HOLLYWOOD, CALIF. – The more complex a child's victimization history, the more likely he or she is to experience multiple negative outcomes, including posttraumatic stress disorder, depression, and substance use, Benjamin E. Saunders, Ph.D., reported at the annual meeting of the International Society for Traumatic Stress Studies.
In a longitudinal study of 530 families reported to the U.S. Navy's Family Advocacy Program for child sexual abuse, child physical abuse, or partner violence, more than two-thirds of the children interviewed reported experiencing several different types of trauma. The average child experienced 2.26 different types of trauma, and 18% of the children experienced four or five different types, said Dr. Saunders of the Medical University of South Carolina, Charleston.
He emphasized that, for the purposes of the study, a child who experienced many instances of physical abuse but no other forms of victimization would be classified as having experienced only a single type of trauma. Data were collected from 12 major naval installations.
Of the 195 children between the ages of 7 and 18 years (mean age, 12.2), 67% were victims of personal assault, including 29% who were victims of sexual assault, 34% who were victims of physical assault, and 48% who were victims of physical abuse. In addition, 80% of the children had witnessed violence, including 70% who had witnessed community violence and 44% who had witnessed domestic violence.
Girls were significantly more likely than boys were to be victims of sexual assault (46% vs. 1%) and to witness domestic violence (49% vs. 34%), but otherwise there were no significant gender differences in the subcategories of violent exposure, Dr. Saunders reported at the meeting, which was also sponsored by Boston University.
The children were assessed at four time points–the first at 2–6 weeks after the initial report and the fourth, 36–40 months after the report. At the first time point, and after researchers controlled for gender and age, the number of victimization types significantly predicted all five measured outcomes–diagnosis of posttraumatic stress disorder, diagnosis of depression, problems with alcohol, problems with other drugs, and participation in a delinquent act, he said.
After 3 years, significant associations were found between the number of victimization types and all but one of those outcomes. Only problems with alcohol failed to show a significant relationship with the number of victimization types, after controlling for gender and age.
In view of the high prevalence of multiple victimizations, one message is that therapists would be wrong to focus on only a single type of victimization in a child, Dr. Saunders said.