***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE This study examined the prevalence and psychological sequelae of childhood sexual and physical abuse in adults from the general population . METHOD A national sampling service generated a geographically stratified , r and om sample of 1,442 subjects from the United States . Subjects were mailed a question naire that included the Traumatic Events Survey ( TES ) [ Traumatic Events Survey , Unpublished Psychological Test , Harbor-UCLA Medical Center , Los Angeles ] and the  Trauma Symptom Inventory ( TSI )  [ Trauma Symptom Inventory Professional Manual , Psychological Assessment Re sources , Odessa , FL ] . Of all potential subjects , 935 ( 64.8 % ) returned substantially completed surveys . RESULTS Sixty-six men and 152 women ( 14.2 % and 32.3 % , respectively ) reported childhood experiences that satisfied criteria for sexual abuse , and 103 males and 92 females ( 22.2 % and 19.5 % , respectively ) met criteria for physical abuse . Twenty-one percent of subjects with one type of abuse also had experienced the other type , and both types were associated with subsequent adult victimization . After controlling for demographics , adult history of interpersonal violence , and other child abuse , childhood sexual abuse was associated with all 10 scales of the TSI , and physical abuse was related to all TSI scales except those tapping sexual issues . Sexual abuse predicted more symptom variance than did physical abuse or adult interpersonal victimization . Various aspects of both physical and sexual abuse experiences were predictive of TSI scores . Abuser sex , however , both alone and in interaction with victim sex , was not associated with additional TSI symptomatology . CONCLUSIONS Childhood sexual and physical abuse is relatively common in the general population , and is associated with a wide variety of psychological symptoms . These relationships remain even after controlling for relevant background variables OBJECTIVE The present study sought to determine whether the 12-session pre- to posttest therapeutic gains that had been found by Deblinger , Lippmann . and Steer ( 1996 ) for an initial sample of 100 sexually abused children suffering posttraumatic stress disorder ( PTSD ) symptoms would be sustained 2 years after treatment . METHOD These sexually abused children , along with their nonoffending mothers , had been r and omly assigned to one of three cognitive-behavioral treatment conditions , child only , mother only , or mother and child , or a community comparison condition , and were followed for 3 months , 6 months , 1 year , and 2 years after treatment . RESULTS A series of repeated MANCOVAs , controlling for the pre-test scores , indicated that for the three measures of psychopathology that had significantly decreased in the original study ( i.e. , externalizing behavior problems , depression , and PTSD symptoms ) , these measures at 3 months , 6 months , 1 year , and 2 years were comparable to the posttest scores . CONCLUSIONS These findings suggest that the pre- to post-treatment improvements held across the 2-year follow-up period . The clinical and research implication s of these findings are discussed The objective of this study was to evaluate and compare the efficacy of two short-term individual therapy interventions for sexually abused girls and their nonoffending female caretakers . Thirty-two girls , ages 8 to 13 , and their caretakers from primarily low-income , African-American families were r and omly assigned to a theoretically based , structured experimental treatment program or to a relatively unstructured comparison intervention . Measures of child outcome were completed before and after the treatment program by each parent and child , and by a clinician blind to treatment condition . Pre- and post measures of maternal outcome were completed by the caretaker and a clinician not involved in the treatment . Both treatment programs yielded decreases in children 's posttraumatic stress disorder symptoms and traumagenic beliefs reflecting self-blame and powerlessness , and increases in children 's overall psychosocial functioning . The experimental intervention was more effective than the comparison program in increasing abuse-related caretaker support of the child and in decreasing caretaker self-blame and expectations of undue negative impact of the abuse on the child . Clinical impfications of these findings include the development of interventions targeting sexually abused children 's traumagenic beliefs and nonoffending parents ' support of their victimized children OBJECTIVE Treatment outcome for sexually abused preschool-age children and their parents was assessed , comparing the effectiveness of a cognitive-behavioral intervention to nondirective supportive treatment . METHOD Sixty-seven sexually abused preschool children and their parents were r and omly assigned to either ( 1 ) cognitive-behavioral therapy adapted for sexually abused preschool children ( CBT-SAP ) or ( 2 ) nondirective supportive therapy ( NST ) . Treatment consisted of 12 individual sessions