Dissociation As a Mechanism of Risk for Interpersonal Victimization Among Adolescent Girls.

Childhood interpersonal violence exposure (IVE) is associated with repeated victimization in adolescence and adulthood. Research suggests dissociation, a psychological phenomenon characterized by alterations and disruptions to consciousness, memory, and perceptions of the environment, and out-of-body experiences, increases the risk of revictimization. Self-report data from a longitudinal study of 92 violence-exposed adolescent girls from a large, urban area were analyzed to assess whether dissociation predicts polyvictimization or exposure to multiple types of interpersonal violence across adolescence. Participants' mental and interpersonal health was assessed at four in-person laboratory visits scheduled across 3.5 years (i.e., T1-T4). IVE included direct or indirect victimization experienced at home, school, the neighborhood, or town, such as child maltreatment, domestic violence, peer victimization, dating aggression, and community violence. Polyvictimization was operationalized as a composite score of the different types of IVE endorsed by the participant or caregiver. A random-intercept cross-lagged panel model was used to test the bidirectional relationships between dissociation and polyvictimization longitudinally. Cross-lagged regressions were analyzed to determine whether dissociation and polyvictimization predicted subsequent dissociation symptoms and polyvictimization. Concurrent and previous dissociation significantly accounted for polyvictimization at T2, T3, and T4. Polyvictimization did not significantly predict future dissociation symptoms. The results from this study provide support for dissociation's unique contribution to polyvictimization among violence-exposed girls, making it an important target for clinical assessment and treatment.

Psychometric Properties of the Sexual Subjectivity Inventory among Lesbian, Gay, and Bisexual Emerging Adults.

Research highlights the significance of positive sexual self-perceptions for general and sexual health. Yet, most research on the sexuality of lesbian, gay, and bisexual (LGB) individuals has been risk-oriented, leaving a critical gap in knowledge about normative and healthy sexuality among sexual minorities. In part, this gap is due to a lack of sexual health measures with established psychometric properties for LGB individuals. The current study examined the factor structure, reliability, factorial invariance, and validity of the Sexual Subjectivity Inventory (SSI) in a sample of 746 lesbian (n = 123), gay (n = 204), and bisexual (n females = 234; n males = 185) emerging adults (Mage = 23.4 years). Factor analyses revealed the same five-factor structure found in similar aged heterosexual samples and strict factorial invariance by sexual and cisgender identities. Factor scores were internally consistent and associated with indicators of sexual well-being (i.e., safe sex self-efficacy, internalized homonegativity) and general well-being (life satisfaction, identity achievement) in theoretically meaningful ways. Sexual subjectivity was largely unrelated to health risk behavior. Results support the use of the SSI with LGB emerging adults for advancing holistic perspectives on LGB sexuality.

Caregivers as gatekeepers: Professional mental health service use among urban minority adolescents.

Mental illness among adolescents frequently goes untreated, especially among low income and ethnic minority families. We sought to examine parent and adolescent psychological factors influencing mental health service use among 120 urban adolescents (82% African American, Age 13-18 years, M = 14.29, SD = 1.52) who had access to mental health treatment through their community primary care setting. We utilized structural equation modeling (SEM) to explore the independent and combined associations among parent and adolescent variables hypothesized to be associated with the youth's engagement in mental health treatment. Results showed that more than half (63.6%) of youth with clinically significant levels of symptoms were not currently engaged in treatment or seeking mental health services. One latent variable emerged: caregivers' perceptions of adolescent mental health problems (consisted of youth psychological symptoms, youth functional impairment, and strain on caregiver). Together with caregivers' attitude toward professional help, these two caregiver-reported variables, but not adolescents' attitude, were associated with higher likelihood of service utilization among adolescents. Findings suggest caregivers functioned as the "gatekeepers" to mental health services. We discuss findings' implications for engaging youth in mental health services as well as study limitations and future directions. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Romantic Conflict Narratives in Emerging Adult Couples: Viewpoint and Gender Matter.

