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PTSD And CSA Therapies And Future Research Annotated Bibliography

Child Abuse Brown, J., Cohen, P. Johnson, J.G. (1999, December). Childhood abuse and neglect: specificity of effects on adolescent and young adult depression and suicidality. Journal of the American Academy of Child and Adolescent Psychiatry, 38(12), 1490-1496.

The authors conducted this study in order to investigate the magnitude and independence of the effects of childhood neglect, physical abuse, and sexual abuse on depression and suicidal behavior in adolescents and adults. Over a 17-year period, a cohort of randomly selected children was assessed for a range of environmental, familial, and childhood risks and psychiatric orders. The history of abuse was verified through official records of abuse and by the retrospective self-report of the 639 youths in the study. The subjects were between the ages of one year and 10 years at the beginning of the study, with a median age of five years.

The results of the study showed that adolescents and young adults that had been neglected, physically abused, and/or sexually abused were three times more likely (significant at p > .01) to become suicidal or depressed when compared with their same age peers who did not have a history of maltreatment such as child neglect, physical abuse, or sexual abuse. The statistical measures used showed that certain adverse contextual factors, such as the characteristics of the parents, of the children, and other aspects of the family environment -- accounted for a substantial amount of the increased risk for suicide attempts and the occurrence of depression in adolescence (significant...

Moreover, the researchers found that the effects of childhood sexual abuse were the most independent of associated factors, and the effects of childhood sexual abuse were the largest factors. Those youths who had a history of sexual abuse were eight times more likely to exhibit the risk of repeated suicide attempts (the odds ratio was = 8.40 and the significance level was p < .01). The researchers concluded that individuals with a history of sexual abuse were at greater risk of becoming suicidal or depressed as adolescents and as young adults. Indeed, adolescence appeared to be a time when young people were the most vulnerable for repeated attempts at suicide. The effects of neglect, however, were found to be more diffuse, and could be attributed to a wide range of contextual factors. The researchers concluded that a broader research scope would be appropriate for investigating intervention in the cases that involved neglect and maltreatment.
The data analysis relied primarily on bivariate associations between the risk for depressive disorders and suicidal behavior in adolescence and young adulthood with childhood maltreatment that included all three types: neglect, physical abuse, and sexual abuse. Statistical control was maintained for gender and age. The logistic regression analysis used determined when these associations could possibly be accounted for by the effects of the contextual risk factors for maltreatment, which had been previously identified. The analyses were repeated, in this manner, for…

Sources used in this document:
Dehlinger, E., Steer, R.A., and Lippmann, J., (1999). Two-year follow-up study of cognitive behavioral therapy for sexually abused children suffering post-traumatic stress symptoms. Child Abuse & Neglect, 23(12), 1371-1378.

The researchers were interested in learning if 2-year gains found in the earlier research by Dehlinger, et al. (1996) would also be shown in this research with 100 children who had been diagnosed with posttraumatic stress disorder as a result of being abused as children. The research by Dehlinger, et al. (1996) involved 12-session pre-test and post-test randomly assigned therapeutic treatments with sexually abused children and their non-offending mothers. The random group assignments were cognitive-behavioral treatments for the child only, for the mother only, for the mother and the child, or for a community comparison condition. The study participants were followed and assessed at 3-months, 6-months, one year, and two years after treatment.

The data was analyzed through the use of a repeated MANCOVA, while controlling for the pre-test scores. Three measures of psychopathology were taken at the assessment intervals, examining specifically for the following: depression, externalizing behavior problems, and PTSD symptoms. The researchers found that the Dehlinger, et al. (1996) study was basically replicable, with the pre-treatment and post-treatment improvements shown and maintained during the 2-year period.
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