Symptom Presentation of Sexually Abused Youth: Associations with Abuse Attributions
Date
2020
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Publisher
University of Nebraska - Lincoln
Abstract
Child sexual abuse (CSA) outcomes are heterogeneous. Some victims display a
combination of externalizing behaviors (e.g., aggression) and internalizing symptoms
(e.g., depression), while others present with minimal symptoms (Domhardt, Munzer,
Fegert, & Goldbeck, 2015). Among the factors that have been explored as relating to
CSA outcomes are child characteristics (e.g., age; Dube et al., 2005), abuse-specific
variables (e.g., abuse severity; Stroebel et al., 2012), and family variables (e.g., familial
social support; Ryan, Kilmer, Cause, Watanabe, & Hoyt, 2000). Although much of the
literature supports these factors as contributing to outcomes following CSA, conclusions
have been inconsistent. Research has begun to investigate cognitive factors, such as
abuse attributions, to attempt to explain differences in outcome. Attributions specific to
sexual abuse include attributions of self-blame and guilt, personal vulnerability,
dangerous world, and empowerment. Understanding how abuse attributions relate to
symptom presentation can provide information about how the attributions can be targeted
in treatment. The purpose of the current study was to (a) determine subgroups of CSA
survivors based on patterns of symptom presentation, (b) examine differences between
each group on endorsements of abuse attributions (e.g., self-blame/guilt), and (c) examine
how changes in internalizing and externalizing symptoms associate with changes in
sexual abuse attributions over the course of treatment for the groups. Participants included 153 sexually abused youth and their non-offending
caregivers presenting for treatment. The study utilized self-report and caregiver-report
measures administered at differing time points throughout treatment. Findings showed
four distinct cluster groups, providing evidence for diversity in CSA outcomes (i.e.,
Subclinical, Marginal Self-Reported Distress, Parent-Reported Child Distress, and Highly
Distressed). Results indicated that there were significant differences between cluster
groups regarding overall attributions, self-blame and guilt, personal vulnerability, and
dangerous world. Groups did not significantly differ on empowerment. Findings
demonstrated a positive relationship between changes in emotional distress and changes
in attributions at post-treatment, indicating that as CSA youth reported greater
improvements in emotional distress, they also reported greater reductions in negative
abuse attributions.
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Keywords
child sexual abuse, research, outcomes, behavior, treatment
Citation
Biles, B. (2020). Symptom Presentation of Sexually Abused Youth: Associations with Abuse Attributions. University of Nebraska - Lincoln