Predictors of Treatment Outcomes Among Depressed Women With Childhood Sexual Abuse Histories

Cort, Natalie A.; Gamble, Stephanie A.; Smith, Phillip N.; Chaudron, Linda H.; Lu, Naiji; He, Hua; Talbot, Nancy L.

doi:10.1002/da.21942

Cited by 27 publications

(42 citation statements)

References 96 publications

(151 reference statements)

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“…Given the fact that 60-80% of sexual abuse survivors do not disclose their abuse or receive treatment until after the age of 18 (Alaggia, 2005), programs, policies, and interventions should encourage the development or maintenance of parental emotional support for this subgroup of individuals. For example, individual psychotherapies, such as Interpersonal Psychotherapy, which has been shown to be effective in addressing depression in women with histories of CSA (Callahan, Price, & Hilsenroth, 2004; Cort et al, 2012) could be modified to include parents in treatment. Family therapies, such as Attachment-Based Family Therapy (Diamond, Diamond, & Levy, 2013), which has demonstrated efficacy reducing depression and suicide risk among adolescent survivors of sexual abuse (Diamond, Creed, Gilham, Gallp, & Hamilton, 2012), could be modified to treat adults and their parents.…”

Section: Discussionmentioning

confidence: 99%

Emotional support and adult depression in survivors of childhood sexual abuse

Musliner

Singer

2014

Child Abuse & Neglect

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The goals of this study were to evaluate the effects of emotional support from friends and parents at two time points (adolescence and adulthood) on adult depression in a nationally representative sample of survivors of childhood sexual abuse (CSA), and examine whether the associations were moderated by the identity of the perpetrator (parent/caregiver vs. not). Data was taken from Waves I and IV of the National Longitudinal Study of Adolescent Health (Add Health). The study sample included 1,238 Add Health participants with a history of CSA and an equivalently sized comparison group of individuals with no history of CSA. Parental support was measured using four items from each wave that assessed the warmth of participants' relationships with their parents and their satisfaction with those relationships. Friend support in adolescence was measured using participants' perceptions of how much their friends cared about them and in adulthood using participants' self-reported number of close friends. Depression was measured using a 10-item subscale of the CES-D. Support from friends and parents in adulthood were significantly associated with lower odds of adult depression in CSA survivors with a history of non-parent/caregiver abuse. Among survivors of parent/caregiver abuse, emotional support was not significantly associated with adult depression regardless of when or by whom it was provided. Emotional support in adulthood from friends and parents is associated with reduced odds of adult depression in CSA survivors, but only in cases where the abuse was perpetrated by someone other than a parent or caregiver.

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Section: Discussionmentioning

confidence: 99%

Emotional support and adult depression in survivors of childhood sexual abuse

Musliner

Singer

2014

Child Abuse & Neglect

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“…As both sleep and CSA have their own negative influences on both mental and physical health, a better understanding of sleep disturbances in adults with CSA histories, which involves elucidating the effect of incident characteristics on sleep and determining gender differences, is important. Treatment of trauma-exposed individuals is complex, and as such, the effectiveness of interventions on sleep (and other related outcomes such as psychopathology) may differ based on CSA status (Cort et al, 2012; Lewis et al, 2010; Pigeon et al, 2009). …”

Section: Introductionmentioning

confidence: 99%

An epidemiologic study of childhood sexual abuse and adult sleep disturbances.

