Abstract
There has been little previous research about histories of child maltreatment and psychological symptoms in adolescent psychiatric patients. This study investigated whether type and characteristics of child physical and/or sexual abuse predicted individual differences in symptoms. Participants were 187 patients in day or residential treatment facilities. Abuse was assessed using structured interviews with the adolescent, the therapist, and the caseworker. Participants completed a standardized, self-report measure of internalizing and externalizing symptoms. Adolescents with histories of dual abuse (i.e., sexual and physical abuse) had elevated depression and anxiety compared with nonabused patients. Histories of any type of abuse were associated with elevated posttraumatic symptoms. Among physically abused patients, severity and duration of abuse predicted individual differences in depression and anxiety, whereas severity and concomitant sexual abuse predicted elevated posttraumatic symptoms. Among sexually abused patients, the characteristics of sexual abuse did not predict individual differences in symptoms. Thus, child abuse, particularly dual abuse and severe physical abuse, predicted elevated internalizing symptoms, even in comparison with other adolescent psychiatric patients. The need for replication is discussed.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
REFERENCES
Achenbach, T. M. (1991). Manual for the Youth Self-Report and 1991 Profile, University of Vermont, Department of Psychiatry, Burlington, VT.
Adams-Tucker, C. (1982). Proximate effects of sexual abuse in childhood: A report on 28 children. Am. J. Psychiatry 139: 1252–1256.
Atlas, J. A., Weissman, K., and Liebowitz, S. (1997). Adolescent inpatients' history of abuse and dissociative identity disorder. Psychol. Rep. 80: 1086.
Beck, A. T., and Steer, R. A. (1987). Beck Depression Inventory manual, The Psychological Corporation Harcourt Brace Jovanovich, Antonio, TX.
Beitchman, J. H., Zucker, K. J., Hood, J. E., daCosta, G. A., and Akman, D. (1991). A review of the short-term effects of child sexual abuse. Child Abuse Negl. 15: 537–556.
Beitchman, J. H., Zucker, K. J., Hood, J. E., daCosta, G. A., Akman, D., and Cassavia, E. (1992). A review of the long-term effects of child sexual abuse. Child Abuse Negl. 16: 101–118.
Bensley, L. S., van Eenwyk, J., Speiker, S. J., and Schoder, J. (1999). Self-reported abuse history and adolescent problem behaviors. J. Adolesc. Health 24: 163–172.
Bifulco, A., Brown, G. W., and Adler, Z. (1991). Early sexual abuse and clinical depression in adult life. Br. J. Psychiatry 159: 11–122.
Blumberry, W., Oliver, J., and McClure, J. (1980). Validation of the Beck Depression Inventory in a university population using psychiatric estimate as criterion. J. Consult. Clin. Psychol. 46: 151–163.
Brand, E. F., King, C. A., Olson, E., Ghaziuddin, N., and Naylor, M. (1996). Depressed adolescents with a history of sexual abuse: Diagnostic comorbidity and suicidality. J. Am. Acad. Child Adolesc. Psychiatry 35: 34–41. 148 Naar-King, Silvern, Ryan, and Sebring
Briere, J., and Runtz, M. (1993). Childhood sexual abuse: Long-term sequalae and implications for psychological assessment. J. Interpers. Violence 8: 312–330.
Browne, A., and Finkelhor, D. (1986). The impact of child sexual abuse:Areview of the research. Psychol. Bull. 99: 66–77.
Carlin, A. S., Kemper, N. B., Ward, H., Sowell, B., Gustafson, B., and Stevens, N. (1994). Subjective and objective definitions of abuse. Child Abuse Negl. 18: 393–399.
Cohen, Y., Spirito, A., Sterling, C., Donaldson, D., Seifer, R., Plummer, B., Avila, R., and Ferrer, K. (1996). Physical and sexual abuse and their relation to psychiatric disorders and suicidal behavior among adolescents who are psychiatrically hospitalized. J. Child Psychol. Psychiatry 37: 989–993.
Dembo, R., William, L., Wotke, J., Schmeldler, J., and Brown, C. H. (1992). The role of family factors, physical abuse, and sexual victimization experiences in high-risk youths' alcohol and other drug use and delinquency: A longitudinal model. Vict. Violence 1: 245–266.
Famularo, R., Kinscherff, R., Fenton, T., and Bolduc, S.M. (1990). Child maltreatment histories among runaway and delinquent children. Clin. Pediatr. 29(12): 713–718.
Flisher, A. J., Kramer, R. A., Hoven, C.W., and Greenwald, S. (1997). Psychosocial characteristics of physically abused children and adolescents. J. Am. Acad. Child Adolesc. Psychiatry 36(1): 123–131.