Healthy romantic relationships entail understanding the needs of the self and other when interpreting conflict events. Yet how couples make meaning around specific conflicts and their capacity to reflect on their own and their partners' unmet needs is understudied. Using narratives, we examined destructive (e.g., extreme anger and break-up anxiety) and constructive (e.g., perspective taking) interpretations of past romantic conflicts in 80 emerging adult heterosexual couples and the extent to which such interpretations varied by viewpoint and gender. Couple members were interviewed separately about two conflict episodes in which their partner did not meet their needs (victim viewpoint) and two episodes in which they did not meet their partners' needs (perpetrator viewpoint). As anticipated, destructive interpretations were more evident in the victim viewpoint and for female couple members. In contrast, within constructive interpretations, the use of insight was greater in the perpetrator than the victim viewpoint. Although perspective taking was expected to be more common in the perpetrator viewpoint and in female narratives, this was not the case, as this type of constructive interpretation was infrequent in narratives about conflict. The findings revealed aspects of meaning making that might be useful to mental health professionals concerned with building skills to improve romantic competence in emerging adult couples.

Las relaciones amorosas saludables implican comprender las necesidades del yo y del otro a la hora de interpretar situaciones de conflicto. Sin embargo, hay pocos estudios sobre la manera en la que las parejas dan sentido a conflictos específicos y su capacidad de reflexionar sobre sus propias necesidades no satisfechas y las de sus parejas. Utilizando relatos, analizamos interpretaciones destructivas (p. ej.: enfado intenso y ansiedad por una separación) y constructivas (p. ej.: adopción de un punto de vista) de conflictos amorosos del pasado en 80 parejas heterosexuales de adultos emergentes y la medida en que dichas interpretaciones variaron según el punto de vista y el género. Se entrevistó por separado a los integrantes de las parejas acerca de dos episodios de conflicto en los cuales su pareja no satisfizo sus necesidades (punto de vista de la víctima) y dos episodios en los cuales ellos no satisficieron las necesidades de sus parejas (punto de vista del perpetrador). Como se anticipó, las interpetaciones destructivas fueron más evidentes en el punto de vista de la víctima y en los integrantes femeninos de la pareja. Por el contrario, dentro de las interpretaciones constructivas, el uso de comprensión fue mayor en el punto de vista del perpetrador que en el de la víctima. Aunque se esperaba que la adopción de perspectivas fuera más común en el punto de vista del perpetrador y en los relatos femeninos, no fue así, ya que este tipo de interpretación constructiva fue infrecuente en los relatos sobre los conflictos. Los resultados revelaron aspectos de la creación de significado que podrían ser útiles para los profesionales de la salud mental interesados en el desarrollo de habilidades orientadas a mejorar la aptitud amorosa en las parejas de adultos emergentes.

Onset Trajectories of Sexting and Other Sexual Behaviors Across High School: A Longitudinal Growth Mixture Modeling Approach.

Sexting is receiving substantial scholarly attention and is now considered commonplace in adolescence. Little is known, however, about the normative contexts and the development of adolescent sexting behavior, including the initiation of sexting in relation to other sexual behaviors. In this study, we used growth mixture modeling to identify classes of onset trajectories for sexual behaviors across high school. Participants included 429 high school students (54% female) who completed annual assessments of sexual behavior over a three-year period. We identified four distinct classes: postponement (9%) with no behaviors other than hand-holding and kissing initiated by Grade 11, gradual onset (44%) with sexting and other sexual behaviors emerging incrementally across high school, continuous onset (32%) with sexting and other sexual behaviors within the first three years of high school, early onset (15%) with initiation of sexting and all other sexual behaviors prior to or by the end of Grade 9. Boys were more likely than girls to be members of the postponement versus gradual onset class, while Black students were more likely than White students to be members of the early versus gradual onset class. Sexting behavior appears to be common in adolescence and co-emerges with genital contact behavior across varying trajectories of sexual development. These findings provide the foundation for contextualizing sexting within normative sexual development. Further, this information can inform efforts to promote sexual health.

