Sleep, Emotional, and Behavioral Problems Among Youth Presenting to Treatment Following Sexual Abuse.

Research indicates that sleep problems are fairly common in childhood. However, the relationship between child sexual abuse (CSA) and sleep problems and how sleep issues influence psychological symptoms in children presenting for treatment remain unclear. The purpose of this study was to examine the presence of sleep problems and the association between sleep problems and psychological symptoms in youth presenting to treatment following CSA. Participants included 276 non-offending caregiver-child dyads at pre-treatment and 106 dyads at post-treatment. Youth were 6 to 19 years old and predominately female (82.9%). Caregivers were 23 to 72 years old and predominately female (87.4%). Youth and caregivers identified as predominately European American (76.6% and 86.0%, respectively). Results indicated that caregiver endorsement of a particular youth sleep problem (as measured by the Child Behavior Checklist sleep items) at pre-treatment ranged between 17.9 and 51.4%. Sleep problems were positively associated with psychological symptoms per caregiver- and youth self-report. Interestingly, a substantial proportion of youth reported decreased sleep problems at the end of treatment even though the treatment did not target sleep issues. This study highlights the commonality of sleep problems in children who experienced sexual abuse. Findings suggest that CSA interventions that do not directly address sleep may be missing a component that can contribute to successful recovery. The results provide preliminary evidence that sleep problems and mental health concerns among youth who experienced CSA are associated, indicating a need for further investigation into the association and potential implications for treatment. Other implications for future research and treatment following CSA are discussed.

Telling a trusted adult: Factors associated with the likelihood of disclosing child sexual abuse prior to and during a forensic interview.

BACKGROUND: Many child sexual abuse (CSA) survivors delay or withhold disclosure of their abuse, even when presenting for formal investigation interviews. OBJECTIVE: This study examined factors that relate to the CSA disclosure process. PARTICIPANTS AND SETTINGS: Participants were CSA victims (N = 1,732) presenting to a Child Advocacy Center (CAC) for a forensic interview. METHOD: We tested a structural model to predict disclosure before and during a forensic interview using secondary data analysis. RESULTS: Youth were less likely to disclose before a forensic interview if they witnessed domestic violence (ß = -.233, p <  .05). Caregivers were less likely to believe the abuse allegation if the alleged perpetrator resided in the home ß = -.386, p <  .05) and more likely to believe if the youth made a prior disclosure (ß = .286, p <  .05). Youth were more likely to disclose during the forensic interview if they were older (ß = .388, p <  .05), if the alleged perpetrator resided in their home (ß = .209, p <  .05), if they disclosed prior (ß = .254, p <  .05), and if their caregiver believed the allegation (ß = .213, p < . 05). The alleged perpetrator residing in the youth's home (ß = -0.082, p < .05) and making a prior disclosure (ß = 0.060, p < .05) were both indirectly associated with forensic interview disclosure through caregiver belief. CONCLUSIONS: Findings highlight the importance of the family context and caregiver belief in the disclosure process for youth involved in formal CSA investigations.

Attention Problems and Comorbid Symptoms following Child Sexual Abuse.

Treatment utilization following child sexual abuse (CSA) is essential in combatting the various negative consequences of CSA. Youth may present to treatment for CSA with symptoms that cut across multiple diagnostic presentations that impact their ability to successfully engage in treatment. In particular, children who have difficulties with attention may have unique treatment needs following CSA. The purpose of this study was to examine how attention problems interplay with comorbid symptoms and how these clinical presentations impact treatment outcomes for youth who have been sexually abused. Participants included 323 families presenting to treatment for CSA. Youth were 7 to 19 years old, 78.5% female, and 76.6% identified as Caucasian/White. Results indicated that 22.9% of the youth presented with clinically elevated attention problems as collected through parent-report of the Child Behavior Checklist (CBCL). Results demonstrated that child survivors of CSA who presented with attention problems self-reported more psychological concerns (e.g., symptoms of depression, anxiety, and post-traumatic stress). At post-treatment, attention problems, interpersonal problems, and thought problems were significantly reduced for youth initially presenting with attention problems. Further implications for treatment following CSA and unique needs for youth with attention problems are discussed.

Attributions of Blame in a Hypothetical Child Sexual Abuse Case: Roles of Behavior Problems and Frequency of Abuse.

