Pathways to PTSD, part II: Sexually abused children.
OBJECTIVE
The goal of this research was to develop and test a prospective model of posttraumatic stress symptoms in sexually abused children that includes pretrauma, trauma, and disclosure-related pathways.


METHODS
At time 1, several measures were used to assess pretrauma variables, trauma variables, and stress reactions upon disclosure for 156 sexually abused children ages 8 to 13 years. At the time 2 follow-up (7 to 36 months following the initial interview), the children were assessed for posttraumatic stress disorder (PTSD) symptoms.


RESULTS
A path analysis involving a series of hierarchically nested ordinary least squares multiple regression analyses indicated three direct paths to PTSD symptoms: avoidant coping, anxiety/arousal, and dissociation, all measured during or immediately after disclosure of sexual abuse. Additionally, age and gender predicted avoidant coping, while life stress and age at abuse onset predicted symptoms of anxiety/arousal. Taken together, these pathways accounted for approximately 57% of the variance in PTSD symptoms.


CONCLUSIONS
Symptoms measured at the time of disclosure constitute direct, independent pathways by which sexually abused children are likely to develop later PTSD symptoms. These findings speak to the importance of assessing children during the disclosure of abuse in order to identify those at greatest risk for later PTSD symptoms.
Department of Psychiatry, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, P.O. Box 1709, Newark, NJ 07101-1709, USA. kaplowjb@umdnj.edu
Julie B
JB
Kaplow
Kenneth A
KA
Dodge
Lisa
L
Amaya-Jackson
Glenn N
GN
Saxe
D000223:Adaptation, Psychological; D000367:Age Factors; D017668:Age of Onset; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology; D002648:Child; D002650:Child Abuse, Sexual / Q000175:diagnosis / Q000523:psychology* / Q000706:statistics & numerical data; D004213:Dissociative Disorders / Q000175:diagnosis / Q000523:psychology; D005260:Female; D005555:Forensic Psychiatry; D006801:Humans; D008016:Life Change Events; D008297:Male; D015233:Models, Statistical; D010555:Personality Inventory; D010641:Phenotype; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology