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PROPOSAL TO INVESTIGATE EFFECTS OF CHILDHOOD SEXUAL ABUSE ON FEMALE ADULTS.
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Paper Abstract:
Research questions, significance of study, literature review, methodology.
Paper Introduction:
EFFECTS OF CHILDHOOD SEXUAL ABUSE ON FEMALE ADULTS
I. INTRODUCTION
Statement of the Problem
Childhood sexual abuse continues to be prevalent and prevention or intervention efforts are considered a failure ("Child," 1999; Gelles, 1998). Childhood sexual abuse results in effects that continue into adulthood. Relationships between this sexual abuse and adult problems such as depression, anxiety, drug abuse, attempted suicide, and psychiatric disorders, have been found (McCauley, Kern, Kolodner, Dill, Schroeder, DeChant, Ryden, Derogatis, & Bass, 1997). In addition, effects of this abuse on college students has been indicated by increased drop-out rates for this population (Duncan, 2000). Studies with clinical populations appear to be
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F.,DeChant, H. Tenof the 12 categories of personality disorder symptoms categorized by theDSM-IV were related to this abuse (Johnson, Cohen, & Brown, 1999, p. The cycle of violence:Revisited 6 years later. A., & Hatch, J. This lack of effective prevention and interventionprograms indicates a further need for effects assessment for different agegroups. L., Ross, C. W. Relation betweensexual abuse in childhood and adult depression: Case-control study.British Medical Journal, 316(7126), 198-2 2. 987). R. Relationships betweendifferent types of maltreatment during childhood and adjustment inadulthood. INTRODUCTION Statement of the Problem Childhood sexual abuse continues to be prevalent and prevention orintervention efforts are considered a failure ("Child," 1999; Gelles,1998). (2 ). (1998). They may have difficulty relating to others on termsother than sexual which can develop into serious adult problems ("Child,"1999, p. Higgins, D. The BrownUniversity Child and Adolescent Behavior Letter, 14(8), 1-3. II. Sexual abuse of children: Strengths andweaknesses of current criminology. Baral, I., Kora, K., Yuksel, S., & Sezgin, U. By age 32 years, nearly half ofthe abuse victims had been arrested for a nontraffic offense (Maxfield &Widom, 1996, p. An information survey will be used to determineprior childhood sexual abuse and the CAS and the IDD will be used tomeasure current symptomatic effects of depression and anxiety. American Journal of Drug and Alcohol Abuse,25(4), 593-6 8. The IDD is a self-reporting,22-item scale used to measure major depression and diagnose majordepressive disorder. References Apgar, B. These children develop a loss of self-esteem with feelings ofworthlessness and they become withdrawn, mistrustful, and have an abnormalsexual perspective. Subjects ranged from age 18 to 87years, 67% were married, 5 % were housewives and 27% were employed fulltime, and 8 % had at least one child. Child sexual abuse. 6 ). (1996). Dissociation is another problem associated with adults who havesuffered childhood trauma. Children are not in aposition to cope with sexual stimulation or the psychological ramificationsinvolved with the interaction. Highestdissociative scores were associated with those sexually abused by familymembers, non-family members, and combined sexual and physical abuse; thosewho had mothers who drank heavily had the most significant levels ofsymptoms (Apgar, 1999, p. Childhood physical and sexual abusein patients with anxiety disorders and in a community sample. Two-week test-retest correlations range from .64 to .74 indicating goodstability. Ignore child abuse now, attend to adultsocial problems later. All social classes were represented. Extensive reviews of prevention programs, haveshown that home health visiting programs are the most effective. & Forde, D. G., & Widom, C. K., Ryden, J., Derogatis, L. Behaviors such as substance abuse,gang and criminal activities, mental illness, prostitution, runawaybehavior, school failure, unemployment, teen pregnancy, sexual offenses,physical ailments, and suicide are found. Studies with clinical populationsappear to be more prevalent than those with nonclinical populations. Prevention programs remain ineffective even after 3 years of ongoing research. In a study of 9 8 participants with court records of child abuse orneglect, the criminal or violent results of this abuse were studied.Results showed that this group was more likely than controls to havejuvenile or adult arrests for nontraffic offenses and for violent crimes,with the emphasis on arrests for violence. Research demonstrated that child abuse results in adult socialproblems, beginning with