The association between peer victimization, PTSD, and dissociation in child victims of sexual abuse

Abstract

BackgroundSexually abused children present a host of psychological difficulties, including dissociation and post-traumatic stress (PTSD) symptoms. Negative repercussions associated with sexual abuse may interfere with children’s ability to interact competently with their peers, and might put them at risk for peer victimization. The aims of the study were 1) to describe peer victimization experiences of sexually abused children using a multi-informant approach (self, parents, teachers), and 2) to examine if peer victimization experiences are associated with clinical levels of PTSD and dissociation after controlling for relevant variables. MethodParticipants were 158 children (104 girls and 54 boys; Mean age=9.10) and their non-offending parents consulting after the disclosure of sexual abuse. Children, parents, and teachers completed a measure assessing peer victimization (Self-Report Victimization Scale). Measures of trauma-related symptoms (PTSD and dissociation) were used as outcome variables. ResultsMore than half (60%) of sexually abused children reported being picked on, 51% reported sustaining verbal victimization and a third (35%) physical victimization by peers in the school context. Inter-informant agreement was higher between parents and teachers than between self-reports and adults’ reports. Peer victimization experiences increased the odds by up to three-fold for clinical levels of dissociation and PTSD symptoms. LimitationsOur findings are based on cross-sectional data, and therefore, causal relationships cannot be inferred. No control group was included in the study. ConclusionsResults have significant relevance for prevention and intervention. Clinicians should include assessment of peer victimization experiences when evaluating sexually abused school-aged children. Prevention initiatives in terms of peer victimization could indirectly prevent worsening of symptoms in abused children.