Personality Disorders, Coping Strategies, and Posttraumatic Stress Disorder in Women With Histories of Childhood Sexual Abuse

• NCJ Number: 204832
• Journal: Journal of Child Sexual Abuse Volume: 12 Issue: 2 Dated: 2003 Pages: 19-39
• Author(s): Dawn M. Johnson; Timothy C. Sheahan; Kathleen M. Chard
• Date Published: 2003
• Length: 21 pages
• Grant Number(s): 1R21MH56633-01
• Sponsoring Agency: National Institute of Mental Health
• Publication Format: Article
• Publication Type: Report (Study/Research)
• Language: English
• Country: United States of America

Annotation

This study examined the influence of coping strategies and posttraumatic stress disorder (PTSD) in the development of personality disorders (PD's) for a sample of treatment-seeking adult females with a history of childhood sexual abuse (CSA).

Abstract

Study data were collected as part of a larger treatment outcome study that tested the efficacy of Cognitive Processing Therapy. The 86 women who participated in the current study were involved in outpatient therapy that focused on symptoms related to CSA. The women reported that the average age at onset of CSA was 6.4 years. The types of CSA experienced were kissing and fondling (94 percent), oral sexual contact (58 percent), and penetration (57 percent). The Coping Strategies Inventory was used to measure coping behaviors reflective of the following eight strategies: problem solving, cognitive restructuring, emotional expression, social support, problem avoidance, wishful thinking, self-criticism, and social withdrawal. These were divided into four secondary and two tertiary factors. The two tertiary factors, approach and avoidant coping, are used in this report. Other instruments administered were the Schedule for Nonadaptive and Adaptive Personality and the Clinician Administered PTSD. A variety of PD's were found among the women, with avoidant, antisocial, dependent PD's having higher frequency than borderline PD. Avoidant coping and PTSD severity significantly correlated with many of these PD's. PTSD severity and avoidant coping were also significantly correlated. In addition, women with PTSD manifested higher rates of avoidant and dependent PD's, as well as more avoidant coping, compared with women without PTSD. This study thus indicates that the PD's commonly diagnosed in women with sexual abuse histories may actually be manifestations of their traumatic experiences and/or PTSD. Consequently, a PD diagnosis may not accurately describe the CSA survivor's presenting problems. A more encompassing diagnostic spectrum, such as Complex PTSD, may produce a more effective treatment plan and long-term prognosis. 3 tables and 63 references