Childhood sexual abuse characteristics, abuse stress, and PTSS: Ties to sexual behavior problems

Sexual Behavior Problems Among Sexually Abused Children: Associations With Co-Occurring Symptoms

“…Much of the research to date has focused on a broader definition of SBPs, including those that are both self-and other-directed. Yet, prior research examining SBPs has provided evidence that ISBPs, or SBPs that are directed towards other children or adults and may include force or coercion, may be a subtype of SBPs (Allen, 2017;Pithers et al, 1998;Silovsky & Niec, 2002;Wamser-Nanney & Campbell, 2020a). Although much of the SBP literature does not differentiate between SBPs and ISBPs, ISBPs may develop under a different framework than non-interpersonal SBPs.…”

“…Collectively, this small literature has indicated that comorbid behavioral problems are typical, or even to be expected, in the context of SBPs (Elkovitch et al, 2009). Among sexually abused children, higher levels of emotional and behavioral concerns have been observed among children who exhibit SBPs, including attention difficulties, aggression and other externalizing behaviors, anger, social concerns, and PTSS (Allen et al, 2015;Allen, 2017;Baker et al, 2008;Silovsky & Niec, 2002;Smith et al, 2019;Szanto et al, 2012;Tarren-Sweeney, 2008;Wamser-Naney & Campbell, 2019, 2020a. In one sample of children with SBPs, 93% met criteria for at least one additional diagnosis; conduct disorder was most common, followed by attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and posttraumatic stress disorder (PTSD) (Gray et al, 1997).…”

“…Nonetheless, given the challenges of diagnosing PTSD in children (Scheeringa, 2011), many of these children may suffer from significant PTSS. Several studies have observed a link between PTSS and SBPs (Allen et al, 2015;Smith et al, 2019;Szanto et al, 2012;Wamser-Nanney & Campbell, 2019, 2020a, but not consistently (Allen, 2017). Given the sparse number of studies in this area, additional work examining levels of PTSS among children with SBPs and ISBPs is needed, particularly while controlling for other symptoms that may be present.…”

“…In light of discrepancies between caregiver's and children's symptom reports (Humphreys et al, 2017;Oransky et al, 2013;Scheeringa et al, 2006), we examined both caregiver and child-reported symptoms in relation to SBPs and ISPBs. Due to important differences in types of sexual behaviors, we also examined both general SBPs and ISBPs (Allen, 2017;Wamser-Nanney & Campbell, 2020a). There may be differences in the associations between more general types of SBPs compared to more intrusive interpersonal sexual behaviors.…”

“…There is also important heterogeneity in SBPs, thus, we examined both the CSBI total scale and created a score to assess ISBPs as the CSBI does not yield a subscale specific to these types of behaviors. The ISBP score was created by summing the 11 interpersonally based items from the CSBI, consistent with prior work (Wamser-Nanney & Campbell, 2020a). The ISBP score included items such as touching or trying to touch other's private parts, attempting to undress others, trying to have intercourse with someone, asking others to engage in sexual acts, putting his/her mouth on a female's breasts, and showing sex parts to others.…”