Youth who are blamed for their sexual abuse may experience increased negative outcomes, such as amplified self-blame. Similarly, blaming nonoffending parents can impede their ability to support their child following disclosure. Understanding the factors that influence how people perceive victim, caregiver, and perpetrator responsibility is imperative for the protection and treatment of families who have experienced sexual abuse. Little research has explored victim and abuse characteristics that influence the perception of sexual abuse. As such, the purpose of this study was to examine the roles of behavior problems and frequency of abuse in the attribution of blame in a hypothetical sexual abuse case. In addition, the relationship between several respondent characteristics and assignment of responsibility were explored as secondary aims. The study used a two (behavior problems: three suspensions in one school semester vs. no mention of behavior problems) by two (one abuse occurrence vs. five abuse occurrences) between-subjects design. Seven hundred forty-two participants read one of the four child sexual abuse (CSA) vignettes and completed measures related to responsibility. ANOVAs revealed those who read a vignette where the youth experienced multiple abuse incidents rated the victim as more responsible regardless of whether or not the youth was described as having behavior problems. Results indicate that respondents may have attributed more blame to the victim due to the belief that she could have done something to stop the abuse after the first incident. The abuse frequency manipulation when combined with the behavior manipulation appeared to relate to how respondents perceived the victim's parents. Males and younger respondents attributed more blame to the victim; however, sexual abuse or assault history did not associate with victim responsibility ratings. Clinical and research implications were discussed.

Psychological Distress and Revictimization Risk in Youth Victims of Sexual Abuse.

Psychological distress, including depression and anxiety, has been associated with increased risk for sexual revictimization in youth who have experienced child sexual abuse. The present study utilized assessment information from treatment seeking youth with histories of sexual abuse to explore specific risk indicators for revictimization-risk taking, social problems, maladaptive cognitions, and posttraumatic stress-that may be indicated by self-reported distress. The relationship between initial levels of distress and change in symptoms over a 12-week course of treatment was also explored. Participants were 101 youth referred to a child-focused therapeutic group for victims of sexual abuse, 65 youth referred to an adolescent-focused group, and their non-offending caregivers. Results revealed that when combined into a distress score, depression and anxiety were associated with delinquent behaviors, interpersonal difficulties, maladaptive cognitions, and posttraumatic stress symptoms for child and adolescent group participants at presentation to treatment. Children exhibited improvement on measures of interpersonal difficulties, maladaptive cognitions, and self-reported posttraumatic stress disorder (PTSD) symptoms. Adolescents exhibited less change over time, with significant improvement on self-reported social problems and PTSD only. Higher psychological distress was associated with less improvement in regard to negative expectations of abuse impact for child group participants. The findings suggest that distress indicates the presence of specific revictimization risk indicators, helping to identify targetable symptoms for intervention. Therefore, screening for psychological distress after discovery of sexual abuse may help detect youth at higher risk for revictimization and guide treatment.

Predicting Sexual Revictimization in Childhood and Adolescence: A Longitudinal Examination Using Ecological Systems Theory.

A substantial proportion of sexual abuse victims report repeat sexual victimization within childhood or adolescence; however, there is limited understanding of factors contributing to revictimization for youth. Thus, the present study examined predictors of sexual revictimization prior to adulthood using ecological systems theory. Records of 1,915 youth presenting to a Child Advocacy Center (CAC) were reviewed to identify individual, familial, and community factors as well as initial abuse characteristics associated with risk for revictimization. Results showed that 11.1% of youth re-presented to the CAC for sexual revictimization. At the individual level, younger children, girls, ethnoracial minority youth, and those with an identified mental health problem were most likely to experience revictimization. Interpersonal factors that increased vulnerability included the presence of a noncaregiving adult in the home, being in mental health treatment, and domestic violence in the family. Community-level factors did not predict revictimization. When factors at all levels were examined in conjunction, however, only individual-level factors significantly predicted the risk for revictimization. Findings from this study provide valuable information for CACs when assessing risk for re-report of sexual abuse and add to the field's understanding of revictimization within childhood.

Evaluating Leaf and Canopy Reflectance of Stressed Rice Plants to Monitor Arsenic Contamination.

