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1.
BackgroundAdolescent victims of sexual assault and exploitation suffer significant mental health distress including PTSD, self-harm, suicidal ideation, and attempts.ObjectiveThis longitudinal observational study investigated the Runaway Intervention Program's influence on trauma responses at 3, 6, and 12 months for adolescents who have run away at least once and have been sexually assaulted or exploited.ParticipantsRunaways (n = 362) received nurse practitioner (NP) home and community visits, intensive case management, and optional empowerment groups.SettingAn urban Midwestern city's hospital-based Children's Advocacy Center.MethodsTrauma responses were measured by the UCLA PTSD-RI index, past 30 days emotional distress scale, and self-harm, suicidal ideation, and suicide attempt questions. Repeated Measures ANOVA assessed trauma response changes over time. Growth curve analyses using intervention doses determined which aspects of the intervention predicted change.ResultsFrom program entry to 3 and 6 months, mean values decreased significantly for emotional distress (−0.67, −.91) self-harm (−.30, −.55), suicidal ideation (−.45, −.57), suicide attempts (−.58, −.61), and trauma symptoms (−11.8, −16.2, all p < .001) all maintained at 12 months. In growth curve models, NP visits independently predicted declines in emotional distress (−.038), self-injury (−.020), suicidal ideation (−.025) and attempts (−.032), while empowerment groups predicted trauma symptoms (−.525) and all others except suicide attempts.ConclusionsThe program, especially NP community visits and empowerment group elements, decreased trauma responses in runaway youth with a history of sexual assault. Given high rates of PTSD and emotional distress among runaways, the Runaway Intervention Program offers promise for improving mental health outcomes. 相似文献
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OBJECTIVE: Studies show that childhood sexual and physical abuse predict repeated suicide attempts and self-mutilation. Little is known about the importance of sexual and physical abuse when compared to other severe childhood adversities with respect to chronic suicidal behavior. METHOD: Seventy-four subjects, 65% of whom were women, consecutively admitted to a general hospital after having made a suicide attempt, were interviewed as part of the intake interview about prior suicide attempts and self-mutilation and received DSM-IV diagnoses. Sexual abuse, physical abuse, neglect, antipathy from parents, loss of parents, and severe discord in the family before the age of 18, were covered by the Childhood Experience of Care and Abuse (CECA) interview schedule. RESULTS: The prevalence of severe sexual abuse was 35%, severe physical abuse 18%, neglect 27%, antipathy 34%, loss of caregiver 37% and exposure to family violence 31%. Physical and sexual abuse were independently associated with repeated suicide attempts when controlling for the effects of the other childhood adverse factors. No other childhood adversity was related to chronic suicidal behavior. The odds ratio of exposure to sexual or physical abuse was highest among those who both repeated suicide attempts and self-mutilated. CONCLUSION: Physical and sexual abuse are significantly and independently associated with repeated suicidal behavior. 相似文献
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OBJECTIVE: A cross-sectional study of gender specific relationships between self-reported child sexual abuse and suicidality in a community sample of adolescents. METHOD: Students aged 14 years on average (N = 2,485) from 27 schools in South Australia completed a questionnaire including items on sexual abuse and suicidality, and measures of depression (Centre for Epidemiological Studies Depression Scale), hopelessness (Beck Hopelessness Scale), and family functioning (McMaster Family Assessment Device General Functioning Subscale). Data analysis included logistic regression. RESULTS: In boys, self-report sexual abuse is strongly and independently associated with suicidal thoughts, plans, threats, deliberate self-injury, and suicide attempts, after controlling for current levels of depression, hopelessness, and family dysfunction. In girls, the relationship between sexual abuse and suicidality is mediated fully by depression, hopelessness, and family dysfunction. Girls who report current high distress about sexual abuse, however, have a threefold increased risk of suicidal thoughts and plans, compared to non-abused girls. Boys who report current high distress about sexual abuse have 10-fold increased risk for suicidal plans and threats, and 15-fold increased risk for suicide attempts, compared to non-abused boys. Fifty-five percent (n = 15) of sexually abused boys attempted suicide versus 29% (n = 17) girls. CONCLUSIONS: A history of sexual abuse should alert clinicians, professionals and carers in contact with adolescents, to greatly increased risks of suicidal behavior and attempts in boys, even in the absence of depression and hopelessness. Distress following sexual abuse, along with depression and hopelessness indicate increased risk of suicidal behavior in girls, as well as boys. 相似文献
