Examination of the relationship between the duration and frequency of abuse and the trauma symptoms among survivors of sexual abuse

Abstract

Objective: In this study, we aimed to investigate whether a relationship between the presence and severity of trauma symptoms and duration/frequency of abuse and socio-demographic variables exist or not. Methods: Sixty-five children, aged between 5-17 years, who were admitted to Child and Adolescent Psychiatry Department of Akdeniz University Hospital due to sexual abuse have been enrolled to the study with their mothers. Existing psychopathologies of children were evaluated by Kiddie Schedule for Affective Disorders and Schizophrenia-Lifetime version (K-SADS-PL) and PTSD were evaluated by Clinician Administered PTSD Scale for Children and Adolescents (CAPS-CA). For identifying PTSD in their parents Clinician Administered PTSD Scale (CAPS) was used. Results: 84.6% of victims (n = 55) were female and15.4% (n = 10) were male. There was no significant relationship between the frequency and duration of abuse and CAPS B, C, and D scores (P> 0.05). Similarly, no significant relationship was present between the frequency and duration of abuse and CAPS B, C, and D scores of the mothers (P> 0.05). In females, age and education level were positively correlated with the CAPS B, C and D scores. Parents' education level was tending to be lower by decreasing age of victimized children. Conclusion: Multiple factors (personal, familial, and pertaining to abuse) may play role in the impact of abuse on mental health of survivors of sexual abuse. Education levels of parents seem to be related with both the abuse risk of children and its impact on the child\'s mental health after sexual abuse.

Keywords

• Sexual abuse, PTSD, frequency of abuse, duration of abuse

Examination of the relationship between the duration and frequency of abuse and the trauma symptoms among survivors of sexual abuse

Abstract

Amaç: Bu çalışmada istismar süresi, istismar sıklığı ve diğer sosyodemografik değişkenler ile travma belirtilerinin varlığı ve şiddeti arasında ilişkinin olup olmadığını araştırmayı amaçladık. Yöntemler: 2010 yılında Akdeniz Üniversitesi ÇERSH polikliniğine cinsel istismar nedeniyle başvuran 5-17 yaşları arasındaki 65 çocuk ve 65 anne değerlendirmeye alındı. Çocukların DSM IV\'e göre tanısının ve eş tanıların belirlenmesi için Okul Çağı Çocukları için Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi Şimdi ve Yaşam Boyu Versiyonu (K-SADS-PL) uygulanmasının ardından Travma Sonrası Stres Bozukluğu (TSSB) varlığının ve şiddetinin belirlenmesi için çocuk ve gençler için klinisyen tarafından uygulanan travma sonrası stres bozukluğu ölçeği” (TSSB-ÖÇE) uygulandı. Annelerde TSSB varlığının ve şiddetinin belirlenmesi için ise klinisyen tarafından uygulanan travma sonrası stres bozukluğu ölçeği” (TSSB-Ö)uygulandı. Bulgular: Mağdurların %84,6\'sı (n=55) kız, %15,4\'ü (n=10) ise erkekti. Hem istismar süresi hem de istismar sıklığı ile CAPS (TSSB-ÖÇE) B, C ve D puanları arasında anlamlı bir ilişki saptanmadı (P>0,05). Benzer şekilde istismar süresi ve istismar sıklığı ile annenin CAPS (TSSB-Ö) B, C ve D puanları arasında da anlamlı bir ilişki yoktu (P>0,05). Kızlarda, yaşın ve eğitim yılının CAPS (TSSB-ÖÇE) B, C ve D puanları ile pozitif korelasyonu vardı. İstismar yaşı düştükçe anne ve babanın eğitim yılı da düşüş göstermekteydi. Sonuçlar: Cinsel istismar sonrası ruhsal etkilenmede çoklu etmenlerin (bireysel, ailesel ve istismara ait) birlikte rol oynadığını düşünmekteyiz. Ebeveynlerin eğitim düzeyi hem istismar riski hem de çocukta istismar sonrası görülen ruhsal etkilenme ile ilişkili olabilir.