adolescence. Research Question & Hypothesis The research questions are as follows: What are the effects ofchildhood sexual abuse on levels of depression and anxiety in adults? III. Success rates of home visits can be found with theunmarried teenage mother population; those receiving visits duringpregnancy and for two years following, show less cases of child abuse(Gelles, 1998, p. Findings of their studydemonstrated that sexual abuse and psychological maltreatment were stronglyassociated to trauma symptomatology and self depreciation. The child may care for the abuser andbecome trapped between the need for that person and the need to be rid ofthe abuse. Child maltreatment prevention programs arestill largely ineffective, after 3 years of research. 1362). Score summing yields a guantitative description of depression.Internal consistency is excellent with an alpha of .92. Two t-Tests forindependent samples will be used to empirically test the hypotheses. Limitations Since this study utilized a convenience sample with only volunteersubjects on an availability basis it is possible that the findings may notgeneralize to a larger population. A.,Eldridge, G. All ofthose who were severely molested, defined as including penetration orattempted penetration, were depressed. (1999). Study Purpose The purpose of this study will be to investigate the effects ofchildhood sexual abuse on female adults, in a nonclinical collegepopulation. Results showed that 29 patients werediagnosed with anxiety disorder, 4 had dissociative disorder, 5 hadborderline personality disorder, three others suffered one each fromdepressive, somatoform, and organic psychotic disorder, and one wasmentally retarded. A study investigating the effects of childhood sexual abuseon depression and anxiety in the college population is needed. (1999). A clinical sample of 125 patients withanxiety disorders (panic disorder, social phobia, and obsessive-compulsivedisorder) was examined for a background in childhood physical or sexualabuse. Archivesof General Psychiatry, 56, 6 -6 6. In a study comparing questionnaire formats for the gathering ofretrospective reports of child abuse, results demonstrated that researcher-defined abuse was more likely to be associated with unfavorable adultadjustment than self-defined abuse indices. Archives ofGeneral Psychiatry, 43, 1 76-1 81.----------------------- 12 Baral, Kora, Yuksel, and Sezgin (1998) studied 42women of this population, in Turkey. It covers the whole range of depressive symptoms inthe DSM III. Levels of dissociative symptoms were significantlyrelated to sexual and physical abuse but not to separation. In addition, effects of thisabuse on college students has been indicated by increased drop-out ratesfor this population (Duncan, 2 ). (1986). Interviews were conducted from 1975 to 1993, and abuse evidence wasobtained from state records and self-reports. A one-day test-retest correlation of .98 demonstrates excellent stability. (1999).Histories of childhood trauma and the effects on risky HIV behaviors in asample of women drug users. Zimmernan, M., Coryell, W., Corenthal, C., & Wilson, S. L. Stein, M. Descriptive statisticswill be used to describe demographic information. LITERATURE REVIEW This review of the literature concerning the effects of childhoodsexual abuse on adult females, will address the following areas relevant tothe study: an overview of childhood sexual abuse; effects of childhoodsexual abuse; specific effects of depression and anxiety, and collegedropout rates and study design. Thus adults may not beaware of what they have experienced as a child, and they may not be able toreport it. For this study effects ofchildhood sexual abuse will be depression, measured by the Inventory toDiagnose Depression (IDD), and anxiety as measured by the Clinical AnxietyScale (CAS). 236, 239). Silvern, L., Waelde, L. Childhood maltreatmentincreases risk for personality disorders during early adulthood. It assesses symptom duration, severity, and presence ofsymptoms. 17 8). P. R., Anderson, G., Hazen, A. Child abuse has become a problem demanding professional, pubic, andpolicy attention. Procedures All subjects will be recruited on a volunteer basis according toavailability. Relationships between this sexual abuse and adult problems suchas depression, anxiety, drug abuse, attempted suicide, and psychiatricdisorders, have been found (McCauley, Kern, Kolodner, Dill, Schroeder,DeChant, Ryden, Derogatis, & Bass, 1997). D. Further examples of adult problems due to childhood sexual abuse aredemonstrated by a longitudinal study of community youths and their mothers. % of womenwith panic disorders, compared to women with other anxiety disorders(3 .8%). J. (1998). The WALMYR assessment scales scoring manual.Tempe, AZ: WALMYR Publishing. Schneider, J. Silvern, Waelde, Baughan, Karyl, and Kaersvang (2 ) report that aneffect of childhood abuse, is the sleeper effect. E., Kolodner, K., Dill, L., Schroeder, A. Previous studies haveexamined effects for both clinical and normal populations, with an emphasison clinical. S. Childhood Sexual Abuse Sexual abuse of children has been reported 8 , times a year andthe numbers of unreported cases is considered to be even greater. Clinical Anxiety Scale (CAS). (1992). Effects of Childhood Sexual Abuse Higgins and McCabe (2 ) report that different types of childhoodmaltreatment result in different adjustment problems in adulthood. Clinical Reference Systems, 262. 