Hayes, W. (1963). Statistics For Scientists, Harper and Row, New York.
Herrenkohl, R. C., Egolf, B. P., and Herrenkohl, E. C. (1997). Preschool antecedents of adolescent assaultive behavior: A longitudinal study. Am. J. Orthopsychiatry 67: 422–432.
Horowitz, M., Wilner, N., and Alvarez, W. (1979). Impact of Events Scale: A measure of subjective stress. Psychosom. Med. 41: 209–218.
Judd, C. M., and McClelland, G. H. (1989). Data Analysis, Harcourt Brace Jovanovich, Orlando,FL.
Kendall-Tackett, W. L., and Finkelhor, D. (1993). Impact of sexual abuse on children: A review and synthesis of recent empirical studies. Psychol. Bull. 113: 164–180.
Kiser, L. J., Heston, J., Millsap, P. A., and Pruitt, D. B. (1991). Physical and sexual abuse in childhood: Relationship with Post-traumatic Stress Disorder. J. Am. Acad. Child Adolesc. Psychiatry 30: 776–783.
Kumar, G., Steer, R. A., and Deblinger, E. (1996). Problems in differentiating sexually abused from non-sexually abused adolescent psychiatric inpatients by self-reported anxiety, depression, internalization, and externalization. Child Abuse Negl. 20: 1079–1086.
Lipschitz, D. S., Winegar, R. K., Nicolaou, A. L., Harnifck, E., Wolfson, M., and Southwick, S. M. (1999). Perceived abuse and neglect as risk factors for suicidal behavior in adolescent inpatients. J. Nerv. and Ment. Dis. 186: 32–39.
McCubbin, H. I., Thompson, A., and McCubbin, M. A. (1996). Family assessment, resiliency, Coping, and Adaptation, University ofWisconsin Publishers, Madison, WI.
Nash, M. R., Hulsey, T. L., Sexton, M. C., Harralson, T. L., and Lambert, W. (1993). Long-term sequalae of childhood sexual abuse: Perceived family environment, psychopathology, and dissociation. J. Consult. Clin. Psychol. 61: 276–283.
Pelcovitz, D., Kaplan, S., Goldenberg, B., Mandel, F., Lehane, J., and Guarrera, J. (1994). posttraumatic stress disorder in physically abused adolescents. J. Am. Acad. Child Adolesc. Psychiatry 33: 305–312.
Reynolds, C. R., and Richmond, B. O. (1990). Revised Children's Manifest Anxiety Scale (RCMAS) Manual, Western Psychological Services, Los Angeles, CA.
Russell, D. E. H. (1986). The secret trauma: Incest in the lives of girls and women, Basic Books, New York.
Silverman, A. B., Reinherz, H. Z., and Gianconia, R. M. (1996). The Long-term sequelae of child and adolescent abuse: A longitudinal community study. Child Abuse Negl. 20: 709–723.
Silvern, L. Waelde, L., Karyl, J., and Kaersvang, L. (1995). Victims' self-labeled child abuse and researchers' criteria: Which predicts adult psychological symptoms? Paper presented at the 1995 National Symposium on Child Victimization, Washington, DC. Type and Severity of Abuse 149
Sirles, E. A., Smith, J. A., and Kusama, H. (1989). Psychiatric status of intrafamilial child sexual abuse victims. J. Am. Acad. Child Adolesc. Psychiatry 28: 225–229.
Spaccarelli, S., and Fuchs, C. (1997) Variability in symptom expression among sexually abused girls: Developing multivariate models. J. Clin. Child Psychol. 26(1): 24–35.
Stinson, and Hendrick, S. (1992). Reported childhood sexual abuse in university counseling center clients. J. Counsel. Psychol. 39: 370–374.
Widom, C. S., and Shepard, R. L. (1996). Accuracy of adult recollections of childhood victimization. Psychol. Assess. 8: 412–421.
Wind, W. T., and Silvern, L. (1992). Type and extent of child abuse as predictors of adult functioning. J. Fam. Violence 7: 261–281.
Wind, T., and Silvern, L. (1994). Parental warmth and childhood stress as mediators of the long-term effects of child abuse. Child Abuse Negl. 18: 439–453.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Naar-King, S., Silvern, L., Ryan, V. et al. Type and Severity of Abuse as Predictors of Psychiatric Symptoms in Adolescence. Journal of Family Violence 17, 133–149 (2002). https://doi.org/10.1023/A:1015057416979
Issue Date:
DOI: https://doi.org/10.1023/A:1015057416979