Arsenic contamination is a serious problem in rice cultivated soils of many developing countries. Hence, it is critical to monitor and control arsenic uptake in rice plants to avoid adverse effects on human health. This study evaluated the feasibility of using reflectance spectroscopy to monitor arsenic in rice plants. Four arsenic levels were induced in hydroponically grown rice plants with application of 0, 5, 10 and 20 µmol·L(-1) sodium arsenate. Reflectance spectra of upper fully expanded leaves were acquired over visible and infrared (NIR) wavelengths. Additionally, canopy reflectance for the four arsenic levels was simulated using SAIL (Scattering by Arbitrarily Inclined Leaves) model for various soil moisture conditions and leaf area indices (LAI). Further, sensitivity of various vegetative indices (VIs) to arsenic levels was assessed. Results suggest that plants accumulate high arsenic amounts causing plant stress and changes in reflectance characteristics. All leaf spectra based VIs related strongly with arsenic with coefficient of determination (r²) greater than 0.6 while at canopy scale, background reflectance and LAI confounded with spectral signals of arsenic affecting the VIs' performance. Among studied VIs, combined index, transformed chlorophyll absorption reflectance index (TCARI)/optimized soil adjusted vegetation index (OSAVI) exhibited higher sensitivity to arsenic levels and better resistance to soil backgrounds and LAI followed by red edge based VIs (modified chlorophyll absorption reflectance index (MCARI) and TCARI) suggesting that these VIs could prove to be valuable aids for monitoring arsenic in rice fields.

Heterogeneous symptom patterns of sexually abused children in treatment: understanding the complexity of the problem.

A major challenge for clinicians and researchers is the heterogeneity of the severity and type of symptoms presented by sexually abused youth, including those who are subclinical on traditional clinical measures but still present to treatment. Most research continues to treat sexually abused youth as a single population and has not assessed the outcomes or symptom trajectories of various groups of sexually abused youth. Participants included 107 sexually abused children and their nonoffending parents presenting to a cognitive-behavioral group treatment. A cluster analysis using child- and parent-report measures revealed four profiles, including Subclinical, Highly Distressed, Problem Behaviors, and Self-Reported Distress clusters. Hierarchical linear modeling was used to create separate child- and parent-report models of weekly symptomatology to examine differential change over the course of treatment. Contrary to expectation, there was little variation in the weekly rates of change for the different symptom groups; however, all groups evidenced a decrease in symptoms over the course of treatment, including the Subclinical cluster.

Child advocacy center based group treatment for child sexual abuse.

The present study examines initial symptom presentation among participants, outcomes, and social validity for a group treatment for child sexual abuse delivered at a child advocacy center. Participants were 97 children and their nonoffending caregivers who were referred to Project SAFE (Sexual Abuse Family Education), a standardized, 12-week cognitive-behavioral group treatment for families who have experienced child sexual abuse. Sixty-four percent of children presented with clinically significant symptoms on at least one measure with established clinical cutoffs. Caregivers of children who presented with clinically significant symptoms reported more distress about their competence as caregivers. Children who presented as subclinical were more likely to have experienced intrafamilial sexual abuse. Posttreatment results indicated significant improvements in functioning for all children who participated in treatment, with greater improvements reported for children who initially presented with clinically significant symptoms. Overall, the program was rated favorably on the posttreatment evaluation of social validity.

Enhanced biogeochemical cycling and subsequent reduction of hydraulic conductivity associated with soil-layer interfaces in the vadose zone.

Biogeochemical dynamics in the vadose zone are poorly understood due to the transient nature of chemical and hydrologic conditions but are nonetheless critical to understanding chemical fate and transport. This study explored the effects of a soil layer on linked geochemical, hydrological, and microbiological processes. Three laboratory soil columns were constructed: a homogenized medium-grained sand, a homogenized organic-rich loam, and a sand-over-loam layered column. Upward and downward infiltration of water was evaluated during experiments to simulate rising water table and rainfall events, respectively. In situ collocated probes measured soil water content, matric potential, and Eh. Water samples collected from the same locations were analyzed for Br, Cl, NO, SO, NH, Fe, and total sulfide. Compared with homogeneous columns, the presence of a soil layer altered the biogeochemistry and water flow of the system considerably. Enhanced biogeochemical cycling was observed in the layered column over the texturally homogeneous soil columns. Enumerations of iron- and sulfate-reducing bacteria showed 1 to 2 orders of magnitude greater community numbers in the layered column. Mineral and soil aggregate composites were most abundant near the soil-layer interface, the presence of which likely contributed to an observed order-of-magnitude decrease in hydraulic conductivity. These findings show that quantifying coupled hydrologic-biogeochemical processes occurring at small-scale soil interfaces is critical to accurately describing and predicting chemical changes at the larger system scale. These findings also provide justification for considering soil layering in contaminant fate and transport models because of its potential to increase biodegradation or to slow the rate of transport of contaminants.

