1 University of Nebraska-Lincoln, USA.
J Interpers Violence. 2019 May;34(9):1930-1960. doi: 10.1177/0886260516658755. Epub 2016 Jul 7.
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.
心理困扰，包括抑郁和焦虑，与经历过儿童性虐待的青年再次遭受性侵害的风险增加有关。本研究利用有性虐待史的寻求治疗的青年的评估信息，探讨了自我报告的困扰可能表明的特定再受害风险指标，包括冒险行为、社会问题、适应不良认知和创伤后应激。还探讨了治疗开始时的初始困扰水平与 12 周治疗过程中症状变化之间的关系。参与者为 101 名被转介到儿童性虐待受害者治疗小组的青少年和他们的非侵害性照顾者，65 名被转介到青少年小组的青少年。结果表明，当抑郁和焦虑合并为一个困扰评分时，与儿童和青少年组参与者在治疗开始时的犯罪行为、人际关系困难、适应不良认知和创伤后应激症状相关。儿童在人际关系困难、适应不良认知和自我报告的创伤后应激障碍（PTSD）症状方面表现出改善。青少年随着时间的推移变化不大，仅在自我报告的社会问题和 PTSD 方面有显著改善。较高的心理困扰与儿童组参与者对虐待影响的负面预期的改善程度较低有关。研究结果表明，困扰表明存在特定的再受害风险指标，有助于确定干预的目标症状。因此，在发现性虐待后对心理困扰进行筛查可能有助于发现再受害风险较高的青年，并指导治疗。