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Adolescent psychiatric inpatients suffer high rates of childhood sexual abuse, trauma-related distress, and suicidality. This study evaluated the hypothesis that three domains of resiliency (i.e., Sense of Mastery, Sense of Relatedness, and Emotional Reactivity) would mediate the effect of trauma-related distress upon suicidal ideation, while accounting for symptoms of depression, and that the indirect effect of trauma-related distress upon suicidal ideation would be greater among survivors of childhood sexual abuse. Chart review patients included 550 adolescents admitted to a public psychiatric hospital in a Northwestern US State from 2010 to 2015. Adolescents completed self-report measures of trauma-related distress, depression, resiliency, and suicidal ideation. Half of the adolescents in this study reported past history of childhood sexual abuse, and more than half disclosed history of attempted suicide. There was a group noninvariant indirect effect of trauma-related distress upon suicidal ideation via emotional reactivity among survivors of childhood sexual abuse (β = 0.10, 95% ACI: 0.04 to .17), as well as a group invariant direct effect of depression symptoms (β = 0.88, p < .001). The other two domains of resiliency, sense of mastery and sense of relatedness did not mediate the association between trauma-related distress and suicidal ideation. These findings demonstrate the importance of emotional reactivity with regard to suicidal ideation, as well as the association between depression symptoms and suicidal ideation in this clinical population, and suggest the potential utility of skills-based interventions, and the need for trauma-informed policy and procedures in adolescent psychiatric inpatient settings. 相似文献
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Mandell DS Walrath CM Manteuffel B Sgro G Pinto-Martin JA 《Child abuse & neglect》2005,29(12):1359-1372
OBJECTIVE: To determine the demographic and psychosocial correlates of physical and sexual abuse among children with autism. METHODS: Data collected from 1997 to 2000 through the national evaluation of the Comprehensive Community Mental Health Services for Children and their Families Program on 156 children with autism were used. Data included a baseline assessment of child and family psychosocial experiences and presenting problems associated with referral into system-of-care service, demographic information, and a clinical record review to obtain psychiatric diagnosis. Binary and multinomial logistic regression was used to determine the association of different characteristics of children who were abused compared with those who were not abused. RESULTS: Caregivers reported that 18.5% of children with autism had been physically abused and 16.6% had been sexually abused. Physically abused children more likely had engaged in sexual acting out or abusive behavior, had made a suicide attempt, or had conduct-related or academic problems. Sexually abused children more likely had engaged in sexual acting out or abusive behavior, suicidal or other self-injurious behavior, had run away from home, or had a psychiatric hospitalization. In adjusted multivariate models, the relationship between sexual abuse and sexual acting out, running away from home and suicidal attempts persisted. CONCLUSION: Based on the prevalence of abuse and its association with various behaviors, clinicians should be as attuned to the psychosocial histories of children with autism as they are for other children, and consider the potential of abuse when these behaviors are observed. 相似文献
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OBJECTIVE: The aim of the current study was to determine whether a prior history of child sexual abuse increased the likelihood of using disengagement methods of coping with a sexual assault that had occurred within the past year. Once this was established, a mediational model was tested in which it was hypothesized that specific traumagenic dynamics and changed world views would mediate the association between child and/or adolescent sexual abuse and increased use of disengagement coping methods in response to a recent sexual assault. METHOD: One thousand and fifty women undergraduates from a New England state university completed a survey for research credit. Respondents were asked detailed questions regarding experiences of sexual assault within the past year, histories of child and/or adolescent sexual abuse, traumagenic dynamics, and world assumptions. Analyses were based on 106 participants