ABSTRACT
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.
ABSTRACT
BACKGROUND: Breastfeeding has a positive impact on child and maternal health outcomes. Black and Latina women and adolescent mothers have lower rates of breastfeeding initiation and continuance in the U.S. Maternal depression and psychosocial stressors may contribute to reduced rates of breastfeeding. The current study aims to better understand behaviours and associated factors related to breastfeeding in a diverse group of adolescent mothers attending a teen-tot clinic for postpartum and infant well care. METHODS: Participants were 191 mother-infant dyads. Mother's age ranged from 13 to 25, and 54% of mothers identified as Latina, 22% Black, 11% more than one race and 5% white. Demographic information and breastfeeding behaviour were abstracted from the medical record. Rates of postpartum mood/anxiety symptoms and psychosocial stressors were obtained from screening measures completed at medical visits. RESULTS: Analyses revealed that 87% of adolescent mothers in the sample initiated breastfeeding at birth and the racial/ethnic breakdown of those mothers closely mirrored the overall population (58% Hispanic or Latina, 17% Black, 10% more than one race, 5% white). At 2 months postpartum, only 41% of the population was still breastfeeding. Mothers with significant mood/anxiety symptoms at the newborn visit were more likely to be breastfeeding at the 1- and 2-month visits. Mothers with psychosocial stressors at the newborn visit were less likely to be breastfeeding at the 1- and 2-month visits. CONCLUSION: Efforts to promote health equity through breastfeeding for at-risk mothers must occur within the first few weeks postpartum and must consider associated factors including postpartum mood/anxiety symptoms and psychosocial stressors.
ABSTRACT
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.
