Psychiatric Status of Sexually Abused Children 12 Months after Disclosure of Abuse

Merry, Sally; Andrews, Leah K.

doi:10.1097/00004583-199409000-00002

Cited by 115 publications

(50 citation statements)

References 14 publications

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“…The abused children in this study had a high prevalence of ADHD (18%), which is similar to previous studies, [2][3][4] and many of the abused children examined exhibited ADHD criteria A symptoms after CA. The question remains of why abused children fulfil the ADHD criteria A after CA.…”

Section: Discussionsupporting

confidence: 90%

“…Developmental disorders such as pervasive developmental disorder (PDD), attention-deficit/hyperactivity disorder (ADHD) and learning disorder are regarded as psychiatric risk factors of CA. 1 ADHD was reportedly observed in 14-46% of abused children, [2][3][4] suggesting that ADHD is more common in abused children than in the general population (3-7% 5 ). However, Glod and Teicher 2 reported that children who had not met ADHD criteria before CA expressed hyperactivity due to a hypervigilant state after CA.…”

Section: Introductionmentioning

confidence: 99%

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Attention‐deficit/hyperactivity disorder and dissociative disorder among abused children

Endo

Sugiyama²,

Someya

2006

Psychiatry Clin Neurosci

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The aim of this study was to investigate the psychiatric problems and characteristics among children of child abuse (CA). Specifically, the authors investigated whether attention-deficit/hyperactivity disorder (ADHD) symptoms were exhibited before or after CA. A total of 39 abused child inpatients who were treated at Aichi Children's Health and Medical Center, Aichi, Japan, (mean age, 10.7 ± 2.6; mean IQ scores, 84.1 ± 19.3) were included in the study. The most frequent diagnosis was dissociative disorder in 59% of abused subjects. ADHD was diagnosed in 18% of abused subjects, and 71% of ADHD children had comorbid dissociative disorder. A total of 67% of all CA subjects fulfilled the ADHD criteria A according to DSM-IV-TR, however, only 27% of those fulfilled the criteria before CA. The subjects of dissociative disorder fulfilled ADHD criteria A more frequently than those of non-dissociative disorder (P = 0.013), and this result led to an increase in the frequency of the apparent ADHD. The rate of ADHD-suspected parents in the subjects who fulfilled ADHD criteria A after CA was significantly lower than those who fulfilled it before CA (P = 0.005). While it is difficult to distinguish ADHD from dissociative disorder, abused children may have increased apparent ADHD due to dissociative disorder. Further studies should be conducted in order to explore the distinct biological differences between ADHD before CA and the subjects who fulfilled ADHD criteria A after CA.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Attention‐deficit/hyperactivity disorder and dissociative disorder among abused children

Endo

Sugiyama²,

Someya

2006

Psychiatry Clin Neurosci

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“…Those studies that have investigated the prevalence of ADHD in a population of abused children have found a high overlap between ADHD and PTSD. Merry and Andrews (1994) found an unexpectedly high rate of ADHD, double that found in the community population, in their sample of sexually abused children 12 months after disclosure of the abuse. McLeer and colleagues determined that 46% of their sample of children with a history of sexual abuse met ADHD criteria (McLeer, Callaghan, Henry, & Wallen, 1994).…”

mentioning

confidence: 80%

Retrospective Reports of Childhood Trauma in Adults With ADHD

et al. 2006

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Objective: Although studies have documented higher prevalence of abuse in children with ADHD, no studies have investigated childhood reports of abuse in individuals identified with ADHD in adulthood. Method: Forty ADHD women, 17 ADHD males, 17 female controls, and 40 male controls complete the Childhood Trauma Questionnaire and other measures of psychosocial functioning. Results: Emotional abuse and neglect are more common among men and women with ADHD as compared to controls. Sexual abuse and physical neglect are more commonly reported by females with ADHD. Although childhood abuse is significantly correlated with depression and anxiety in adulthood, having ADHD is a better predictor of poorer psychosocial functioning in adulthood. Conclusion: Clinicians are alerted that patients with ADHD symptoms have a high probability of childhood abuse.

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“…Rather, the results of this study suggest that dissociation mediates the relation between PTSD and attention problems in sexually abused children. In other words, despite the strong link between PTSD symptoms and attention problems in adults (e.g., Bremner, Krystal, Southwick, & Charney, 1995;Litz &Keane, 1989) andchildren (e.g., McLeer et al, 1994;Merry & Andrews, 1994;Saigh, Mroueh, & Bremner, 1997), it may be the accompanying dissociative symptoms, which are so often comorbid with PTSD symptoms, that actually drive this relationship. In fact, a recent study of Vietnam combat veterans suggests that attentional functioning may be less influenced by PTSD status than by the presence or absence of a concurrent dissociative trait (Kaufman, 2002).…”

Section: Discussionmentioning

confidence: 99%

“…For example, McLeer, Deblinger, Henry, and Orvaschel (1992) found that two of the most predominant diagnoses in a sample of clinically referred sexually abused children were Posttraumatic Stress Disorder (PTSD, 44%) and Attention-Deficit Hyperactivity Disorder (ADHD, 33%), and a later study indicated that ADHD was the most frequent diagnosis among sexually abused children (McLeer, Callaghan, Henry, & Wallen, 1994). In a study comparing sexually abused children to a community sample, Merry and Andrews (1994) found the rate of ADHD in the sexually abused sample to be double that of the community sample.…”

Section: Introductionmentioning

confidence: 99%

Dissociation predicts later attention problems in sexually abused children

Kaplow¹,

Hall²,

Koenen³

et al. 2008

Child Abuse & Neglect

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Objective-The goals of this research are to develop and test a prospective model of attention problems in sexually abused children that includes fixed variables (e.g., gender), trauma, and disclosure-related pathways.Methods-At Time 1, fixed variables, trauma variables, and stress reactions upon disclosure were assessed in 156 children aged 8 to 13 years. At the Time 2 follow-up (8 to 36 months following the initial interview), 56 of the children were assessed for attention problems.Results-A path analysis involving a series of hierarchically-nested, ordinary least squares multiple regression analyses indicated two direct paths to attention problems including the child's relationship to the perpetrator (β = .23) and dissociation measured immediately after disclosure (β = .53), while controlling for concurrent externalizing behavior (β = .43). Posttraumatic stress symptoms were only indirectly associated with attention problems via dissociation. Taken together, these pathways accounted for approximately 52% of the variance in attention problems and provided an excellent fit to the data.Conclusions-Children who report dissociative symptoms upon disclosure of CSA and/or were sexually abused by someone within their family are at an increased risk of developing attention problems.Practice Implications: Findings from this study indicate that children who experienced sexual abuse at an earlier age, by someone within their family, and/or report symptoms of dissociation during disclosure are especially likely to benefit from intervention. Effective interventions should involve (1) providing emotion regulation and coping skills; and (2) helping children to process traumatic aspects of the abuse to reduce the cyclic nature of traumatic reminders leading to unmanageable stress and dissociation.

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Psychiatric Status of Sexually Abused Children 12 Months after Disclosure of Abuse

Cited by 115 publications

References 14 publications

Attention‐deficit/hyperactivity disorder and dissociative disorder among abused children

Attention‐deficit/hyperactivity disorder and dissociative disorder among abused children

Retrospective Reports of Childhood Trauma in Adults With ADHD

Dissociation predicts later attention problems in sexually abused children

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