This is a continuation of grant R01 MH49885, """"""""Adaption to sexual abuse in childhood and adolescence."""""""" Although sexually abused children vary widely in their adjustment, limited work is available on processes that can help explain individual differences in symptomatology. Our research examines variations in children's adjustment to the trauma of sexual abuse as a function of shame and attribution style measured at the time of discovery and as they develop through adolescence and into adulthood. Greater shame for the abuse and self-blaming attribution style should be related to more psychological distress including more symptoms of depression. Post-Traumatic Stress Disorder (PTSD), problems with sexuality and substance abuse, and dissociation. Although at the time of abuse discovery, shame and self-blame vary as a function of abuse severity, over time these process variables are more likely to become related to risk (e.g, stress events) and protective (e.g., support) factors than to the abuse. We propose to examine the extent to which risk and protective factors are related to shame and self-blame which in turn are hypothesized to be related to symptomatology. The currently funded study (spanning childhood to middle adolescence) has maintained a sample of 160 participants. We propose to follow the current sample of children and adolescents. Studies of children, with few exceptions, have looked at immediate impact or followed abuse victims for a year or less. Following this sample from adolescence into adulthood will allow us to examine the extent to which initial and subsequent patterns of shame and a self-blaming attribution style explain variations in later problems. This study has important implications for the development of theory and research based treatment strategies. The greatest potential for designing effective interventions is to study the mechanisms that explain how children and adolescents become symptomatic and the developmental nature and course of such symptoms, as well as differences in how individuals process their sexual abuse.
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