HISTORY OF CHILD SEXUAL ABUSE AND ACTING OUT AMONG ADOLESCENTS IN ...

119 Pages·2007·0.88 MB·English

HISTORY OFCHILD SEXUALABUSEAND ACTINGOUT AMONG
ADOLESCENTS INRESIDENTIALTREATMENT
KristinWolffGatoux
Adissertationsubmitted tothefacultyoftheUniversityof NorthCarolina at Chapel
Hill inpartial fulfillment oftherequirements forthedegreeofDoctorofPhilosophyinthe
Department ofSchool Psychology.
Chapel Hill
2007
Approvedby
Advisor: RuneJ.Simeonsson
Reader: RayNewnam
Reader: Natasha Bowen
Reader: Sam Song
Reader: PatrickAkos
2007
©
KristinWolffGatoux
ALLRIGHTS RESERVED
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ABSTRACT
KRISTINWOLFF GATOUX: HistoryofChildSexual AbuseandActingOut
AmongAdolescents inResidential Treatment
(UnderthedirectionofRuneJ.Simeonsson)
Adolescents inresidential treatment withreported histories ofCSAanddiagnoses of
PTSDexhibit significant actingout behaviors,especiallyduringtheevening.This study
sought toevaluatewhetherchildsexuallyabused(CSA)adolescents exhibitingsignificant
psychopathologyinresidential treatment differed from non-abusedpeers interms offrequency
andtimeofactingout,numberoftotal diagnoses, rates ofPTSDdiagnoses,andgender
differences inbehavior. Thetimeofactingout incidents among78 adolescents withreports of
childsexual abuse(CSA)was comparedtothetimingofincidents amongadolescents not
reportedtohavebeenabused. Informationwas obtainedfrom previouslycollected
retrospectiveobservations.Reliabilityofinformationcollectedwas assessedbyconductinga
reliabilitystudyandreviewingaselect numberof records ofsubjects. An Independent
Samples t-test analysis was performedtotest thehypothesis that adolescents withreports of
CSAexperiencemoreincidents duringtheeveningthan theirnon-CSAcounterparts.
Significant findings revealedhighertotal co-morbiddiagnoses,higherdiagnoses ofPTSD,and
genderdifferences inbehaviorshown. However, nosignificant groupdifferences infrequency
ortimeofactingout werefound.Thefindings contributetoabetterunderstandingofthe
functionofactingout,as well as tocreatingappropriatepreventionandtreatment strategies to
helpreduceincidents and improveadolescent well-being.
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DEDICATION
ToAnneJanet CullenCirillo,whoseconsistent love,support andrecognitionofthosein
needinspiredmetoseek understandingandacknowledgetheirstrengths.
iv
ACKNOWLEDGEMENTS
ToRuneSimeonsson,whoseconsistent support throughout this process allowedmeto
developintoabetter researcher. Thank you forremainingsteadfast in your abilityto
provideconstructive criticism,advise,encourage andurgeme alongthroughout these years.
Yourabilitytobe asupportivemalerolemodel will not beforgotten.
ToNatasha Bowen,whosesupportiveand nurturingspirit allowedmetopersevereoverthe
years. Thank youforinstructingmesowell ineveryareainwhich Isought assistance.
Youare a giftedresearcherandteacher. Iwill neverforget thetime youhavedevotedto
instructingmealongthe way.
ToRayNewnam,whose abilitytorecognizeindividual needs andprovide nurturing
support overthe years duringmyinternshipand dissertation years will always be
remembered. It is youwhoinspiredmeconduct this study. Thank youfor theclinical and
research base youhaveprovided. Becauseof you, Iwill beabetter clinician.
ToSam SongandPatrick Akos,whosekeenobservations providedmewithgreat insights
andquestions toquerythroughout mydissertation. Iam veryappreciative ofthetime you
havetakento assist meinbringingthis dissertationtocompletion.
v
ToEdwardandSusanWolff,myparents,whohaveinspiredmetopursue mydreams.
Dad,thank youforprovidingmewithaninnateclinical senseabout people andteachingme
howtoassist thoseinneed. Mom,thank youforshowingmethat I“could doanythingthat
Iput mymindto.” You bothhavepushedmeto growandalways domybest. Bothof you
havetaught mehowtobehonest,open,caring,andsupportivetothoseinneed. Icannot
thank you enoughfor everything youhavedoneforme. Youbotharemybest supporters.
ToDavid,myhusband, whosesilent andreliable support forpursuingmydreams has not
goneunnoticed. Yourpatienceinmycareerpursuit is trulyamazing. You havehelpedme
ineverywayimagined. Thank youforbelievinginmyabilities and givingmethestrength
when Iwas tired. Youhavebeenawonderful rolemodel forhowtomanage ateam and
staytrueto yourbeliefs andphilosophies. Ihavealways respected your abilitytowork
withsomanydifferent personalities andeffectivelyleadthem tovictory. Youare a gifted
leaderwho will continuetoleaveamarkoneveryone youmeet. Thank you.
Toall ofmyfriends and familymembers, whosestablesupport will remain truetomy
heart. Thank you.
ToM andB,whoseconstant unconditional loveandsupport haveprovided mewith
laughteranda warm heart. Thank you.
Finally,thank youtoall ofthewonderful children andadolescents Ihave workedwith,as
well as thoseinneedwhom Ihavenot met. You haveall taught meabout unconditional
love,beauty,andunrelentinglove. Youarethetrueheroes ofthis world. Staystrongto
yourbeliefs and, remain trueto yourvalues.
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TABLEOFCONTENTS
Page
LISTOFTABLES........................................................................................................xi
LISTOF FIGURES.....................................................................................................xii
Chapter
I INTRODUCTION.................................................................................1
II REVIEW OFTHE LITERATURE.......................................................4
Definitions andMethodological Problems................................4
Gender Differences inthePrevalenceofCSA………………..5
ChildSexual AbuseSequelae……………………………........7
PTSDas aSequelaeofCSA…………………………………..9
NeuroendocrineVulnerabiltity………………………………10
SleepDisturbance and CSA………………………………….12
RegulationofAffect inCSAChildrenandAdolescents….....18
Reexperiencing,Dissociation,and ActingOut………………21
DissociativeBehavioral Responses………………………….22
ReexperiencingandActingOut inResidential Treatment…..24
Gender Differences inActingOut Behavior………………...28
SleepandActingOut………………………………………...31
Rationale/Purpose/Hypotheses………………………………32
III METHODOLOGY………………………………………………......37
Participants..............................................................................37
DiagnosticProfileofParticipants............................................39
Procedures................................................................................40
Variables..................................................................................41
DataAnalysis...........................................................................42
IV RESULTS……………………………………………………………44
Total Diagnostic Differences BetweenCSAand N-CSAGroups.......44
Diagnostic Differences BetweenCSA/N-CSAand
PSTD/N-PTSDGroups........................................................................45
Differences BetweenCSAandN-CSAGroups In
TimeofActingOut..............................................................................46
Impact ofCSAonType ofBehaviorforAdolescent
Males andFemales...............................................................................47
V DISCUSSION……………………………………………………......48
Hypothesis 1.........................................................................................48
Hypothesis 2.........................................................................................51
Hypothesis 3.........................................................................................55
Hypothesis 4.........................................................................................63
Implications forResearchand Practice................................................66
Limitations...........................................................................................75
Conclusion...........................................................................................77
APPENDICES.............................................................................................................80
Appendix A: Representative Instruments toAssess ChildSexual
Abuse………………………………………………………………..80
Appendix B: Trauma-focusedCognitive-behavioral Therapy……..81
REFERENCES...........................................................................................................83
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