dimensions, with abused girls reporting increased difficulties. However, the magnitude of these associations differed from one dimension to another. CONCLUSIONS: Our findings support the continued study of sleep in adolescent girls who experienced sexual abuse. They also support the use of a fine-grained perspective when assessing various dimensions of sleep health in girls with a history of child sexual abuse for improved tertiary prevention and intervention. CITATION: Langevin R, Pennestri M-H, Hershon M, Pirro T, Hébert M. The association between child sexual abuse and self-reported sleep in adolescent girls. J Clin Sleep Med. 2023;19(11):1933-1939.

Differential Profiles of Sexually Abused Adolescent Boys.

Victims of child sexual abuse (CSA) are a heterogeneous population. Several characteristics may influence the outcomes associated with this adverse childhood experience, including personal (e.g. age) and CSA characteristics (e.g. relationship to the perpetrator). This study relied on a person-centered approach to account for this heterogeneity and focused on adolescent boys, an understudied population. Data were drawn from a representative sample of high school students aged 14 to 18 years old in Quebec, Canada. A total of 3.9% (n = 138) of boys reported CSA. Various CSA characteristics (severity, relationship to the perpetrator, and number of events) were used as indicators to derive classes. A four-class solution emerged from the latent class analysis: CSA in a sports context (6%), intrafamilial CSA (8%), extrafamilial CSA (52%) and multiple CSA (34%). The multiple CSA profile included boys who were sexually abused in multiple situations by different perpetrators and who were victims of acts involving penetration. The exploration of correlates associated with class membership revealed that adolescent boys included in the multiple CSA profile were distinguished by higher rates of delinquent behaviors and alcohol and drug use. They were more likely than members of other latent classes to belong to sexual minorities. This exploratory study sheds light on sexually victimized adolescent boys and the deleterious consequences that may affect them, particularly boys who have experienced multiple CSA events. We conclude that prevention efforts should focus on the demystification of sexual trauma among boys and on using trauma-informed care approaches for adolescent externalizing behaviors.

An Analysis of Risk and Protective Factors Associated with Cyber-Dating Violence Victimization of Adolescent Girls: An Ecological Perspective.

Cyber-dating violence (cyber-DV) is a prevalent issue among adolescent girls that can have negative consequences including post-traumatic stress symptoms and suicidal ideations and attempts. In the aim to reduce its prevalence and impacts, researchers are increasingly relying on the identification of risk and protective factors associated with cyber-DV across multiple ecological contexts. The current study aimed to examine the influence of individual (e.g., dissociation), interpersonal (e.g., offline forms of dating violence) and community level (e.g., community support) factors associated with the cyber-DV victimization of adolescent girls. A sample of 456 adolescent girls (M = 16.17 years old, SD = 1.28) was recruited online to complete a survey. At the individual level, emotion dysregulation, dissociative symptoms, post-traumatic stress symptoms and resilience were measured. Offline forms of DV and a history of child sexual abuse were assessed at the interpersonal level. Finally, at the community level, community support, community resilience, neighborhood material and social disadvantage were evaluated. Results from a hierarchical logistic regression indicated that exposure to offline DV namely verbal-emotional DV, sexual DV, threats, as well as living in neighborhoods with lower levels of social disadvantage were significantly associated with an increased risk of cyber-DV victimization. Cyber-DV preventative intervention efforts should focus on incorporating cyber-DV specific modules and activities into offline DV prevention and intervention programs as to reduce the likelihood of adolescents suffering both forms of DV and their associated repercussions.

Dating Violence Trajectories in Adolescence: How Do They Relate to Sexual Outcomes in Canada?