Heterogeneity of individuals with a history of child sexual abuse: an examination of children presenting to treatment.

The current study examined children and families who presented for treatment through Project SAFE (Sexual Abuse Family Education) following childhood sexual abuse. Pretreatment assessment data were used to develop clusters of participants with significantly differing presentation of symptom outcome following abuse. Four clusters were discovered: (a) a Highly Distressed group, whose members had clinically elevated scores on all self- and parent-report measures; (b) a Problem Behaviors group, whose members had scores within the normal range for self-report measures and elevated scores on all parent-report measures; (c) a Subclinical group, whose participants had scores below the mean and below cutoff scores for all self- and parent-report measures; and (d) a Self-reported Distress group, whose members had elevated scores on self-report measures and scores below clinical cutoffs for all parent-report measures.

An evaluation of the applicability of the tripartite constructs to social anxiety in adolescents.

The current study examined the tripartite model of anxiety and depression in relation to social phobia in a nonclinical sample of adolescents (ages 13-17). Adolescent/parent dyads participated in a semistructured interview and completed self-report measures of the tripartite constructs and social anxiety. Adolescents gave an impromptu speech, and heart rate was monitored. Low positive affect, high negative affect, and high physiological hyperarousal were characteristic of adolescents diagnosed with social phobia; adolescents with elevated social anxiety symptoms who did not meet criteria for social phobia did not evidence low positive affect. Heart rate reactivity during the speech was not significantly correlated with social anxiety symptomatology or with self-reported physiological hyperarousal.

Understanding child sexual behavior problems: a developmental psychopathology framework.

Children exhibiting sexual behavior have increasingly gained the attention of child welfare and mental health systems, as well as the scientific community. While a heterogeneous group, children with sexual behavior problems consistently demonstrate a number of problems related to adjustment and overall development. In order to appropriately intervene with these children, a comprehensive understanding of etiology is imperative. The overarching goal of the present paper is to review the extant research on mechanisms associated with the development of problematic sexual behavior in childhood within a developmental psychopathology framework. What is known about normative and nonnormative sexual behavior in childhood is reviewed, highlighting definitional challenges and age-related developmental differences. Further, the relationship between child sexual abuse and child sexual behavior problems is discussed, drawing attention to factors impacting this relationship. Risk factors for child sexual behavior problems, beyond that of sexual abuse, are also reviewed utilizing a transactional-ecological framework. Finally, we conclude with a discussion of implications of a developmental psychopathology perspective on problematic child sexual behaviors to inform future research and intervention efforts. Such implications include the need for attention to normative childhood sexual behavior, developmental sensitivity, and examinations of ecological domain in concert.

Nonoffending parent expectations of sexually abused children: predictive factors and influence on children's recovery.

This study examined the influence of parental expectations on the functioning of sexually abused children. Participants included 67 sexually abused youth and 63 of their nonoffending primary caregivers. Parental expectations about how sexual abuse will impact children were predictive of parents' ratings of children's behavior at pretreatment, while parental expectations of children's overall future functioning were not predictive of parents' ratings of children's behavior. Parental expectations about how sexual abuse will impact their children and about their children's overall future functioning were not predictive of parents' ratings of children's behavior at posttreatment. Results highlight the influential role the sexual abuse label has in shaping parental expectations about children's functioning. Recommendations for research and intervention are discussed.

Weekly problems scales: instruments for sexually abused youth and their nonoffending parents in treatment.

This study's purpose was to determine if efficient measures could be created to assess multiple problematic behaviors identified in youth who were sexually abused and in treatment. Because of the lack of easily administered brief instruments that assess multiple domains of interest in this population, complementary parent and child assessment measures were developed. The Weekly Problems Scale-Child Version (WPSC) and the Weekly Problems Scale-Parent Version (WPS-P) were created to monitor the weekly progress of the child and family in treatment and focus specifically on common areas of difficulties in this population. Exploratory factor analysis was conducted to assist in identifying the number of underlying dimensions in the scales. Results indicate that the WPS-C and WPS-P demonstrate adequate internal consistency, temporal stability, and construct validity. The WPS-C and WPSP display significant promise as research and clinical assessment tools for use with youth who are sexually abused and their nonoffending parents in treatment.

