title: Rape-related symptoms in adolescents: short- and long-term outcome after cognitive behavior group therapy.
abstract: BACKGROUND
  Efficacy studies on treatment in adolescent victims of single rape are lacking, even though sexual victimization is most likely to occur during adolescence and despite the fact that adolescents are at risk to develop subsequent posttraumatic stress disorder.
  
  
  OBJECTIVE
  The aim of this prospective observational study was to evaluate the short- and long-term outcomes of a nine-session cognitive behavior group therapy (STEPS), including a parallel six-session parents' group on rape-related symptomatology in female adolescents (13-18 years). STEPS includes psychoeducation, exposure in sensu as well as in vivo, cognitive restructuring, and relapse prevention.
  
  
  METHODS
  Fifty-five female adolescents with mental health problems due to single rape, but without prior sexual trauma, received STEPS while their parents participated in a support group. Subjects were assessed on posttraumatic stress (PTS) and comorbid symptoms using self-report questionnaires prior to and directly after treatment, and at 6 and 12 months follow-up.
  
  
  RESULTS
  Repeated measures analysis showed a significant and large decrease in symptoms of PTS, anxiety, depression, anger, dissociation, sexual concerns, and behavior problems directly after treatment, which maintained at 12 months follow-up. Time since trauma did not influence the results. Dropout during STEPS was 1.8%.
  
  
  CONCLUSIONS
  The results potentially suggest that the positive treatment outcomes at short- and long-term may be caused by STEPS. The encouraging findings need confirmation in future controlled studies on the effectiveness of STEPS because it may be possible that the treatment works especially well for more chronic symptoms, while the less chronic part of the sample showed considerable improvement on its own.
authors.affiliation: National Psychotrauma Center for Children and Youth, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Iva
authors.initials: I
authors.lastname: Bicanic
authors.affiliation: Psychotrauma Center for Children and Youth, GGZ Rivierduinen Leiden, Leiden, The Netherlands.
authors.forename: Carlijn
authors.initials: C
authors.lastname: de Roos
authors.affiliation: Department of Methodology and Statistics, University of Utrecht, Utrecht, The Netherlands.
authors.forename: Floryt
authors.initials: F
authors.lastname: van Wesel
authors.affiliation: National Psychotrauma Center for Children and Youth, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Gerben
authors.initials: G
authors.lastname: Sinnema
authors.affiliation: Department of Pediatrics, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Elise
authors.initials: E
authors.lastname: van de Putte
keywords: Adolescents; PTS symptoms; cognitive behavior therapy; group therapy; rape; sexual assault