Sexual abuse

What tools are used and how far have these projects gone Previous issues of PROBE and many other publications as well, have recently highlighted the potential use of this ultimate weapon of mind control. Part of this article will explore the lesser known but depraved use of this power over a group of selected people with incestual and sexual abuse backgrounds. 

Allegations of widespread sexual abuse of children by well known politicians and a contingent of popular Hollywood personalities were reported by both O Brien and Gunderson. 

Panic disorder is a common clinical problem. Over the course of their lives, about 1 of every 5 people experience at least one panic attack. Less than half of these have a spontaneous or unexpected panic attack in a situation in which they would not have expected to be anxious, but even those do not necessarily fulfill the diagnostic criteria for panic disorder, which requires a persistent worry about the consequences of attacks or the possibility of having future attacks. The lifetime incidence of panic disorder is 2-4%. It is evenly distributed among all races and ethnic groups, but women are twice as likely to be affected as men. Early childhood trauma, such as sexual abuse, markedly increases the risk for the development of panic disorder in adulthood. 

The DSM-IV diagnostic criteria for PTSD (cf. Table 5.10) requires that the patient has been exposed to a traumatic stressor. In this context, the concept of traumatic stress is specifically defined as an event involving actual or threatened death or serious injury, or a threat to physical integrity. Such traumatic events include sexual abuse (e.g., rape, molestation), life-threatening accidents, interpersonal violence, natural disasters, and combat. 

Gender is another important risk factor for PTSD. Although men are more likely to experience a traumatic event, PTSD is at least twice as common among women. This apparent gender discrepancy, however, provides an opportunity to examine the manner in which varied risk factors might interact. The gender difference might be explained, at least in part, by the nature of the traumatic stressors that are more likely to be experienced by women. In particular, women are disproportionately victimized by sexual traumas, such as rape or childhood sexual abuse. Sexual traumas, in both men and women, are more likely to lead to the development of PTSD than other traumas such as natural disasters. 

Dissociative identity Disorder (DID). There are numerous similarities between this dissociative illness, which includes multiple personality disorder, and BPD. Patients with both disorders are commonly victims of physical or sexual abuse as children and experience intense shifts in affect and periods of dissociation. Some clinicians in fact discount the validity of DID as a psychiatric diagnosis, contending that the phenomena of DID can be explained by BPD. In fact, severely ill BPD patients very much resemble the prototypical patient with DID. 

Bremner JD, Randall P, Vermetten E, Staib L, Bronen RA, Mazure C, CapeUi S, McCarthy G, Innis RB, Charney DS (1997) Magnetic resonance imaging-based measm-ement of hippocampal volimie in posttraumatic stress disorder related to childhood physical and sexual abuse—a preliminary report. Biol Psychiatry 41 23-32... 

Bremner JD, VythUingam M, Vermetten E, Southwick SM, McGlashan T, Staib LH, Soufer R, Charney DS (2003) Neural correlates of declarative memory for emotionally valenced words in women with posttraumatic stress disorder related to early childhood sexual abuse. Biol Psychiatry 53 879-889... 

Davidson J, Lipper S, KUts CD, Mahorney S, Hammett E (1985) Platelet MAO activity in posttraumatic stress disorder. Am J Psychiatry 142 1341-1343 Davis M (2002) The role of NMDA receptors and MAP kinase in the amygdala in extinction of fear clinical implications for exposure therapy. Eur J Neurosci 16 395-398 DeBellis MD, Letter L, Trickett PK, Putnam FW (1994) Urinary catecholamine excretion in sexually abused girls. J Am Acad Child Adoles Psychiatry 33 320-327 Debiec J, LeDoux JE, Nader K (2002) Cellular and systems reconsolidation in the hippocampus. Neuron 36 527-538... 

The use of salivary assessments has helped supply data in studies of children and adolescents, for whom even a blood draw may be too invasive, and also helped in our evaluation of longitudinal outcomes. King et al. (2001) observed significantly low cortisol levels in children aged 5-7 years who had been sexually abused compared to control subjects. Goenjian et al. (1996) demonstrated a relationship between low sahvary cortisol levels and PTSD symptoms in adolescents exposed to the Armenian earthquake. However, both lipschitz et al. (2003) and Carrion et al. (2002) failed to note differences in salivary cortisol levels at basehne in multiply traumatized adolescents. 

Observations regarding the cellular immune response in PTSD are also consistent with enhanced GR responsiveness in the periphery. In one study, beclomethasone-induced vasoconstriction was increased in women PTSD subjects compared to healthy, non-trauma-exposed comparison subjects (Coupland et al. 2003). Similarly, an enhanced delayed-type hypersensitivity of skin test responses was observed in women who survived childhood sexual abuse vs those who did not (Altemus et al. 2003). Because immune responses, like endocrine ones, can be multiply regulated, these studies provide only indirect evidence of GR responsiveness. However, when considered in the context of the observation that PTSD patients showed increased expression of the re-... 

