Psychological Distress and Revictimization Risk in Youth Victims of Sexual Abuse

Abstract

Psychological distress, including depression and anxiety, has been associated with increased risk for sexual revictimization in youth who have experienced child sexual abuse. The present study utilized assessment information from treatment seeking youth with histories of sexual abuse to explore specific risk indicators for revictimization—risk taking, social problems, maladaptive cognitions, and posttraumatic stress—that may be indicated by self-reported distress. The relationship between initial levels of distress and change in symptoms over a 12-week course of treatment was also explored. Participants were 101 youth referred to a child-focused therapeutic group for victims of sexual abuse, 65 youth referred to an adolescent-focused group, and their non-offending caregivers. Results revealed that when combined into a distress score, depression and anxiety were associated with delinquent behaviors, interpersonal difficulties, maladaptive cognitions, and posttraumatic stress symptoms for child and adolescent group participants at presentation to treatment. Children exhibited improvement on measures of interpersonal difficulties, maladaptive cognitions, and self-reported posttraumatic stress disorder (PTSD) symptoms. Adolescents exhibited less change over time, with significant improvement on self-reported social problems and PTSD only. Higher psychological distress was associated with less improvement in regard to negative expectations of abuse impact for child group participants. The findings suggest that distress indicates the presence of specific revictimization risk indicators, helping to identify targetable symptoms for intervention. Therefore, screening for psychological distress after discovery of sexual abuse may help detect youth at higher risk for revictimization and guide treatment.

The Relevance of Cognitive Behavioral Models of Post-Traumatic Stress Following Child Maltreatment: A Systematic Review

“…Two studies explored appraisals of the impact of the abuse (Kolko et al, 2002, QA = 61%; Pittenger et al, 2016, QA = 40%). Both studies found that individuals who believed the abuse would impact their resources, relationships, emotional adjustment, and need for help had significantly greater PTSS.…”

“…Five studies found a significant association, five did not, and one (longitudinal) study had mixed findings at different time points. Specifically, five studies identified a significant association with small to medium effect sizes (Alix, Cossette, Hébert, Cyr, & Frappier, 2017; Crouch, Smith, Ezzell, & Saunders, 1999; Kletter, Weems, & Carrion, 2009; Pittenger et al, 2016; V. Wolfe et al, 1991).…”

Reconsidering Reconciliation Within Families of Youth Who Sexually Offend

“…Moreover, since a great deal of the literature on youth sexual offending focuses on the violence itself, recidivism rates, risk factors, victim distress and consequences, or treatment interventions (Latzman et al, 2011; Lim et al, 2012; Pittenger et al, 2019; Reitzel & Carbonell, 2006; Tidefors et al, 2010; Wright et al, 2019; Yoder et al, 2018), there is a need to build better understandings of the complex ways in which reparation and reconciliation do or do not unfold following the offending behavior. It is often the case that many parents of children who have sexually offended will be apologetic and try to make amends for their child’s offense (Jones, 2015; Pierce, 2011), but there is a dearth in the literature thoroughly exploring how those familial and community relations become transformed, entangled, or repaired after the harm has occurred.…”

Five year cost savings of a multimodal treatment program for child sexual abuse (CSA): a social return on investment study

“…Costs associated with even one such event are substantial; jury awards for pain and suffering associated with sexual assault exceed $100,000 in today’s dollars [ 34 ]. That therapy is likely to reduce this probability is supported by research suggesting that PTSD symptomatology per se appears to increase one’s risk of a subsequent attack [ 35 , 36 ].…”