Posttraumatic Stress Disorder in Sexually Abused Children - Term Paper Example

Running Head: PTSD in Sexually Abused Children PSTD in Sexually Abused Children Customer’s Name: Customer’s Course: Tutor’s Name: June 29th, 2012 Introduction Domestic violence against children has not reduced in prevalence last few years. The most devastating form of this abuse is characterized by sexual molestation of children. The traumatic experience associated with sexual molestation sometimes develops into a chronic psychological problem referred to as PTSD. PTSD is characterized by three common symptoms: Hyperarousal, Intrusion and Constriction. Hyperarousal is the body’s alertness of conditions perceived as threats of the reoccurrence of trauma while intrusion is a fixation on the memory of trauma or the occurrence of vivid images of the trauma event. The final symptom constriction is the state of blocking or dissociating with past life. The study presented in this paper presents a literature review of the alternative interventions that can be used to assist children who have been sexually abused overcome PTSD experienced well after the traumatic event happened. It aims at providing the best intervention in PTSD cases involving sexually abused children. To effectively intervene in a PTSD case involving a sexually abused child any health practitioner must fully understand the condition and how it manifests itself. Various scholars has studied the condition and come up with theories that enable social workers to understand PTSD more deeply and know the kind of intervention to apply in order to make sure children with the disorder return to normal psychological health. Several theories have been used to explain PTSD, as it is an old condition the theories that were originally used to try and understand PTSD are now referred to as the early theories of PTSD. Contemporary theories that largely draw from the older theories have been developed to explain the disorder in recent years. After analyzing the theories and empirical evidence about the various intervention strategies the cognitive behavioral intervention was chosen as the best intervention option for the PTSD cases in sexually abused children. Theories of PTSD Stress Response theory was one of the first theory that tried to analyze PTSD. The theory proposes that people respond to trauma by having some kind of outcry and they later try to get used to the trauma (Brewin and Holmes, 2003). Information overload is responsible for PTSD as the body tries to defend itself psychologically. People who have been traumatized avoid being reminded of the incident that caused the trauma. The theory of shattered assumptions argues that PTSD is as a result of an individual’s positive illusion of the nature of world being broken. The core assumptions that make the world a better place according to Janoff-Bulman (1992) are: the world is Benevolent, the world is meaningful, and the world is self-worth. The theory proposes that the world follows a set of rules and those humans are well-meaning towards each other. Any experience that happens and shatters this illusion may be traumatic to some individuals. The Conditioning theory of PTSD was originally developed for other disorders other than PTSD (Brewin and Holmes, 2003). The theory proposes that people’s fear of a traumatic experience is decreased by repeated exposure to the trauma while avoidance of trauma only leads to non-extinction of PTSD. Emotional processing Theory is an elaboration of the network theory and is based on the comparison of knowledge before the trauma and after the trauma (Basoglu et al, 1997). Individuals who had a strong positive view of their own competence and viewed the world as a very safe place before the trauma especially victims of sexual abuse are at a higher risk of PTSD. The Dual representation theory proposes that the memory of traumatic event is different from other memories and is separately stored (Brewin and Holmes, 2003). This theory is used to explain why trauma victims miss non-visual events that could help them recover from their trauma. Brewin, Dalgleish, and Joseph, 1996) expands the theory by proposing that one of the memory system may take over as the main system from to time to time. Ehlers and Clark (2000) argue that PTSD patient are worried about the future even though their trauma occurred in the past. According to this theory patients are able to conceive new threat s by processing the old traumatic information. People suffering from PTSD view themselves negatively and some think they deserved to undergo the traumatic experience. The theory supports that PTSD is a dissociation of traumatic experience to a separate memory system (Batten, Follette and Aban, 2001). Remembering of such events becomes difficult as their storage structure is distorted as the memories are poorly elaborated, and out of context in terms of time and place. Analysis of the empirical literature It is evident that interventions that are put in place to help children who have suffered post-traumatic stress disorder due to sexual abuse and harassment are characterized by strengths and weakness (Cohen & Mannarino, 1996). Along the way in interventions process, facilitators/researchers are faced with unique scientific, legal and assessment challenges while undertaking treatment studies to children who are traumatized. Unlike in adults, recording traumatic events and experiences from children require independent verification which proofs difficult to researchers in the methodology (Amaya-Jackson & DeRosa, 2007). In the methodology, developmental level influences how symptoms are measured since information seekers must pass through the parents, child report, observation and consensus rating among other strategies (Bolton, et al 2007). Moreover, if the guardian or the parent has personal PTSD they tend to be biased on the reporting of the child’s disorders while the report is very important to the traumatized child. In addition, the legal issues surrounding interventions provide