title: Behavioural psychopathology of child sexual abuse in schoolgirls referred to a tertiary centre: a North London study.
abstract: The sexually abused girls in this study were a sub-sample of a group of girls referred to a Regional Centre for Psychotherapy for the whole of London, North Thames. An inclusion criterion was that they were psychologically symptomatic and so it is likely that they were more problematic cases causing concern in their locality. The control clinical group consisted of referrals to local Child and Family consultation services, were an opt-in matched sample and not a total clinic referral sample. In addition, the reasons for referral covered both child disorder and family problems. It is, therefore, important to bear in mind the differences between these two groups. Certain clear cut findings have emerged from this study. No disorders specific to child sexual abuse in girls were identified but the extent and severity of the disturbance in the sexually abused sample was most striking. In these girls an event (CSA), together with referral because of emotional symptoms, was associated with enhanced severity of disorder and comorbidity particularly with reference to a cluster of disorders comprising post-traumatic stress disorder, depressive disorder, anxiety disorders (general and separation), social phobias and reactive attachment disorder. In the community clinic sample the identified disorders were mainly those of separation anxiety disorders and adjustment. Wide comorbidity was common in the sexual abuse sample and also severity of impairment was notable when compared to the clinic sample. However, because of the selected nature of the abuse group the findings are not generalisable beyond the population from which they emerged. The view is advanced that there are strong grounds for exploring the utility of psychodynamic psychotherapy in similar samples of sexually abused girls. These findings are discussed in the light of the current literature.
authors.affiliation: Tavistock Centre, London, United Kingdom.
authors.forename: J
authors.initials: J
authors.lastname: Trowell
authors.forename: B
authors.initials: B
authors.lastname: Ugarte
authors.forename: I
authors.initials: I
authors.lastname: Kolvin
authors.forename: M
authors.initials: M
authors.lastname: Berelowitz
authors.forename: H
authors.initials: H
authors.lastname: Sadowski
authors.forename: A
authors.initials: A
authors.lastname: Le Couteur
mesh_terms: D000293:Adolescent; D002391:Catchment Area, Health; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology*; D002653:Child Behavior Disorders / Q000175:diagnosis* / Q000523:psychology*; D005260:Female; D006801:Humans; D008131:London; D008605:Mental Health Services / Q000600:supply & distribution; D011569:Psychiatric Status Rating Scales; D012017:Referral and Consultation; D012720:Severity of Illness Index