Two hundred and eighty-four adults from the metropolitan New York area reported on their history of childhood sexual abuse (CSA), childhood physical abuse (CPA), and on the nature of their exposure to the terrorist attack on the World Trade Center. The respondents also completed the Impact of Events Scale-Revised (IES-R), the Attachment Style Questionnaire (ASQ) and the Dissociative Experiences Scale (DES). Those reporting histories of CSA and/or CPA were found to endorse more serious symptoms of PTSD, as did those who witnessed the terrorist attack live. The presence of secure attachments and dissociative symptoms were related significantly to both CSA and CPA, and to scores on the IES-R. Adult attachment and dissociation were found to mediate the relationship between childhood abuse and severity of PTSD.
Emotional abuse and secondary abuse of children are increasingly recognized within the mental health and legal professions as at least as damaging to adjustment as physical abuse, sexual abuse, and neglect. However, emotional and secondary abuse are relatively more difficult for mandated reporters to recognize and document, and reporting laws are problematic. This review article was written to acquaint professionals with the seriousness and prevalence of emotional and secondary child abuse and with the issues surrounding the reporting of such abuse.
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