Melissa K. Runyon

Relationship of Attributional Style, Depression, and Posttrauma Distress Among Children who Suffered Physical or Sexual Abuse

This study examined the relationship of attributional style, posttrauma, and depressive symptoms among children who have suffered either physical or sexual abuse. Ninety-eight children (67 physically abused, 31 sexually abused) were administered a depression inventory, the Post-Traumatic Stress Disorder–Reaction Index (PTSD-RI), and Childrens Attributional Style Questionnaire (CASQ). With regard to group differences, the sexual abuse group scored significantly higher on the PTSD-RI, whereas the physical abuse group scored higher on the CASQ Composite for Negative Events. Results also indicated that attributional style predicted depression beyond the variance accounted for by abuse type (i.e., physical or sexual). However, the best predictor of PTSD-RI scores was an interaction effect between abuse type and negative attributional style. Clinical implications of these findings for children who suffer abuse are discussed.

Understanding and Treating Feelings of Shame in Children Who Have Experienced Maltreatment

Feelings of shame have been found to be an important mediating factor in influencing a childs recovery from abuse. This article conceptualizes the development and maintenance of shame in the aftermath of experiencing child sexual and/or physical abuse. Research is reviewed that may shed light on the impact of shame and dysfunctional attributions with a view toward understanding how this type of painful emotional suffering can be prevented and/or treated. Trauma-focused interventions that have demonstrated efficacy in helping children overcome feelings of shame are described. Directions for future research that may further our understanding of the development, impact, and treatment of feelings of shame are suggested.

An overview of child physical abuse: developing an integrated parent-child cognitive-behavioral treatment approach.

This article reviews and summarizes the extant literature regarding child physical abuse (CPA). Literature is summarized that describes the wide range of short-and long-term effects of CPA on children as well as the documented characteristics of parents/caregivers who engage in physically abusive parenting practices. Although the reviewed research documents that interventions geared only toward the parent have been found to produce significant improvements with respect to parenting abilities, parent-child interactions, and children’s behavior problems, there is a paucity of research examining the efficacy of interventions developed specifically to target the child’s emotional and behavioral difficulties. Based on the few studies that have shown emotional and behavioral gains for children who have participated in treatment, an integrated parent-child cognitive-behavioral therapy (CBT) approach is proposed here to address the complex issues presented by both parent and child in CPA cases. The direct participation of the child in treatment also may improve our ability to target posttraumatic stress disorder (PTSD), depressive symptoms as well as anger control and dysfunctional abuse attributions in the children themselves. Implications for practice, public policy, and research are also addressed.

Differential symptom pattern of post-traumatic stress disorder (PTSD) in maltreated children with and without concurrent depression.

OBJECTIVE The present study attempted to examine specific differences in the Post-Traumatic Stress Disorder (PTSD) symptomatology among abused children with and without concurrent depression. METHOD PTSD and depressive symptoms were identified that discriminate between 98 children divided into three groups: (1) abused children with PTSD, (2) nonabused children who meet criteria for Major Depressive Disorder (MDD), and (3) abused children with both PTSD and MDD. RESULTS Analyses revealed that nine items reflecting depressive symptomatology, primarily vegetative symptoms, differentiated the diagnostic groups (PTSD-only, MDD-only, and the combined group). A discriminant analysis revealed that the sum of responses to the nine significant items adequately predicted diagnostic classification for those with PTSD and depression, but did not correctly diagnose any in the combined group. Analyses also revealed that three post-trauma symptoms, including psychological amnesia, flashbacks/reenactments, and sleep difficulties, discriminated between the groups. The PTSD-only group reported more episodes of psychological amnesia while the PTSD and MDD group experienced more flashbacks. CONCLUSIONS For the sample of abused children examined, these results illuminate differences with respect to PTSD symptom presentation for those children with PTSD who have a concurrent depressive disorder and their nondepressed counterparts. Children with PTSD who have a concurrent depression report greater levels of intrusive PTSD-related symptoms.

Child Sexual Abuse: A Primer for Treating Children, Adolescents, and Their Nonoffending Parents

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Improvements in personal resiliency among youth who have completed trauma-focused cognitive behavioral therapy: A preliminary examination

This preliminary investigation assessed whether different aspects of personal resiliency improved for youth (7-17 years old) impacted by child sexual abuse (CSA) after completing trauma-focused cognitive behavioral therapy (TF-CBT). The Resiliency Scales for Children and Adolescents (RSCA; Prince-Embury, 2007) were administered to 157 youth before and after participating in TF-CBT with their nonoffending caregivers. Hierarchal regression analyses were performed to ascertain whether pretest RSCA resiliency scores moderated decreases in the posttraumatic stress and self-reported depressive symptoms at posttreatment. The RSCA scales did not moderate any of the improvements on the PTSD and depression outcome measures. Paired t-tests between the mean pre- and posttest RSCA Sense of Mastery (MAS), Sense of Relatedness (REL), and Emotional Reactivity (REA) scores demonstrated significant (ps<0.001) improvements on these measures over time. Using residualized posttest scores for the three RSCA scales to assess improvement, significant correlations were found between changes in resiliency and various residualized outcome scores for posttraumatic stress disorder (PTSD) and depression measures. Decreases in the REA scores and increases in the MAS and REL scores were related to fewer symptoms of hypervigilance and less self-reported depression after completing TF-CBT. Only improvements in the REL scores were associated with fewer symptoms of re-experiencing after treatment. The results were discussed as indicating that significant improvements in personal resiliency had occurred over time with effect sizes less than those found for posttraumatic stress symptoms, but comparable to those found for self-reported depression reductions. Limitations and future research recommendations are discussed.