Keywords

• Cinsel istismar, TSSB, istismar süresi, istismar sıklığı

References

1. Pereda N, Guilera G, Forns M, Gómez-Benito J. The preva- lence of child sexual abuse in community and student sam- ples: a meta-analysis. Clin Psychol Rev 2009;29:328–338.
2. Stoltenborgh M, van Ijzendoorn MH, Euser EM, Baker- mans-Kranenburg MJ. A global perspective on child sexual abuse: meta-analysis of prevalence around the world. Child Maltreat 2011;16:79–101.
3. Molnar BE, Buka SL, Kessler RC. Child sexual abuse and subsequent psychopathology: results from the National Co- morbidity Survey. Am J Public Health 2001;91:753–760.
4. Şimşek Ş. Post-Traumatic stress disorder in children who were sexually abused and in their parents. Dicle Med J 2011;38: 318–324.
5. Kolko DJ, Hurlburt MS, Zhang J, et al. Posttraumatic stress symptoms in children and adolescents referred for child welfare investigation. A national sample of in-home and out-of-home care. Child Maltreat 2010;15:48–63.
6. Jonas S, Bebbington P, McManus S, et al. Sexual abuse and psychiatric disorder in England: results from the 2007 Adult Psychiatric Morbidity Survey. Psychol Med 2011;41:709– 719.
7. Jonzon E, Lindblad F. Risk factors and protective factors in relation to subjective health among adult female victims of child sexual abuse. Child Abuse Negl 2006;30:127–143.
8. Eisen ML, Qin J, Goodman GS, Davis SL. Memory and sug- gestibility in maltreated children: age, stress arousal, dis- sociation, and psychopathology. J Exp Child Psychol 2002; 83:167–212.

9. Chaffin M, Wherry JN, Dykman R. School age children’s coping with sexual abuse: Abuse stresses and symptoms associated with four coping strategies. Child Abuse Negl 1997;21:227–240.
10. Ullman SE. Social reactions to child sexual abuse disclo- sures: a critical review. J Child Sex Abuse 2003;12:89–121.
11. Goodman GS, Ghetti S, Quas JA, et al. A prospective study of memory for child sexual abuse: new findings rel- evant to the repressed-memory controversy. Psychol Sci 2003;14:113–118.
12. Kim TK, Choi S, Shin YJ. Psychosocial factors influenc- ing competency of children’s statements on sexual trauma. Child Abuse Negl 2011;35: 173–179.
13. Ullman SE. Relationship to perpetrator, disclosure, social reactions, and PTSD symptoms in child sexual abuse survi- vors. J Child Sex Abuse 2007;16: 19–36.
14. Crowley MS, Seery BL. Exploring the multiplicity of child- hood sexual abuse with a focus on polyincestuous contexts of abuse. J Child Sex Abuse 2002;10: 91–110.
15. Johnson DM, Pike JL, Chard KM. Factors predicting PTSD, depression, and dissociative severity in female treatment- seeking childhood sexual abuse survivors. Child Abuse Negl 2001;25:179–198.
16. Hebert M, Collin-Vezina D, Daigneault I, et al. Factors linked to outcomes in sexually abused girls: a regression tree analysis. Compr Psychiatry 2006;47: 443–455.
17. Heath V, Bean R, Feinauer L. Severity of childhood sexual abuse: Symptom differences between men and women. Am J Fam Ther 1996;24: 305–314.
18. Fahrudin A, Edward D. Family characteristics and traumatic consequences associated with the duration and frequency of sexual assault. Asian Soc Work Policy Rev 2009;3:36–50.
19. Amerikan Psikiyatri Birliği. (2007). DSM-IV-TR Ruhsal Bozuklukların Tanısal ve Sayımsal El Kitabı. Köroğlu E (Çeviri Ed.), Ankara: Hekimler Yayın Birliği, 470-473.
20. Kaufman J, Birmaher B, Brent D, et al. Schedule for Af- fective Disorders and Schizophrenia for School-Age Chil- dren-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psy- chiatry 1997;36:980–988.
21. Gökler B, Ünal F, Pehlivantürk B, et al. Okul çağı çocukları için duygulanım bozuklukları ve şizofreni görüşme çi- zelgesi şimdi ve yaşam boyu şekli-Türkçe uyarlamasının geçerlik ve güvenirliği. Turk J Child Adolesc Ment Heal 2004;11:109–116.
22. Karakaya I, Memik NÇ, Ağaoğlu B, et al. Reliability and Validity Of Clinician Administered Post Traumatic Stres Disorder Scale For Children And Adolescents (CAPS-CA). Turk J Chıld Adolesc Ment Heal 2007;14:125–132.
23. Banyard VL, Williams LM, Siegel JA. The long-term men- tal health consequences of child sexual abuse: an explor- atory study of the impact of multiple traumas in a sample of women. J Trauma Stress 2001;14: 697–715.
24. Feiring C, Taska L, Lewis M. Age and gender differences in children’s and adolescents’ adaptation to sexual abuse. Child Abuse Negl 1999;23:115–128.
25. Martin A, Najman JM, Williams GM, et al. Longitudinal analysis of maternal risk factors for childhood sexual abuse: early attitudes and behaviours, socioeconomic status, and mental health. Aust N Z J Psychiatry 2011;45: 629–637.
26. Putnam FW. Ten-year research update review: Child sexual abuse. J Am Acad Child Adolesc Psychiatry 2003;42:269– 278.
27. Zielinski DS, Bradshaw CP. Ecological influences on the sequelae of child maltreatment: A review of the literature. Child Maltreat 2006;11:49–62.