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Biomedical subjects

P C Alexander

Publications and source records attributed to P C Alexander.

17 recordsLinked to original sources

Childhood sexual abuse history and role reversal in parenting.

OBJECTIVE: This study explored the main and interactive effects of sexual abuse history and relationship satisfaction on self-reported parenting, controlling for histories of physical abuse and parental alcoholism. METHOD: The community sample consisted of 90 mothers of 5- to 8-year-old children. The sample was limited to those mothers currently in an intimate relationship, 19 of whom reported a history of childhood sexual abuse. Participants completed the Child Behavior Checklist, the Parenting Stress Inventory, the Family Cohesion Index, and questions assessing parent-child role reversal, history of abuse and parental alcoholism, and current relationship satisfaction. RESULTS: Results of analyses and multivariate analyses of covariance suggested that sexual abuse survivors with an unsatisfactory intimate relationship were more likely than either sexual abuse survivors with a satisfactory relationship or nonabused women to endorse items on a questionnaire of role reversal (defined as emotional overdependence upon one's child). Role reversal was not significantly predicted by histories of physical abuse or parental alcoholism or child's gender. While parenting stress was inversely predicted by the significant main effect of relationship satisfaction, neither parenting stress nor child behavior problems were predicted by the main effect of sexual abuse history or by the interaction between sexual abuse history and relationship satisfaction. CONCLUSIONS: These results suggest the unique relevance of sexual abuse history and relationship satisfaction in the prediction of a specific type of parent-child role reversal--namely, a mother's emotional overdependence upon her child.

Adult↗

Adult attachment and long-term effects in survivors of incest.

OBJECTIVE: The aim of the study was to test the hypothesis that adult attachment is related to distress and personality disorders in incest survivors. METHOD: Adult female incest survivors recruited from the community participated in a structured interview (Family Attachment Interview; Bartholomew & Horowitz, 1991) and completed measures of current functioning (Impact of Event Scale, SCL-10, Beck Depression Inventory) and personality (MCMI-II). Complete data from 92 cases out of the total sample of 112 were analyzed. RESULTS: Analyses of variance suggested that attachment (as represented by a category) was significantly related to personality structure, with fearful individuals showing more avoidant, self-defeating, and borderline tendencies and preoccupied individuals showing more dependent, self-defeating, and borderline tendencies than secure or dismissing individuals. Results of hierarchical regression analyses suggested that attachment (as represented by four dimensions) was significantly associated with personality structure, depression and distress, and abuse severity with post traumatic stress disorder (PTSD) symptoms (intrusive thoughts and avoidance of memories) and depression. CONCLUSIONS: The findings demonstrated the propensity for insecure attachment among incest survivors. Sexual abuse severity and attachment have significant but distinct effects on longterm outcome; abuse characteristics predict classic PTSD symptoms and attachment insecurity predicts distress, depression, and personality disorders above and beyond any effects of abuse severity.

Adult↗

Application of attachment theory to the study of sexual abuse.

Research on sexual abuse frequently fails to address the influence of the family as a risk factor for the onset of all kinds of sexual abuse and as a mediator of its long-term effects. Attachment theory provides a useful conceptual framework for understanding the familial antecedents and long-term consequences of sexual abuse. Themes associated with insecure parent-child attachment (rejection, role reversal/parentification, and fear/unresolved trauma) are frequently found in the dynamics of families characterized by sexual abuse, and specific categories of sequelae are related to probable attachment experiences. Implications for intervention and research on sexual abuse are suggested.

Adolescent↗

Introduction to the special section on adult survivors of childhood sexual abuse.

Sexual abuse researchers need to use more complex models of abuse and more sophisticated research designs for studying long-term effects and for evaluating treatment programs. The articles that comprise this special section integrate the study of sexual abuse with perspectives on adult victimization, developmental psychopathology, and attachment theory and also offer specific methodological suggestions for improving research on long-term effects and therapy with the abuse survivor.

Adolescent↗

Individual predictors of outcome in group treatment for incest survivors.

Sixty-five abused women who participated in time-limited group therapy were evaluated before treatment on demographic variables, sexual abuse history, characteristics of the family of origin, and initial levels of depression and distress. Hierarchical regression analyses were conducted to determine the impact of these variables on response to treatment. Results suggest that education, marital status, type of sexual contact, and initial levels of depression and distress predicted response to treatment. In addition, a history of previous therapy showed a tendency to interact with type of group format to predict outcome. Implications for therapy and further research are considered.

Adult↗

A comparison of group treatments of women sexually abused as children.

We randomly assigned 65 women who had been sexually abused by a father, stepfather, or other close relative to 1 of 3 treatment conditions: a 10-week interpersonal transaction (IT) group, a 10-week process group, or a wait list condition. Subjects were evaluated at pretreatment, posttreatment, and (if assigned to a group) a 6-month follow-up on measures of social adjustment, depression, fearfulness, and general distress. Results suggested that both the IT and process group formats were more effective than the wait list condition in reducing depression and in alleviating distress; changes were maintained at follow-up. Subjects in the process group format exhibited improvement in social adjustment, whereas subjects in the wait list condition actually deteriorated.

Adaptation, Psychological↗

Family characteristics and long-term consequences associated with sexual abuse.

As opposed to father-daughter incest, little attention has been paid to the long-term consequences and family dynamics associated with child sexual abuse of females perpetrated by extended family members or extrafamilial contacts. Female undergraduates (n = 586) completed questionnaires on family history, sexual experiences, and current functioning. Results confirmed other research suggesting that father-daughter incest is associated with a traditional patriarchal family structure. However, sexual abuse overall, regardless of perpetrator, was associated with certain uniform family characteristics. Moreover, sexual abuse had certain long-term consequences, regardless of perpetrator. These results suggest the importance of attention to family characteristics in all cases of child sexual abuse.

Adolescent↗

A systems theory conceptualization of incest.

In this paper, father-daughter incest is examined from the perspective of general systems theory. Three characteristics of an open system--information exchange with the environment, negentropy, and dynamic homeostasis--are described and examined with respect to the functioning of incestuous families. Two case studies of families with father-daughter incest illustrate the tendency of these families to be more characteristic of the "closed" end of the continuum. The role of the environment in the origin and maintenance of the incestuous symptom is also examined. Implications for treatment are presented within the context of this theoretical perspective.

Adolescent↗

Effect of marihuana on intraocular and blood pressure in glaucoma.

Marihuana inhalation was accompanied by increased heart rate and decreased intraocular and blood pressure in 18 subjects with heterogenous glaucomas. The hypotensive effects appeared in 60 to 90 minutes as the decrease in intraocular pressure (IOP) appeared to follow the decrease in blood pressure. In addition to any local effect, the mechanism of lowered to any local effect, the mechanism of lowered IOP may also involve the decreased pressure perfusing the ciliary body vasculature as a result of the peripheral vasodilatory properties of marihuana. Postural hypotension, tachycardia, palpitations, and alterations in mental status occurred with such frequency as to mitigate against the routine used in the general glaucoma population. Our data indicate that further research should be directed to local means of delivering the ocular hypotensive cannabinoid to the glaucomatous eye.

Adult↗