Behavior problems in sexually abused preschoolers over a 1-year period: The mediating role of attachment representations

Abstract

According to the developmental psychopathology framework, adverse childhood experiences, including child sexual abuse (CSA), may alter the course of normal development in children. Attachment security has been identified as a protective factor against psychopathology and may thus play a critical role in predicting victims' adaptation. The main objective of the present study was to investigate the mediating effect of attachment representations in the relation between CSA and behavior problems over a 1-year period. The sample consisted of 391 children (251 sexually abused) aged 3.5 to 6 years. The Attachment Story Completion Task and the Child Behavior Checklist were used. Disorganized attachment partially mediated the relation between CSA and children's internalizing and externalizing behavior problems 1 year following the initial assessment. This mediation effect was not found for ambivalent nor secure attachment dimensions. Child gender was found to moderate the association between CSA and disorganization, with larger effects of CSA among boys. These findings underscore the importance of considering attachment representations in treatment programs for preschool victims. Evidence-based practice focusing on trauma could be combined with an attachment-based intervention targeting the parent-child relationship. Moreover, interventions should be gender sensitive, as CSA appears to affect boys and girls differently.

The attachment video-feedback intervention (AVI) combined to the trauma-focused cognitive behavioral therapy (TF-CBT) for sexually abused preschoolers and their parents: A pilot study examining pre- to post-test changes

“…This pilot study could then be seen as a first step in the evaluation of an innovative combined protocol for the recovery of SA preschool children. Given that SA children are also likely to show insecure and disorganized attachments (Charest et al, 2019; Ensink et al, 2020), this approach is promising to foster positive adaptation despite severe adverse experiences at an early age.…”

“…Charest et al (2019) also found higher scores of attachment disorganization to mediate the relation between SA and internalizing or externalizing problems in preschool-aged victims of SA (Charest et al, 2019). Furthermore, SA children with disorganized attachment were 6 times more likely to show behavior problems reaching clinical levels than victims of SA with a secure attachment (Beaudoin et al, 2013).…”

Maternal History of Child Sexual Abuse and Maladaptive Outcomes in Sexually Abused Children: The Role of Maternal Mental Health

“…Dissociation was defined by Spiegel and Cardena (1991) as "a structured compartmentalization of mental processes (e.g., thoughts, emotions, conation, memory, and identity) that are typically integrated" and is known to have long lasting deleterious consequences on multiple domains of children 's functioning (e.g., school, interpersonal;Silberg, 2014). Consistent with the CPTSD model, other consequences have been documented in sexually abused children (e.g., emotional dysregulation, sleep problems, insecure attachment patterns, somatic complaints; e.g., Charest et al, 2019;Langevin et al, 2019) but given the centrality of behavior problems and dissociation and their deleterious impacts on developmental trajectories (e.g., Colman et al, 2007;Reef et al, 2010), these will be the focus of the current investigation. Notably, a literature review concluded that 10%-53% of sexually abused children do not present difficulties following the abuse (Domhardt et al, 2015).…”

“…One of the most documented short-term outcomes of CSA is behavior problems. Congruent evidence suggests that child victims of sexual abuse have significantly greater externalizing (i.e., delinquent and aggressive behavior) and internalizing symptoms (i.e., withdrawal, somatic complaints, and anxiety/depression) compared to nonabused children (e.g., Charest et al, 2019 ; Langevin et al, 2015 ; Maniglio, 2015 ). A recent study compared behavior problems in sexually abused youth and maltreated (physical and emotional abuse, and neglect) but nonsexually abused youth and results showed the increased vulnerability of sexually abused children to these difficulties ( Lewis et al, 2016 ).…”

Deconstructing Mainstream Discourses of Child and Youth Development as It Connects to Sexualized Violence Against Children

“…However, Tejada and Linder (2018) argued that this age group should not be dismissed from the research; they estimated that approximately 35% of CSA victims in the United States are less than 7 years old. Despite the large number of survivors in this age group, very few studies have examined it specifically (Charest et al, 2018a(Charest et al, , 2018bCollin-Vézina et al, 2013;Hébert et al, 2013). Rather, research examining adults has been widely covered in sexual abuse research (Hébert et al, 2013).…”