who had experienced a sexual assault within the past year. RESULTS: Sexually assaulted young women with a history of child sexual abuse used more disengagement methods of coping to deal with the adult sexual assault than women without this history. In addition, the relationship between prior sexual abuse and the use of disengagement coping strategies was mediated by feelings of stigma, but not by feelings of betrayal and powerlessness or beliefs in the meaningfulness and benevolence of the world. CONCLUSIONS: This is the first study to find that sexually revictimized young women may be particularly at-risk of relying on disengagement methods of coping with sexual assault. Furthermore, this association is mediated by feelings of shame or stigma. Directions for further research and clinical implications are discussed. 相似文献
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《Journal of College Student Psychotherapy》2013,27(2):145-155
This article examines college students' self-reported mood states during a suicidal crisis and the relationship between mood and indicators of suicidality. Multilevel modeling demonstrated that the moods of hopelessness and anger predicted stronger intent; anxiety/worry predicted weaker thoughts of suicide; hopelessness increased the odds of receiving professional help, having a specific plan, and having contemplated methods; and guilt decreased the odds of having made preparations for an attempt. The associations between mood and precipitants of suicidal ideation are presented. Implications of these findings for increasing collaboration during the course of risk assessment and treatment are also discussed. 相似文献
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Robin Wilbourn Lee Michele E. Caruso Shelley E. Goins Jennifer P. Southerland 《Journal of College Counseling》2003,6(1):14-24
The authors discuss concepts that are related to providing education and training regarding sexual assault, as outlined by the Crime Awareness and Campus Security Act of 1990, as amended in 1992. Because college counseling center staff members often initiate and plan campus outreach prevention programs, an outline is provided of a prevention/awareness week intervention that is designed to address sexual assault on university and college campuses. 相似文献
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OBJECTIVE: The aim of this article is twofold: first, to examine the prevalence of being the victim of actual and attempted rape among a large representative sample of Cape Town high school students; and second, to identify the correlates of sexual assault for both boys and girls, including alcohol, tobacco and other drug use, behavioral problems, and suicidality. METHOD: Data for this study were derived from the 1997 South African Community Epidemiology Network on Drug Use (SACENDU) school survey. A stratified sampling procedure was used to select students in Grades 8 and 11 at non-private high schools in Cape Town. A total of 2,946 students completed a survey consisting of socio-demographic questions and items about substance abuse, sexual activity, and other adolescent health risk behaviors. A subsample of 939 was randomly selected to complete items about sexual violence. RESULTS: The results revealed that 8.4% of respondents were victims of attempted rape, while 5.8% were victims of actual rape. Ordinal logistic regression showed that girls were 3.9 times more likely than boys to have been victims of sexual abuse. Family structure was also significantly related to rape as persons who lived with a single parent (OR = 1.74, CI = 1.00-3.04) and those who resided with one biological parent and one step parent (OR = 2.59, CI = 1.34-5.01) were more likely to have been have been victims of sexual abuse than those living with both biological parents. Alcohol use (OR = 2.0, CI = 1.10-3.62), anti-social behavior (stolen property, caused physical damage to property, bullied others, or been in physical fights) (OR = 1.44, CI = 1.12-1.86), suicidal dialogue (OR = 2.48, CI = 1.19-5.19), and suicidal attempts (OR = 3.2, CI = 1.65-6.30) were also significant predictors of sexual abuse victimization. Racially classified social groups (RCSG), age, drug use, and cigarette smoking were not significant predictors of sexual abuse victimization, while socioeconomic status was found to be marginally significant. CONCLUSION: This study reinforces the importance of multiple factors including alcohol use, anti-social behavior, suicidal thoughts and actions, and family structure with respect to sexual assault of adolescents in South Africa. Establishing and strengthening intervention programs, school based child protective protocols, professional education of teachers and school personnel, community prevention programs, and initiatives could help prevent adolescent sexual violence and reduce the sequelae associated with this problem. 相似文献
10.
