Cognitions about Sexual Abuse and Youths' Mental Health

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DESCRIPTION (provided by applicant): Childhood Sexual Abuse (CSA) is a known risk factor for adolescent adjustment problems, such as depression, post traumatic stress disorder, externalizing problems, substance use, and risky sexual behavior. However, outcomes for youth with CSA histories markedly vary, and methods that aid in identifying processes that place adolescents at risk or aid in recovery are sorely needed. The proposed project develops a method for indexing individual differences in how adolescents make meaning of their abuse, a process believed to be central in post-CSA adaptation. Successful meaning-making entails actively processing abuse-related affects and cognitions, deriving coherent meaning from them, and integrating these meanings into core belief systems in a way that restores positive views of self, others, and the world. Identifying individual differences in how adolescents make meaning of abuse experiences can advance our understanding of when adjustment problems are likely following CSA. Yet little is known about the assessment of meaning-making processes in CSA victims or how such processes are related to adjustment over time. The proposed study seeks to develop a coding system for assessing how adolescents with confirmed cases of CSA make meaning of their abuse experiences. The coding system focuses on the structural elements of abuse-specific narratives, including coherence, organization, and resolution strategies (CORS). There are 3 specific aims: (1) establish the reliability of the coding system; (2) establish the validity of the coding system; and (3) examine the role of meaning-making in the longitudinal associations between conditions related to abuse (e.g., abuse severity, caregiver support) and subsequent psychological adjustment. Extant longitudinal data from 121 adolescents with confirmed CSA histories will be used to accomplish these aims. The data include measures of abuse severity obtained from case records, caregiver support and adjustment problems assessed within 8 weeks of abuse discovery (T1), a year (T2) and 6 years later (T3), and transcribed oral narratives of abuse experiences (T3). Pilot data provides strong evidence for the reliability, validity, and utility of our narrative coding system. This is the first study to systematically assess meaning-making processes in a relatively large sample of CSA-specific narratives. Understanding differences in how individuals make meaning of their abuse and how such differences are related to adjustment problems will contribute to the design of more specific interventions.