for both the child and parent , monitored for integrity with the therapeutic model through intensive training and supervision , use of treatment manuals , and rating of audiotaped sessions . Parents completed the Child Behavior Checklist , the Child Sexual Behavior Inventory , and the Weekly Behavior Report to measure a variety of emotional and behavioral symptoms . RESULTS Within-group comparison of pretreatment and posttreatment outcome measures demonstrated that while the NST group did not change significantly with regard to symptomatology , the CBT-SAP group had highly significant symptomatic improvement on most outcome measures . Repeated- measures analyses of variance demonstrated group x time interactions on some variables as well . Clinical findings also supported the effectiveness of the CBT-SAP intervention over NST . CONCLUSIONS Findings provide strong preliminary evidence for the effectiveness of a specific cognitive-behavioral treatment model for sexually abused preschool children and their parents OBJECTIVE To determine the rate and risk of clinical and personality disorders diagnosed in childhood and adulthood in those known to have been sexually abused during childhood . METHODS  Forensic medical records of 2,759 sexually abused children assessed between 1964 and 1995 were linked with a public psychiatric data base between 12 and 43 years later . Cases were compared to control subjects matched on gender and age groupings drawn from the general population through a r and om sample of the national electoral data base . RESULTS A lifetime record of contact with public mental health services was found in 23.3 % of cases compared to 7.7 % of controls . The rate of contact among child sexual abuse victims was 3.65 times higher ( 95 % CI , 3.09 - 4.32 , p<0.001 ) . It was estimated that child sexual abuse accounted for approximately 7.83 % of mental health contact . Exposure to sexual abuse increased risks for the majority of outcomes including psychosis , affective , anxiety , substance abuse , and personality disorders . Rates of clinical disorders diagnosed in adulthood and childhood remained significantly higher among child sexual abuse cases . Older age at sexual abuse and those exposed to severe abuse involving penetration or multiple offenders were associated with greater risk for psychopathology . CONCLUSIONS This study confirms that child sexual abuse is a substantial risk factor for a range of mental disorders in both childhood and adulthood . PRACTICE IMPLICATION S Those treating victims of sexual abuse must assess not only disorders commonly associated with trauma , but also low prevalence disorders such as psychosis OBJECTIVE To measure the durability of improvement in response to two alternative treatments for sexually abused children . METHOD Eighty-two sexually abused children ages 8 - 15 years old and their primary caretakers were r and omly assigned to trauma-focused cognitive-behavioral therapy ( TF-CBT ) or non-directive supportive therapy ( NST ) delivered over 12 sessions ; this study examines symptomatology during 12 months posttreatment . DATA ANALYSIS Intent-to-treat and treatment completer repeated measures analyses were conducted . RESULTS Intent-to-treat indicated significant group x time effects in favor of TF-CBT on measures of depression , anxiety , and sexual problems . Among treatment completers , the TF-CBT group evidence d significantly greater improvement in anxiety , depression , sexual problems and dissociation at the 6-month follow-up and in PTSD and dissociation at the 12-month follow-up . CONCLUSION This study provides additional support for the durability of TF-CBT effectiveness OBJECTIVE To examine the differential efficacy of trauma-focused cognitive-behavioral therapy ( TF-CBT ) and child-centered therapy for treating posttraumatic stress disorder ( PTSD ) and related emotional and behavioral problems in children who have suffered sexual abuse . METHOD Two hundred twenty-nine 8- to 14-year-old children and their primary caretakers were r and omly assigned to the above alternative treatments . These children had significant symptoms of PTSD , with 89 % meeting full DSM-IV PTSD diagnostic criteria . More than 90 % of these children had experienced traumatic events in addition to sexual abuse . RESULTS A series analyses of covariance indicated that children assigned to TF-CBT , compared to those assigned to child-centered therapy , demonstrated significantly more improvement with regard to PTSD , depression , behavior problems , shame , and abuse-related attributions . Similarly , parents assigned to TF-CBT showed greater improvement with respect to their own self-reported levels of depression , abuse-specific distress , support of the child , and effective parenting practice s. CONCLUSIONS This study adds to the growing evidence supporting the efficacy of TF-CBT with children suffering PTSD as a result of sexual abuse and suggests the efficacy of this treatment for children who have experienced multiple traumas The differential efficacies of supportive and cognitive behavioral group therapy models