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

摘要

Background: PTSD symptoms are frequent in child victims of sexual abuse. Yet, authorshave argued that early trauma could lead to alterations in development that go far beyondthe primary symptoms of PTSD and have proposed Complex PTSD as an alternativediagnosis encompassing difficulties in affect regulation, relationships and self-concept.Objective: To delineate profiles in child victims of sexual abuse and explore whetherprofiles are associated with treatment response to Trauma-Focused Cognitive BehaviouralTherapy.Method: Latent class analysis was used to identify symptom profiles at baseline assessmentof 384 children ages 6 to 14, recruited in a Child Advocacy Centre following disclosure ofsexual abuse. Dimensions of Complex PTSD diagnosis as proposed by the ICD-11 werederived from self-report questionnaires.Results: Latent class analysis identified a best fitting model of three classes: Classic PTSDregrouping 51% of children, Complex PTSD describing 23% of children, and Resilientdescribing 25% of children. Trauma-focused therapy was associated with a significantreduction of dissociation, internalizing, and externalizing problems for children of all threeclasses. Trauma-focused therapy was also linked to a significant reduction of PTSD symp-toms with larger effect size (d = .90; 95%CI: 0.63–1.16) for children classified in the ComplexPTSD class.Conclusion: These findings highlight the utility of a person-oriented approach to enhanceour understanding of the diversity of profiles in child victims. The results offer empiricalsupport for the ICD-11 PTSD and Complex PTSD distinction in a clinical sample of sexuallyabused children and the relevance of this distinction in foreseeing treatment outcomes.