A Dyadic Perspective on Sexual Subjectivity and Romantic Relationship Functioning.

Sexual subjectivity is a central feature of healthy sexuality that is believed to shape and be shaped by relationship experiences. However, no studies have examined sexual subjectivity within a dyadic context. The current study examined partner similarity in sexual subjectivity within 75 heterosexual couples and associations with sexual relationship functioning using actor-partner interdependence models. Within couples, partners' scores were significantly correlated on three of five elements of sexual subjectivity and showed similar mean levels on four of the five elements. Men's and women's sexual self-efficacy were positively associated with their own sexual communication. Other associations varied by gender. Men's sexual body esteem and entitlement to self-pleasure predicted their reports of sexual relationship functioning, and women's entitlement to pleasure from partners and sexual reflection predicted their reports of relationship functioning. Few partner effects were observed. Findings suggest that partners' sexual subjectivity is relevant for dyadic functioning in emerging adulthood. Longitudinal research is needed to examine how experiences within and across relationships contribute to the development of sexual self-concepts and sexual functioning.

Longitudinal Relations Between Childhood Maltreatment, Maltreatment-Specific Shame, and Postpartum Psychopathology.

The persistence of shame-based reactions to child maltreatment (CM) has been associated with poor posttraumatic adjustment. Despite evidence that the postpartum period is a vulnerable time for women with CM histories, little is known about the consequences of maltreatment-specific (MS) shame for postpartum functioning. The current study examined individual differences in MS shame among a sample of women during the postpartum period ( n = 100) as well as prospective relations from MS shame to postpartum psychopathology at 6-, 12-, 15-, and 18-month postpartum. Linear growth curve (LGC) analyses showed that MS shame predicted higher levels of depression symptoms but not post-traumatic stress disorder (PTSD) symptoms at all time points whereas path analyses showed that shame mediated the relations from multi-maltreatment to both depression and PTSD symptoms at all time points. Results point to the long-term consequences of MS shame during postpartum and the importance of attending to shame in clinical care of maltreatment survivors who present with postpartum psychopathology.

Caregivers' abuse stigmatization and their views of mental health treatment following child sexual abuse.

Many families do not utilize mental health services after the discovery of child sexual abuse (CSA), even when trauma-focused treatments are offered at low or no cost. Non-offending caregivers frequently serve as gatekeepers to youths' treatment, and their reactions to CSA may figure into decisions about treatment engagement. The current study examined caregivers' abuse stigmatization (i.e., self-blame and shame about their children's CSA) and associations with two factors predictive of treatment engagement (motivation, obstacles). Participants were recruited from a Child Advocacy Center where they received forensic interviews and were offered services following CSA discovery. Participating caregiver-child dyads included 52 non-offending caregivers (83% biological parents) and their children (69% girls; Mage=10.94, SDage=2.62). Caregiver abuse stigmatization was associated with higher motivation for treatment but also more obstacles to treatment. Further, abuse stigmatization moderated associations between children's PTSD symptoms and perceived obstacles to treatment with medium effect sizes (M f2=0.287). Among caregivers experiencing high abuse stigmatization, greater child PTSD symptoms were associated with more obstacles to treatment. Among caregivers experiencing low stigmatization, child PTSD was either associated with fewer treatment obstacles or was unrelated to treatment obstacles. Results highlight the potential significance of reducing parents' abuse stigmatization for increasing mental health service utilization following CSA discovery, especially for more symptomatic youth.

Attentional Bias for Sexual Threat Among Sexual Victimization Survivors: A Meta-Analytic Review.

The current meta-analysis examined the effects of sexual victimization (SV) on attentional bias for sexual threat. This relationship was also examined among victims of SV with and without a current diagnosis of post-traumatic stress disorder (PTSD). The broader aim was to elucidate potential mechanisms operating between SV and negative health outcomes. As hypothesized, the findings supported a positive relationship between SV and attentional bias toward sexual threat stimuli, and subanalyses indicated that PTSD symptomatology significantly contributed to this association.