Victoria E. Kress J. Brad Shepherd Renee I. Anderson Aaron J. Petuch James Michael Nolan Darlene Thiemeke 《Journal of College Counseling》2006,9(2):148-157
The authors examined the impact of a mandatory, coeducational sexual assault prevention program on college freshmen's rape myth attitudes. Data from 174 college freshmen required to attend the program indicated that, regardless of gender, the proposed sexual assault prevention program significantly decreased participants' rape myth acceptance attitudes. Implications of the findings for college counselors and directions for future research are discussed. 相似文献
11.
大学生自杀现象之心理分析 总被引：26，自引：0，他引：26
自杀是一个对大学生健康成长构成破坏性威胁的问题。依据对35个大学生自杀案例的调查，从社会心理学的角度分析大学生自杀的诱因和, 现人格障碍和绪失调是导致大学生自杀的首要原因，而大学生对挫折的不良认知以及心理挫折承受能力低也是导致其自杀的又一原因，据此特提出预防大学生自杀的途径和措施。 相似文献
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OBJECTIVE: The purpose of this study was to examine the relationship between a history of physical and/or sexual abuse and current suicidality in college-age women. It was hypothesized that abuse history would significantly predict level of suicidality. A secondary hypothesis was that abuse status would predict attitudes about life and death. METHOD: Female college students (n = 707) were screened for histories of childhood (before age 15) and adulthood (after age 15) contact sexual abuse and physical abuse sequelae. Ninety-five women reported a history of childhood sexual abuse, 116 adult sexual abuse, 104 child physical abuse, and 55 adult physical abuse. Participants completed measures of attitudes about life and death and current suicidal ideation. RESULTS: Child physical abuse and child sexual abuse accounted for variance in current suicidal ideation. Adult sexual abuse explained variance in positive attitudes about life. Adult physical abuse, adult sexual abuse, and child sexual abuse accounted for variance in negative attitudes about life. Finally, child sexual abuse and adult sexual abuse accounted for variance in fear of death. CONCLUSIONS: Detailed assessment of female college students' abuse histories should facilitate understanding of their level of suicide risk. Patterns of attitudes about life and death may also be informative. 相似文献
13.
BackgroundJuvenile justice-involved youth have high rates of trauma exposure, physical and sexual abuse and PTSD. Several factors have been found to be related to PTSD symptoms in youth including number and chronicity of traumatic events.ObjectiveTo simultaneously examine the relationships between allostatic load (defined here as number of traumatic experiences), poly-victimization (exposure to two or more forms of victimization based on 5 of the 6 categories in Ford et al.’s 2010 study), physical/sexual abuse and PTSD in justice-involved youth.Participants and SettingThe sample consisted of 1984 youth in juvenile detention in a Northeastern city. The sample was 73.4% male and the majority of youth were either African American or Hispanic.MethodsClinicians collected demographic and psychosocial information, and measured symptoms of PTSD, depression, and problematic substance use.ResultsResults showed that youth with more traumas, those who experienced poly-victimization and those who experienced physical/sexual assault/abuse were not only more likely to have PTSD, but also more likely to have depression, thoughts of suicide/self-harm, and problematic substance use (as indicated by the presence of 2 or more of 6 possible indicators). Poly-victimization was a stronger correlate of PTSD than number of traumas or physical/sexual assault/abuse. However, among youth with PTSD, number of traumas was associated with co-occurring problems while poly-victimization and physical/sexual assault/abuse were not.ConclusionsFindings can be used to help direct resources to juvenile justice-involved youth who are most in need of treatment. 相似文献
14.
自杀是指有意识、自愿的结束自己生命的行为;而自杀意念是指偶然体验的自杀行为动机,但没有采取或实现自杀的外显行为.以大学生中自杀意念预警人员为研究对象,通过对大学生自杀意念的归因分析发现,内外向、神经质、抑郁、精神病性4个因子显著地影响着大学生自杀意念的产生及严重程度. 相似文献
15.
Laura G. Hensley 《Journal of College Counseling》2002,5(2):175-181
The use of gamma‐hydroxybutyric acid (GHB) to facilitate sexual assault is increasing on campuses nationwide. This article provides college counselors with an overview of the use of GHB in campus sexual assault, outlines suggestions for crisis intervention, and discusses the challenges of counseling survivors of drug‐facilitated sexual assault. 相似文献
16.
