Showing papers by "Frank W. Putnam published in 2011"

The impact of sexual abuse on female development: lessons from a multigenerational, longitudinal research study.

Abstract: This is a report on the research design and findings of a 23-year longitudinal study of the impact of intrafamilial sexual abuse on female development. The conceptual framework integrated concepts of psychological adjustment with theory regarding how psychobiological factors might impact development. Participants included 6- to 16-year-old females with substantiated sexual abuse and a demographically similar comparison group. A cross-sequential design wasused andsix assessments have takenplace,with participantsat medianage 11 at thefirst assessment andmedianage25 at thesixthassessment. Mothers of participants took part in the early assessments and offspring took part at the sixth assessment. Results of many analyses, both within circumscribed developmental stages and across development, indicated that sexually abused females (on average) showed deleterious sequelae across a host of biopsychosocial domains including: earlier onsets of puberty, cognitive deficits, depression, dissociative symptoms, maladaptive sexual development, hypothalamic‐pituitary‐adrenal attenuation, asymmetrical stress responses,high rates of obesity, more major illnesses and healthcare utilization, dropping out of high school, persistent posttraumatic stress disorder, self-mutilation, Diagnostic and Statistical Manual of Mental Disorders diagnoses, physical and sexual revictimization, premature deliveries, teen motherhood, drug and alcohol abuse, and domestic violence. Offspring born to abused mothers were at increased risk for child maltreatment and overall maldevelopment. There was also a pattern of considerable within group variability. Based on this complex network of findings, implications for optimal treatments are elucidated. Translational aspects of extending observational research into clinical practice are discussed in terms that will likely have a sustained impact on several major public health initiatives.

An open trial of in-home CBT for depressed mothers in home visitation.

Abstract: Research has demonstrated that low income mothers participating in home visitation programs have high rates of depression. This study used an open trial design to evaluate In-Home Cognitive Behavioral Therapy (IH-CBT), an evidence-based treatment for depression that is delivered in the home setting and has been adapted to address the needs of low income mothers participating in home visitation. 64 depressed mothers recruited from a home visitation program and who had completed IH-CBT were compared to 241 mothers from the same setting who met identical screening criteria at enrollment but did not receive the treatment. In addition, pre- and post-treatment measures of depression and related clinical features were contrasted in the 64 mothers receiving IH-CBT. There was a significantly greater reduction in depressive symptoms in the IH-CBT group relative to their counterparts who did not receive the treatment. Results from pre-post comparisons showed that treated mothers had decreased diagnosis of major depression, lower reported stress, increased coping and social support, and increased positive views of motherhood at post-treatment. Findings suggest that IH-CBT is a promising approach to addressing maternal depression in the context of home visitation and warrants further study. Public health implications for home visiting programs are discussed.

Attachment Representations and Anxiety: Differential Relationships Among Mothers of Sexually Abused and Comparison Girls:

Abstract: The present study sought to document an example of how childhood sexual abuse and attachment representation interact while contributing to the trait anxiety of nonoffending mothers following the disclosure of their daughters' sexual abuse. The study sample consisted of 57 ethnically diverse mothers of sexually abused girls aged 6 to 16 and 47 mothers of comparison girls who were matched with the abused girls on age, socioeconomic status, and family constellation. Results indicate that the mothers' representations of past attachment relationships with their own fathers were differentially related to their current attachment styles, depending on their daughters' childhood sexual abuse status. The representation of past attachment relationships with peers had both main and protective effects on the mothers' trait anxiety symptoms. The relevance of attachment perspectives to adjustment among these mothers and intergenerational process in childhood sexual abuse are discussed, and implications for future research and clinical practices are identified.

Childhood Cruelty to Animals: Psychiatric and Demographic Correlates

Abstract: This retrospective study compared frequencies of aggressive behaviors and abuse histories noted during a psychiatric intake assessment for children where animal cruelty was endorsed and a control sample of youth for whom animal cruelty was not endorsed to determine if rates of concerning behaviors differed significantly. Relative to the control group, the cruelty group was significantly more likely to have had problems with peers, perpetrated bullying, experienced sexual abuse, and have a history of sexually acting out. Recommendations for childhood animal cruelty screening in mental health settings are discussed.

Anger expression and adaptation to childhood sexual abuse: The role of disclosure.

Abstract: Previous research on anger and childhood sexual abuse (CSA) is largely cross-sectional and retrospective. In this study, we prospectively examined the consequences of expressing anger among sexually abused women in contexts of either voluntarily disclosing or not disclosing a previous abuse episode (n 94). All CSA survivors in the study had documented histories of CSA. These participants and a matched, nonabused sample were asked to describe their most distressing experience while being videotaped to allow coding of anger expression. Approximately two thirds of the CSA survivors voluntarily disclosed a previous abuse experience. Participants completed measures of internalizing symptoms and externalizing symptoms at the time of disclosure and again two years later. The expression of anger was associated with better long-term adjustment (decreased internalizing and externalizing symptoms), but only among CSA survivors who had expressed anger while not disclosing an abuse experience. For CSA survivors who disclosed an abuse experience and for nonabused women, anger expression was unrelated to long-term outcome. These findings suggest that the benefits of anger expression for CSA survivors may be context specific.