중복대인관계외상이 성폭력 피해 아동의 외상후스트레스 증상, 내․외현화 행동문제, 성행동에 미치는 영향
The effects of multiple interpersonal traumas on PTSD symptoms, behavior problems, sexual behaviors in sexually abused children
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초록
본 연구는 중복대인관계외상 경험이 아동성폭력 피해 후 다양한 심리적 부적응에 미치는 영향을 확인하고자 하였다. 만 4-13세 성폭력 피해 아동 275명을 대상으로 현재 의뢰된 성폭력 피해 이외에 가정폭력의 목격, 신체학대, 외상성 소식의 직면, 다른 가해자로부터의 성폭력 등의 대인관계외상의 중복 경험이 아동성폭력 피해 후유증의 주요 영역인 외상후스트레스 증상, 내․외현화 행동문제, 성행동에 미치는 영향을 분석하였다. 위계적 중다회귀분석 결과, 중복대인관계외상은 인구학적 변인(연령, 성별), 환경 요인(가족월수입, 가족형태), 성폭력 특성(피해강도, 피해기간, 가해자와의 관계), 사건 후 요인(발고지연, 도움지연)을 모두 함께 고려했을 때 내․외현화 행동문제와 성행동에 유의한 설명력이 있음을 확인하였다. 반면에 외상후스트레스 증상에는 유의한 영향이 없었다. 본 연구 결과는 중복대인관계외상 경험이 아동 성폭력 피해 후 내․외현화 행동문제와 성행동 등의 심리적 부적응에 중요한 영향을 미치고 있음을 보여주었다. 본 연구의 의의와 제한점에 대해 논의하였다.
Abstract
The purpose of this study was to explore the effects of multiple interpersonal traumas on psychological maladjustments in sexually abused children. With 275 sexually abused children(ages 4-13), we assessed contributions of cumulative of interpersonal traumas other than the current alleged sexual abuse(witnessing or victim of violent crime, physical abuse, sexual abuse, witness of domestic violence, confronted with traumatic news) on symptoms of PTSD, internalizing/externalizing behavior problems, sexual behaviors. We found a significant contribution of multiple interpersonal traumas on internalizing/externalizing behavior problems and sexual behaviors in a hierarchial regression analysis where demographic variables(age, sex), environment factor(family income, family structure), sexual abuse characteristics(severity of abuse, duration of abuse, relationship with perpetrator), and post-incident factors(disclosure, delay in help) were considered together. However, the effect of multiple interpersonal trauma experiences on PTSD symptoms was not significant. The result of this study indicate that experiences of multiple traumas must be considered when understanding psychological maladjustment following child sexual abuse. Limitations of this study and suggestions for future research discussed.
참고문헌 (44)
- 김영신, "한국판 K-SADS-PL" (2003), 중앙문화사
- 노충래, "아동성학대의 치료" (1993), 학지사
- 오경자, "아동・청소년 행동평가 척도" (1997), 중앙적성출판사
- Achenbach, T. M., "Manual for Child Behavior Checklist and Revised Child Behavior Profile" (1983), University Association in Psychiatry
- Ackerman, P. T., "Prevalence of post-traumatic stress disorder and other pyschiatric diagnosis in tree groups of abused children(sexual, physical, and both)", Child Abuse and Neglect, 22, pp.759~774 (1998)
- American Psychiatric Association, "Diagnostic and Statistical Manual of Mental disorders, 4th ed" (1994), American Psychiatric Association
- Arata, C. M., "To tell or not to tell : current functioning of child sexual abuse survivors who disclosed their victimization", Child Maltreatment, 3(1), pp.63~71 (1998)
- Bagley, C., "Sexual abuse in childhood : Psychosocial outcomes and implications for social work practice", Journal of Social Work and Human Sexuality, 4, pp.33~47 (1986)
- Beitchman, J. H., "A review of the short-term effects of child sexual abuse", Child Abuse and Neglect, 15, pp.537~556 (1991)
- Boney-McCoy, S., "Prior victimization : A risk factor for child sexual abuse and for PTSD-related symptomatology among sexually abused youth", Child Abuse and Neglect, 19(12), pp.1401~1421 (1995)
- Briere, J., "Trauma Symptom Checklist for Young Children: professional manual" (2001), Psychological Association
- Briere, J., "Prevalence and psychological sequela of self-reported childhood physical and sexual abuse in a general population sample of men and women", Child Abuse & Neglect, 27, pp.1205~1222 (2003)
- Briere J., "Childhood maltreatment, intervening variables, and adult psychological difficulties in women. an overview", Trauma Violence, 10(4), pp.375~388 (2009)
- Briere, J., "Accumulated Childhood Trauma and Symptom Complexity", Journal of Traumatic Stress, 21(2), pp.223~226 (2008)
- Browne, A., "Impact of child sexual abuse : a review of the research", Psychological Bulletin, 99(1), pp.66~77 (1986)
- Burgess, A. W., "Abused to abuser : Antecedents of socially deviant behaviors", American Journal of Psychiatry, 144, pp.1431~1436 (1987)
- Choi, J. Y., "The effects of multiple traumas on psychological maladjustment in sexually abused children", ~