Dating violence during adolescence is a major public health issue: it is highly prevalent and extensive research has documented its physical and psychological consequences, yet very little has focused on its sexual consequences. The present study investigated the longitudinal associations between dating violence victimization (psychological, sexual or physical) and sexual well-being (sexual satisfaction and sexual distress) among 1442 sexually active adolescents aged between 14 and 17 years who completed at least one of three data waves (51.1% girls; 45.7% boys; 0.3% non-binary; 3.0% varying gender identity). The study also examined whether these associations differed by gender identity and sexual minority status. Adolescents completed online questionnaires on electronic tablets during class. The results indicated that psychological, physical (except for boys), and sexual dating violence victimization were all associated with lower sexual satisfaction and greater sexual distress over time. Moreover, the between-level associations between dating violence and poorer sexual outcomes were stronger among girls and gender varying adolescents than among boys. The within-level association between physical dating violence and sexual satisfaction was significant among adolescents with a nonvarying sexual minority status, but not among those with a nonvarying heterosexual status or that varied in sexual minority status. Findings offer cues for dating violence prevention and intervention programs by suggesting the need to examine sexual well-being over time.

Who seeks sex therapy? Sexual dysfunction prevalence and correlates, and help-seeking among clinical and community samples.

Sexual dysfunctions (SD; e.g., female sexual interest/arousal disorder, erectile disorder, female orgasmic disorder, delayed ejaculation, genito-pelvic pain/penetration disorder, etc.) affect up to a third of individuals, impairing sexuality, intimate relationships, and mental health. This study aimed to compare the prevalence of SDs and their sexual, relational, and psychological correlates between a sample of adults consulting in sex therapy (n = 963) and a community-based sample (n = 1,891), as well as examine barriers to sexual health services for SD and the characteristics of individuals seeking such services. Participants completed an online survey. Analyses showed that participants in the clinical sample reported lower levels of sexual functioning and sexual satisfaction and higher levels of psychological distress than participants in the community-based sample. Moreover, higher SD rates were related to lower relational satisfaction and higher psychological distress in the community sample, and to lower sexual satisfaction in both samples. Among participants in the community sample who sought professional services for SD, 39.6% reported that they were unable to access services, and 58.7% reported at least one barrier to receiving help. This study provides important data regarding the prevalence of SD and the link between SD and psychosexual health in clinical and nonclinical samples, as well as barriers to treatment access.

Gender Differences in Behavioral Problems in Child Victims of Sexual Abuse: Contribution of Self-Blame of the Parent and Child.

The consequences associated with child sexual abuse are well known. However, factors exacerbating child behavior problems following sexual abuse (SA) deserve further attention. Self-blame following the abuse has been identified as a predictor of negative outcomes in adult survivors, however there is limited evidence regarding the impact of self-blame on consequences in child victims of sexual abuse. This study assessed behavioral problems in a sample of sexually abused children and tested the mediating role of children's internal blame attributions in the association between the parent's self-blame and the internalizing and externalizing difficulties of the child. A sample of 1066 sexually abused children between 6 and 12 years of age and their non-offending caregiver completed self-report questionnaires. Parents completed questionnaires related to the child's behavior following the SA and their own feelings of self-blame regarding the SA. Children completed a questionnaire assessing their level of self-blame. Results showed that parents' self-blame was associated with a higher level of self-blame in the child which, in turn, was linked to more child internalizing and externalizing behavior problems. In addition, parents' self-blame was directly associated with a higher level of internalizing difficulties in children. These findings underscore the importance of considering the non-offending parent's self-blame in interventions aiming the recovery of child victims of SA.

Diversity of Profiles and Coping Among Adolescent Girl Victims of Sexual Dating Violence.

