This application requests funds to conduct the first large scale, prospective, and longterm assessment of the relationship between childhood victimization and lifetime revictimization, using substantiated cases of childhood physical and sexual abuse and neglect from approximately 25 years ago and a comparison group matched on the basis of age, sex, race/ethnicity, and approximate family social class at the time. The work proposed here is part of a research project begun in 1986 with an initial focus on criminal behavior. The direction of this work has been expanded systematically to include other domains of functioning, including mental health outcomes as well as alcohol and drug abuse. During the years 1989-1995, we conducted in-person follow-up interviews with 1,196 individuals (676 cases of child abuse and neglect and 520 matched comparisons), collecting extensive information about their psychiatric, cognitive, intellectual, social, and behavioral functioning up to that time. In-person interviews will be conducted with 1,196 individuals who participated in the earlier research. There are four broad goals: (1) to test the hypothesis that childhood victimization contributes to increased vulnerability for revictimization in adolescence and adulthood, by comparing the extent to which victims of childhood abuse and neglect are at increased risk for subsequent victimization (""""""""lifetime"""""""" and """"""""current"""""""") compared to matched comparison group subjects. We expect differences in the extent and characteristics of subsequent revictimization experiences (type, frequency, pattern, and perpetrator) and by gender, race/ethnicity, and type of childhood abuse or neglect experience;(2) to determine characteristics associated with revictimization across a broad range of domains of functioning (psychiatric, emotional, social, behavioral, occupational, cognitive, and physical health); (3) to determine physiological stress responses associated with victimization and revictimization, measured in terms of HPA reactivity (cortisol) and cell mediated immunocompetence (EBV-VCA) using new procedures developed for biological data collection in the field; and (4) to test hypotheses about potential pathways--traumatic reactions, risk exposure, and an integrated path--from childhood victimization to revictimization. We will employ analytic strategies involving recursive partitioning and bootstrapping to test these hypotheses. Assessing lifetime and current rates provides two different perspectives on revictimization probabilities and, together, provides a comprehensive picture of one important consequence of childhood victimization.
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