Maltreatment Disclosures Related to Problem Sexualized Behaviors and Trauma Symptoms in Youth

Background and Purpose: Youth with problem sexualized behaviors (PSB) initiate harmful or developmentally inappropriate behaviors that involve sexual body regions. Many sexually aggressive adolescents report first engaging in sexually inappropriate behaviors before the age of 12. Evidence indicates that juveniles who engage in sexually abusive behaviors experience early childhood maltreatment at higher rates than adolescents in the general population. These maltreatment histories may partially explain the sexually abusive behaviors they exhibit. Childhood trauma has likewise been found to contribute to developmental and behavioral issues observed in children with PSB; only a small proportion of youth with PSB have no substantiated experiences of sexual or physical abuse or exposure to violence. Still, little is known about the specific types of abuse that may be unique to youth who engage in PSB. Moreover, few studies have examined the types of abuse associated with post-traumatic stress symptomology for this group. This study explored two research questions: (1) Do children with PSB differ from children without PSB in terms of their abuse disclosures?; and (2) Are the types of abuse disclosed associated with the child’s likelihood of having clinically significant scores on a measure of post-traumatic stress?

Methods: Administrative data were collected for youth (N=950) ages 3-18 who completed a clinical assessment at a child advocacy center in a midwestern state during the 2015 calendar year. The center primarily serves individuals with experiences of sexual abuse. Youth completed an intake assessment that included demographic information and their history of maltreatment, in addition to either the Trauma Symptom Checklist for Young Children (TSCYC) for children ages 3-12, or the Trauma Symptom Checklist for Children (TSCC) for children ages 8-18. Bivariate logistic regression models with hierarchical entry were run to answer the research questions.

Results: Results for the first model indicated older youth had lower odds of PSB compared with younger youth (OR=.911, p=.005), and youth disclosing offender to victim fondling were also less likely to disclose PSB (OR=.460, p=.026). Youth disclosing exposure to pornography had substantially higher odds of engaging in PSB (OR=3.253, p=.001) compared with youth who did not disclose pornography exposure. Results for the second model revealed that older youth were less likely to have clinically significant scores on the sexual concerns subscale of the TSCC/TSCYC (OR=.904, p<.001); similarly, males had lower odds of clinically significant scores (OR=.542, p<.001). Youth disclosing physical abuse had higher odds of reaching TSCC/TSCYC clinical significance (OR=1.678, p=.001), as did youth disclosing victim to offender sexual contact (OR=2.242, p=.003).

Conclusions and Implications: This study has implications for practitioners, recognizing that maltreatment, trauma, and sexualized behavior problems should be addressed cohesively in treatment. Future research should examine PSB, maltreatment, and trauma prospectively, exploring the possibility that PSB may emerge as a means of coping with abuse histories and the resulting symptoms of post-traumatic stress. In addition to abuse type, research should also consider the roles of abuse severity, developmental timing, duration, and polyvictimization as they relate to the emergence of PSB and trauma symptoms in youth.