design ed for young children ( ages 2 to 8) who have experienced sexual abuse and their nonoffending mothers were compared . Forty-four mothers and their respective children participated in either supportive or cognitive behavioral therapy groups with the group format being r and omly determined . Repeated measures MANOVAs indicated that compared to mothers who participated in the support groups , the mothers who participated in cognitive behavioral groups reported greater reductions at posttest in ( a ) their intrusive thoughts and ( b ) their negative parental emotional reactions regarding the sexual abuse . The children treated with cognitive behavioral therapy demonstrated greater improvement in their knowledge regarding body safety skills at posttest than did the children who received supportive therapy The present study evaluated alternative treatments for children ( N = 112 , ages 7 - 13 ) referred for severe antisocial behavior . Children were r and omly assigned to one of three treatments : problem-solving skills training ( PSST ) , problem-solving skills training with in vivo practice ( PSST-P ) , which included therapeutically planned activities to extend training to setting s outside of treatment , or client-centered relationship therapy ( RT ) . PSST and PSST-P children showed significantly greater reductions in antisocial behavior and overall behavior problems , and greater increases in prosocial behavior than RT children . These effects were evident on measures obtained immediately after treatment and at a 1-year follow-up , and on measures of child performance at home and at school . PSST-P  children showed greater changes than  PSST children on measures of functioning at school at posttreatment , but these differences were no longer evident at follow-up . Children in both PSST conditions showed significant reductions in deviant behavior and improvements in prosocial behavior from pretreatment to follow-up , whereas RT children tended to remain at their pretreatment level of functioning . Notwithst and ing the significant improvements , comparisons with nonclinic ( normative ) sample s revealed that the majority of youth remained outside of the normal range of deviant behavior . Possible directions for improving treatment for antisocial youth are highlighted BACKGROUND Evidence is accumulating that child sexual abuse ( CSA ) is associated with many psychiatric disorders in adulthood . This paper uses the detailed information available from the 2007 Adult Psychiatric Morbidity Survey of Engl and ( APMS 2007 ) to quantify links between CSA and a range of psychiatric conditions . METHOD The prevalence of psychiatric disorder was established in a r and om sample of the English household population ( n=7403 ) , which also provided sociodemographic and experiential information . RESULTS We analyzed six types of common mental disorder , alcohol abuse and drug abuse , and people who screened positively for post-traumatic stress disorder ( PTSD ) and eating disorders . All were strongly and highly significantly associated with  CSA  , particularly if non-consensual sexual intercourse was involved , for which odds ratios ( ORs ) ranged from 3.7 to 12.1 . These disorders were also related to adult sexual abuse ( ASA ) , although the likelihood of reverse causality is then increased . Revictimization in adulthood was common , and increased the association of CSA with disorder . For several disorders , the relative odds were higher in females but formal tests for moderation by gender were significant only for common mental disorders and only in relation to non-consensual sexual intercourse . The population attributable fraction ( PAF ) was higher in females in all cases . CONCLUSIONS The detailed and high- quality data in APMS 2007 provided important confirmation both of the strength of association of CSA with psychiatric disorder and of its relative non-specificity . Our results have major implication s at the public health level and the individual level , in particular the need for better recognition and treatment of the sequelae of CSA In this study a psychosocial treatment for 47 Ss ( aged 9 - 13 years ) with anxiety disorders was investigated . A 16-session cognitive-behavioral treatment was compared with a wait-list condition . Outcome was evaluated using child self-report , parent report , teacher report , cognitive assessment , and behavioral observations .  Pretreatment-posttreatment changes and maintenance of gains at 1-year follow-up were examined . Results revealed that many treated Ss were found to be without a diagnosis at posttest and at follow-up and to be within normal limits on many measures . The child 's perception of the 
    Output:
    
Treatment as usual was , for the most part , supportive , unstructured psychotherapy .
Data suggest that CBT may have a positive impact on the sequelae of child sexual abuse , but most results were not statistically significant .
Strongest evidence for positive effects of CBT appears to be in reducing PTSD and anxiety symptoms , but even in these areas effects tend to be ' moderate ' at best .