Title

Pathways to PTSD, Part II: Sexually Abused Children.

Publication Date

Summer 7-1-2005

Journal

American Journal of Psychiatry

DOI

10.1176/appi.ajp.162.7.1305

PMID

15994713

PMCID

PMC2754170

Published Open-Access

yes

Keywords

Adaptation, Psychological, Age Factors, Age of Onset, Anxiety Disorders, Child, Child Abuse, Sexual, Dissociative Disorders, Female, Forensic Psychiatry, Humans, Life Change Events, Male, Models, Statistical, Personality Inventory, Phenotype, Prospective Studies, Psychiatric Status Rating Scales, Regression Analysis, Risk Factors, Stress Disorders, Post-Traumatic

Abstract

OBJECTIVE: The goal of this research was to develop and test a prospective model of posttraumatic stress symptoms in sexually abused children that includes pretrauma, trauma, and disclosure-related pathways.

METHOD: At time 1, several measures were used to assess pretrauma variables, trauma variables, and stress reactions upon disclosure for 156 sexually abused children ages 8 to 13 years. At the time 2 follow-up (7 to 36 months following the initial interview), the children were assessed for posttraumatic stress disorder (PTSD) symptoms.

RESULTS: A path analysis involving a series of hierarchically nested ordinary least squares multiple regression analyses indicated three direct paths to PTSD symptoms: avoidant coping, anxiety/arousal, and dissociation, all measured during or immediately after disclosure of sexual abuse. Additionally, age and gender predicted avoidant coping, while life stress and age at abuse onset predicted symptoms of anxiety/arousal. Taken together, these pathways accounted for approximately 57% of the variance in PTSD symptoms.

CONCLUSIONS: Symptoms measured at the time of disclosure constitute direct, independent pathways by which sexually abused children are likely to develop later PTSD symptoms. These findings speak to the importance of assessing children during the disclosure of abuse in order to identify those at greatest risk for later PTSD symptoms.

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