The Emergence of Sexual Risk Among Sexually Abused Adolescent Females

描述（由申请人提供）：有迫切需要了解儿童性虐待（CSA）如何影响青少年女性的性风险行为。青春期女性性传播感染的比例特别高，主要是由于异性性接触（CDC，2008年）。CSA女性特别脆弱，因为她们倾向于在早期就开始性行为，参与更高比例的性风险行为，并且与她们的未受虐待的同龄人相比，从传统的风险降低努力中获益较少（Senn等人，2008; Greenberg，2001）。虽然CSA相关的性风险开始在青春期，很少有人知道CSA青年的早期性发育或CSA赋予高风险的机制。这个K01职业发展奖提出了一个培训和指导研究经验的计划，这将为一个独立的发展知情的前瞻性研究计划奠定基础，该计划旨在阐明CSA青年中的性风险机制。培训将获得（1）性风险和降低风险;（2）方法和问题进行前瞻性纵向研究与CSA青年;（3）生理评估的影响调节;和（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。培训也被纳入研究计划，其中包括两项研究，旨在确定CSA的具体途径，以紧急性风险。研究1使用CSA长期前瞻性研究的现有数据，探讨了精神病理学（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，以检查青春期早期的性风险轨迹，并测试两个潜在的风险机制：（1）创伤性化TS），CSA扭曲对性的认知和情感取向的过程，和（2）精神病理学（创伤后应激障碍和外化问题。TS是概念化的认知和情感扭曲，表现在青少年的主观和生理经验。参与者将包括120名年龄在11 - 14岁之间的性虐待和非虐待的年轻青春期女性，他们将接受为期18个月的随访。TS和PTSD预计将在CSA青年的性风险中发挥独特的作用。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CSA青年性风险增加因素的了解，以便为这一高度脆弱的人群制定更有效的降低风险方案。研究结果将为R01提案的制定提供信息，该提案旨在对创伤性化在随意和浪漫关系中对性健康的作用进行更长期，更全面的研究。

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.