Lind¹,

Aggen²,

Kendler³

et al. 2016

Psychological Trauma: Theory, Research, Practice, and Policy

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Objective Childhood sexual abuse (CSA) is linked to negative consequences, including insomnia. Few studies have examined enduring effects of CSA on adult insomnia. Given the relationship between sleep and poor health, a better understanding of these effects has clinical implications. Method We used a representative sample of adult twins. Both men and women were assessed with a broad variable representative of CSA, while a subset of females (n=424) were given additional items that captured escalating physical contact and abuse characteristics. A sum score of past month insomnia symptoms was calculated from the shortened version of the SCL-90. Logistic regression was used to estimate the effects of CSA on insomnia symptoms, as well as the effects of physical contact and incident characteristics. Results Of the full sample (n=8184), 9.8% reported broad CSA. CSA significantly predicted insomnia symptoms in the female sample (n=1407) (OR=1.67, 95% CI=1.35–2.06, p<0.0001). The continuum of physical contact did not predict sleep. On a univariate level, more than one perpetrator and feeling forced/threatened increased risk for sleep problems, while having a male perpetrator (vs. female or multiple perpetrators) decreased risk. These associations did not hold at a multivariate level. In the mixed-sex sample (n=6777), we replicated our CSA finding (OR=1.65, 95% CI=1.34–2.03, p<0.0001) and found that female gender (OR=1.16, 95% CI=1.03–1.30, p=0.0125) was significant. However, the female gender*CSA interaction was not significant. Conclusion CSA predicts insomnia symptoms in adults 25–30 years post-abuse, but the small sample size for incident characteristics (n=424) resulted in limited conclusions about associated risk.

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“…In particular, major depressive disorder (MDD), Posttraumatic Stress Disorder, anxiety, interpersonal aggression, and suicide attempts are frequently noted sequelae in adults reporting abuse and neglect in early development (Hamilton, Micol-Foster, & Muzik 2015; Harford & Grant 2014; Kaplow & Widom 2007; Sexton, Hamilton, McGinnis, Rosenblum, & Muzik 2015). Compounding these threats to public health, a history of CM increases risk of recurrent depressive episodes throughout the lifespan and is associated with more treatment refractory responses to evidence based interventions for postpartum depressive symptoms (PDS) (Cort et al 2012; Nanni, Uher, & Danese 2012). …”

Section: Introductionmentioning

confidence: 99%

Family Social Support Modifies the Relationships Between Childhood Maltreatment Severity, Economic Adversity and Postpartum Depressive Symptoms

Muzik

Umarji

Sexton

et al. 2016

Matern Child Health J

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Objectives This study examines the main and moderating effects of childhood abuse or neglect severity, income, and family social support on the presence of postpartum depressive symptoms (PDS). Methods Participants included 183 postpartum mothers who endorsed a history of childhood maltreatment (CM) and enrolled in a longitudinal study of mother and child outcomes. Participants completed questionnaires to assess CM severity, associated societal and maternal characteristics, and depressive symptom severity. Results The results confirm previously identified links between CM severity and PDS. Further, hierarchical linear regression analyses indicate the interaction of household income and interpersonal support from the family attenuates the relationship between CM severity and PDS. The final model accounted for 29% of the variance of PDS scores, a large effect size. Conclusions This study is the first to demonstrate interrelationships between income and social support on resilience to postpartum psychopathology in childhood trauma-surviving women. Social support appeared to protect against PDS for all mothers in this study while income only conferred a protective effect when accompanied by family support. For clinicians, this implies the need to focus on improving family and other relationships, especially for at-risk mothers. Significance A history of CM has demonstrated deleterious effects in general and postpartum populations. Given the potential negative impact on mothers and their children, investigators have examined the potential for income and social support to protect against adverse outcomes. Our study adds to this literature by examining the variance explained by CM severity and the interaction of family support and income on depression following childbirth. Our unique findings identify specific contexts in which family support and income buffer against CM-PDS associations for women with compound risks. As such, particular policies and clinical interventions may be more strategically tailored for this population.

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Predictors of Treatment Outcomes Among Depressed Women With Childhood Sexual Abuse Histories

Cited by 27 publications

References 96 publications

Emotional support and adult depression in survivors of childhood sexual abuse

Emotional support and adult depression in survivors of childhood sexual abuse

An epidemiologic study of childhood sexual abuse and adult sleep disturbances.

Family Social Support Modifies the Relationships Between Childhood Maltreatment Severity, Economic Adversity and Postpartum Depressive Symptoms

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