Predicting sediment metal toxicity using a sediment biotic ligand model: methodology and initial application.

An extension of the simultaneously extracted metals/acid-volatile sulfide (SEM/AVS) procedure is presented that predicts the acute and chronic sediment metals effects concentrations. A biotic ligand model (BLM) and a pore water-sediment partitioning model are used to predict the sediment concentration that is in equilibrium with the biotic ligand effects concentration. This initial application considers only partitioning to sediment particulate organic carbon. This procedure bypasses the need to compute the details of the pore-water chemistry. Remarkably, the median lethal concentration on a sediment organic carbon (OC)-normalized basis, SEM*(x,OC), is essentially unchanged over a wide range of concentrations of pore-water hardness, salinity, dissolved organic carbon, and any other complexing or competing ligands. Only the pore-water pH is important. Both acute and chronic exposures in fresh- and saltwater sediments are compared to predictions for cadmium (Cd), copper (Cu), nickel (Ni), lead (Pb), and zinc (Zn) based on the Daphnia magna BLM. The SEM*(x,OC) concentrations are similar for all the metals except cadmium. For pH = 8, the approximate values (micromol/gOC) are Cd-SEM*(xOC) approximately equal to 100, Cu-SEM*(x,OC) approximately equal to 900, Ni-SEMoc approximately equal to 1,100, Zn-SEM*(x,OC) approximately equal to 1,400, and Pb-SEM*(x,OC) approximately equal to 2,700. This similarity is the explanation for an empirically observed dose-response relationship between SEM and acute and chronic effects concentrations that had been observed previously. This initial application clearly demonstrates that BLMs can be used to predict toxic sediment concentrations without modeling the pore-water chemistry.

Understanding mental health needs of Southeast Asian refugees: historical, cultural, and contextual challenges.

Research and clinical information pertaining to mental health needs of Asians residing in the United States is limited but growing. There is a tendency to group all persons of Asian descent together and, therefore, the empirical literature does not sufficiently address the mental health needs in specific subgroups. The focus of this article is to understand the mental health needs of one subgroup of Asians--Southeast Asian refugees (SEAR). The main purpose is to review the relevant literature pertaining to Southeast Asian refugees' experiences and to understand the manifestation of psychiatric disorders by examining historical, cultural, and contextual challenges. Despite the well-documented mental health needs for SEAR, most do not present for mental health services. Therefore, resilience and protective factors are discussed. Research and clinical implications are described and suggestions are offered on how to apply information obtained from Southeast Asian refugees' experiences to future refugees.

Testing soils and cornstalks to evaluate nitrogen management on the watershed scale.

High nitrate (NO3-N) concentrations in Iowa rivers have been linked to areas of intensive row crop production, but they have not been experimentally linked to specific management practices used during row crop production. This study demonstrates how the late-spring test for soil NO3-N and the end-of-season test for cornstalk NO3-N can be used to measure N sufficiency levels across many fields and how the results can be used to evaluate management practices within a watershed. More than 3200 soil and cornstalk samples were collected over a 12-yr period from fields planted to corn (Zea mays L.) and already fertilized by farmers using their normal practices. Results showed that early-season rainfall and associated N losses were major factors affecting N concentrations in soils and cornstalks. Evidence for NO3-N movement from fields to rivers was provided by an inverse relationship between annual means for NO3-N concentrations in soils and rivers. Because these losses can be avoided by delaying N applications, the practice of applying N several weeks or months before plants grow was linked to inefficient use of fertilizer and manure N by crops. Results of the study demonstrate how aggregate analyses of soil and cornstalk samples collected across many farms and years make it possible to identify the major factors affecting N management outcomes and, therefore, N management practices that are likely to produce the best outcomes within a watershed or region. This approach seems to have unique potential to interrelate the management practices of farmers, the efficiency of N fertilization, and NO3-N concentrations in rivers.

Factors influencing children to self-disclose sexual abuse.

Self-disclosure by victims of child sexual abuse (CSA) is critical to initiate legal and therapeutic intervention. Unfortunately, research indicates that lengthy delays in disclosure and even nondisclosure are common. A comprehensive review of the clinical and research literature on CSA and an overview of related bodies of literature was conducted. Areas addressed include the context of sexual abuse as it relates to disclosure, the context and elements of children's disclosures, motivational factors inhibiting disclosure, and models of the disclosure process. Ancillary and analogue research on secrecy and disclosure are also reviewed. Implications for future research and practice are discussed.