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

健康

基本信息

批准号：
8806572
负责人：
JENNIE G NOLL
金额：
$ 61.06万
依托单位：
PENNSYLVANIA STATE UNIVERSITY, THE
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-02-11 至 2016-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8806572
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 Rearing Child Sexual Abuse Childhood 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 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 cognitive ability 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 resilience social stressor theories transmission process

项目摘要

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，因为它通常在发展的早期开始，跨越长时间，与阴险的身体侵犯，受到高度污名化，可能会羞辱和沮丧，并对性发展产生严重影响。尽管大量文献表明，儿童性虐待对社会和心理发展产生有害影响，但有新兴的证据表明，它也可能改变了假定的机制，以促进成年后不良生理健康结果的风险。确实，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（成年后妇女的十大主要死亡原因之一）。但是，迄今为止的证据是相关性的，并且受方法论缺陷的限制，例如回顾性评估，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中赋予后代风险的过程。据估计，有30％的母亲有虐待历史继续滥用其后代或重现几代人虐待的环境。弹性很少是对性虐待受害者的重点和知识，他们在生活过程中保持相对健康的情况很少。发现连续性和变化的机制可以为现有治疗方法和意外的干预目标引发新的方法。对生物学过程作用的社会心理因素对于揭露至关重要，但是这些多种级别的人类功能很少被包括在同一研究中。女性成长与发展研究（FGD）始于1987年，保留了96％的女性样本，具有证实的性虐待和匹配的比较，它有权解决这些关键差距。在跨越6个时间点的加速纵向，跨序列的设计中，在儿童/青春期中，重复了三次多级，生物心理社会评估，在青春期后两次，成年后一次。 T6评估了超过90％的后代。由于其独特的方法论严格，在发育，心理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。 T7和T8的另外两项评估将研究性虐待对成年时期独有的不良健康结果的长期影响。在T7和T8上，大多数后代将在评估母亲时很久以来，可以通过相同的仪器和观察技术来检查代际连续性。 T7和T8将采用创新技术，新兴的理论范例和新颖的数据分析技术，以显着提高有关早期生活压力影响的科学知识。这样做将（1）加强因果推断，并为实现早期和持续干预的方向政策提供必要的牵引力，以及（2）针对一组复杂的生物心理社会风险的基于经验的治疗方式。