BackgroundIn recent years, research has increasingly focused on examining the relationship between one type of child maltreatment -- emotional violence -- and suicidal behaviors. However, the growing body of empirical evidence supporting these associations has been mostly limited to high-income contexts.ObjectiveThis study examines how exposure to emotional violence is associated with suicide ideation in childhood and adolescence in low- and middle-income countries (LMICs), and whether this association differs by sex.Participants and settingWe employ nationally representative samples of 13–24 year-old males and females from the Violence Against Children Surveys in Tanzania (conducted in 2009), Kenya (2010), and Haiti (2012).MethodsWe use logistic regressions to estimate the odds of ever reporting suicide ideation, separately, for each country; models control for self-reported exposure to emotional violence, physical violence from a caregiver, physical violence by an adult in the community, sexual violence, intimate partner violence, and age. Formal moderation by sex for each form of child maltreatment is tested using interaction terms.ResultsWe find the odds of suicide ideation are consistently and significantly greater for adolescents who report ever exposure to emotional violence. This same consistency is not observed for any other form of maltreatment across countries. The size of the relationship between emotional violence and suicide ideation is statistically significantly larger for males in Kenya only.ConclusionResearch in LMICs should explore the mediating factors linking emotional abuse in childhood and adolescence to suicide ideation in adolescence, paying special attention to whether these pathways might operate differently by sex. 相似文献
17.
自杀意念指个体想要自杀的想法,对自杀意念影响因素的考察将有利于在认知上控制自杀风险。反刍思维作为一种沉浸式的认知反应方式,是探讨自杀意念产生与发展的新切入点。反应风格理论、自杀人际关系理论、自杀认知模型和动机-意志整合模型都能为反刍思维影响自杀意念提供理论支撑。未来除需要加深对二者行为作用机制的探讨外,还应增加追踪、对照研究设计和认知神经机制层面的探索,并加强反刍思维之于个体积极意义的考察。 相似文献
18.
目的：探讨高职院校大学生自杀的有效预防和危机干预对策,方法：采用自编自杀调查问卷、症状自评量表（SCI-90）、Beck抑郁问卷对我院1240名大学生进行现场调查,采用非条件logistic回归及通径分析探索自杀意念与各类社会心理因素之间的关系。结果20．25％的高职大学生有自杀意念,女生略高于男生,大学生自杀意念、心理健康水平之间呈显著相关。结论：不良的心理健康水平是高职大学生自杀意念产生的重要因素。应制定和采取综合干预措施．提高高职大学生心理健康水平,以降低高职大学生的心理危机及自杀行为的发生率。 相似文献
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The aim of this study is to examine associations among childhood physical, emotional, or sexual abuse and violence toward self (suicide attempts [SA]) and others (interpersonal aggression [IA]). Data were obtained from the National Epidemiologic Survey on Alcohol and Related Conditions Waves 1 and 2 (n = 34,653). Multinomial logistic regression examined associations between type of childhood abuse and violence categories, adjusting for demographic variables, other childhood adversity, and DSM-IV psychiatric disorders. The prevalence of reported childhood abuse was 4.60% for physical abuse, 7.83% for emotional abuse, and 10.20% for sexual abuse. Approximately 18% of adults reported some form of violent behavior, distributed as follows: IA, 13.37%; SA, 2.64%; and SA with IA, 1.85%. After adjusting for demographic variables, other childhood adversity, and psychiatric disorders, each type of childhood abuse was significantly related to increased risk for each violence category as compared with the no violence category. Furthermore, the odds ratio of childhood physical abuse was significantly higher for SA with IA when compared with IA, and the odds ratio of childhood sexual abuse was significantly higher for SA and SA with IA when compared with IA. Childhood physical, emotional, and sexual abuse is directly related to the risk for violent behaviors to self and others. Both internalizing and externalizing psychiatric disorders impact the association between childhood abuse and violence. The inclusion of suicidal behaviors and interpersonal aggression and internalizing/externalizing psychiatric disorders within an integrated conceptual framework will facilitate more effective interventions for long-lasting effects of child abuse. 相似文献