A blunted ACTH response to CRF in the context of a normal cortisol response was also observed in sexually abused girls, but the diagnosis of PTSD was not systematically made in this study (deBellis et al. 1994). When Hving in the context of ongoing abuse, abused children with depression showed an enhanced ACTH response to CRF in comparison with abused children without depression and normals (Kauffman et al. 1997). Again, although such subjects... 

Carrion VG, Weems CF, Ray RD, Glaser B, Hessl D, Reiss AL (2002) Diurnal salivary cortisol in pediatric posttraumatic stress disorder. Biol Psychiatry 51 575-582 Coupland NJ, Hegadoren KM, Myrholm J (2003) Increased beclomethasone-induced vasoconstriction in women with posttraumatic stress disorder. J Psychiatr Res 37 221-228 De Beilis MD, Chrousos GP, Dorn LD, Burke L, Helmers K, Kling MA, Trickett PK, Putnam FW (1994) Flypothalamic-pituitary-adrenal axis dysregulation in sexually abused girls. J Clin Endocrinol Metab 78 249-255... 

Kellner M, Yehuda R, Arlt J, Wiedemann K (2002b) Longitudinal comse of salivary cortisol in posttramnatic stress disorder. Acta Psychiatr Scand 105 153-155 King JA, Mandansky D, King S, Fletcher KE, Brewer J (2001) Early sexual abuse and low cortisol. Psychiatry Clin Nemosci 55 71-74... 

Stein MB, Yehuda R, Koverola C, Hanna C (1997) Enhanced dexamethasone suppression of plasma cortisol in adult women traumatized by childhood sexual abuse. Biol Psychiatry 42 680-686... 

Fergusson DM, Horwood J, Lynskey MT (1996) Childhood sexual abuse and psychiatric disorder in young adulthood 11. Psychiatric outcomes of childhood sexual abuse. J Am Acad Child Adolesc Psychiatry 34 1365-1374... 

Psychosocial morbidity association. Cannabis dependence is a prevalent comorbid substance use disorder among patients early in the course of a schizophrenia-spectrum disorder. Among 29 eligible patients, 18 participated in the study. First-episode patients with comorbid cannabis dependence (n = 8) reported significantly greater childhood physical and sexual abuse compared with those without comorbid cannabis dependence (n = 10). The result indicated the preliminary evidence of an association between childhood maltreatment and cannabis dependence among this especially vulnerable population. Child-... 

Why is this At least part of the reason seems to reside in the well-rehearsed belief that the family caused the problem in the first place through dysfunction and abuse. Many people with drug problems report terrible childhoods marked by parental alcohol or drug use, by neglect or physical or sexual abuse. If this is the case, what could be the possible rationale for any further involvement of the extended family ... 

According to the U.S. Department of Health and Human Services, 1.4 million cases of child maltreatment are reported annually, with 160,000 children suffering serious injuries and 2000 children dying each year as a consequence of maltreatment. Prevalence rates have been evaluated for different types of abuse in clinical, community, and national samples. Prevalence rates of sexual abuse range from 7%-62% in women (McCauley et al., 1997). A reanalysis of 166 studies on the prevalence of sexual abuse in boys revealed rates from... 

DeBellis, M.D., Chrousos, G.P., Dorn, L.D., Burke, L., Helmers, K., Kling, M.A., et al. (1994a) Hypothalamic-pituitary-adrenal dys-regulation in sexually abused girls. / Clin Endocrinol Metab 78 249-255. 

DeBellis, M.D., Lefter, L., Trickett, P.K., and Putnam F.W. (1994b) Urinary catecholamine excretion in sexually abused girls. / Am Acad Child Adolesc Psychiatry 33 320—327. 

Holmes, W.C. and Slap, G.B. (1998) Sexual abuse of boys definition, prevalence, correlates, sequelae, and management. JAMA 280 1855-1862. 

Kendall-Tackett, K.A., Williams, L.M., and Einkelhor, D. (1993) Impact of sexual abuse on children a review and synthesis of recent empirical studies. Psychol Bull 113 164-80. 

Kendler, K.S., Bulik, C.M., Silberg, J., Hettema, J.M., Myers, J., and Prescott C.A. (2000) Childhood sexual abuse and adult psychiatric and substance use disorders in women an epidemiological and cotwin control analysis. Arch Gen Psychiatry 57 953-959. 

Orr SP, Lasko NB, Metzger LJ, Berry NJ, Ahern CE, and Pitman RK (1998). Psychophysiologic assessment of women with posttraumatic stress disorder resulting from childhood sexual abuse. / Consult Clin Psychol 66 906-913. 

Stein, M.B., Koverola, C., Hanna, C., Torchia, M.G., and McClarty, B. (1997a) Hippocampal volume in women victimized by childhood sexual abuse. Psychol Med 27 951-959. 

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