Sexual dating violence (DV) is common among female adolescents, and victims may experience other forms of DV (physical, psychological, and cyberviolence) and report a history of child sexual abuse (CSA). Heterogeneity of these victimization experiences could influence how adolescent girls' cope. We aimed to identify distinct profiles of victimization experiences among adolescent girls who reported sexual DV and to explore if these profiles were associated to their coping strategies. Of an initial sample of 1,300 female adolescents who completed online questionnaires, 835 (Mage = 16.8 years) reported at least one experience of sexual DV and were included in the analyses. Hierarchical classification with the Two Step analysis revealed four distinct profiles of victimization. A first cluster named Moderate CSA & Cyber-sexual DV (21.4%) is characterized by moderate percentage of all forms of victimization. The second cluster CSA & DV excluding cyber-sexual DV (34.4%) included victims of traditional DV, moderate rates of CSA and no experience of cyber-sexual DV. A third cluster CSA & DV Co-occurrence (20.6%) regrouped victims who have experienced different forms of DV in co-occurrence and CSA. Finally, the fourth cluster, named No CSA & DV Co-occurrence (23.6%) involved victims who have experienced different forms of DV in co-occurrence, but did not report a history of CSA. Analyses revealed significant differences between the profiles on the use of avoidance coping, in their perceived social support, and on help-seeking strategies deployed toward a partner and a health professional. These findings offer cues for prevention and intervention efforts for victimized female adolescents.

Alexithymia as a Mediator between Intimate Partner Violence and Post-Traumatic Stress Symptoms in Mothers of Children Disclosing Sexual Abuse.

Purpose: The unveiling of child sexual abuse (CSA) can elicit symptoms of post-traumatic stress disorder (PTSD) in non-offending parents. The impact of disclosure is stronger for mothers who have already experienced interpersonal trauma, such as CSA or intimate partner violence (IPV). Alexithymia often serves as a coping mechanism in the aftermath of a trauma, as it creates a distance between oneself and distressing events. It could prevent individuals from resolving their trauma, be a risk factor for PTSD symptoms and compromise mothers' capacity to support their child. The objective of this study was to examine whether alexithymia mediated the relationship between the experiences of interpersonal violence (IPV and CSA) of mothers of sexually abused children, and mothers' PTSD symptoms following disclosure of their child's abuse. Method: A sample of 158 mothers of sexually abused children completed questionnaires assessing CSA and IPV and the Toronto Alexithymia Scale, which measures the capacity to identify and express emotions. The Modified PTSD symptom Scale-Self-Report evaluated PTSD symptoms related to their child's disclosure of sexual abuse. Results: Results of a mediation model revealed that alexithymia significantly mediated the relationship between IPV and PTSD symptoms. Mothers' CSA was directly associated with higher levels of PTSD following their child's disclosure of abuse, but the relationship was not mediated by alexithymia. Conclusions: Our findings highlight the importance of assessing mothers' history of interpersonal trauma and ability to recognize and identify emotions as well as the need to offer support and specific intervention programs to mothers.

The Associations between Self-Silencing and Delinquency in Adolescent Who Experienced Child Sexual Abuse.

A large body of research reveals that child sexual abuse is an adverse experience associated with many negative socioemotional and behavioral consequences during adolescence. Notably, adolescent victims of child sexual abuse are more likely to engage in delinquent behavior, which has importance for their adaptation later in life. While research on the psychological antecedents of delinquent behavior has independently considered each core feature of silencing the self (i.e., low assertiveness and self-expression, conflict avoidance, presenting a non-authentic self, anger, and hostility), it has failed to jointly consider these as potential predictors of delinquent behaviors in adolescent victims of child sexual abuse. The purpose of this study was to examine the associations between the two dimensions of self-silencing (i.e., divided self and silencing the self) and delinquency in adolescent victims of child sexual abuse. A sample of 110 adolescents seeking services following child sexual abuse completed self-reported questionnaires, and case files were analyzed to gather information regarding child sexual abuse severity. Hierarchical regression analyses revealed that, after controlling for the effect of age, gender, parental monitoring, and child sexual abuse severity, self-silencing was positively associated with delinquent behaviors, affiliation with delinquent peers, as well as alcohol and drug use. Divided self contributed to the prediction of aggressive behaviors. Implementing interventions aimed at increasing adolescents' assertiveness, conflict management skills, and emotion regulation and promoting congruence between their behaviors and authentic selves may lower their involvement in delinquency.