Health & wellbeing of sexually abused females & offspring: 25 and 27 yr. followup

健康

• 批准号: 8432920
• 负责人: JENNIE G NOLL
• 金额: $ 20.29万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-02-11 至 2013-08-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8432920
• 关键词: Accounting; Acute; Address; Adolescence; Adult; Affect; Age; Attention; Attenuated; Battered Women; Biological Markers; Biological Process; Cardiovascular Diseases; Cause of Death; Child; Child Sexual Abuse; Childhood; Cognitive; Complex; Data; Development; Diabetes Mellitus; Domestic Violence; Environment; Family; Female; Fostering; Generations; Grant; Growth and Development function; HIV; Health; Human; Individual; Intervention; Journals; Knowledge; Life; Life Cycle Stages; Life Stress; Literature; Long-Term Effects; Longitudinal Studies; Malignant Neoplasms; Measurement; Medical; Mental Health; Modality; Modeling; Mothers; Nature; Obesity; Outcome; Parenting behavior; Parents; Personal Satisfaction; Physiological; Policies; Preventive Intervention; Process; Psychopathology; Puberty; Public Health; Public Policy; Publishing; Recommendation; Recording of previous events; Relative (related person); Research Design; Retrospective Studies; Risk; Sampling; Scientific Advances and Accomplishments; Sexual Development; Sexual abuse; Shame; Staging; Stress; Substance abuse problem; Survivors; Techniques; Testing; Time; Traction; Trust; Victimization; Woman; abuse victim; adverse outcome; aged; allostatic load; base; biopsychosocial; cancer risk; cohort; coping; design; early adolescence; emerging adult; innovation; innovative technologies; instrumentation; intergenerational; maltreated children; maltreatment; novel; novel strategies; obesity risk; offspring; physical conditioning; prevent; prospective; psychologic; psychosocial; public health relevance; resilience; social; stressor; theories; transmission process

DESCRIPTION (provided by applicant): Over 1.2 million children are maltreated each year, of who over 137,000 are victims of sexual abuse. Sexual abuse is distinct from other adversities because it often starts early in development, spans long durations, is associated with insidious bodily boundary violations, is highly stigmatized, can be shaming and demoralizing, and has serious implications for sexual development. While a substantial literature suggests that childhood sexual abuse has deleterious effects on social and psychological development, there is emerging evidence that it may also alter putative mechanisms that promote risk for adverse physiological health outcomes in adulthood. Indeed, childhood sexual abuse is associated with increased risk of cancer, cardiovascular disease, diabetes, and HIV (all among the top ten leading causes of death for women in adulthood). However, evidence has thus far been correlation and limited by methodological drawbacks such as retrospective assessments, cross-sectional designs and inadequate control of confounds. Sexual abuse also affects processes in parents that confer risks to offspring. It is estimated that 30% of mothers with histories of abuse go on to abuse their offspring or recreate environments where abuse persists across generations. Resiliency is rarely a focus and knowledge about sexual abuse victims who remain relatively healthy over the life course is scant. Uncovering mechanisms for continuity and change can spark novel approaches to existing treatments and unanticipated targets for intervention. Psychosocial agents that act on biological processes are exceedingly important to uncover, yet these multiple levels of human functioning are rarely included within the same study. The Female Growth and Development Study (FGDS), which began in 1987 and has retained 96% of a sample of females with substantiated sexual abuse and matched comparisons, is uniquely poised to address these critical gaps. In an accelerated longitudinal, cross-sequential design spanning 6 time points (T1-T6), a multi-level, biopsychosocial assessment was repeated three times in childhood/early adolescence, twice in late adolescence and once in early adulthood. Over 90% of offspring were assessed at T6. Due to its distinctive methodological rigor, results published in developmental, psychological and medical journals have provided some of the most definitive evidence for the effects of sexual abuse. Two additional assessments, T7 & T8, will examine the long-term effects of sexual abuse on adverse health outcomes that are unique to the adulthood period. At T7 & T8, the majority of offspring will be at ages when their mothers were assessed, allowing an examination of intergenerational continuity through identical instrumentation and observation techniques. T7 & T8 will employ innovative technologies, emerging theoretical paradigms and novel data analytic techniques to significantly advance scientific knowledge about the impact of early life stress. Doing so will (1) bolster causal inference and provide the necessary traction to orient policy toward early and sustained intervention, and (2) illuminate empirically based treatment modalities targeting a complex set of biopsychosocial risks.

描述（由申请人提供）：每年有超过 120 万儿童受到虐待，其中超过 137,000 人是性虐待的受害者。性虐待与其他逆境不同，因为它通常在发育早期就开始，持续时间较长，与阴险的身体边界侵犯有关，受到高度污名化，可能令人羞辱和士气低落，并对性发育产生严重影响。虽然大量文献表明，儿童期性虐待对社会和心理发展具有有害影响，但有新的证据表明，它也可能改变增加成年期不良生理健康结果风险的假定机制。事实上，儿童期性虐待与癌症、心血管疾病、糖尿病和艾滋病毒（所有这些都是成年女性死亡的十大原因）的风险增加有关。然而，迄今为止的证据都是相关的，并受到方法学缺陷的限制，例如回顾性​​评估、横断面设计和混杂控制不足。性虐待还会影响父母给后代带来风险的过程。据估计，30%的母亲有虐待史 继续虐待他们的后代或重建虐待持续代代相传的环境。复原力很少成为焦点，而且对在生命历程中保持相对健康的性虐待受害者的了解也很少。揭示连续性和变化的机制可以激发现有治疗方法和意外干预目标的新方法。揭示作用于生物过程的心理社会因素非常重要，但这些人类功能的多个层面很少包含在同一项研究中。女性生长与发展研究 (FGDS) 于 1987 年开始，保留了 96% 遭受过性虐待的女性样本并进行匹配比较，该研究旨在解决这些关键差距。在跨越 6 个时间点 (T1-T6) 的加速纵向、交叉序列设计中，在儿童期/青春期早期重复进行多层次生物心理社会评估 3 次，在青春期后期重复两次，在成年早期重复一次。超过 90% 的后代在 T6 时接受评估。由于其独特的方法严谨性，在发育、心理学和医学期刊上发表的结果为性虐待的影响提供了一些最明确的证据。另外两项评估，T7 和 T8，将检查性虐待对成年期特有的不良健康结果的长期影响。在 T7 和 T8，大多数后代将在其母亲接受评估时的年龄，从而可以通过相同的仪器和观察技术检查代际连续性。 T7和T8将采用创新技术、新兴理论范式和新颖的数据分析技术来显着推进有关早期生活压力影响的科学知识。这样做将会 (1) 加强因果推理，并提供必要的牵引力，使政策转向早期和持续干预，(2) 阐明针对一系列复杂的生物心理社会风险的基于经验的治疗方式。