Cognitions about Sexual Abuse and Youths' Mental Health

描述（由申请人提供）：儿童期性虐待（CSA）是青少年适应问题的已知风险因素，如抑郁症、创伤后应激障碍、外化问题、物质使用和危险的性行为。然而，有CSA病史的青少年的结果明显不同，帮助识别将青少年置于风险中的过程或帮助其康复的方法是迫切需要的。拟议的项目开发了一种方法，用于索引青少年如何理解其虐待的个体差异，这一过程被认为是后csa适应的核心。成功的意义建构需要积极处理与虐待有关的影响和认知，从中获得连贯的意义，并以一种恢复对自我、他人和世界的积极看法的方式，将这些意义整合到核心信仰体系中。识别青少年如何理解虐待经历的个体差异，可以促进我们对CSA后何时可能出现适应问题的理解。然而，对CSA受害者意义生成过程的评估，以及这些过程与时间调整的关系，我们知之甚少。这项拟议的研究旨在开发一个编码系统，用于评估确诊患有CSA的青少年如何理解他们的虐待经历。编码系统侧重于特定虐待叙述的结构要素，包括连贯性、组织和解决策略（CORS）。具体目标有3个：(1)建立编码系统的可靠性；(2)建立编码系统的有效性；(3)研究意义制造在与虐待有关的条件（如虐待严重程度、照顾者支持）和随后的心理调整之间的纵向关联中的作用。现有的纵向数据来自121名确认有CSA病史的青少年，将用于完成这些目的。这些数据包括从案件记录中获得的虐待严重程度、在发现虐待后8周（T1）、一年（T2）和6年后（T3）评估的照顾者支持和适应问题，以及对虐待经历的口头叙述（T3）的转录。试验数据为我们的叙事编码系统的可靠性、有效性和实用性提供了强有力的证据。这是第一个在相对较大的csa特定叙事样本中系统评估意义形成过程的研究。了解个体如何理解其虐待行为的差异，以及这种差异与适应问题的关系，将有助于设计更具体的干预措施。

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.