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危险因素，如抑郁症、创伤后应激障碍、外在问题、药物使用和危险的性行为。然而，对于有CSA病史的青少年来说，结果明显不同，迫切需要帮助识别将青少年置于风险中的过程或帮助恢复的方法。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行为的个体差异，这一过程被认为是后CSA适应的核心。成功的意义构建需要积极地处理与虐待相关的情感和认知，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念系统中。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之后可能出现适应问题的理解。然而，对于CSA受害者的意义形成过程的评估，或者这种过程如何随着时间的推移与调整有关，人们知之甚少。这项拟议的研究旨在开发一种编码系统，用于评估确诊为CSA病例的青少年如何利用他们的虐待经历。编码系统侧重于针对虐待的叙述的结构要素，包括连贯、组织和解决策略(CORS)。有三个具体目标：(1)建立编码系统的可靠性；(2)建立编码系统的有效性；(3)考察意义形成在虐待相关条件(如虐待严重程度、照顾者支持)与随后的心理调整之间的纵向联系中的作用。现有的纵向数据来自121名有CSA病史的青少年，将被用来实现这些目标。这些数据包括从案例记录、照顾者支持和在发现虐待后8周内评估的适应问题(T1)、一年(T2)和6年后(T3)获得的虐待严重程度的衡量标准，以及转录的虐待经历口头叙述(T3)。飞行员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。这是第一次在相对较大的CSA特定叙事样本中系统地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，以及这种差异如何与适应问题相关联，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.