SEXUAL ABUSE SEVERITY/COURSE--RELATION TO PTSD

描述（改编自申请人摘要）：有几个模型

DESCRIPTION (Adapted from applicant's abstract): Several models have been developed to account for the variety of symptoms common among sexually abused children. While many researchers have conceptualized sexual abuse sequelae as PTSD, critics have argued that the PTSD model does not account for the full range of symptoms these children display. Based upon Terr's conceptualization of Types I and II trauma, an expanded PTSD model was developed, which suggests that "severity of abuse" (level of sexual activity, use of coercion/force) relates to the intensity of core PTSD symptoms (re-experiencing of trauma, fears and avoidance, hyperarousal), whereas "course of abuse" (duration/frequency of abuse, relationship to perpetrator) relates to gender-specific alterations in attributional and coping styles. These attributional and coping changes are thought to lead to long-term global adjustment difficulties (i.e., learned helplessness, depression, dissociation, anger, and avoidance-focused coping). To examine this model three groups will be assessed: 280 male and female sexual abuse victims (CSA); 100 clinic referred children; 100 community children. The following analyses will be conducted: (a) percentages of CSA children who meet DSM-IV PTSD diagnostic criteria; (b) group comparisons on PTSD symptoms and the attributional and coping style variables; (c) hierarchical multiple regression analyses with PTSD symptoms and attributional and coping style variables as DVs and the abuse severity, abuse course, time since disclosure, and gender as IVs; (d) planned gender comparisons for PTSD symptoms and the attributional style and coping strategy variables; (e) hierarchical multiple regression predicting long-term adjustment (for children whose time since disclosure > 1 year) with severity and course of abuse and the attributional and coping style variables as predictors. To examine the heuristic value of the Type I/Type II typologies, a 2 (high/low severity) x 2 (gender) x 2 (time since disclosure; < 1 year vs. > 1 year) MANOVA will be performed, with both PTSD and attributional and coping style variables as the DVs. A second similar analysis will also be conducted for which the groups will be separated according to abuse course rather than abuse severity.