1 ). Summing ofscores produces a range with higher scores indicating greater anxiety.Internal consistency is excellent with a coefficient alpha of .94. The abuse maytake place in various situations, to include within the family, in aschool, at a neighbors, or with a random molester. Known-groups validity is described as good with significantdiscrimination between groups with anxiety and controls (Hudson, 1992). Self-mutilating behavior of sexually abused female adults in Turkey. Journal of InterpersonalViolence, 15(9), 987-995. In a study of 1,931 women, those who reported childhood physical orsexual abuse (1 %) were found suffer more from depression, anxiety, drugabuse, attempted suicide, and psychiatric disorder hospitalization, thanthose not reporting the prior abuse (McCauley, Kern, Kolodner, Dill,Schroeder, DeChant, Ryden, Derogatis, & Bass, 1997, p. The long-term effects of this abuse are far reaching and devastating. Definition of Terms Childhood Sexual Abuse. Serious emotional and socialconsequences are detrimental to development of the child and they becomeless able to function adequately as adults (Phillips, 1998, p. Stein, Walker, Anderson, Hazen, Ross, Eldredge, and Forde (1996)reported on their matched case-control study of the effects of childhoodsexual abuse and adult anxiety. Inaddition, effects of this abuse have been associated with the collegepopulation, as indicated by drop-out rates of victims, however in thiscase, descriptions of specific emotional disturbances leading to drop-outrates is lacking. W. Aself-report scale to diagnose major depressive disorder. (1997).Clinical characteristics of women with a history of childhood abuse:Unhealed wounds. A group offemale students with prior childhood sexual abuse will be compared to agroup of female students with no prior childhood sexual abuse on effectvariables. A., Desmond, D. R., & Bass, E. Philips, B. Cheasty, M., Clare, A. J., & McCabe, M. EFFECTS OF CHILDHOOD SEXUAL ABUSE ON FEMALE ADULTS I. C., Baughan, B. (1998). Childhood trauma and dissociation in adulthood.American Family Physician, 6 (3), 972. Two formats for eliciting retrospective reports of childsexual and physical abuse: Effects on apparent prevalence and relationshipsto adjustment. (2 ). Foundonline on infotrac at: www.lapl.org Duncan, R. The Information Questionnaire,constructed by the investigator, consists of demographic questions as wellas a systematic inquiry to determine childhood sexual abuse. (1996). Subjects will be informed that their participation is voluntaryand they may withdraw from the study at any time, and that confidentialitywill be maintained. Specific Effects of Depression and Anxiety Cheasty, Clare, and Collins (1998) studied the effects of childhoodsexual abuse on adult depression in a case controlled study. Gelles, R. Childhood sexual abuse results in effects that continue intoadulthood. In conclusion, research has demonstrated that childhood sexual abuseresults in many adult problems, to include depression and anxiety. Additional limitations of this studymay be volunteer bias, subject group size, and geographic location. Any lewd or lascivious act upon or with thebody, or any part or member thereof, of a child (up to 14 years), with theintent of arousing, appealing to, or gratifying the lust or passions orsexual desires of such person or of such child by an adult (Schneider,1997). P. It has also been found that a questionnaire withresearcher-defined criteria is more effective than reporting of self-defined criteria regarding childhood trauma. 