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137，000人是性虐待的受害者。性虐待与其他逆境不同，因为它往往在发育早期开始，持续时间长，与阴险的身体边界侵犯有关，受到高度污名化，可能会感到羞耻和沮丧，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产生有害影响，但有新的证据表明，它也可能改变推定的机制，从而增加成年后不良生理健康结果的风险。事实上，儿童期性虐待与癌症、心血管疾病、糖尿病和艾滋病的风险增加有关（所有这些都是成年女性十大死亡原因之一）。然而，迄今为止，证据是相关的，并受到方法学缺陷的限制，如回顾性评估，横断面设计和混淆控制不足。性虐待也影响父母给后代带来风险的过程。据估计，30%有虐待史的母亲 继续虐待他们的后代或重新创造虐待持续几代人的环境。复原力很少是一个焦点，对性虐待受害者在生命过程中保持相对健康的知识很少。揭示连续性和变化的机制可以激发现有治疗方法和未预料到的干预目标的新方法。对生物过程起作用的社会心理因素是非常重要的，但这些多层次的人类功能很少包括在同一研究中。女性成长和发展研究（FGDS）始于1987年，保留了96%的女性样本，这些样本证实了性虐待和匹配的比较，这是解决这些关键差距的唯一准备。在一个加速的纵向，交叉顺序设计跨越6个时间点（T1-T6），一个多层次的，生物心理社会评估重复三次在儿童期/青春期早期，两次在青春期后期和一次在成年早期。超过90%的后代在T6时接受评估。由于其独特的方法的严谨性，在发展，心理和医学期刊上发表的结果提供了一些最明确的证据，性虐待的影响。另外两项评估T7和T8将研究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，大多数后代将处于他们的母亲被评估的年龄，允许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，以显着推进有关早期生活压力影响的科学知识。这样做将（1） 支持因果推理，并提供必要的牵引力，引导政策走向早期和持续的干预，（2）阐明以经验为基础的治疗方式，针对一系列复杂的生物心理社会风险。

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.