Abstract:
Background: PTSD symptoms are frequent in child victims of sexual abuse. Yet, authors
have argued that early trauma could lead to alterations in development that go far beyond
the primary symptoms of PTSD and have proposed Complex PTSD as an alternative
diagnosis encompassing difficulties in affect regulation, relationships and self-concept.
Objective: To delineate profiles in child victims of sexual abuse and explore whether
profiles are associated with treatment response to Trauma-Focused Cognitive Behavioural
Therapy.
Method: Latent class analysis was used to identify symptom profiles at baseline assessment
of 384 children ages 6 to 14, recruited in a Child Advocacy Centre following disclosure of
sexual abuse. Dimensions of Complex PTSD diagnosis as proposed by the ICD-11 were
derived from self-report questionnaires.
Results: Latent class analysis identified a best fitting model of three classes: Classic PTSD
regrouping 51% of children, Complex PTSD describing 23% of children, and Resilient
describing 25% of children. Trauma-focused therapy was associated with a significant
reduction of dissociation, internalizing, and externalizing problems for children of all three
classes. Trauma-focused therapy was also linked to a significant reduction of PTSD symptoms with larger effect size (d = .90; 95%CI: 0.63–1.16) for children classified in the Complex
PTSD class.
Conclusion: These findings highlight the utility of a person-oriented approach to enhance
our understanding of the diversity of profiles in child victims. The results offer empirical
support for the ICD-11 PTSD and Complex PTSD distinction in a clinical sample of sexually
abused children and the relevance of this distinction in foreseeing treatment outcomes.