972). Childhood maltreatment and college drop-outrates: Implications for child abuse researchers. The CAS is a self-reporting, 25-itemscale used to measure amounts, degrees, and severity of clinical anxiety.Items are based on anxiety disorder criteria in the DSM III. Resultsshowed that out of 237 women interviewed, 132 were depressed and 37% of thedepressed women had been sexually molested prior to age 16 years. The Brown University Child and Adolescent BehaviorLetter, 14(8), 1 . B. Diagnostic sensitivity is considered to be over 8 % regardinglevels of depression (Zimmerman, Coryell, Corenthal, & Wilson, 1986). Maxfield, M. (1998). Inventory to Diagnose Depression (IDD). The use of a nonclinical college student populationwill provide unique results. Symptoms disrupt consciousness in areas ofmemory, identity, and environmental perception. Hypothesis 2: There will be a significant difference the childhoodsexual abuse group and the non-sexual abuse group, regarding scores on theCAS. Since prevention and intervention effortsregarding childhood sexual abuse and its effects, has resulted in failedattempts, an understanding of these effects on a nonclinical female collegepopulation will provide additional information needed to assist with futuredirections for the mental health care system. METHODOLOGY Subjects The subjects for the study will be 3 local college students, ages 18years to 24 years, chosen from those who voluntarily presented themselvesto the investigator for participation in the study. Significance of the Study Research shows effects of depression and anxiety for childhood sexualabuse victims, however a large portion of the literature is derived from aclinical population. (1999). Other reports found that cutting arms or wrists was the mostfrequent behavior, however this study found hitting oneself to be the mostfrequent. By the end on the senior year, 5 % of thosesexually abused, 35% of those who experienced multiple abuse, and 6 % ofnonvictims remained (Duncan, 2 , p. P., Zule, W. It is also possible that behaviors are measuredinaccurately, or that maltreating caretakers are inaccurately assessed aswanting change. Childhood sexual abuse was found in 45.1% of women with anxietydisorders compared to controls (15.4%), and it was found in 6 . (2 ). (1997). 262). McCauley, J.., Kern, D. Thirty female adults will be chosen to participate in thestudy based availability. Theystudied self-reports of 175 adults from a community sample regardingchildhood sexual abuse, physical abuse, psychological maltreatment,neglect, and witnessing family violence. B., Walker, J. Effects of Childhood Sexual Abuse. JAMA, 275(22), 7 8. JAMA, 277(17), 362-369. AmericanJournal of Psychiatry, 153(2), 275-278. Instruments Information Questionnaire. Child Maltreatment, 5(3), 261-272. G., Cohen, P., Brown, J. College Dropout Rates & Study Design Childhood maltreatment is associated with college drop-out rates. The hypotheses are as follows: Hypothesis 1: There will be a significant difference the childhoodsexual abuse group and the non-sexual abuse group, regarding scores on theIDD. W., & Collins, C. Thus a survey with researcher-defined questions is more likely to illicit a more accurate assessment ofchildhood abuse (pp. Concurrentvalidity is excellent, correlating with the Beck Depression Inventory andothers. M., Karyl, J., & Kaersvang,L. Hudson, W. International Journal of Offendertherapy and Comparative Criminology, 41(4), 31 -324. 1). It isunclear whether programs are simply inappropriate, too small, or beingimplemented improperly. Journal ofInterpersonal Violence, 13(4), 427-438. Johnson, J. Theserelationships were consistent regardless of family background factors (pp.261, 268). Astudy is needed to investigate specific effects of depression and anxietyfor the nonclinical female adult population, and use of the collegepopulation will be of particular interest. Ina longitude study of 21 freshmen and their four years of college, it wasfound that those who had experienced more than one type of abuse inchildhood, and those sexually assaulted were more likely to drop out beforetheir second semester. Self-mutilating behavior (SMB) is also found in childhood sexuallyabused female adults. In a study of 16 psychiatric inpatients, results showedthat all the experiences were interrelated; sexual and physical abuse wererelated to early parental separation and sexual abuse was not related towitnessing violence. Medrano, M. It remains unclear if thedissociation is a response to the sexual or physical abuse or whether itincludes parental factors such as loss of parents, witnessing violence, orchronic neglect. Child Maltreatment, 5(3), 236-25 . Results showed that thosewho suffered from childhood abuse (physical, sexual, and neglect) were overfour times as likely to suffer from diagnosed personality disorders. Data Analysis A quasi-experimental design will be used to investigate therelationship between the independent variable (childhood sexual abuse) andthe dependent variables (depression and anxiety). It was also found that SMB was correlated with sexualabuse, to the extent that it may be considered a signal for the presence ofthis abuse.
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