Perceptions of general and parenting-specific posttraumatic change among postpartum mothers with histories of childhood maltreatment.

Although adaptive meanings of childhood maltreatment (CM) are critical to posttraumatic adaptation, little is known about perceptions of posttraumatic change (PTC) during the vulnerable postpartum period. PTC may be positive or negative as well as global or situational. This study examined general and parenting-specific PTC among 100 postpartum women with CM histories (Mage=29.5 years). All reported general and 83% reported parenting PTC. General PTC were more likely to include negative and positive changes; parenting PTC were more likely to be exclusively positive. Indicators of more severe CM (parent perpetrator, more CM experiences) were related to parenting but not general PTC. Concurrent demographic risk moderated associations between number of CM experiences and positive parenting PTC such that among mothers with more CM experiences, demographic risk was associated with stronger positive parenting PTC. Results highlight the significance of valence and specificity of PTC for understanding meanings made of CM experiences.

Early Stigmatization, PTSD, and Perceived Negative Reactions of Others Predict Subsequent Strategies for Processing Child Sexual Abuse.

OBJECTIVE: Trauma processing is central to healthy recovery, but few studies examine how youth process experiences of child sexual abuse (CSA). The current study builds on our prior work identifying individual differences in CSA processing strategies (i.e., Constructive, Absorbed, Avoidant) to examine whether abuse stigmatization, PTSD symptoms, and negative reactions from others experienced during the year after abuse discovery were associated with subsequent CSA processing strategies. METHOD: Participants included 160 ethnically diverse youth (8-15 years, 73% female) with confirmed cases of CSA. Predictors were measured at abuse discovery (T1) and 1 year later (T2). Individual differences in CSA processing strategies were assessed 6 years after discovery (T3) from participants' abuse narratives. RESULTS: The persistence of abuse stigmatization from T1 to T2 significantly increased the odds of using either an Avoidant or Absorbed (vs. Constructive) strategy at T3. Higher levels of PTSD symptoms at T1 as well as their persistence from T1 to T2 each significantly increased the odds of having an Absorbed versus Constructive strategy. The persistence of perceived negative reactions from others from T1 to T2 increased the odds of an Absorbed versus Avoidant strategy. Effect sizes ranged from medium to large (M d = 0.636). CONCLUSIONS: Results further validate prior work identifying distinct CSA processing strategies and suggest the persistence of abuse-specific disruptions over the year after abuse discovery may be associated with subsequent problems processing CSA experiences.

Positive and Negative Posttraumatic Change Following Childhood Sexual Abuse Are Associated With Youths' Adjustment.

Meanings made of childhood sexual abuse (CSA) experiences are important to psychosocial adjustment. The current study examined adolescents' and young adults' perceptions of posttraumatic change (PTC) in the self, relationships, sexuality, and worldviews attributed to prior CSA experiences. We sought to document the prevalence of positive and negative PTC and examine their unique and joint associations with psychosocial adjustment. Participants included 160 youth with confirmed cases of CSA (73% female; 8-14 years at abuse discovery) who were part of a longitudinal study of the long-term effects of CSA. Six years after discovery, youth were interviewed about their abuse experiences. Interviews were coded for the valence and strength of PTC. The majority of youth reported PTC, and negative changes were more frequent and stronger than positive changes. Controlling for age, gender, abuse severity, and negative PTC, positive PTC was associated with lower abuse stigmatization for all youth. Controlling for age, gender, abuse severity, and positive PTC, negative PTC was associated with greater abuse stigmatization, post-traumatic stress disorder, sexual problems, and dating aggression for all youth. Relations of positive PTC with depression and support from friends and romantic partner were moderated by negative PTC, such that positive PTC was associated with better adjustment for youth with low versus high levels of negative PTC. Results highlight the importance of both negative and positive PTC for understanding meanings made of CSA experiences and their implications for psychosocial adjustment and intervention.

Naturalistically observed conflict and youth asthma symptoms.

OBJECTIVE: To investigate the links between naturalistically observed conflict, self-reported caregiver-youth conflict, and youth asthma symptoms. METHOD: Fifty-four youth with asthma (age range: 10-17 years) wore the Electronically Activated Recorder (EAR) for a 4-day period to assess interpersonal conflict and caregiver-youth conflict as they occur in daily life. Conflict also was assessed with baseline self-report questionnaires and daily diaries completed by youth participants and their caregivers. Asthma symptoms were assessed using daily diaries, baseline self-reports, and wheezing, as coded from the EAR. RESULTS: EAR-observed measures of conflict were strongly associated with self-reported asthma symptoms (both baseline and daily diaries) and wheezing coded from the EAR. Further, when entered together in regression analyses, youth daily reports of negative caregiver-youth interactions and EAR-observed conflict uniquely predicted asthma symptoms; only EAR-observed conflict was associated with EAR-observed wheezing. CONCLUSION: These findings demonstrate the potential impact of daily conflict on youth asthma symptoms and the importance of assessing conflict as it occurs in everyday life. More broadly, they point to the importance of formulating a clear picture of family interactions outside of the lab, which is essential for understanding how family relationships "get under the skin" to affect youth health.

Negative life events and non-suicidal self-injury in an adolescent inpatient sample.

Although life stressors have been implicated in the aetiology of various forms of psychopathology related to non-suicidal self-injury (NSSI), particularly depression and suicidal behavior, they have rarely been examined in relation with NSSI. The objective of the current study was to assess the association between life stressors and NSSI in adolescent inpatients. Adolescent inpatients (n = 110) completed measures of life events, NSSI, and depressive symptoms at 3 time-points over a 9-month period. Higher rates of life stressors were significantly associated with greater NSSI. This finding held even after covarying concurrent depressive symptoms and gender. Life stressors may have a unique role in the pathogenesis of NSSI. Directions for future research and clinical implications are discussed.

Potential pathways from stigmatization and externalizing behavior to anger and dating aggression in sexually abused youth.

Although experiencing childhood sexual abuse (CSA) puts youth at risk for involvement in relationship violence, research is limited on the potential pathways from CSA to subsequent dating aggression. The current study examined prospective pathways from externalizing behavior problems and stigmatization (abuse-specific shame and self-blame attributions) to anger and dating aggression. One hundred sixty youth (73% female, 69% ethnic/racial minorities) with confirmed CSA histories were interviewed at the time of abuse discovery (T1, when they were 8-15 years of age), and again 1 and 6 years later (T2 and T3). Externalizing behavior and abuse-specific stigmatization were assessed at T1 and T2. Anger and dating aggression were assessed at T3. The structural equation model findings supported the proposed relations from stigmatization following the abuse to subsequent dating aggression through anger. Only externalizing behavior at T1 was related to later dating aggression, and externalizing was not related to subsequent anger. This longitudinal research suggests that clinical interventions for victims of CSA be sensitive to the different pathways by which youth come to experience destructive conflict behavior in their romantic relationships.

Temporal relationship between substance use and delinquent behavior among young psychiatrically hospitalized adolescents.

There is considerable evidence linking substance use and delinquent behavior among adolescents. However, the nature and temporal ordering of this relationship remain uncertain, particularly among early adolescents and those with significant psychopathology. This study examined the temporal ordering of substance use and delinquent behavior in a sample of psychiatrically hospitalized early adolescents. Youth (N = 108) between the ages of 12 and 15 years completed three assessments over 18 months following hospitalization. Separate cross-lagged panel models examined the reciprocal relationship between delinquent behavior and two types of substance use (e.g., alcohol and marijuana). Results provided evidence of cross-lagged effects for marijuana: Delinquent behavior at 9 months predicted marijuana use at 18 months. No predictive effects were found between alcohol use and delinquent behavior over time. Findings demonstrate the stability of delinquent behavior and substance use among young adolescents with psychiatric concerns. Furthermore, results highlight the value of examining alcohol and marijuana use outcomes separately to better understand the complex pathways between substance use and delinquent behavior among early adolescents.

