Symptomatology in adolescents following initial disclosure of sexual abuse: the roles of crisis support, appraisals and coping.
OBJECTIVE
The present study examined possible explanations for symptom development and variability in sexually abused adolescents. A theoretical model of sexual abuse, in which appraisal, coping and crisis support play prominent roles, was tested in a clinical group of 100 sexually abused adolescents.


METHODS
Participants, aged 12-18 years, completed questionnaires regarding severity of abuse, negative appraisals, crisis support, coping strategies, and trauma-related stress symptoms.


RESULTS
Since severity of abuse had no influence on the association between appraisals and symptoms it was eliminated from our model. Structural equation modeling analyses showed a significant interrelationship between the examined concepts. Adolescents who appraised the abuse as more threatening showed more internalizing and externalizing trauma symptoms. Moreover, more negative appraisals were associated with more avoidance as well as with more active coping strategies. Direct crisis support was associated with less negative appraisals and with the use of more active coping strategies.


CONCLUSIONS
The study showed that especially the buffering role of crisis support and the role of negative appraisals explained symptom development and variety in sexually abused adolescents.


CONCLUSIONS
Adaptation to sexual abuse includes the ways in which adolescents perceive the event as threatening and harmful, how they cope with the abusive experience, and how they receive direct support from their family. Clinicians, therefore, need to expand the focus of their assessments beyond age- and trauma-specific symptoms, to age- and trauma-specific appraisals, coping, and social support. The assessment of these factors should take place as soon as possible after the disclosure of the abuse. Individualized treatment plans and clinical interventions need to be based on these personal and environmental variables, rather than reliance on the influence of abuse-related characteristics, such as the severity or type of abuse.
Bal
Sarah
S
Department of Experimental Clinical and Health Psychology, Ghent University, Belgium.
Crombez
Geert
G
De Bourdeaudhuij
Ilse
I
Van Oost
Paulette
P
D000223:Adaptation, Psychological; D000293:Adolescent; D001530:Belgium; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D012742:Sex Offenses / Q000523:psychology*; D012944:Social Support; D011795:Surveys and Questionnaires; D015599:Trauma Severity Indices; D014342:Truth Disclosure