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

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13.7万是性虐待的受害者。性虐待与其他逆境不同，因为它通常在发育早期开始，持续时间长，与阴险的身体边界侵犯有关，高度污名化，可能使人感到羞耻和士气低落，并对性发展产生严重影响。虽然大量文献表明，儿童期性虐待对社会和心理发展有有害影响，但有新证据表明，它也可能改变促进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、糖尿病和艾滋病毒的风险增加有关（所有这些都是妇女成年后死亡的十大主要原因）。然而，到目前为止，证据是相互关联的，并受到方法缺陷的限制，如回顾性评估、横断面设计和对混杂因素的控制不足。性虐待还会影响父母的心理过程，从而给后代带来风险。据估计，有虐待史的母亲中有30%

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.