Romantic partner selection and socialization of young adolescents' substance use and behavior problems.

This study examined romantic partner selection and socialization of substance use (cigarettes, alcohol) and behavior problems among a sample of 78 young adolescents (6th-8th graders) over eleven months. Adolescent and romantic partner behaviors were assessed before and after relationships were initiated via school records and self-report. Most selection and socialization effects were apparent for the eighth grade adolescents (at Time 1). Prior to their relationship, eighth graders and romantic partners were alike on alcohol use. In contrast, romantic socialization effects emerged for eighth graders' cigarette use and behavior problems. The nature of the partner socialization effects depended on the combination of adolescents' and partners' pre-relationship behaviors. Eighth graders who dated partners with fewer problems showed the greatest instability in their behavior problems and partner behavior predicted greater decreased in problem behaviors among adolescents with more problems. The implications of these findings are discussed within the broader context of adolescent peer relationships.

Making meaning of traumatic events: youths' strategies for processing childhood sexual abuse are associated with psychosocial adjustment.

The need to make meaning of childhood sexual abuse (CSA) is common and often persists long after the abuse ends. Although believed to be essential for healthy recovery, there is a paucity of research on how youth process their CSA experiences. The current study identified individual differences in the ways youth process their CSA and examined associations with psychosocial adjustment. A sample of 108 youth with confirmed abuse histories enrolled in the study within 8 weeks of abuse discovery, when they were between 8 and 15 years old. Six years later, they participated in interviews about their CSA experiences, reactions, and perceived effects. Using a coding system developed for this study, youths' CSA narratives were reliably classified with one of three processing strategies: Constructive (13.9%), Absorbed (50%), or Avoidant (36.1%). Absorbed youth reported the highest levels of psychopathological symptoms, sexual problems, and abuse-specific stigmatization, whereas Constructive youth tended to report the fewest problems. Avoidant youth showed significantly more problems than Constructive youth in some but not all areas. Interventions that build healthy processing skills may promote positive recovery by providing tools for constructing adaptive meanings of the abuse, both in its immediate aftermath and over time.

Abuse-specific self-schemas and self-functioning: a prospective study of sexually abused youth.

Potential pathways from childhood sexual abuse (CSA) to negative self-schemas to subsequent dissociative symptoms and low global self-esteem were examined in a prospective longitudinal study of 160 ethnically diverse youth with confirmed CSA histories. Participants were interviewed at the time of abuse discovery, when they were 8 to 15 years of age, and again 1 and 6 years later. Abuse-specific indicators of stigmatization, in particular the combination of shame and self-blame more than general self-blame attributions for everyday events, explained which youth with CSA histories experienced more dissociative symptoms and clinically significant levels of dissociation. Abuse-specific stigmatization was found to operate as a prospective mechanism for subsequent dissociative symptoms but not self-esteem.

Interparental Conflict and Adolescents' Romantic Relationship Conflict.

This study examined associations between interparental conflict and adolescents' romantic relationship conflict. High school seniors (N=183) who lived with married parents completed questionnaires about their parents' marriage and their own romantic relationships. A subset of 88 adolescents was also observed interacting with their romantic partners. Adolescents' perceptions and appraisals of interparental conflict were related to the amount of conflict in romantic relationship and adolescents' conflict styles. Adolescents' appraisals of interparental conflict (i.e., self-blame, perceived threat) moderated many of the associations between interparental conflict and conflict behavior with romantic partners. The patterns of moderated effects differed by gender. These findings suggest that the meanings boys and girls ascribe to interparental conflict are important for understanding how family experiences contribute to the development of romantic relationships.