ویژگی سوء استفاده جنسی مرتبط با آسیب شناسی روانی بازماندگان
|کد مقاله||سال انتشار||تعداد صفحات مقاله انگلیسی||ترجمه فارسی|
|35042||2000||14 صفحه PDF||سفارش دهید|
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Publisher : Elsevier - Science Direct (الزویر - ساینس دایرکت)
Journal : Child Abuse & Neglect, Volume 24, Issue 7, July 2000, Pages 951–964
Objective: This study was designed to examine predictors of psychopathology in non-clinically referred, sexually abused (SA) children, ages 6–16 years, 30–60 days following abuse disclosure and termination. Method: Eighty SA children were administered a structured diagnostic interview and a variety of rating-scale instruments. Several forms of psychopathology were assessed, including posttraumatic stress, global functioning, anxiety, depression, and externalizing behavior. Abuse interviews also were used to guide the collection of demographic (victim age, gender) and abuse-related information (e.g., frequency of abuse). Results: Abuse-related factors and demographic variables accounted for greater than half of the variance predicting global functioning, and accurately predicted posttraumatic stress disorder (PTSD) status for 86% of the participants. Also, analyses yielded significant predictors of parent-reported attention problems and sexual behavior. Of additional importance, none of the abuse-related and demographic variables predicted scores on measures of general anxiety, depression, and externalizing behavior. Conclusions: Specific demographic and sexual abuse information may, to some extent, be used to identify children who are at increased risk for short-term post-abuse psychopathology. Although the present findings suggest that such information may not be useful in the prediction of general anxiety, depression, and externalizing behavior, demographic and abuse-related variables importantly appear to account for significant variance in the prediction of global functioning, posttraumatic stress, attentiveness, and sexual behavior. Additional research is needed to improve mental health professionals’ ability to identify SA children who are at high risk for psychopathology.
IN THE PAST decade, the empirical literature has reflected an increasing interest in the effects of child sexual abuse (SA), particularly the relation of SA to survivor psychopathology. Researchers examining this relation reliably have reported heightened levels of psychopathology among SA children relative to non-SA children in the general population (e.g., Mannarino et al 1989 and McLeer et al 1998). For instance, researchers have reported that SA children tend to exhibit certain externalizing behavior problems, such as “aggressive” behavior and running away from home, more frequently than non-SA children (Stern, Lynch, Oates, O’Toole, & Cooney, 1995). In addition, SA children have tended to experience deficits in academic achievement (Rust & Troupe, 1991), low self-esteem (e.g., Stern et al., 1995), and high levels of depression and anxiety (e.g., McLeer et al., 1998) relative to non-SA control-group children (see Beitchman, Zucker, Hood, DaCosta, & Akman, 1991, for a review). Similarly, results of long-term retrospective studies with adult survivors of child SA have suggested that SA is a significant predictor of heightened adult anxiety (e.g., Yama, Tovey, & Fogas, 1993), depression (e.g., Boudewyn & Liem, 1995), and sexual functioning (e.g., Mullen, Martin, Anderson, Romans, & Herbison, 1994; for reviews, see Beitchman et al 1992 and Polusny and Follette 1995). Although the empirical literature has identified several forms of survivor psychopathology that appear to be related to SA, research has suggested that symptoms of posttraumatic stress disorder (PTSD) are the most prevalent correlates (e.g., Kiser et al 1991, McLeer et al 1988, McLeer et al 1998 and Wolfe et al 1989). For instance, in a recent investigation, McLeer and colleagues used a structured interview to assess PTSD criteria according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R; American Psychiatric Association, 1987), comparing 80 non-clinically-referred SA children with 77 clinically-referred non-SA children and 73 non-clinically-referred, non-SA children. Results revealed that, 1–2 months following disclosure and termination of SA, 65% of the SA children reported at least one reexperiencing symptom, 43.7% endorsed three or more avoidant behaviors, and 57.5% reported two or more symptoms of autonomic hyperarousal. In contrast, among the two non-SA control groups, approximately 2% endorsed at least one PTSD-related reexperiencing symptom, 8.6% reported 3 or more avoidant behaviors, and 10.6% endorsed at least two symptoms of hyperarousal. To date, research clearly has provided considerable empirical support for the relation between SA and survivor psychopathology. Accordingly, a number of empirical efforts to extricate this relation have led to the identification of specific abuse-relevant correlates (e.g., SA severity) of post-abuse functioning. Findings derived from studies of this nature are important because they may lead to improvements in mental health professionals’ ability to identify SA children who are at high risk for psychopathology. In the present study, we attempt to contribute to this growing body of literature with an examination of various demographic and abuse-relevant characteristics that potentially are correlated with various forms of psychopathology. Importantly, this study includes three strengths that distinguish it from previous investigations. First, to our knowledge the present study is the first to statistically control the time between the termination of SA and initial assessment. Controlling this time interval is important because researchers have identified considerable variation in patterns of psychopathology as time passes following termination and disclosure of abuse Kendall-Tackett et al 1993 and Wolfe and Birt 1997. Second, the current study is one of the first to have recruited SA participants from a non-clinical setting, thus averting a sampling bias that is pervasive in the SA literature (Famularo, Kinscherff, & Fenton, 1992). Third, the sample recruited for this study was comprised primarily of African-American participants, an underrepresented population in the SA literature. With these points in mind, we review results of previous studies that have employed otherwise similar methodologies.