The Emergence of Sexual Risk Among Sexually Abused Adolescent Females

描述（申请人提供）：迫切需要了解儿童性虐待（CSA）如何影响青春期女性的性风险行为。青春期女性的性传播感染率高得不成比例，主要是由于异性性接触（疾病预防控制中心，2008年）。受性虐的女性尤其容易受到伤害，因为她们倾向于在很小的年龄就开始性行为，从事高风险性行为的比例更高，而且与未受虐待的同龄人相比，她们从传统的降低风险努力中获益较少（Senn等人，2008;Greenberg, 2001）。尽管性风险与CSA相关始于青春期，但对CSA青少年的早期性发展或CSA增加风险的机制知之甚少。K01职业发展奖提出了一个培训和指导研究经验的计划，该计划将为一个独立的发展知情前瞻性研究项目奠定基础，该项目旨在阐明CSA青少年性风险的机制。培训内容包括：(1)性风险和降低风险；(2)对CSA青少年进行前瞻性纵向研究的方法与问题；(3)情感调节生理评估；(4)先进的纵向数据分析技术。培训将在资源丰富的环境中进行，鼓励创新和合作研究。培训也纳入了研究计划，其中包括两项研究，旨在确定csa特定的途径，以产生紧急性风险。研究1利用一项CSA长期前瞻性研究的现有数据，检验了精神病理学（PTSD和外化问题）、创伤相关影响的生理调节和性风险行为之间的纵向关联。研究2需要一个新的前瞻性数据收集来检查青春期早期性风险的轨迹，并测试两种潜在的风险机制：(1)创伤性化，CSA扭曲对性的认知和情感取向的过程；(2)精神病理（PTSD和外化问题）。青少年的认知和情感扭曲在青少年的主观和生理体验中表现出来。参与者将包括120名年龄在11-14岁之间的性虐待和非性虐待的年轻少女，她们将被跟踪调查18个月。预计TS和PTSD在CSA青少年性风险的出现中发挥独特的作用。外化行为问题有望预测未受虐待青少年的性风险。拟议的工作将增加我们对增加CSA青少年性行为风险的因素的了解，以便为这一高度脆弱的人群制定更有效的风险降低计划。结果将为R01提案的发展提供信息，以进行更长期、更全面的研究，研究创伤性化在随意和浪漫关系中对性健康的影响。

DESCRIPTION (provided by applicant): There is a pressing need to understand how child sexual abuse (CSA) affects adolescent females' sexual risk behavior. Adolescent females have disproportionately high rates of sexually transmitted infections, largely due to heterosexual contact (CDC, 2008). CSA females are especially vulnerable, as they tend to initiate sex at early ages, engage in higher rates of sexual risk behavior, and benefit less from traditional risk reduction efforts than their non-abused peers (Senn et al., 2008; Greenberg, 2001). Although the sexual risks associated with CSA begin in adolescence, little is known about the early sexual development of CSA youth or the mechanisms by which CSA confers heightened risk. This K01 Career Development Award proposes a plan of training and mentored research experiences that will lay the foundation for an independent program of developmentally-informed prospective research directed at articulating mechanisms of sexual risk among CSA youth. Training will be acquired in (1) sexual risk and risk-reduction; (2) methods and issues in conducting prospective longitudinal research with CSA youth; (3) physiological assessment of affect regulation; and (4) advanced longitudinal data analytic techniques. Training will occur in a resource-rich environment that encourages innovative and collaborative research. Training is also integrated into the research plan, which includes two studies that seek to identify CSA-specific pathways to emergent sexual risk. Study 1 examines longitudinal associations between psychopathology (PTSD and externalizing problems), physiological regulation of trauma-related affect, and sexual risk behavior using extant data from a long-term prospective study of CSA. Study 2 entails a new prospective data collection to examine trajectories of sexual risk during early adolescence and test two potential risk mechanisms: (1) traumatic sexualization TS), the process by which CSA distorts cognitive and affective orientations towards sexuality, and (2) psychopathology (PTSD and externalizing problems. TS is conceptualized in terms of cognitive and affective distortions that are manifest in youths' subjective and physiological experiences. Participants will include 120 sexually abused and non- abused young adolescent females between the ages of 11-14 years who will be followed over an 18-month period. TS and PTSD are expected to play a unique role in the emergence of sexual risk among CSA youth. Externalizing behavior problems are expected to predict sexual risk among non-abused youth. The proposed work will increase our knowledge of the factors that increase sexual among CSA youth risk so that more effective risk reduction programs can be developed for this highly vulnerable population. Results will inform the development of an R01 proposal for a longer-term, more comprehensive study of the role that traumatic sexualization plays in sexual health within casual and romantic relationships. PUBLIC HEALTH RELEVANCE: Existing sexual risk reduction programs are less effective for sexually abused youth, and the reasons for this are unclear. This is particularly concerning because sexually abused youth are at heightened risk for sexual health problems beginning in early adolescence. The proposed work will increase our knowledge of the factors that increase sexually abused youths' sexual risk so that more effective risk reduction programs can be developed for this highly vulnerable population.