a1 University of Southern California
a2 Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine
This is a report on the research design and findings of a 23-year longitudinal study of the impact of intrafamilial sexual abuse on female development. The conceptual framework integrated concepts of psychological adjustment with theory regarding how psychobiological factors might impact development. Participants included 6- to 16-year-old females with substantiated sexual abuse and a demographically similar comparison group. A cross-sequential design was used and six assessments have taken place, with participants at median age 11 at the first assessment and median age 25 at the sixth assessment. Mothers of participants took part in the early assessments and offspring took part at the sixth assessment. Results of many analyses, both within circumscribed developmental stages and across development, indicated that sexually abused females (on average) showed deleterious sequelae across a host of biopsychosocial domains including: earlier onsets of puberty, cognitive deficits, depression, dissociative symptoms, maladaptive sexual development, hypothalamic–pituitary–adrenal attenuation, asymmetrical stress responses, high rates of obesity, more major illnesses and healthcare utilization, dropping out of high school, persistent posttraumatic stress disorder, self-mutilation, Diagnostic and Statistical Manual of Mental Disorders diagnoses, physical and sexual revictimization, premature deliveries, teen motherhood, drug and alcohol abuse, and domestic violence. Offspring born to abused mothers were at increased risk for child maltreatment and overall maldevelopment. There was also a pattern of considerable within group variability. Based on this complex network of findings, implications for optimal treatments are elucidated. Translational aspects of extending observational research into clinical practice are discussed in terms that will likely have a sustained impact on several major public health initiatives.
(Online publication April 18 2011)
c1 Address correspondence and reprint requests to: Penelope K. Trickett, School of Social Work, Montgomery Ross Fisher Building, University of Southern California, Los Angeles, CA 90899-0411; E-mail: [email protected].
This research was partially supported by grants from the National Institute of Mental Health (MH48330, MH01284); National Institute of Child Health and Human Development (HD41402, HD045346, HD060604); National Center on Child Abuse and Neglect (90-CA-1549, 90-CA-1686); and private foundations including the W. T. Grant Foundation, Smith Richardson Foundation, and John Templeton Foundation (ID5119). We acknowledge the invaluable contribution of each of the following: Barbara Everett, Robert Weinstein, and Karen Helmers, who are the original research staff who helped develop the protocol; William Saltzman, Carol Altstatt, Lisa Horowitz, Bethany Brand, Helena Jereb, Deborah Nagel, Joanna Voseolis, Robin Kelley, Mary Loos, Mia Sypeck, Amy Sickel, Dawn Kurtz, Lara Litvinov, Jessica Norris, Laura Kwako, Mary Alice Silverman, Kendra Orjada, and Katherine Haralson, who were the dedicated staff of interviewers, many of whom received their advanced degrees while working on the project; Jaclyn Barnes, Chad Shenk, and Kihyun Kim, who brought key data to fruition; Lisa Connelly, who provided invaluable assistance with the production of this manuscript; and Anne Petersen, John Horn, Elizabeth Susman, John J. McArdle, Robert Cairns, Beverly Cairns, Lorah Dorn, and Steven Porges, who were our academic consultants. The most important acknowledgment is to the participants of this study for so graciously sharing their struggles, their triumphs, and their lives.