Posttraumatic symptom profiles among adult survivors of childhood sexual abuse: A longitudinal study

Iris M Steine; Dagfinn Winje; Jens Christoffer Skogen; John H Krystal; Anne Marita Milde; Bjørn Bjorvatn; Inger Hilde Nordhus; Janne Grønli; Ståle Pallesen

doi:10.1016/j.chiabu.2017.03.002

Posttraumatic symptom profiles among adult survivors of childhood sexual abuse: A longitudinal study

Child Abuse Negl. 2017 May:67:280-293. doi: 10.1016/j.chiabu.2017.03.002. Epub 2017 Mar 19.

Authors

Iris M Steine¹, Dagfinn Winje², Jens Christoffer Skogen³, John H Krystal⁴, Anne Marita Milde⁵, Bjørn Bjorvatn⁶, Inger Hilde Nordhus⁷, Janne Grønli⁸, Ståle Pallesen⁹

Affiliations

¹ 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. Electronic address: iris.steine@uib.no.
² Department of Clinical Psychology, University of Bergen, Christiesgate 12, 5015 Bergen, Norway.
³ Department of Public Mental Health, Division of Mental Health, Norwegian Institute of Public Health, Christiesgate 13, 5020 Bergen, Norway.
⁴ Clinical Neuroscience Division, VA National Center for PTSD, 950 Campbell Avenue West Haven, CT 06516, USA; Department of Psychiatry, Yale University School of Medicine, 300 George Street, Suite 901, New Haven, CT 06511 USA.
⁵ Regional Centre for Child and Youth Mental Health and Child Welfare, Postbox 7810, 5020 Bergen, Norway; Department of Biological and Medical Psychology, University of Bergen, Jonas Lies vei 91, 5009 Bergen, Norway.
⁶ Department of Global Public Health and Primary Health Care, University of Bergen, Kalfarveien 31, 5018 Bergen, Norway; Norwegian Competence Center of Sleep Disorders, Haukeland University Hospital, PO Box 1400, 5021 Bergen, Norway.
⁷ Department of Clinical Psychology, University of Bergen, Christiesgate 12, 5015 Bergen, Norway; Institute of Basic Medical Sciences, University of Oslo, PO Box 1110 Blindern 0317 Oslo, Norway.
⁸ Department of Biological and Medical Psychology, University of Bergen, Jonas Lies vei 91, 5009 Bergen, Norway; Washington State University, PO BOX 1495 Spokane, WA 99210-1495, USA.
⁹ Norwegian Competence Center of Sleep Disorders, Haukeland University Hospital, PO Box 1400, 5021 Bergen, Norway; Department of Psychosocial Science, University of Bergen, Christiesgate 12, 5015 Bergen, Norway.

PMID: 28327414
DOI: 10.1016/j.chiabu.2017.03.002

Abstract

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.

Keywords: Adult survivors of childhood sexual abuse; Childhood sexual abuse; Longitudinal symptom outcomes; Posttraumatic stress symptom trajectories.

MeSH terms

Adolescent
Adult
Adult Survivors of Child Abuse / psychology*
Anxiety / etiology
Child
Child Abuse, Sexual / psychology*
Child, Preschool
Female
Humans
Longitudinal Studies
Male
Norway
Parents
Stress Disorders, Post-Traumatic / etiology*