Long-Term Correlates of Childhood Abuse among Adults with Severe Mental Illness: Adult Victimization, Substance Abuse, and HIV Sexual Risk Behavior
- 781 Downloads
The prevalence of childhood sexual and physical abuse among persons with severe mental illness (SMI) is disproportionately high. Adults with SMI also engage in high rates of HIV risk behaviors. This study examined the association between childhood abuse and adult victimization, substance abuse, and lifetime HIV sexual risk in a sample of 152 adults with SMI receiving community mental health services. Structured interviews assessed psychiatric, psychosocial, and behavioral risk factors. Seventy percent reported childhood physical and/or sexual abuse, and 32% reported both types of abuse. Participants with childhood abuse were more likely to report adult victimization and greater HIV risk. A structural equation model found that childhood abuse was directly and indirectly associated with HIV risk through drug abuse and adult vicitimization. Integrated treatment approaches that address interpersonal violence and substance abuse may be necessary for HIV risk reduction in this population.
KeywordsSevere mental illness HIV risk behavior Childhood abuse Substance abuse Revictimization
This study was supported by grants F31-MH067370 and T32-DA01536 from the National Institutes of Health.
- APA. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Text revision. Washington, DC: American Psychiatric Association.Google Scholar
- Bollen, K. A. (1989). Structural equations with latent variables. New York: Wiley.Google Scholar
- Briere, J. (2002). Treating adult survivors of severe childhood abuse and neglect: Further development of an integrative model. In L. Berliner, J. E. B. Myers, J. Briere, C. T. Hendrix, C. Jenny, & T. Reid (Eds.), The APSAC handbook on child maltreatment (2nd ed., pp. 26). Newbury Park, CA: Sage Publications.Google Scholar
- Briere, J. (2003). Integrating HIV/AIDS prevention activities into psychotherapy for sexual abuse survivors. In L. J. Koenig, L. S. Doll, A. O’Leary, & W. Pequegnat (Eds.), From child sexual abuse to adult sexual risk: Trauma, revictimization, and intervention. Washington, DC: American Psychological Association.Google Scholar
- Edwards, V. J., Holden, G. W., Felitti, V. J., & Anda, R. F. (2003). Relationship between multiple forms of childhood maltreatment and adult mental health in community respondents: Results from the adverse childhood experiences study. American Journal of Psychiatry, 160, 1453–1460.PubMedCrossRefGoogle Scholar
- Green, B. L. (1996). Trauma history questionnaire. In B. H. Stamm (Ed.), Measurement of stress, trauma, and adaptation (pp. 366–368). Lutherville, MD: Sidran.Google Scholar
- Hansen, N. B., Sikkema, K. J., Tarakeshwar, N., Kochman, A., Briere, J., Fox, A. M., et al. (2006, November). Group intervention for sexually abused, HIV positive adults: Resiliency, process and outcome. Paper presented at the Annual Meeting of the International Society for Traumatic Stress Studies, Hollywood, CA.Google Scholar
- Jaccard, J., & Wan, C. K. (1996). LISREL approaches to interaction effects in multiple regression. Thousand Oaks, CA: Sage.Google Scholar
- Joreskog, K. G. (2004). Structural equation modeling with ordinal variables using LISREL. Retrieved 12/06/2006, 2006, from http://www.ssicentral.com/lisrel/techdocs/ordinal.pdf.
- Preacher, K. J., & Hayes, A. F. (2004). SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavioral Research Methods, Instruments, and Computers, 36, 717–731.Google Scholar
- UNAIDS. (2006). Report on the global AIDS epidemic. Geneva: UNAIDS.Google Scholar
- Wenninger, K., & Ehlers, A. (1998). Dysfunctional cognitions and adult psychological functioning in child sexual abuse survivors Journal of Traumatic Stress, 11, 231–300.Google Scholar