barriers when conducting research. Say, when legislations call for both parents to provide approval for child’s treatment. On the same point, if one of the parents was the perpetrator of sexual harassment, he or she may deny that the event or the experience really occurred to the child which biases the research’s sample (Cohen & Mannarino, 1996). Regardless of these weaknesses, empirical treatment literature for traumatized children has improved greatly since the first one emerged around 1990s. It is worth noting that most of these intervention literatures were done in real-life situations. The literature has been conducted in places like homes, schools, clinics, refugee camps just to mention but a few. The analysis in this review may not be comprehensive but most importantly, it provides some insights about current treatment literature in treating children with PTSD (Amaya-Jackson & DeRosa, 2007). The intervention results for sexually abused child and their parents were matched and measured based on effectiveness of cognitive-behavioral intervention against other indirect support intervention (Bolton, et al 2007). It was observed that 67 of the sexually abused pre-school children who were put under the cognitive-behavioral intervention responded well and actually recovered quickly from the disorder as compared to their counterparts in the other intervention. Again, within cohort comparison of pretreatment and post treatment results measured, it was noted that while NST cohort had no significant change in relation to symptomology, SAP-CBT cohort demonstrated a significant change in improvement in every result measured (Ahmad & Sundelin-Wahlsten, 2008). In terms of strengths the interventions demonstrated good real-life applicability of treating sexually abused children with PTSD. In addition, the two interventions are applicable not only to sexually abused children who suffer PTSD but also to adults who suffer from the same disorder. It is worth noting that, even with these benefits, the interventions require more efforts for optimum advantage and outcome. Nevertheless, the interventions are applicable to the required group with significant advantages noted. Summary It is evident that the since 12 years ago, there were no empirical treatment results researches based on traumatized children. From that time, regardless of the challenges, clinical studies have given a range of information based on how to intervene a wide variety of trauma associated symptoms for persons between the ages of 4-18years (Ahmad & Sundelin-Wahlsten, 2008). The two mentioned interventions are only but an example from several interventions and treatment that can be used to treat sexually abused children who have developed PTSD from the experience. There are diverse interventions in theoretical models, format, setting and at all developmental levels. In that respect, facilitators and implementers of interventions have a variety to select from when opting for evidence-supported treatment mostly to PTSD children. These practitioners first attend to families with domestic violence and enquire for sexually abused child from which they seek the parents’ consent to go ahead with interventions. They finally attend to their own strengths and abilities as they provide interventions and treatments (Cohen, Mannarino & Knudsen, 2005). In most cases, the practitioners did not involve the parents in the interventions. Therefore, to empirically analyze the issue the results were as follows: those who underwent through this interventions portrayed big improvements as compared to those who had no interventions at all and those who underwent non-evidence based kind of interventions. Finally, the interventions are applicable to sexually abused children with posttraumatic stress disorder hence I can be recommend it be applied at my placement. Moreover, the approach can also be used in refugee camps where the number of sexually abused children is rampant. Moreover, government and non-government organizations can apply this approach since it is applicable in all settings and to most victims of sexually abused persons (Cohen, Mannarino & Knudsen, 2005). . References Ahmad, A., & Sundelin-Wahlsten, V. (2008). Applying EMDR on children with PTSD: European Child and Adolescent Psychiatry, 17, 127-132 Amaya-Jackson, L., & DeRosa, R (2007). Treatment consider-ations for clinicians in applying evidence-based practice to com-plex presentations in child trauma: Journal of Traumatic Stress, 20, 379-390 Basoglu, M., Mineka, S., Paker, M., Aker, T., Livanou, M., & Gök, S (1997). Psychological preparedness for trauma as a protective factor in survivors of torture: Psychological Batten, S. V., Follette, V. M., & Aban, I. B. (2001). Experiential avoidance and high-risk sexual Behavior in survivors of child sexual abuse. Journal of Child Sexual Abuse, 10, 101-120. Bolton, P., Bass, J., Betancourt, T., Speelman, L., Onyango, G., Clougherty, K. et al. (2007). Interventions for depression symptoms among adolescent survivors of war and displacement in northern Uganda: A randomized controlled trial. Journal of the American Medical Association, 298, 519-527. Brewin, C. R., & Holmes, E. A. (2003). Psychological theories of posttraumatic stress disorder. Brewin, C. R., Dalgleish, T., & Joseph, S. (1996). A dual representation theory of post-traumatic stress disorder: Psychological Review, 103, 670–686. Clinical Psychology Review, 23, 339-376. Cohen & Mannarino, A. (1996). A treatment outcome study for sexually abused preschool children: Initial find­ings: Journal of the American Academy of Child and Adolescent Psychiatry, 35, 42-50. Cohen, J., Mannarino, A & Knudsen, K. (2005) .Treating sexually abused children: 1 year follow-up of a randomized controlled trial: Child Abuse and Neglect, 29, 135-145. Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder: Behaviour Research and Therapy, 38, 319–345. Janoff-Bulman, R. (1992). Shattered assumptions: towards a new psychology of trauma. New York: Free Press. Medicine, 27, 1421-1433. Read More