Dissociation as a Mediator of Psychopathology Among Sexually Abused Children and Adolescents

Cassandra Kisiel · John S. Lyons

247 citations0/0 files storedAmerican Journal of Psychiatry

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Child Abuse and Trauma Psychoanalysis and Psychopathology Research Psychosomatic Disorders and Their Treatments

Abstract

OBJECTIVE: This study investigated the role of dissociation as a mediator of mental health outcomes in children with a history of sexual abuse. METHOD: The study group consisted of 114 children and adolescents (ages 10-18 years) who were wards of the Illinois Department of Children and Family Services and were living in residential treatment centers. Interviews, provider ratings, and chart reviews were used to assess the relationship of childhood abuse history, dissociative responses, and psychopathology. RESULTS: Sexual abuse history was significantly associated with dissociation, whereas a history of physical abuse was not. Both sexual abuse and dissociation were independently associated with several indicators of mental health disturbance, including risk-taking behavior (suicidality, self-mutilation, and sexual aggression). Severity of sexual abuse was not associated with dissociation or psychopathology. Analysis of covariance indicated that dissociation had an important mediating role between sexual abuse and psychiatric disturbance. These results were replicated across several assessment sources and varied perspectives. CONCLUSIONS: The findings suggest a unique relationship between sexual abuse and dissociation. Dissociation may be a critical mediator of psychiatric symptoms and risk-taking behavior among sexually abused children. The assessment of dissociation among children may be an important aspect of treatment.

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References

1983Manual for the Child: Behavior Checklist and Revised Child Behavior Profile 1991Manual for the Youth Self-Report and 1991 profile 1993Impact of sexual abuse on children: A review and synthesis of recent empirical studies.1985The traumatic impact of child sexual abuse: A conceptualization.1991A review of the short-term effects of child sexual abuse

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