- Cloitre, M, "Beyond PTSD : Emotion regulation and interpersonal problems as predictors of functional impairment in survivors of childhood abuse", Behavior Therapy, 36, pp.119~124 (2005)
- Cloitre, M., "A developmental approach to complex PTSD : childhood and adult cumulative trauma as predictors of symptom complexity", Journal of Traumatic Stress, 22(5), pp.399~408 (2009)
- Conte, J. R., "Factors associated with and increased impact of child sexual abuse", Child Abuse and Neglect, 11, pp.201~211 (1987)
- Courtois, C. A., "The incest experience and its aftermath", Victimology, 4, pp.337~347 (1979)
- Deblinger, E., "Post-traumatic stress in sexually abused, physically abused, and nonabused children", Child Abuse & Neglect, 13, pp.403~408 (1989)
- Fergusson, D. M., "Exposure to childhood sexual and physical abuse and adjustment in early adulthood", Child Abuse and Neglect, 32, pp.607~619 (2008)
- Fergusson, D. M., "Childhood sexual abuse, adolescent sexual behaviors and sexual revictimization", Child Abuse and Neglect, 21(8), pp.789~803 (1997)
- Finkelhor, D., "Poly-victimization : A neglected component in child victimization", Child Abuse and Neglect, 31, pp.7~26 (2007)
- Friedrich, W. M., "Child sexual behavior inventory : normative, psychiatric, and sexual abuse comparisons", Child Maltreatment, 6(1), pp.37~49 (2001)
- Friedrich, W. N., "Child sexual behavior inventory; Normative and clinical comparison", Psychological Assessment, 4, pp.303~311 (1991)
- Kendall-Tackett K. A., "Impact of sexual abuse on children; a review and synthesis of recent Empirical studies", Psychology Bulletin, 110, pp.164~180 (1993)
- Langmade, C. J., "The Impact of pre-and postpubertal onset of incest experience in adult women as measured by sex anxiety, sex guilty, sexual satisfaction and sexual behavior", Dissertation Abstracts International, 44, pp.917B~ (1983)
- Letoruneau, E. J., "Children and adolescent with sexual behavior problems", Child Maltreatment, 9, pp.49~61 (2004)
- Luster, T., "Sexual abuse history and problem in adolescence : exploring the effects of moderating variables", Journal of Marriage and the Family, 59, pp.131~142 (1997)
- McLeers, S. V., "Post-traumatic stress disorder in sexually abused children", Journal of the American Academy of Child and Adolescent Psychiatry, 27, pp.650~654 (1988)
- Paolucci, E. O., "A meta-analysis of the published research on the effects of child sexual abuse", Journal of Psychology, 135(1), pp.17~36 (2001)
- Pelcovitz, D., "Development of a criteria set and a structured interview for disorders of extreme stress(SIDES)", Journal of Traumatic Stress, 18, pp.449~459 (1997)
- Roth, S., "Complex PTSD in victims exposed to sexual and physical abuse : Results from the DSM-IV field trial for posttraumatic stress disorder", Journal of Traumatic Stress, 10(4), pp.539~555 (1997)
- Russell, D. E. H., "The secret trauma : Incest in the lives of girls and women" (1986), Basic Books
- Schaff, K. K., "Relationship of childhood sexual, physical, and combined sexual and physical abuse to adult victimization and posttraumatic stress disorder", Child Abuse and Neglect, 22(11), pp.1119~1133 (1998)
- Scheeringa, M. S., "New finding alternative set of criteria for posttraumatic stress disorder(PTSD)for preschool children", Journal of the American Academy of Child & Adolescent Psychiatry, 42(5), pp.561~570 (2003)
- Shields, A., "Parental maltreatment and emotion dysregulation as risk factors for bullying and victimization in middle childhood", Journal of Clinical Child Psychology, 30(3), pp.349~363 (2001)
- Sim, L. Friedrich, W. N., "The child behavior checklist as an indicator of posttraumatic stress disorder and dissociation in normative, psychiatric, and sexually abused children", Journal of Traumatic Stress, 18(6), pp.697~705 (2005)
- Smith, D., "Delay in disclosure of childhood rape : Results from a national survey", Child Abuse and Neglect, 24, pp.273~287 (2000)
- Trickett, P. K., "Variants of intrafamilial sexual abuse experience : Implications for long-term development", Journal of Development and Psychopathology, 13, pp.1001~1019 (2001)
- Tufts' New England Medical Center, "Sexually exploited children: Service and research project, In Final report for the Office of Juvenile Justice and Delinquency Prevention" (1984), US. Department of Justice
- Wozencraft, T., "Depression and suicide ideation in sexually abused children", Child Abuse and Neglect, 15, pp.505~511 (1991)
