NCJ Number
199959
Journal
Trauma, Violence, Abuse Volume: 4 Issue: 2 Dated: April 2003 Pages: 95-111
Date Published
April 2003
Length
17 pages
Annotation
After presenting two early models of response to child sexual abuse (CSA) and its impact on mental health, two more recent models are profiled.
Abstract
Wyatt, Newcomb, and Notgrass (1991) proposed a model that identifies psychosocial factors that mediate and moderate the impact of sexual abuse on mental health. A "mediator" is defined as being "generated in the encounter, and it changes the relationship between the antecedent and the outcome variable." The following four moderators were included in a test of the model: age of the victim at latest abuse, severity of abuse, maximum rapes per incident, and proximity of the perpetrator to the victim (relationship to the abuser). The three mediators incorporated in the study were response to confiding, involvement of authorities, and attribution of blame. The model fit the data well when 55 female abuse survivors were examined. Draucker (1995) proposed a second model that attempted to identify factors that mediate the impact of sexual abuse on mental health. Draucker's model was based in part on Finkelhor and Browne's (1985) model of CSA in which powerlessness, betrayal, stigmatization, and traumatic sexualization are believed to result from abuse and influence the impact of abuse on mental health. The model proposes that the impact of these four variables on outcome is mediated by three cognitive tasks that influence coping: the search for meaning/understanding, attaining a sense of mastery/control, and the process of self-enhancement/social comparison. Current theoretical perspectives use more comprehensive models that implicate a wide range of personal, cognitive, social, and environmental factors as mediators and moderators of individuals' reactions to trauma. This more comprehensive focus also includes variables that are more integrally linked to models of therapeutic intervention. Two such models are Joseph, Williams, and Yule's (1995) integrative cognitive-behavioral model and Shapiro and Levendosky's (1999) attachment and coping models. This overview of the four models concludes that whereas no single variable can, on its own, account for individual variation in symptom development, empirically tested models point toward a complex interaction between abuse-related factors, interactions with others (e.g., responses to disclosure and attachment) and individual factors (e.g., attributions and emotion-focused coping) as mediators and moderators of outcome. This article includes a discussion of the implications of the models for clinical presentations and the formulation of treatment plans. 8 figures, 65 references, and 4 suggested readings