Latent class analysis of post-traumatic stress symptoms and complex PTSD in child victims of sexual abuse and their response to Trauma-Focused Cognitive Behavioural Therapy

• Published in: European journal of psychotraumatology 2020-12, Vol.11 (1), p.1807171-1807171
• Main Authors: Hébert, Martine, Amédée, Laetitia Mélissande
• Format: Article
• Language: English
• Subjects: Abused children; Abuso sexual infantil; Basic; Behavior modification; Child sexual abuse; Children & youth; Cognition; cognitive behavioural therapy; Cognitive therapy; complex PTSD; diagnosis; Diagnóstico; Latent class analysis; Post traumatic stress disorder; Responses; Self concept; Self control; Sexual abuse; Symptoms; TEPT Complejo; Terapia Cognitivo Conductual; Therapy; This study reveals three subgroups of child victims of sexual abuse: resilient children, children displaying PTSD and children showing Complex PTSD symptoms. Trauma-focused cognitive behavioural therapy was found to be effective in sustaining recovery for all subgroups; Trastorno de Estrés Postraumático; Trauma; Treatment outcomes; Victims; 儿童性虐待; 创伤后应激障碍; 复杂性PTSD; 认知行为疗法
• ISSN: 2000-8066; 2000-8198; 2000-8066
• DOI: 10.1080/20008198.2020.1807171

Background: PTSD symptoms are frequent in child victims of sexual abuse. Yet, authors have argued that early trauma could lead to alterations in development that go far beyond the primary symptoms of PTSD and have proposed Complex PTSD as an alternative diagnosis encompassing difficulties in affect regulation, relationships and self-concept. Objective: To delineate profiles in child victims of sexual abuse and explore whether profiles are associated with treatment response to Trauma-Focused Cognitive Behavioural Therapy. Method: Latent class analysis was used to identify symptom profiles at baseline assessment of 384 children ages 6 to 14, recruited in a Child Advocacy Centre following disclosure of sexual abuse. Dimensions of Complex PTSD diagnosis as proposed by the ICD-11 were derived from self-report questionnaires. Results: Latent class analysis identified a best fitting model of three classes: Classic PTSD regrouping 51% of children, Complex PTSD describing 23% of children, and Resilient describing 25% of children. Trauma-focused therapy was associated with a significant reduction of dissociation, internalizing, and externalizing problems for children of all three classes. Trauma-focused therapy was also linked to a significant reduction of PTSD symptoms with larger effect size (d = .90; 95%CI: 0.63-1.16) for children classified in the Complex PTSD class. Conclusion: These findings highlight the utility of a person-oriented approach to enhance our understanding of the diversity of profiles in child victims. The results offer empirical support for the ICD-11 PTSD and Complex PTSD distinction in a clinical sample of sexually abused children and the relevance of this distinction in foreseeing treatment outcomes.