Department of Clinical Psychology, University of Bergen, Christiesgate 12, 5015 Bergen, Norway; Visiting Scholar, UC Berkeley, Department of Psychology, 4123 Tolman Hall, Berkeley, CA 94720-1690, USA.
Department of Clinical Psychology, University of Bergen, Christiesgate 12, 5015 Bergen, Norway.
Child Abuse Negl. 2017 May;67:280-293. doi: 10.1016/j.chiabu.2017.03.002. Epub 2017 Mar 19.
In the present study, our aim was to examine longitudinal posttraumatic stress symptom (PTSS) trajectories in a Norwegian sample of adults who had experienced sexual abuse during childhood, and to identify predictors of PTSS-trajectory belongingness. The sample consisted of 138 adult survivors of childhood sexual abuse (96.4% women, mean age=42.9years, mean age at the first abuse=5.9 years), recruited from support centers for sexual abuse survivors. The majority (78.3%) reported penetrative abuse, and a large proportion of the sample reported that the perpetrator was a biological parent (38.4%) or someone they trusted (76.1%), reflecting a high severity level of the abusive experiences. Latent Profile Analyses revealed the best overall fit for a two PTSS-trajectories model; one trajectory characterized by sub-clinical and decreasing level of PTSS (54.9%), and the other by high and slightly decreasing level of PTSS (45.1%). Increased odds for belonging to the trajectory with clinical level symptoms was found among those who reported higher levels of exposure to other types of childhood maltreatment (OR=3.69, p=0.002), sexual abuse enforced by physical violence (OR=3.04, p=0.003) or threats (OR=2.56, p=0.014), very painful sexual abuse (OR=2.73, p=0.007), or who had experienced intense anxiety, helplessness or fear during the abuse (OR=2.97, p=0.044). Those in the trajectory with clinical level PTSS reported lower levels of perceived social support and more relational difficulties compared to those in the sub-clinical PTSS trajectory. In conclusion, different longitudinal PTSS trajectories can be found among adult survivors of childhood sexual abuse. Significant predictors of PTSS-trajectory belongingness are discussed alongside their potential implications for preventive efforts and clinical interventions.
在本研究中，我们的目的是检验挪威一组经历过儿童期性虐待的成年人的纵向创伤后应激症状（PTSS）轨迹，并确定 PTSS 轨迹归属的预测因素。该样本由 138 名儿童期性虐待幸存者（96.4%为女性，平均年龄为 42.9 岁，首次受虐待年龄为 5.9 岁）组成，他们均来自性虐待幸存者支持中心。大多数人（78.3%）报告存在实质性虐待行为，且样本中很大一部分人报告施虐者是亲生父母（38.4%）或他们信任的人（76.1%），这反映了受虐待经历的严重程度较高。潜在剖面分析显示，两个 PTSS 轨迹模型的整体拟合度最佳；一个轨迹的特征是亚临床和逐渐减少的 PTSS 水平（54.9%），另一个轨迹的特征是高且略有减少的 PTSS 水平（45.1%）。报告暴露于其他类型的儿童期虐待（OR=3.69，p=0.002）、性虐待伴有身体暴力（OR=3.04，p=0.003）或威胁（OR=2.56，p=0.014）、非常痛苦的性虐待（OR=2.73，p=0.007）或在受虐待期间经历强烈焦虑、无助或恐惧（OR=2.97，p=0.044）的个体，更有可能属于具有临床水平症状的轨迹。与具有亚临床 PTSS 轨迹的个体相比，处于具有临床水平 PTSS 轨迹的个体报告的感知社会支持水平较低，且人际关系困难更多。总之，儿童期性虐待幸存者中可以发现不同的纵向 PTSS 轨迹。讨论了 PTSS 轨迹归属的重要预测因素及其对预防工作和临床干预的潜在影响。
