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PTSD symptom cluster profiles of youth who have experienced sexual or physical abuse
Overview of Study
This research examined whether youths between the ages of 6-17 who were referred for treatment due to sexual, physical or both types of abuse show Post Traumatic Stress Syndrome (PTSD) according to the DSM-IV-TR cluster of symptoms. 749 youths participated in the study resulting in 5 cluster profiles were identified with each profile representing 20% of the youths. The youths were referred for treatment in the aftermath of child sexual, physical, or both sexual and physical abuse. Two cognition approaches were done designed for traumatized children and either their offending or non-offending parents were described for treating the youths with the distinct behaviors. Research has indicated that the DSM of Mental Health Disorders by the American Psychological Association, 2000 diagnostic criteria yield significant agreement with respect to diagnosing of PTSD with adults of age 17 years and older. However, the appropriateness of PTSD for youths of age 18 or less has not yet been established. It has not yet been decided is the symptoms for adults are valid for youths as they have not yet gone through their developmental stages. The purpose of the study was to determine whether youths presented symptoms such as Re-experiencing, Avoidance, and Hyperarousal based on their responses in the questionnaires. The study also examined if symptoms might be different from one another with respect to selected background and clinical characteristics of the youth. It was predicted that children who experienced sexual abuse would present with a unique set of PTSD symptoms compared to those who were physically abused.
The sample consisted of 749 youths who were evaluated at the medical college-based institute specializing in sexual and physical abuse. Sexual abuse involves sexual contact such as physical contact, kissing, fondling, oral, anal, or virginal stimulation or penetration. Noncontact sexual exposure is exposure to pornographic materials, pornography of the child, exhibitionism, or having the child removes his or her clothing. Physical abuse is defined as broadly as any act committed by a parent or other person acting in the caregiving role those results in physical injury or threatened injury to a child. This includes hitting by a hand or object, kicked, shaken, thrown, burned, stabbed, or choked. Abuse of the children was documented by an independent party such as the local Child Protective Services or Prosecutor’s office, medical professional or mental health professional.
The sample had 528 girls and 221 boys comprising of 317 Europeans Americans, 209 African Americans, 116 Hispanic Americans, and 107 other ethnic background. Of the total 749 participants, 645 were referred for sexual abuse and 104 for physical abuse, however, of the 645 who experienced sexual abuse, 14% of them also experienced physical abuse.
Four test questionnaires were administered. They include The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (Kaufman, 1997), The Children Depression Inventory (Kovacs, 1992), The Beck Depression Inventory-II (Beck, Steer & Brown, 1996, and The Child Behavior Checklist (Achenbach,, 1991). After written consent from the parents and consent from the youths, the tests were administered. 10 variables were chosen because they were common to all the abuse and did not discriminate between sexual or physical abuse. The participants were divided into 5 groups, each group being tested for PTSD symptoms of Re-experiencing, Avoidant, and Hyperarousal.
Results and Discussion
When calibrated, the mean number of symptoms across the groups was 2 to 3 symptoms with 2.5 as the sample mean. The overall pattern of results indicates that youths who had experienced sexual or physical abuse or both were present with distinctive symptom clusters. The results of this study may allow youths to be treated for PTSD according to the DSM-IV. Children may benefit from a short-term course of treatment, however different treatment may need to be targeted based on the symptoms of each youth. The results did not show any differences between the groups with respect to gender, ethnicity, and whether legal charges against the abuser were filed.
Strengths or Limitations
With respect to the study’s limitations, the sample was composed of youths who were referred to a treatment center where the use of the test questionnaires are a standard part of the assessment process. Being in treatment may have influenced the responses and responses from those who may not have sought treatment may have resulted in different responses. There was no strength noted as part of this study write up.
Runyon, M.K., Deblinger, E., Steer, R.A., (2013). PTSD symptoms cluster profiles of youth who have experienced sexual or physical abuse. Child Abuse and Neglect, 38, 84-90.